Understanding Health at Every Size (HAES®) and why weight-inclusive care matters

At Maitri Health we are committed to providing tailored and evidence-based advice that prioritises inclusivity.  We are a HAES® aligned practice that recognises being ‘healthy’ looks different on everyone. If you have not come across the HAES® principles before, we offer a look at what this means below and why it is an important pillar of our practice.

What is HAES®?

The Health at Every Size® paradigm is about increasing access to healthcare for bodies of all sizes that is respectful, safe and free from bias. Rooted in the fat acceptance movement of the 1960s and 1970s, it was first given its name in the 1990s when the Association for Size Diversity and Health (ASDAH) was formed (1).

Why is weight-inclusive care important?

In Australia, the weight-loss industry is worth around $500 million annually. Weight-loss marketing typically offers “quick & easy” ways to manage your weight however statistically we know that only 5-10% of people can maintain weight-loss in the long run. There are many biological, behavioural and environmental factors affecting this however society often stigmatizes the human being at the centre of it as lacking willpower or motivation, which is an untrue and damaging idea (2).

For many people, weight-loss attempts result in a cycle of intense restriction, deprivation, overeating and self-despondency. The principles of HAES® can offer an alternative pathway to common healthcare interventions and specifically distance the idea that weight and body size are valid indicators of health.

Research indicates that when following a HAES® approach to health interventions, there are significant improvements in measures such as blood pressure, lipid values and health behaviour engagement like exercise and nutrition. Interestingly, the HAES® approach as compared with a weight-focused intervention has much better improvements in psychosocial outcomes like mood, self-esteem and body image (3). For this reason, it is an appropriate and useful strategy when overcoming disordered-eating behaviours such as restrictive dieting, weight-cycling, bingeing, food obsession and over-exercising.

The 4 Principles of HAES®

Since its creation, the HAES® principles have been revised several times but still hold the same goal of addressing weight bias faced in healthcare settings:

Principle 1: Healthcare is a human right for people of all sizes, including those at the highest end of the size spectrum.

When you access healthcare, you deserve to be given non-biased, equal care not determined by predisposed ideas about health and weight. Unfortunately, anti-fat bias is present with many health practitioners, which can ultimately lead to avoidance by those living in a larger body and poorer quality care when they do seek it. At Maitri Health, we celebrate diversity and ensure an environment that is accepting and comfortable for all our clients.

Principle 2: Wellbeing, care and healing are resources that are both collective and deeply personal.

We want to take the time to understand YOU in the complete picture. We are guided by your idea of health and wellbeing goals not outdated charts or measures.

Principle 3: Care is fully provided only when free from anti-fat bias and offered with people of all sizes in mind.

HAES® promotes autonomous decisions for everyone about health and how they value it among all other aspects of life. You decide what health looks like for you and we will help you get there.

Principle 4: Health is a sociopolitical construct that reflects the values of society.

Current society views of health still largely position thin-centric ideas. While we know that bodies come in plenty of shapes and sizes, weight-loss is still largely pushed as ‘health behaviour.’ Research indicates that often pursuits of weight loss are unsuccessful and in fact weight cycling can have other detrimental effects on health irrespective of weight such as inflammatory markers, higher risk of mortality and hypertension (4).

If you are tired of not feeling heard in a clinic room and would like your health to be taken seriously outside of the generic weight-loss advice. Then reach out and see how we can help. We always aim to provide a service that is respectful and inclusive of everyone as healthcare should be accessible and safe to all.

If it is your first time hearing of HAES® principles, you can find out more from https://www.sizeinclusivehealth.org.au/ .

 References

1. Association for Size Diversity and Health (ASDAH). (2023). Health at Every Size Principles. https://asdah.org/haes/
   

2. Hall, K. D., & Kahan, S. (2018). Maintenance of Lost Weight and Long-Term Management of Obesity. Med Clin North Am, 102(1), 183-197. https://doi.org/10.1016/j.mcna.2017.08.012
   

3. Bacon, L., & Aphramor, L. (2011). Weight Science: Evaluating the Evidence for a Paradigm Shift. Nutrition Journal, 10(1), 9. https://doi.org/10.1186/1475-2891-10-9
   

4. Tylka, T. L., Annunziato, R. A., Burgard, D., Daníelsdóttir, S., Shuman, E., Davis, C., & Calogero, R. M. (2014). The weight-inclusive versus weight-normative approach to health: evaluating the evidence for prioritizing well-being over weight loss. J Obes, 2014, 983495. https://doi.org/10.1155/2014/983495