Health at Every Size® (HAES) 101
People in all bodies can work towards health — without trying to lose weight.
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What is Health at Every Size?
Health at Every Size, or HAES, is a framework for health, wellness and medical care that considers all bodies to be worthy of dignified and respectful care as they exist right now.
The Association for Size Diversity and Health (ASDAH), which owns the trademark for the HAES name, defines it as:
“The Health At Every Size® (HAES®) approach is a continuously evolving alternative to the weight-centered approach to treating clients and patients of all sizes. It is also a movement working to promote size-acceptance, to end weight discrimination, and to lesson 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.”
Health at Every Size is a weight-neutral approach to health, which means that “A person’s health status, risk level, or quality of life cannot be assumed based solely on a number on a scale. Bodyweight is not as directly and linearly related to higher quality of life and reduced risk of disease as is commonly thought.”
This doesn’t mean that every person in every body is healthy at this specific moment, but it means that every person can work towards health and healthy behaviors — whatever that looks like for them. Health at Every Size takes into account differences in body size and shape, chronic illness and the social determinants of health.
The Foundations of HAES
Anti-racism is a vital component of Health at Every Size. Fearing the Black Body by Sabrina Strings explores the history of how racism and fatphobia are tightly linked.
The book Body Respect by Lindo Bacon and Lucy Aphramor is a foundational HAES read. It replaces the older version called Health at Every Size.
Intuitive Eating by Evelyn Tribole and Elyse Resch is a guide to food and nutrition that dovetails with HAES principles.
The Body Is Not an Apology offers radical self-love as the balm to heal the wounds inflicted by violent systems of oppression.
What does Health at Every Size mean?
There are five principles underlying Health at Every Size:
- Weight inclusivity
- Health enhancement
- Respectful care
- Eating for well-being
- Life-enhancing movement
Find more information on each principle on the ASDAH website.
This talk from Lesley Williams and ASDAH seeks to explore innovative ways to engage medical providers who are resistant to utilizing the HAES approach in their practices.
Where did HAES come from?
Health at Every Size was developed over decades of work and research by people of all sizes, including both healthcare providers and fat acceptance activists. Though HAES would also be considered body positive, its roots lie in radical fat activism. As a framework, it was designed to center the most marginalized people (e.g., fat and very fat folks, Black and other People of Color, and other oppressed groups), so practitioners should be prepared to incorporate intersectional social justice into their work.
Is Health at Every Size anti-diet? Isn’t losing weight healthy?
Health at Every Size is an evidence-based framework. That means that rather than going with what “everybody knows” about body size and health (which perpetuates racism and weight stigma that prevent people in larger bodies from getting respectful and effective healthcare), HAES is based on actual science.
Studies show that 95-98% of people will gain back all the weight they lose from diets and “lifestyle changes” within five years — and two-thirds of them will gain back even more than they lost. We don’t have a single study (even from diet companies!) that shows it’s possible to lose more than a few pounds and keep it off in the long term.
What we do have is new science that shows that weight cycling — gaining and losing weight repeatedly — is much worse than just living in a fat body. We know that body size is largely determined by genetics and the social determinants of health, rather than willpower, individual choices or moral virtue.
Given these facts, it only makes sense to work with the bodies we have, and pursue healthy behaviors rather than intentional weight loss.
Terms to Know
- Body liberation: “The freedom from social and political systems of oppression that designate certain bodies as more worthy, healthy, and desirable than others” (read more).
- Body positive: The concept that all bodies have worth as they exist today (read more).
- Fat: As used here, a neutral descriptor of a large body. Though some people use this as an insult, I and many other fat people have reclaimed the term. (You are, of course, welcome to identify with the word or not; it’s up to you!)
- Fat acceptance: The concept that fat bodies are just as worthy as thin bodies and should be accepted as a natural part of human variation (read more).
- Fat positive: The concept that fat bodies are not just worthy, but have beauty and value of their own (read more).
- Health at Every Size: The concept that every body can work toward its own version of health at its current size (read more).
- Intuitive eating: Listening to your body and eating in accordance with it (read more).
- Overweight, obesity and obesity stigma: Outdated, offensive terms that medicalize and stigmatize a group of people with perfectly normal human bodies.
- Privilege: “A set of unearned benefits given to people who fit into a specific social group” (read more).
- Intersectionality: Overlapping and interdependent systems of discrimination or disadvantage (read more).
- Marginalization: “Pushing a particular group or groups of people to the edge of society by not allowing them an active voice, identity, or place in it” (read more).
- Mindful eating: Eating with the intention of feeling better when you’re finished eating than you did when you started, and eating with the attention necessary for noticing and enjoying your food and its effects on your body (read more).
- Social determinants of health: “Conditions in the places where people live, learn, work, and play that affect a wide range of health and quality-of life-risks and outcomes” (read more).
- Weight stigma: “Weight stigma, also known as weight bias or weight-based discrimination, is discrimination or stereotyping based on a person’s weight. Weight stigma can increase body dissatisfaction, a leading risk factor in the development of eating disorders. The best-known environmental contributor to the development of eating disorders is the sociocultural idealization of thinness” (read more).
- 9 Foundational 101 Reads for Health at Every Size (HAES)
- An Evidence‐Based Rationale for Adopting Weight‐Inclusive Health Policy
- Body Trust® training
- HAES books
- HAES Health Sheets
- HAES Curriculum
- HAES Q&A from ASDAH
- Intuitive Eating books
- The Weight-Inclusive versus Weight-Normative Approach to Health: Evaluating the Evidence for Prioritizing Well-Being over Weight Loss
- Unpacking Weight Stigma I
- What are We Going to Do About the Weight?: Weight Stigma in Health Care
- Fat Friendly Health Professionals List
- Fat Liberation Syllabus for Revolutionary Leftists
- Fat-friendly waiting room furniture
- HAES-Aligned Resources for PCOS
- HAES Australia Find a Provider
- HAES professional search (HAES Community)
- HAES Resources for Chronic Illness and Diabetes
- HAES stock photos
- Love What You Eat (HAES-aligned recipes)
- PNW Fattitude Healthcare Provider Directory
- Resources from Aunt Amelia on weight stigma
- Workweek Lunch (HAES-friendly recipes)