Why Understanding Health at Every Size® Improves Body Image

The Health At Every Size® (HAES) approach is a continuously evolving alternative to health’s conventional weight-centered approach. The conventional weight-centered approach to health emphasizes measures like weight and BMI as essential health indicators. This conventional model of health often purports weight loss, weight control, or weight management as an effective way to improve or sustain health. [1, 2, 4, 7]

This conventional weight-centered approach to health perpetuates weight stigma and bias and ultimately harms individuals’ health rather than improving it. [1-4]

HAES offers an alternative paradigm to health. It is a movement working to promote size-acceptance, to end weight discrimination, and to lessen the cultural obsession with weight loss and thinness. The HAES approach promotes balanced eating, life-enhancing physical activity, and respect for the diversity of body shapes and sizes. [3]

The Health at Every Size® approach comes out of discussions among healthcare workers, consumers, and activists who reject both the use of weight, size, or BMI as proxies for health, and the myth that weight is a choice. [3]

The HAES model is an approach to both policy and individual decision-making. It addresses broad forces that support health, such as safe and affordable access to healthcare. It also helps people find sustainable practices that support individual and community well-being. [3]

The HAES approach honors the healing power of social connections, evolves in response to the experiences and needs of a diverse community, and grounds itself in a social justice framework.[3]

Moreover, Health at Every Size® provides a lens to look at how society negatively views larger bodies and promotes the “thin ideal” — the best-known environmental contributor to the development of eating disorders. Our society is innately fat-phobic and assumes that every person in a larger body can be thin if they just work hard enough.

HAES rejects these notions and refuses to blame people for their health outcomes and works to end discrimination and stigma based on body size or any other form of identity. [1-5]

Research on HAES has shown to have the following long-term health outcomes [2, 4]

• Lower blood pressure

• Improved lipid profiles

• Increased physical activity

• Lower levels of disordered eating

• Improved eating and activity habits

• Improved dietary quality

• Improved mood

• Increased self-esteem

• Improved body image

• Significantly higher retention rates compared to dieting (92% vs. 41% after two years)

• No weight cycling

• Greater resilience to weight stigma

In essence, Health at Every Size®, as written in Linda Bacon’s Book, Health at Every Size: The surprising truth about your weight, acknowledges that well-being and healthy habits are more important than any number on the scale. [4]

The HAES principles that you can adopt into your everyday life

Accept your size. Love and appreciate the body you have. Self-acceptance empowers you to move on and make positive changes.

Trust yourself. We all have internal systems designed to keep us healthy — and at a healthy weight. Support your body in naturally finding its appropriate weight by honoring its signals of hunger, fullness, and appetite.

Adopt healthy lifestyle habits. Develop and nurture connections with others and look for purpose and meaning in your life. Fulfilling your social, emotional, and spiritual needs restores food to its rightful place as a source of nourishment and pleasure.

• Find the joy in moving your body and becoming more physically vital in your everyday life.

• Eat when you’re hungry, stop when you’re full, and seek out pleasurable and satisfying foods.

• Tailor your tastes so that you enjoy more nutritious foods, staying mindful that there is plenty of room for less nutritious choices in the context of an overall healthy diet and lifestyle.

Embrace size diversity. Humans come in a variety of sizes and shapes. Open to the beauty found across the spectrum and support others in recognizing their unique attractiveness.

Health at Every Size® and Body Image

Body image is about your personal relationship with your body. It includes your perceptions, beliefs, thoughts, feelings, and actions related to your physical appearance.

When the HAES principles are fully understood and adopted into your life, it’s likely that your attitudes about your weight, shape, and appearance will shift towards body neutrality, respect, and appreciation.

With this shift, you may find yourself less concerned about your physical appearance and feel more at peace with your body. [2, 6, 8]. It is important to address body image in eating disorder recovery. In fact, the Academy for Eating Disorders lists the treatment of body image as equally important as weight restoration for full recovery from eating disorders.

Understanding HAES principles and incorporating the principles into eating disorder recovery can be a helpful tool when addressing body image and cultivating a respectful relationship with your body. [9]

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Sources:

[1] Bacon, L. (2010). Health at Every Size: The Surprising Truth About Your Weight. BenBella Books.

[2] Bacon, L. & Aphramor, L. (2014). Body Respect: What Conventional Health Books Get Wrong, Leave Out, and Just Plain Fail to Understand about Weight. Dallas, TX: BenBella Books.

[3] Association for Size Diversity & Health. HAES Approach. Retrieved from https://www.sizediversityandhealth.org/content.asp?id=152 on Sept 10, 2020.

[4] Bacon, L., & Aphramor, L. (2011). Weight Science: Evaluating the evidence for a paradigm shift. Nutrition Journal, 10(1). doi:10.1186/1475-2891-10-69

[5] National Eating Disorder Association. Size Diveristy and Health at Every Sized. Retrieved from https://www.nationaleatingdisorders.org/size-diversity-health-every-size on Sept 10, 2020.

[6] Bacon L, Stern JS, Van Loan MD, Keim NL. Size acceptance and intuitive eating improve health for obese, female chronic dieters. J Am Diet Assoc. 2005;105(6):929-936. doi:10.1016/j.jada.2005.03.011

[7] Fielder-Jenks, C. The Size Diversity Competency Training Workbook. Retrieved from https://thrivecounselingaustin.com/resources/size-diversity-competency-training-for-healing-professionals-workbook on Sept 11, 2020.

[8] Cash, T. F. (2008). The body image workbook: An eight-step program for learning to like your looks. Oakland, CA: New Harbinger Publications.

[9] AED Report. (2016). Eating disorders: A guide to medical care. Academy for Eating Disorders. Retrieved from https://www.aedweb.org/resources/online-library/publications/medical-care-standards on Sept 11, 2020.

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About the Author:

Chelsea Fielder-Jenks is a Licensed Professional Counselor in private practice in Austin, Texas. Chelsea works with individuals, families, and groups primarily from a Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) framework.

She has extensive experience working with adolescents, families, and adults who struggle with eating, substance use, and various co-occurring mental health disorders. You can learn more about Chelsea and her private practice at ThriveCounselingAustin.com.

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The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published September 23, 2020, on EatingDisorderHope.com
Reviewed & Approved on September 23, 2020, by Jacquelyn Ekern MS, LPC