So, you’re curious about what it’s like to work with a HAES dietitian. You’ve heard about intuitive eating and Health at Every Size™, and they sound great. But if you’re being honest, you don’t totally understand they are. You think you could benefit from working with a dietitian who takes this approach to health. But, you’re not sure how. Here’s what you need to know.
Health at Every Size is an inclusive approach to healthcare.
That’s a problem, because it leads to lower-quality care and worse health outcomes for people in larger bodies .
It’s one reason why fat patients are more likely to avoid doctors than those in thin bodies.
The HAES approach is an alternative to all that. (It’s also called weight-inclusive or weight-neutral.) By rejecting diets and weight loss goals, weight-inclusive practitioners support people in appreciating, trusting, and taking care of their bodies. A Health at Every Size dietitian helps you learn healthy behaviors without focusing on weight.
Health at Every Size is a social justice movement.
It’s about social justice as much as it’s about personal health. Why? Because it’s about respecting all bodies and ending weight-based discrimination. Health at Every Size is grounded in five principles, written by the Association for Size Diversity and Health (ASDAH) in 2003. (They were revised in 2013 to better reflect the values of the movement.) Here they are, directly from the ASDAH website.
The 5 Principles of Health at Every Size
1. Weight Inclusivity: Accept and respect the inherent diversity of body shapes and sizes and reject the idealizing or pathologizing 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.
There are several books that could help you better understand Health at Every Size. This one by Lindo Bacon (as Linda Bacon) is a great place to start. Body Respect, by Lindo Bacon (as Linda Bacon) and Lucy Aphramor is another great one.
There’s evidence that a weight-inclusive approach can improve your health.
To be clear: Accepting your body and abandoning your quest for weight loss isn’t “letting yourself go.” Far from it! As the 5 principles clearly state, body acceptance actually makes it easier to form truly healthy habits.
When you finally stop dieting, you eventually start craving a wide variety of foods. (Yes, including nutritious ones like fruits and vegetables.) Plus, dieting often leads to weight cycling — constantly losing and regaining weight — which comes with health risks. Ending this cycle is not only good for your physical health, but for your mental and emotional health, too.
Exercise gets much better when you think about it as a fun way to move your body. Not as a punishment.When you find a weight-neutral dietitian and a doctor who give you health guidance that supports whatever body you have, you’re going to be much better off.
There’s evidence to support this. I’ll go into specifics about intuitive eating below, but here I’ll highlight two studies that looked specifically at a HAES approach. One 2002 clinical trial found that women who adopted healthier habits without trying to lose weight, ended up improving their health more than similar women who dieted.
A HAES dietitian will help you learn the difference between health-promoting behaviors and diet behaviors.
Most people seek out a dietitian because they want to take control of their health. They want to stop feeling obsessed with food, and out of control while eating. Unfortunately, a dietitian who focuses on weight loss might end up prescribing restrictive diet behaviors. And as we know, dieting just makes food obsession worse. But good health behaviors will do the opposite.
A weight-inclusive dietitian won’t encourage you to lose weight as a way to improve your health. Instead, we work with you to establish health-promoting behaviors that fit into your lifestyle and support the body you have. These behaviors are tailored specifically to you — your values, goals, ability level, and financial means. We focus on intuitive eating and healthy behavior change, instead of strict nutrition rules. It’s about long-term health, not a quick diet fix.
There are also HAES-informed doctors, therapists, and other health practitioners.
Of course, the weight-inclusive approach doesn’t just apply to nutrition. Having a HAES doctor is incredibly helpful, too. Often, people in larger bodies dread the doctor, because doctors have made them feel ashamed of their weight. If you’ve experienced this, look through this directory and see if there’s a weight-inclusive doctor in your area! You can find other health professionals in the directory, too.
Intuitive eating helps you appreciate and care for your body, no matter its size.
If you’re looking for expert intuitive eating guidance, a HAES dietitian is a must. Plenty of people claim to be intuitive eating dietitians. Unfortunately, some of them advertise intuitive eating for weight loss.
Weight loss isn’t realistic with any diet or eating framework. A 2011 review by well-known HAES proponents Lindo Bacon and Lucy Aphramor looked at existing weight loss studies. It found that virtually no one maintained weight loss for more than 2-5 years. A 2013 review found that between one-third and two-thirds of dieters regain more weight than they lost. A 2020 analysis of 121 studies found that dieters couldn’t keep weight off for a year or more.
If a dietitian tells you that you can use intuitive eating for weight loss, they’re lying. Sure, you might lose weight when you start eating intuitively. You might also stay the same weight. Or, you could gain weight, especially if you were on a strict diet beforehand. But, weight isn’t the point.
There are so many benefits to intuitive eating. A 2013 study found that intuitive eating can improve body appreciation, self-esteem, and body awareness. It also found that intuitive eating lowers the risk of eating disorders and body shame. Plus, 2017 survey study of over 40,000 French adults found that intuitive eaters generally eat healthier diets than people who restrict their food.
A weight-inclusive dietitian will help you make peace with food and your body.
As a weight-inclusive, HAES dietitian, I help people figure out a way of eating that makes them feel their best. As a journalist, I explain that body acceptance and intuitive eating are inclusive, life-affirming, and accessible. Being body positive isn’t about transforming your body, it’s about accepting it!
Before I found intuitive eating and Health at Every Size, I was ready to quit writing about nutrition. I was sick of dietitians providing weight loss tips for my stories, because I knew they didn’t work. Personally, I understood that dieting just made me feel obsessed with food. That any weight I lost would come back quickly. If weight loss was as easy as some made it seem, why is the diet industry so massive?
Now I know that there’s a better way to get healthier and live a more fulfilling life. The Health at Every Size framework guides my approach to coaching and my philosophy about food.
Do you want to heal your relationship with food and learn more about Health at Every Size? Sign up for my weekly newsletter. Every week, I talk about these things in a way that’s relevant and easy to understand. And, I answer reader questions and teach you how to navigate diet culture without giving in to it.