the HAES files: how to tell if you are getting a diet-in-haes-clothing

by Health At Every Size® Blog

by Deb Burgard, PhD

Along with the increasing public recognition of the Health at Every Size® model, there is some confusion about what the HAES SMmodel is and is not.  Some discussions of the HAES approach are omitting or distorting aspects that are critical to its practitioners.  There are several renditions of the model’s tenets (listed at the end), but first I would like to offer some critical questions to ask when you see it being discussed in the media. 

If you can answer “yes” to these questions, you may be reading an inaccurate or at least incomplete presentation of the model. 

Does the account you are reading:

Perpetuate the Pursuit of Weight Loss, e.g.:

  • Promise weight loss?
  • Fail to recognize the harms for people of all sizes of the existing interventions for changing weight?
  • Create a new set of “rules” about how to eat?
  • Shame some aspect of our inner selves by trying to “get rid of it, starve it, cut it out, imprison it”?

Perpetuate Healthism, e.g.:

  • Present only fat people who are healthy as “poster children”?
  • Create a class of “Good Fatties” vs. “Bad Fatties”?
  • Collude with the notion that healthier people are morally better?
  • Fail to demand quality medical treatment for fat people with health challenges?
  • Fail to critique the moral corruptness of trying to eliminate health costs by eliminating people with health challenges?

Reduce the model to Individual Choices, leaving out the critique of Weight Stigma, e.g.:

  • Omit any reference to the environmental sources of ill health, especially weight stigma?
  • Fail to propose any policy or institutional solutions to the problem of weight stigma?
  • Propose that individuals solve the problem of institutionalized weight stigma and shaming by losing weight and leaving the stigmatized group?
  • Fail to connect the dots with weight loss efforts of people across the weight spectrum, including people who have disordered eating from the pursuit of weight loss?

Perpetuate the Misclassification of Diversity as Disease, e.g.:

  • Explicitly or implicitly condone the use of BMI categories to classify people?
  • View higher-weight people as “diseased” based solely on weight?
  • Attribute any health problems at higher weights to being at a higher weight, and fail to treat health problems regardless of weight?
  • Overlook the health problems or fail to consider the health status of lower-weight people?
  • Assume that thinner is healthier?

Perpetuate a Short-Term vs. Sustainability Focus, e.g.:

  • Present as a “makeover”?
  • Fail to incorporate the question of what is sustainable for unique individuals?
  • Focus on outcomes rather than the quality of day-to-day life?
  • Reduce the profound idea of body acceptance to the notion of “confidence”?

Perpetuate “Expertism,” e.g.

  • Fail to include the input from members of the community itself, especially members who are trying to change institutionalized weight stigma?
  • Place “expert” knowledge above people’s felt, embodied experience?
  • Propose a specific eating regimen for all people that fails to incorporate the individual’s physical and psychological experience of food and eating?
  • Fail to expose public policy and medical practice to the test of whether they themselves promote weight stigma?
  • Present a “one-size-fits-all” perspective that is closed to update and revision, especially to the lived experiences of the community members?

Perpetuate a War with the Body, e.g.:

  • Place more confidence in the mind’s ability to regulate eating and weight (ie “discipline”) than the body’s?
  • Label normal body processes as diseased?
  • Propose as “cure” the disruption of normal functioning of healthy organs?
  • Fail to appreciate the biological value of having some members of our species be fatter/more fuel-efficient?
  • Prescribe a particular body size that is not attainable through healthy living?

The people who have developed the Health at Every Size model have integrated decades of experimental and epidemiological research and clinical practice, as well as the lessons of many social justice and civil rights movements, to find a path that reconnects us with our bodies, our life purposes, and each other.  We ask that presentations of the HAES® model be as complete and nuanced as possible, and avoid the aforementioned pitfalls and mischaracterizations.

Additional sources of information on the HAES Tenets:

9 Comments to “the HAES files: how to tell if you are getting a diet-in-haes-clothing”

  1. Another informative and interesting blog. I appreciate what you do!
    Thanks

  2. Thank you for this clarification. As a vegan, I can tell you that when terms like ‘vegan’ and ‘HAES’ make it into the public consciousness, there is little to do with the distortion that goes along with it.

    I am HAES in my heart, but tracking my food at My Fitness Pal. I was happy to see a HAES group setting up there, though it feels a bit like setting up camp in the enemy’s territory. I am trying to eat vegan for health right now–the main focus is tracking things like sodium, fiber, iron, and protein to see how health-sustaining my food choices truly are. I am also following a calorie-restricted plan for myself because I almost didn’t qualify for private health insurance in October.

    I can rail against the formidable corporate and private forces that are demonizing people based at BMI. I hate that they are making me feel like I have no option but to lose weight, or suffer being uninsured or priced out of the market. I feel marginalized, defensive, shamed, and manipulated. It seems my stellar blood work, blood pressure and other indices of disease, which are widely thought to be associated with obesity, aren’t enough.

