T here are many harmful stereotypes about larger bodied individuals, this is also referred to as weight stigma or weight bias.
This focus on weight and body size, and discrimination based on body size, is rampant in our households/families, schools, stores, sport teams, and even in the healthcare system where body-mass-index (BMI) is used to label people as “underweight”, “normal weight,” “overweight” or “obese”. BMI is a terribly outdated tool from the 1800s and doesn’t tell us anything about an individual’s health status. The belief that anyone larger bodied should work towards shrinking their body to achieve health or to heal anything that ails them is extremely flawed and causes significant harm. Unfortunately, this implicit bias results in health care professionals treating patients differently based on their body size.
Many health care practitioners are identifying the harm caused by the weight-focused approach to healthcare and are shifting to a Health at Every Size® (HAES®) approach to care. The HAES® approach shifts the focus away from weight and body size to a more inclusive view of health, which will vary greatly from person to person. It emphasizes that every person has the right to pursue health (if they want) in ways that work for them and their life, regardless of their body size.
HAES® practitioners work with individuals to promote health-supporting practices and behaviours, while taking into consideration their lifestyle, goals, medical and psychological history, genetics, socioeconomic status, culture, access to care, and more. A common misconception is that the HAES® approach means that everyone is Healthy at every size, but it's important to note that health and weight have very little to do with one another.
Health At Every Size® is a social justice movement that encompasses 5 key principles. These principles were originally developed by the Association for Size Diversity and Health in 2003. Keep reading to learn about the 5 Principles of HAES®.
1. Weight Inclusivity
It is important to accept and respect that it is normal for bodies to come in different shapes and sizes. Just like we aren't all the same height or have the same shoe size, we should also see a wide range of body sizes. This approach emphasizes that all individuals should receive the same quality of care, and not have their body size or weight deemed as unhealthy or a problem.
2. Health Enhancement
Sometimes we forget that our health is a complex network of physical, mental, social, emotional, spiritual, cultural, and economic factors. We can miss out on many health-promoting opportunities when we only focus on numbers and measurements. The HAES® approach emphasizes that people of all sizes can pursue health-supporting behaviours such as balanced eating, enjoyable movement, and self-care, if they want to. Our care providers should also provide these recommendations in a way that works best for them in their life, taking into consideration all of their needs. This network approach of health provides an opportunity to incorporate a variety of practices beyond those that target weight and body size.
3. Respectful Care
Larger-bodied people are more likely to face challenges accessing the same treatments that are given to smaller-bodied people. These individuals often put off accessing health care because they have experienced shame and judgement from professionals who are supposed to be helping them, which can result in a worsening of their overall health. The HAES® approach believes that all bodies are worthy of respect, and body size should not influence the quality of care they are given. HAES® practitioners should work to reduce barriers to achieving health, such as experiencing discrimination.
To be treated with respect, care providers must consider the ways an individual's social identities impact the way they live in this world and experience weight bias. When a health provider considers the whole individual and values their experiences, they are more likely to feel safe, supported, and ready to face new challenges and reach their personal health goals.
Examples of Social Identities:
4. Eating for Wellbeing
To promote a positive relationship with food, it's important to give yourself the freedom to eat foods that you enjoy and that make you feel your best, in both your body (nutritionally) and your mind (satisfaction, pleasure, emotional relationship with food). Eating for health should not require the strict food rules and restrictions that come with dieting. In other words, eating for wellbeing is a mindset that understands that everyone’s nutritional needs are unique and can look different from person to person. There is no “perfect” or universally “good” diet.
5. Life-enhancing movement
Exercise is reframed as activities that you enjoy doing and that meets your individual abilities, interests, and routines. Rather than being prescribed a strict exercise regimen, HAES® promotes movement that allows people of all sizes to explore ways of moving that bring them joy.
Science shows us that weight-loss strategies are often more harmful than helpful. Diets and weight-loss endeavours do not work long-term, and we actually have much less control over our body size than we are led to believe. Thankfully, the 5 HAES Principles give us a framework to improve our health through realistic, achievable, and enjoyable behaviours in a way that invites everybody to participate.
Written by Mackenzie Tarasoff, Natalie Hamilton, Martin Chan, Melanie Liu, and Liz Powell, RD