I got a great question from a reader yesterday about the nature of Health at Every Size:
While I think HAES is the best option for fat people right now, the whole natural organic from scratch thing really rubs me the wrong way and keeps me from fully embracing the movement. I love going out and I love my processed food. And nothing is going to change that. So not to try and derail but where is there room in HAES for someone like me? I have plenty of options and I’m making the deliberate choice to eat the foods I love and that make me happy. So does that element of preachiness I’m detecting from HAES really exist, or am I just being oversensitive?
I have definitely experienced people who consider themselves Health at Every Size practitioners and also seem to feel like theirs is the gospel of health. I find this to be not only obnoxious, but also antithetical to a HAES perspective.
I firmly believe that Health at Every Size is about a paradigm change (from a weight-centered paradigm to a health-centered paradigm) and not about specific foods or behaviors that are “right” for everyone. Let’s look at the two paradigms first:
Weight Centered Paradigm
- Weight is used as a proxy for health
- It is believed that in order to be healthy, bodies must be within a specific weight range
- Body size interventions are given for health problems (ie: if a fat patient presents with a health problem they are prescribed weight loss, if a thin patient presents with the same health problem they are given an intervention that is not weight loss)
- If people are above the specific weight range (or concerned about becoming so) food and exercise are seen as ways to manipulate body size, often using very specific rules and restrictions, and with success being judged by body size
Health at Every Size
- Health is seen as multi-dimensional and not entirely within our control. Health is assessed through a variety of measurements including health markers (blood glucose, blood pressure) and quality of life with a clear understanding that it’s about what you can do, with what you have, where you are
- It is believed that bodies can be healthy at a variety of sizes
- Health interventions are given for health problems (regardless of the size of the patient, the intervention for a given health problem is the same and based on evidence)
- Eating is seen as a part of life and people are encouraged to take into consideration nutrients, pleasure, and their own internal cues of satiety and fullness
While there are excellent professionals who help people eat from a Health at Every Size perspective, (Michelle at The Fat Nutritionist is one of my favorites), HAES itself is not a specific set of foods or food choices and it drives me nuts when people want to spout out general advice “everyone feels better eating blah blah blah” or “nobody should be eating blah blah blah”. When we talk about food choices we should stick to telling our own stories and making our own choices, health/food/exercise/is not a one size fits all situation.
My firm belief is that people get to prioritize their health however they want and they get to choose their path to health. Our job, if public health is important to us, is to make sure that people have access to the foods that they want to eat and safe movement options in which they want to partake (if any), and the best in evidence-based education and healthcare. Then we butt the hell out and let people make choices.
A separate issue can be the pressure that HAES practitioners can feel (and perhaps put on each other) to be “perfect” in our habits, and I’ll talk about that in tomorrow’s blog.
Can you help Robert?
The brilliant Marilyn Wann let me know about a gentleman named Robert Gibbs has made a heart-wrenching YouTube plea for help He is a fat man with mobility problems who wants to lead a better life. I’m hoping that there may be some HAES professionals reading this who could help him out. I’ve heard rumors that Dr. Phil and Dr. Oz are looking to get involved. Weight-based interventions have failed him repeatedly (and statistics say that they will keep failing him) and I would love to see the HAES community come together to offer help and support whether it’s expert advice or just an encouraging comment on his YouTube video.
This blog is supported by its readers rather than corporate ads. If you feel that you get value out of the blog, can afford it, and want to support my work and activism, please consider a paid subscription or a one-time contribution. The regular e-mail subscription (available at the top right hand side of this page) is still completely free. Thanks for reading! ~Ragen












