By Erika Bettermann, nutrition graduate student in the Coordinated Program
Women and men are inundated with messages about the ideal body, how to dress and how to look. Women and girls, especially, receive these messages both passively–from society and social media – and actively – through hearing, discussing, and propagating. The internalization of these messages leads to weight-based oppression, which negatively impacts quality of life, perceived health, relationships with food and increases risk for dementia, hypertension, diabetes, and stress just to name a few. It is not just the media that have contributed to this stigmatization. The medical world has performed countless interventions to improve individuals’ health by combating obesity and losing weight. However, many of these studies show weight regain of up to 30% - 40% of the initial lost weight within a year. The poor long-term results of weight-loss interventions, in addition to the weight stigma that grows from such disdain for obesity, calls for a more effective and humane method to addressing weight.
What is Health at Every Size?
Health at Every Size (HAES) stems from the rejection of the ideology that weight, body size or body mass index (BMI) is a proxy for health and that higher body weight results from only personal choices. It supports the evidence that while there are correlations between high weight and various health problems, other factors contributing to higher weight have an even stronger correlation with poor health, such as genetic variability, food access and social class. HAES recommends that we encourage body acceptance, support intuitive eating and support active embodiment – exercising for enjoyment rather than feeling the need to do so.
HAES promotes body positivity
A study of college-aged Arabic women evaluated the HAES approach through four brief body-positivity activities called Love Your Body that took participants only 10-15 minutes to complete. An example of such activities includes a Yay!ScaleTM, in which numbers on the scale were replaced with positive affirmations such as amazing, beautiful or glorious. The purpose of this approach was to see the impact of the HAES approach on thoughts of body weight and body appreciation over a short period, regardless of the individual’s body weight. In the 38 women who participated, body appreciation and self-reflection on body acceptance significantly improved. Although this was a brief and small study, it shows that promoting HAES leads to a more positive body image and reduced weight-based stigma.
What’s the problem with HAES?
The Love Your Body study was small and conducted in one just school. The small sample size is common among most HAES studies. Additionally, most HAES studies include normal weight (BMI 18.5-24.9), overweight (BMI 25-29.9) or class I (BMI 30-34.9) obese individuals, and not those who are morbidly obese (BMI 35+), a class of obesity which is growing at an alarming rate. HAES studies also do not consider the importance of modest weight reduction in improving health. Finally, studies that address obesity require resources, time and money. Those resources are available because obesity is a chronic disease, that allows such studies to happen. Some argue that acceptancing the HAES approach may lead to obesity no longer being classified as a disease.
Is Health at Every Size really healthy?
In short, yes. HAES has proven to reduce weight-based stigma regardless of an individual’s body weight or weight history. Men and women of any size are susceptible to harmful messages about body image and can benefit from improved body acceptance. However, studies that have been conducted require resources, time and money, which may not be translatable in some community settings. Therefore, it is important to place strong emphasis on reducing weight stigma, encouraging body acceptance and supporting intuitive eating and exercise so that more funds may be allocated.