by Daxle Collier
The question seems to come up frequently between Health At Every Size® (HAES) oriented health professionals: “What do you do when a client or patient tells you they want to lose weight?” It’s a loaded question. I want to outline some of the considerations I believe should go into answering this question, but first, my short answer is, “Ask them why they want to lose weight.”
It’s tempting to assume that since the desire to lose weight stems from the effects of living with weight stigma, the best course of action is to educate the client about the HAES principles and the research they are founded upon. While embracing HAES can ease some of the pain associated with living in a body shaming culture, it doesn’t magically erase the concerns of the client, or provide them with a clear path to their health goals.
A person may want to lose weight to gain the approval of another health professional, loved ones, or colleagues. They may be tired of moving through a world that was not designed to comfortably accommodate their body. They may be exasperated with the effects of weight stigma, and yet, as much as we may want to “save” them with HAES, they may be entirely resistant to adopting the HAES principles.
It’s important to note that the current HAES principles state that “Pursuing health is neither a moral imperative nor an individual obligation.” It may be implied, but I think we should expand upon this idea and say that adopting the HAES principles is also neither a moral imperative nor an individual obligation.
I didn’t come to this conclusion easily. When I get into a philosophy, I fall for it hard. I want to sing it from the rooftops and bully everyone around me until they agree with me. I sincerely believe that the world would be a better place if everyone adopted the HAES principles, and yet, I think we need to make room for people (our clients, in particular) to have opposing beliefs and desires without our belittling assumptions that if only they were more well educated, they’d see things our way.
I want to be absolutely clear that I am not talking about hiding the fact that you operate according to the HAES principles, especially not in hopes that you can trick a client into adopting the principles further into your professional relationship. That wouldn’t be ethical or effective. I am suggesting disclosing your philosophy from the very beginning, while still remaining open and non-judgmental about your client’s beliefs and desires.
HAES is broader than the choice of an individual to engage in behaviors such as intuitive eating, joyful movement, and/or body acceptance. The HAES principles include the arguably more potent social determinants of health and acknowledge that “Health should be conceived as a resource or capacity available to all regardless of health condition or ability level, and not as an outcome or objective of living.”
That said, the HAES principles can still be applied to the situation of health professionals who are supporting their clients in making individual choices towards the pursuit of greater wellness. Do we need our clients to adopt the HAES principles before we can help them define and pursue their own vision of health? I don’t think so. I think it is more ethical and compassionate to meet them where they are.
My coaching teacher, Linda Bark, teaches that the positioning of a coach should be next to and a little behind the client. The client is in the lead. I help my clients to see more clearly where they want to go, and to think through how they might get there. As much as possible, I avoid telling them what I think their goals should be or what steps I think they should take to achieve their goals.
I recognize that while I can support clients with things like healing their relationship with food, coping with stress, and finding ways of incorporating enjoyable movement into their lives, I can’t erase the reality that certain clothing sizes are harder to find in stores, or that airplane seats don’t accommodate the diverse range of bodies. While coping strategies and validation of feelings can help clients deal with these types of difficult situations, the difficult situations still exist. We can’t blame our clients for wanting to avoid them.
I could not ethically or in good conscience support a client with the process of trying to lose weight, but I can empathize with their desire to lose weight, especially once I understand the roots of their desire. My experience tells me that it is much more powerful to sit with a client while they give voice to their pain than it is to try to convince them that trying to lose weight is hopeless.
As ASDAH members, our mission may be to educate others about the HAES principles, but as health professionals, our mission is to support our clients and patients in pursuing greater wellness. The HAES principles provide us an excellent framework from which we may do our work, but it is our clients who must take the lead.
Daxle Collier is a health coach, educator, and certified intuitive eating counselor. She offers one-on-one remote health coaching, online courses through Udemy, and local workshops in Oakland, CA. She is currently serving as secretary on ASDAH’s board of directors, and is a member of the social media and public relations committee. Find out more at www.presentperfectwellness.com and www.haesworkshops.com.