The Basics of Health at Every Size
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So what does that even mean, and how can you apply the framework of HAES? I’m breaking it all down in today’s post.
What is Health?
“Health” is on a continuum and it’s definitely not set in stone. There are so many factors that go into health and it changes based on where you are in your life. It’s a very vague term without a clear definition.
But health is something that everybody on this earth gets to pursue. It’s also something you could pursue but isn’t necessarily an objective for life.
Furthermore, pursuing health is not an obligation. No one should be judged morally depending on their choice to pursue health or not. So part of what HAES is trying to say is that we need to drop the judgments of “Oh, that person is so unhealthy (IE lazy and terrible) because they’re large,” and so on. They just live in a larger body. There is no reflection on their morality because of that.
HAES asks that your health status doesn’t inform your value, and definitely doesn’t inform how you should be treated. And you already know that HAES and intuitive eating are spreading the word that health is not the same thing as weight.
Sadly, most of the world equates health with weight. Even though they are wrong, and even if they will never change their way of thinking, someone’s weight (what they would consider “health”) shouldn’t have any reflection on someone’s value and how they should be treated.
If we think about HAES as a social justice movement, it’s providing an alternative to our weight-centric approach to healthcare. It works to end weight discrimination specifically in the realm of quality and access to healthcare.
The 5 Principles of Health at Every Size
There are 5 (currently, probably soon to be 3) Principles of the Health at Every Size movement:
Weight Inclusivity
All care and treatment needs to be available to people in all sizes. This includes chairs and equipment that can fit any body size, as well as the actual medical treatment provided.
For instance, someone in a larger body might go to their doctor for shoulder pain. Ideally, they would get a referral for PT, medication, surgery, etc. – whatever is medically necessary. But for a doctor who is not HAES-aligned, their recommendation might be “lose weight.” And often, their symptoms have nothing to do with their weight – so they’re not given a true remedy. They are not given recommendations that a thin person would get.
Health Enhancement
This principle recommends the support and promotion of policies that improve and equalize access to healthcare, and eliminate weight discrimination.
To me, part of this principle is prescribing health promoting behaviors for everyone. For example, a HAES-aligned doctor might recommend that someone increase physical activity with a walk around the block each day, which could promote health no matter what someone’s size is, if they are doing zero movement. Treatment should enhance someone’s health with actual health-promoting behaviors besides referring to just weight loss. (Weight loss isn’t a good medical recommendation, as there’s a high rate of failure to lose and keep weight off. Plus, it can cause weight cycling which is actually harmful to one’s health.)
Respectful Care
This refers to just plain and simple respecting the individual who comes in for care. That means eliminating weight bias in treatment. It means, not using someone’s weight as the central piece of information about their well being.
Additionally, all medical recommendations need to happen based on informed consent – meaning the patient knows all the risks of a medical recommendation. For instance, if a doctor prescribes weight loss surgery, the patient needs to know there is a high rate of failure for that surgery and that there are lots of long term irreversible consequences.
Eating for Well-Being
Everybody can eat for well-being and engage in a version of intuitive eating. This principle promotes flexible eating based on hunger cues and other reasons, rather than eating (or not eating) for weight loss.
Life-Enhancing Movement
Everybody can engage in joyful, health-promoting movement, no matter their size.
Finding a HAES-Aligned Doctor
If you get one thing from this post, Health at Every Size is NOT healthy at every size. It’s a framework for access to healthcare, and saying everyone has a right to pursue “health.” It states health is not necessarily correlated with a person’s size.
This is why it’s so important to find a HAES-aligned doctor. We all know that when we go to the doctor, they’ll weigh you, make recommendations based on your weight, and will tell you to lose weight if you’re not in the middle of the BMI chart.
But for people who are in larger bodies, that’s the entirety of their medical experience, and that’s just terrible. When that happens, people stop going to the doctor. They miss routine checkups, and people die as a result.
We need to improve our HAES education and our medical education, so people are treated for their medical conditions and NOT for their weight. This doesn’t mean weight doesn’t matter. Weight is most important as a metric to let us know when other testing should be done (meaning, if it has been fluctuating greatly) – and nothing more than that.
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Tweetable Quotes
“Health at Every Size is not at all suggesting that somebody is healthy at every size.” – Rachelle Heinemann
“Health at Every Size is a framework about access to healthcare for everybody.” – Rachelle Heinemann
“Health is something that everybody on this earth gets to pursue.” – Rachelle Heinemann
“A lot of people don’t go to doctors because they’re expecting their doctor to say ‘lose weight,’ which is totally unhelpful… they miss routine checkups, and people die.” – Rachelle Heinemann
Resources
Understanding Disorder Eating podcast episodes:
45. The Basics of Intuitive Eating
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