Food freedom

Health At Every Size

Before I know what Health At Every Size was – when I ate or drank anything – I asked myself the following: will this make me thin or fat?

And that was pretty much all I cared about.

There was no “will I truly enjoy this?”  There was no “how will this make me feel?”

And there was no concern for my actual health. I didn’t really care if what I was about to eat contained a million different chemicals in an attempt to try and replace the flavour of the missing fat and sugars to keep it “low calorie.”

I didn’t care about anything else apart from my reality of “thin-is-good” / “fat-is-bad”.

My obsession with food and weight lead me to a variety of disordered eating behaviours, including:

  • Constant attempts at under-eating/restriction,
  • followed by binge eating
  • weight-cycling (aka “yo-yo dieting”)
  • food obsession,
  • low self-esteem,
  • (A LOT) of emotional eating,
  • Anxiety around going out for food
  • Body dysmorphia
  • and generally feeling like a crazy person around food.

When I started my recovery journey, I clung tightly to the hope that I could “recover” from disordered eating yet still casually try to lose weight.

But let me tell you this, I was never able to truly heal my relationship with food—including my binge eating—until I fully committed to giving up all aspects of dieting and started seeking “health” in weight-neutral ways.

Health At Every Size, combined with Intuitive Eating and some profoundly important self-acceptance and body image work eventually helped me to break free from the diet-binge cycle.  

So what is Health At Every Size (HAES)?

Health At Every Size (“HAES”) is a weight-neutral approach to health care. It encourages seeking healthful behaviours (like eating vegetables, moving your body, getting enough protein, etc.) for the fundamental health benefits of those behaviours. Instead of the chasing and motivation of weight loss and body manipulation.

For example, HAES wellness professionals (such as myself) might suggest that clients move their bodies in a way that feels good for them, purely for the sake of the cardiac or mental health benefits—instead of attempted weight loss.

Health At Every Size also encourages the pursuit of health outcomes (like balanced blood sugar, blood pressure, heart health, etc.) through the motivation of wanting to take care of health instead of through the motivation of wanting to lose weight.

For example, HAES doctors may suggest that patients manage diabetes or heart disease through body movement or nutritional therapy instead of asking patients to lose weight.

Why should we choose Health At Every Size (instead of dieting)?

Health At Every Size is a much more reliable alternative to our society’s current weight-focused approach to health care—an approach which has been proven many times to be ineffective.

Below are some reasons as to why our current weight-focused health care system doesn’t work and are actually making people sicker long-term.

#1. Diets don’t work.

The Health At Every Size approach was developed because of the ever-growing research showing us that diets for weight loss don’t work and don’t improve health outcomes for most people long-term.

The statistic is that 95% (ish) of diets fail over time.

(Statistic meaning: a fact or piece of data obtained from a study of a large quantity of numerical data.)

What this statistic actually means is that no weight loss research—of any kind or by any method—can demonstrate consistent “weight loss success” in the long term for more than 5% of people.

Most people are able to lose weight temporarily through dieting, But no more than 5% of people who participate in the research are able to maintain “significant” weight loss—by any method—for more than 3-5 years. More on this here.

These numbers decline even further in the rare cases that weight loss lasts more than 5 years, and those rare people who DO maintain “long-term, significant” weight loss often exhibit attitudes and behaviours that would be diagnosed as eating disorders in lower-weight people

(e.g. they must stay obsessed with food and exercise and not much else.)

Most people do not succeed at forced attempts at weight loss in the long-term—no matter how, or why, they are trying to do so.

HAES rejects the idea that “health” should be defined by body size. Many fat people live perfectly healthful lives in the bodies they have, and thin people are not immune to “weight-related” illnesses like heart disease or diabetes.

#2. Diets cause you to gain weight.

Research suggests that forced attempts at weight loss lead to long-term (rebound) weight-gain in about a third of cases.

In other words,

every time you lose weight on a diet—you have about a 30% chance of ending up bigger than when you started, after going through a full diet-rebound cycle.

As it turns out, dieting (or trying to lose weight) is the number one predictor of weight gain over time! 🤯

People who don’t diet on-diet or those practising HAES and size acceptance—maintain their natural set point weight effortlessly over time.

