The Association for Size Diversity and Health or ASDAH has developed and promoted the Health At Every Size or HAES approach as a central element of its advocacy to end discrimination and stigma related to weight, lessen the cultural obsession with weight loss and thinness, and promote acceptance of diverse weights and sizes.
Originally developed in 2003 and revised in 2013, the HAES approach has become both a social justice movement and a weight-inclusive approach to health, thus offering a new paradigm in weight management science.
It challenges the conventional assertions that correlate specific ranges of weight with both physical and mental health outcomes. Thus, in promoting further this approach, ASDAH has identified and defined its five principles.
HAES Basics: The Five Principles of Health At Every Size
Below are the five principles of HAES taken from the official website of the Association for Size Diversity and Health:
1. Weight Inclusivity
Accept and respect the inherent diversity of body shapes and sizes and reject the idealizing or pathologizing of specific weights.
2. Health Enhancement
Support health policies that improve and equalize access to information and services, and personal practices that improve human well-being, including attention to individual physical, economic, social, spiritual, emotional, and other needs.
3. Respectful Care
Acknowledge our biases, and work to end weight discrimination, weight stigma, and weight bias. Provide information and services from an understanding that socio-economic status, race, gender, sexual orientation, age, and other identities impact weight stigma, and support environments that address these inequities.
4. Eating for Well-being
Promote flexible, individualized eating based on hunger, satiety, nutritional needs, and pleasure, rather than any externally regulated eating plan focused on weight control.
5. Life-Enhancing Movement
Support physical activities that allow people of all sizes, abilities, and interests to engage in enjoyable movement, to the degree that they choose.
Studies: Current Research on the Applicability of HAES
Several studies in the fields of weight management and public health have started to explore the applications, especially the values and effectiveness of Health At Every Size approach.
For starters, a review paper by Tarra L. Penney and Sara F. L. Kirk noted that HAES is a weight-neutral, public health approach that could be used to address obesity and related chronic diseases. However, the researchers noted that uncovering and realizing the values of this approach would require advancing further the understanding about it, particularly by conducting empirical studies across a range of population.
Another review by Linda Bacon and Lucy Aphramor evaluated the evidence for a paradigm shift in weight science. They explained that conventional guidelines for weight loss that centered on lifestyle modification involving diet, exercise, and other behavior change are not effective in long-term weight loss and improving morbidity and mortality.
On the other hand, the review also mentioned how randomized controlled clinical trials indicated the positive association of the HAES approach with statistically and clinically relevant improvements in physiological measures, health behaviors, and psychosocial outcomes.
Bacon and Aphramor concluded that the new paradigm had achieved better health outcomes than conventional weight loss approaches revolving around diet modification and exercise or physical activity programs.
FURTHER READINGS AND REFERENCES
- Association for Size Diversity and Health. 2019. “HAES Principles.” Association for Size Diversity and Health. Available online
- Bacon, L. and Aphramor, L. 2011. “Weight Science: Evaluating the Evidence for a Paradigm Shift.” Nutrition Journal. 10(9). DOI: 10.1186/1475-2891-10-9
- Penney, T. L. and Kirk, S. F. L. 2015. “The Health At Every Size paradigm and obesity: Missing empirical evidence may help push the reframing obesity debate forward.” American Journal of Public Health. 105(5): e38-e42. DOI: 10.2105/AJPH.2015.302552