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Can You Be ‘Healthy at Every Size’?

Key Findings

HAES results in significant and lasting benefits to self-esteem, body image, hunger cues, and cognitive restraint.
These results are similar to social support programs
HAES does not result in substantive benefits to physical health.
A combined approach, focussed on psycho-social and physical indicators of health is likely to the best approach

Traditional weight loss methods are based primarily on a medical model which treats obesity as a disease requiring diet, exercise, or pharmaceutical intervention. Conversely, the increasingly popular ‘Health At Every Size’ (HAES) movement believes that “individuals who are overweight and obese want to exercise and eat healthy foods, and they are capable of doing so when barriers are removed”.1

The Health At Every Size® Principles are:

  1. Weight Inclusivity: Accept and respect the inherent diversity of body shapes and sizes and reject the idealizing or pathologising of specific weights.
  2. Health Enhancement: Support health policies that improve and equalize access to information and services, and personal practices that improve human well-being, including attention to individual physical, economic, social, spiritual, emotional, and other needs.
  3. Respectful Care: Acknowledge our biases, and work to end weight discrimination, weight stigma, and weight bias. Provide information and services from an understanding that socio-economic status, race, gender, sexual orientation, age, and other identities impact weight stigma and support environments that address these inequities.
  4. Eating for Well-being: Promote flexible, individualized eating based on hunger, satiety, nutritional needs, and pleasure, rather than any externally regulated eating plan focused on weight control.
  5. Life-Enhancing Movement: Support physical activities that allow people of all sizes, abilities, and interests to engage in enjoyable movement, to the degree that they choose.

While many academics, researchers, and practitioners applaud the overall aims of the HAES movement, in particular articles 1 and 4 have drawn criticism,2 due to the a) demonstrable harm of adverse adiposity and b) the focus on inherent cues without external regulation that is at odds with our biology (i.e. the desire to seek and find pleasure in calorie-dense, sugar and fat-rich foods).

Are overweight and obesity a risk factor for early death and disease?

One of the key considerations in any debate about whether we can have health at every size is whether being overweight or obese are risk factors for poorer health outcomes, including earlier death and disease. In other words, can we, in actuality, be healthy irrespective of body size or adiposity?

Read more and listen to the audio below

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