#3. Diets are physically, mentally & emotionally unsafe

Not only does dieting as a “treatment” for fatness not usually work, but it comes with a long list of side effects such as:

  • binge eating
  • emotional eating
  • low self-esteem
  • food obsession
  • eating disorders
  • depression/anxiety
  • and a wide variety of physical ailments that may result from malnutrition or weight cycling.

Weight cycling, also known as yo-yo dieting, is a known stressor on the body and is associated with some of the same chronic illnesses that are usually blamed on fatness.

Some research suggests that some negative health outcomes linked with fatness (e.g. diabetes and heart disease) may be the result of chronic yo-yo dieting, which is immensely encouraged in larger-bodied people.   

Why does Health At Every Size “work?”

Many people feel hopeless about their ability to diet (rightly so) and they are worried that they are doomed for ill health and disease if they’re unable to achieve or maintain long-term weight loss.

HAES is an alternative to dieting that is more effective in improving health outcomes AND has fewer side effects—including less binge eating, weight cycling, and less feeling “like a crazy person” around food.

The HAES approach is actually quite simple…

Pursue a healthy lifestyle—including things like eating vegetables, getting regular movement, managing stress or [insert healthy behavior of your choice]

…without worrying about the weight part.

Ta-da!

Why is this the case…?

HAES is easy to maintain as a lifestyle

  1. People are more likely to continue healthy behaviours (like eating vegetables, and moving their bodies) when those behaviours are NOT motivated by weight-related goals.   

There are a couple of reasons for this:

Weight loss may motivate people to work out or eat vegetables on “Day One”

…but the second a dieter thinks they have “fell off the wagon” or becomes frustrated when they don’t get the weight loss results they were hoping for, they tend to press the F-it button on whatever health behaviours they had attached to dieting…until their next diet of course. 

If someone were to follow the principles of HAES then their health behaviours would be motivated by the benefits of how the behaviours would make them feel.. (e.g. endorphins, better sleep, better energy, better digestion, generally feeling better, etc.)

2. Restricted eating is biologically difficult to maintain—even for the most strong-willed or “motivated” people. 

Limiting calories or major macronutrients (e.g. fat, carbs, etc.), which is often encouraged by diets “for weight loss” sends our bodies into starvation mode and our biological instincts quickly rebel—leading to binge eating, rebounding, and other complications of malnutrition. 😧   

Diets tend to focus on taking things out – limiting amounts or types of food – the HAES approach focuses on adding in healthful behaviors, like exercise, vegetables, etc.

Adding “healthful” things into our life is significantly easier for our human brains than taking “unhealthful” things out. After all, we’ve evolved over millions of years to seek food rather than resist it.

When limiting certain food types IS necessary for “health” (e.g. physical allergies, etc.), people are more likely to succeed long-term—and are less likely to fall into binge eating behaviours—when pursuing these restrictions in a weight-neutral way.

Weight doesn’t mean Health

Another reason that HAES is more effective than weight-loss focused health strategies, is that not all bodies are genetically “designed” for thinness.

Some people’s healthiest possible weight—the weight they end up at when they’re at the top of their personal “health” game—is higher than current medical BMI “recommendations.”

BMI:

B-ullsh*t

M-isunderstood

I-nformation

Health At Every Size recognizes that bodies – including “healthy” bodies – naturally occur in a range of shapes and sizes.

Some data suggests that more than half of “overweight” people are “metabolically healthy” (meaning healthy blood sugar, blood pressure, cholesterol, etc.) and about a quarter of thin or “normal weight” people have at least two risk factors typically associated with “obesity.”

Body diversity is a thing…and it’s been a thing for thousands of years.

body diversity

HAES reduces weight-bias in health care environments.

One of the biggest problems with our weight focused health care system is that it encourages weight-bias in almost every aspect of our medical system.

For example, fat people are told to lose weight (aka diet) in response to just about every health problem, ache, or pain. Thin people however are treated with actual evidence-based medicine.

It’s not uncommon for serious medical threats (eg: tumours, blood clots, broken bones, etc.) to go undetected in larger patients because doctors assume their symptoms (everything from knee-pain to chest pain to trouble breathing) are no more than simple side effects of fatness that would go away if they just lost weight.

Larger bodied patients are viewed by doctors and nurses as “lazy” or said to be “incompetent at following diets” (when diets don’t work) and so they hesitate to seek medical care to avoid being shamed and judged for their size.

