by Fall Ferguson, JD, MA, President, Association for Size Diversity and Health
I began contributing to this blog before I became the President of ASDAH. Since then, I have considered it important to write as “just me” rather than from the point of view of an official of an organization. While this post is not an official ASDAH statement and all points of view remain my own, I am breaking my own rule today and writing explicitly as ASDAH’s president for what I believe to be an excellent reason: the announcement of the first revision of ASDAH’s Health At Every Size® Principles in the organization’s 10-year history.
After 10 years of existence, ASDAH has become more diverse and complex as a community of professionals, practitioners, activists, and researchers. Over time, through observation as well as feedback from members and others, we have learned much about what has worked to get our approach to health out to the broader public and where the concepts still fell short in comprehensiveness and inclusiveness.
ASDAH’s HAES Principles do not constitute the only formulation of the HAES approach, but they do, in large part, define who we are as an organization. Moreover, because ASDAH is a significant voice in the larger size acceptance and HAES-positive communities, the influence of our HAES Principles extends beyond our own organizational purposes. Thus, it is important, both for ASDAH’s organizational integrity and for our communities, that our HAES Principles reflect the best possible formulation of the values and ideals that comprise the HAES approach.
Why a Revision Now?
In 2013, we marked our 10-year anniversary as an organization. It has been a time to reflect upon many things, including the HAES Principles. The core ideas of ASDAH’s Principles as they were first written remains sound, affirming body diversity, the multi-dimensionality of health, a basic health promotion approach, and individualized eating and movement practices for health and well-being rather than in the pursuit of weight loss.
However, the public health landscape has changed in the past ten years. Healthism, intersectionality, and social justice have emerged as important critical perspectives—perspectives of concern to all who seek to bring about a genuine reform to our broken health system. We began to realize that our silence on these issues could be interpreted as contributing to such challenges as healthism, ableism, cultural imperialism, and the social determinants of health.
Accordingly, the ASDAH Leadership Team decided in early 2013 to review and revise the ASDAH HAES Principles. A task force convened at our educational conference in June, 2013, and after the conference, all members were invited to join them. That group’s draft of the new principles was then reviewed by ASDAH’s Weight Stigma and Intersectionality Task Forces. These groups provided ideas and language they felt would be important to incorporate in the updated principles.
Once the input from these project teams was gathered, ASDAH’s Internal Policy Committee (IPC) —along with myself—merged the various components provided by the three task forces into one document. We gave our proposal to the ASDAH Leadership Team (comprised of the 2013-14 elected Board of Directors as well as the current committee chairs), who discussed, edited, and revised as needed. The newly updated Health At Every Size Principles are the final result of this process. I am profoundly grateful to all who participated in the process, for their time and thoughtful consideration along every step of the way. I believe that this document reflects the current thinking of our membership. Even as I write this, there are at least two different threads talking about the social determinants of health on the ASDAH listserv.
I am always proud to be the President of ASDAH, but especially so today, as I have the pleasure of announcing the release of our new Health At Every Size Principles. I believe that with this revision, we bring more breadth, more depth, and a greater inclusiveness to the HAES approach than in any previous articulation. The two paragraphs of the preamble frame the context for the new principles, which must be considered in light of the preamble and each other, not separately. The revised HAES Principles are now available on the ASDAH website and are also reprinted at the end of this post.
I look forward to hearing everyone’s reactions to the new principles. One thing is true—these new principles are longer and more complex than the previous version. In my opinion, that complexity is necessary in order to reflect the complexity of the social, cultural, and political context for the HAES approach. It’s important to speak out and affirm the importance of social connection, social justice, and community. It’s important to speak out and acknowledge that effective and equitable individual and community choices about health will be made by the individuals and communities in question rather than by health “experts.” It’s important to speak out and recognize that all such choices about health occur against a backdrop of health inequities, stigma, and lack of access.
That being said, this new formulation of the HAES approach isn’t appropriate for every situation. When ASDAH creates flyers and position statements to distribute at a variety of venues—from “obesity conferences” to HAES-positive gatherings and everything in between—we tailor the message to the audience, using the HAES Principles as the touchstone but not always reprinting them verbatim. Amy Herskowitz, ASDAH’s International Vice President, was on the HAES Principles task force and also serves on the IPC and ASDAH’s Leadership Team. Thus, she was present for more of the revision process than anyone, and captures the aspirational nature of the updated document with her comments:
“The wording of the revised principles lends itself to a specific audience, but then I think that ASDAH is a professional organization and these principles are not expected to be used as directives for how each member espouses or explains the Health At Every Size® philosophy to others. They’re principles and therefore, explainable, adjustable, and adaptable to our varying audiences. These new principles contain so much more richness than the previous version and include concepts we all hold dear but haven’t explicitly addressed before, like social justice, weight stigma, and individual and community well-being.”
Dr. Deb Burgard, one of the acknowledged founders of the Health At Every Size movement, was on the Intersectionality task force and provided input during the revision process, so she had seen an earlier draft. I recently shared the final version with her and asked if she wanted to provide a comment for this post. I close by reprinting Deb’s words here, as they convey more than anything the important idea that this revision of ASDAH’s HAES Principles reflects an ongoing dialogue with ourselves and others:
“I am grateful for the explicit origin story that gives context to why the HAES model is about “health” at all, especially given the way “health” is so burdened with moral smugness these days. I am grateful for the explicit invitation for ongoing revision in light of the lived experiences of many other groups of people who have had limited access to HAES so far—the HAES model is not owned by the limited group of people who have conceptualized it thus far. I am grateful for a beginning acknowledgement that our connections with each other are integral to our well-being and often overlooked in the “food and exercise” focus. I am grateful for a beginning acknowledgement that the structural inequalities of our world impact our well-being and need to be addressed in any model of human health. I am grateful for the new focus on our own responsibility as healthcare workers to own and challenge our weight biases. I feel like our little model is out in the real world and growing up.”