After nearly five years, I have decided to leave my job in medical weight management to explore and practice a Health at Every Size® (HAES®) approach.
Diets do more harm than good. Research shows that dieting is more likely to lead to weight gain than weight loss. A review of 31 weight loss studies found that dieting was ineffective at producing long term weight loss, and one-third to two-thirds of dieters gained more weight than they lost (Mann et al, 2007). Calorie restriction leads to preoccupation with food, binge eating and weight obsession.
Weight loss programs contribute to weight stigma. Weight loss programs perpetuate the idea that being “overweight” is a flaw or character defect. In reality, weight is determined by a complex interaction between genes, environment and social influences. Once a set-point weight range is established, the brain works hard to defend it. Size diversity should be respected and embraced, just like other types of diversity.
Weight loss is not necessary for health improvement. People who exercise regularly, eat a healthy diet, and practice other forms of self-care can improve their health, without losing weight (Matheson et al. 2012; Schaefer and Magnuson, 2014.)
What is HAES?
The Health at Every Size approach emphasizes:
- Self-acceptance regardless of weight, size, or shape.
- Physical activity for enjoyment and enhanced quality of life.
- Normalized eating in response to physiologic hunger and fullness cues rather than external guidelines or rules.
- An approach to healthy living that does not necessarily involve weight loss for overweight individuals.
My journey to embracing a HAES approach:
Reading Linda Bacon, PhD’s book, Health at Every Size, was the first step that led me to question the weight-centered approach. But I still needed a few years to fully embrace the approach. When I finally saw the harm that dieting was causing my clients, I knew it was time for a change.
Ultimately, Sandra Aamodt, PhD’s TED talk, Why Dieting Doesn’t Usually Work, was the catalyst behind my decision to embrace a HAES approach. In this powerful video, Aamodt explains how the brain fights against lasting weight loss. She recommends mindful eating as an alternative approach to health.
In April, I attended Ditchin’ the Diet: Non-Diet Approaches in Nutrition Education, a seminar hosted by dietitians and university professors Dawn Clifford, PhD, RD and Michelle Neyman Morris, PhD, RD, which furthered my commitment. These amazing women are teaching HAES curriculum to students at California State University, Chico. These HAES videos recorded by Clifford are available for anyone to watch. I wish someone had taught me about the HAES approach when I was in school.
Tools to support a HAES practice:
Michelle May, MD has also been an influential figure. Reading her Eat What You Love, Love What You Eat books gave me new ideas and inspiration on how to teach mindful eating skills.
The book Wellness, Not Weight contains a wealth of information and is an amazing resource. Each chapter is written by a different health expert and backed by dozens of research articles.
The National Association to Advance Fat Acceptance (NAAFA) has published Guidelines for Nutritionists and Dietitians to help us adopt a HAES practice.
I am excited and proud to be taking a stand for Health at Every Size. If you have questions about HAES, please feel free to send me an email or post in the comments section.
Health At Every Size and HAES are registered trademarks of the Association for Size Diversity and Health and used with permission.