OBJECTION: “But fat bodies are unhealthy”

While it seems pretty clear from research that this is NOT actually true as there are plenty of fat people that live long, disease-free lives, and there are plenty of thin people who die from “weight-related” illnesses like diabetes and heart disease.

HAES does not claim that “everyone is healthy at every size,” or that “every size is equally healthy” or any version of this opinion.

HAES is simply promoting a weight-neutral approach to health care. One that focuses on the promotion of healthy behaviours and lifestyles, rather than trying to make people thin as a substitute for good health.

In other words, HAES is promoting a more effective way of pursuing health whilst warning against the dangers and ineffectiveness of forced weight loss attempts.

Get Started with Health At Every Size

When you finally come to terms with how unhelpful and ineffective dieting is (I know…there may be some mourning involved…), here are some steps that you can take to pursue your happiest, healthiest life in whatever body you’re realistically working with.

#1. Set Weight-Neutral Health Goals.

Instead of obsessively trying to lose weight for years on end with no lasting results,

think about the health or fitness goals that matter to you—the things you think you’ll get through weight loss—and start pursuing those goals directly in the body you have right now.

For example,

  1. Do you want to work on mobility? Great, let’s do some strength training and stretching…that’ll help whether you lose weight or not.
  2. Do you want to walk, run, or climb up the stairs more easily? Awesome, let’s get some more cardio in…that will also help whether you lose weight or not.  
  3. Do you want to manage your blood sugar or blood pressure more effectively? Fab! Let’s work on getting enough protein and fibre at meals and snack times especially when you would like to eat sugar—a little cardio helps here too!

…all of which helps whether you lose weight or not!

There are loads of things you can do to improve pretty much any “weight-related” health condition…that have nothing to do with diets-that-don’t-work-anyway.

In other words, start thinking about Plan B: weight-neutral actions you can take to achieve the health outcomes you’re looking for…regardless of what happens with your size. 

Additionally, set weight-neutral health goals that are reasonable for your unique body and lifestyle.

If a particular form of movement isn’t available to you—for weight or non-weight-related reasons—you have to meet yourself where you are.

Similarly, if a particular dietary change isn’t realistic for economic, lifestyle, mental health or any other reasons—work within your life circumstances rather than against them.

There is no “right” way to do health…and all health pursuits should be realistic, practical and most importantly feel good to the individual pursuing them.

(Otherwise…what’s the point?)

#2. Be okay with what you can’t control.

Recognize that, just like weight, “health” outcomes are not fully within your control either.

Although focusing on behavioural change is more effective than dieting when it comes to long-term health outcomes—behavioural change itself can only go so far.  

When we honestly acknowledge the role of genetics, environment, social inequality, and an infinite number of unknowable factors—it becomes clear that we are only “in control” of a small fraction of our own “health” inputs.  

Arguably our own behaviours are not even fully within our control, because our behaviours are impacted by our environment, energy levels, attitudes and beliefs, etc.

So take some of the pressure off yourself.

Despite what most health blogs would have you believe—it’s not all on you, and you don’t get to choose the day you die.

#3. Don’t forget about mental health.

There is NO nutrition or health choice that will make you immortal. There is no point in even trying to pursue what the health gurus tell you to do if you have to be miserable to achieve it… don’t forget to enjoy your life now!

Physical health has little value if you can’t enjoy your life in this moment.

Even if I could “misery” my way into living for a long time, I’d gladly take a few years off my life if it meant that I could have fun and live well in the years I had, rather than spend my life anxious and food-obsessed.

Additionally, there is strong research suggesting that people who are relaxed and happy are better protected from a range of illnesses, including heart disease and diabetes.

Mental health and well-being is an equally important piece of our overall “health” equation.

If your pursuit of physical health is destructive to your mental health—it’s probably not sustainable and almost certainly not worth it.

Find support and resources.

What I’ve shared with you today is the tip of the iceberg of problems associated with a weight-obsessed (and weight-biased) health care system, and we all need as much help as we can get to manage the shitstorm of problems that result from a culture of widespread fatphobia.

If you’ve had enough of diets-that-don’t-work and are ready to pursue a weight-neutral, body-positive approach to health—seek out support in whatever ways are realistic for you.

I talk about this in detail in my End the Diet-Binge Cycle Masterclass. Or if you prefer a more 1:1 approach, explore what it would look like to work with me 1:1.

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