The Health At Every Size Philosophy (HAES)

‘Health at every size’ (HAES) aims to promote self-care by addressing health behaviours, while acknowledging and tackling weight stigma. It’s about being inclusive of human diversity in terms of body size and shape, ethnicity, sexual orientation, gender identification and social status. 
  
If people can feel better within themselves, they are more likely to engage in behaviours that improve health and be motivated to take care of their bodies. The current public obesity interventions may be having the opposite effect by perpetuating ‘weight stigma’ which is a kind of social prejudice toward people in larger bodies. This stigmatisation elicits shame, preventing people from pursuing healthful behaviours, threatening their psychological and physical health. 

The HAES philosophy has received some negative press with regard to it not focusing on weight and it has been suggested that it actually promotes obesity. 

However, HAES is not anti-weight loss, it just doesn’t promote weight loss as a health strategy. This is because, weight is not a behaviour. HAES focuses on addressing behaviours, focusing on weight only perpetuates weight stigma. Weight loss through behaviour change and improved self-care is a beneficial side effect, not the primary goal. 
  
In my experience, as a Senior Dietitian, if weight loss is the only focus, a person may take steps to improve their eating and activity however they may not achieve their desired weight loss goal (or lose any weight at all). Even if their health improves, they feel disheartened about not losing weight and may then lose motivation to sustain the positive behaviour change. This is highly relevant if people are restricting food or engaging in exercise they don’t truly enjoy. Food is for survival but also a great source of pleasure and vital for social connection. Meddling with these factors without a clear benefit or result can leave a person wondering why they would continue to restrict and exercise if it’s not pleasurable and has become a real chore. 

In some cases, people push themselves too hard with restriction and excessive activity, rather than making sustainable change. This can end up as a negative experience interfering with long term behaviour change and self-care. Those who do lose weight through behaviour change may still experience body dissatisfaction, they are not pleased with the result and are not truly happy with their body. Few keep weight off long term, they regain and may end up heavier than before. 
 
Not using weight loss as a primary goal means promoting eating well and physical activity that is enjoyable and motivating. This is why I use the HAES philosophy in consultation with my clients at Melbourne Centre for Women’s Mental Health.

By Senior Dietitian Dianne Rennard