    I believe the aging baby boomer bump going into retirement is going to strain health care resources to the brink. When that happens, the witch hunt is likely to accelerate. And it’s still perfectly okay in this politically-correct world to judge, tar and feather people of size. I don’t want to be discouraging, or sound like I have totally ‘caved’ to the pressure, but the forces I feel upon me are worse than anytime in my 57 year experience being an overweight/obese woman. That’s how I feel, any way.

  3. Linda, you are not alone, and I agree with you that things are worse now than I have ever seen – even though they are also better now in terms of the consciousness of other approaches like HAES. But what is a person to do about weight stigma?? These are genuine dilemmas, not a bit trivial. Each of us has to decide what makes sense, the mixture of changing your culture and doing stereotype management.

    Experimenting with what kinds of food serve your body the best is a great investment under any circumstances. My advice is to make sure that whatever you try, you have a reasonable expectation that it will be sustainable. But of course that knowledge comes from trying stuff out. My best to you in your journey.

  4. Thanks, Deb. I have been a veg*n for ethical reasons since my teens. But, I am now 57, and want to lessen my chances of developing debilitating diseases. So, the veg*nism is totally sustainable for the long-term to me because it is a deeply felt ethic, not a fad diet. The tweaking of the particulars of my veg*n diet from a health-standpoint is a new endeavor within the last few years. It’s been a process of change. I certainly do not need to subsist on French fries, potato chips, tempura (well maybe?!?), veg*n cakes, pies and cookies. This is not treating my body–large or small–with honor and respect, in my opinion. I do listen to by body and/or mind when only a certain rich food will do, but I am trying not to make these foods mainstays.

    If I read HAES right, trying to get sane about food is what it’s about. I want to eat for optimal nutrition and stop binging on foods that trigger a jag of eating that makes me bloated and sad. I don’t know how successful my efforts will be. I am no stranger to the yo-yo phenomenon. I wish the pressure coming from gov’t campaigns and insurance companies would stop. I feel squeezed to make changes faster than it should be done.

    Regardless of whatever size I am, I want to advocate for HAES. Weight stigma is a horror that should never hurt this much. I want to be part of the solution, not part of the problem. I hope I am not using the label ‘HAES’ while being a poor representative. If you feel what I describe here is inconsistent with the HAES philosophy, feel free to tell me. I don’t want to be part of the confusion HAES will face with more adopters.

  5. Linda, I do not want to police people in their sincere efforts to work all this out – it is complicated enough! But I wrote this so people can understand the intentions behind the model. I also understand that this process of figuring out the kinds of fuel that are supportive to both your body and your other needs – for deliciousness, for satiety, for entertainment, for stimulation, for memory, for connection – is really challenging in our culture, where so many other issues get stuck to food. When you think about it, eating is pretty strange – we take this stuff that is not us, chew on it, swallow, and some of it becomes us. It is so intimate. Stripping it down and really being curious about your own experience is worth the time and effort – it grounds you in the face of all the crap out there that is about other agendas that have nothing to do with your own well-being. I wish I could snap my fingers and make those all go away. Instead, what I can do is remind us of the anchoring power of our own experiences of our precious, amazing bodies.

  6. Oh Deb, I so needed to read this right now. As a HAES Coach and student dietitian I am being constantly told that the only way I will ‘reach’ people is to talk in their language, as in weightloss etc. The whole rhetoric in dietetics is a struggle and is overwhelming at times. BUT I can’t, won’t and refuse to just fit in by towing the line and talking weightloss/obesity/diets. To me it will do nothing but confuse people more. Sure I might grow my business quicker and make lots of money or whatever but that isn’t my aim. My aim it to offer an alternative, to help people step out of the die-t merry-go-round and begin to connect back to themselves. It’s also about me being able to listen to those who are experiencing this and validating them. It’s about the whole body image issue. Healthism is another category that does my head in. The absolutes, the moralising, the attempt to feel superior due to food choices argh. I am so grateful for all the HAES community and the leaders in this field.

  7. Hi Kerry,

    So glad the post resonates with you! There will be lots of people who take the “promise weight loss” path – and so if you do not, you will be offering a genuine alternative. I feel strongly that, for myself, I want people to have informed consent about what I am offering and how it is not the promise of weight loss. If they are not a customer for what I am offering, that is perfectly fine, and I don’t want to waste either of our times; but I have seen that there are plenty of people who are tired of the old paradigm and for them, I think we need to be visible and unambiguous. So do what your values dictate and see if you can make a living that way – you will be a lot happier!

  8. Deb, what about the client side of the equation? I know many clinicians who are supportive of HAES, or would be supportive if their clients demanded HAES. More often, clients are demanding weight loss and really don’t care about health –they just want to be thin and nothing else matters to them. Is there any way for a HAES practitioner to work with a client locked into the old paradigm?

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