In a world that can sometimes feel a little too obsessed with weight loss and rigid dieting, Health at Every Size offers a refreshing paradigm shift that prioritizes individual health and well-being over arbitrary numbers on a scale. Embracing diversity and body acceptance, this empowering approach to nutrition and wellness challenges conventional diet culture by recognizing that health is not determined solely by body size but rather by nurturing a balance, holistic relationship with food, physical activity, and self-care.

That’s why Health at Every Size or HAES is one of the core philosophies that guide our Nutrition Programming at Western with registered dietitian Tad Taggart. Tad strives to implement the principles of Health at Every Size backed by the latest in nutritional science into his work with nutrition clients.

Before we dive into the Health at Every Size philosophy, take a look at some of our past Wellness Corner blogs to get an overview of some of the more insidious history and traps of diet culture, like the myth of the BMI, the body image trap, and setpoint theory.

Does weight loss equal health?

Imagine you do not currently exercise and eat very little fruits or vegetables. Imagine your diet is primarily foods you choose out of convenience and not so much out of health considerations.

Imagine you go to the doctor, and they point out that your health biometrics (blood pressure, cholesterol, blood sugar, etc.) are concerning and put you at risk of some scary health consequences.

As a result, the doctor suggests losing weight. Feeling motivated, you begin a new exercise and diet plan. You’re more active than you were before and find yourself eating many more fruits and vegetables. After several months of this, you find your weight is down several pounds. You return to the doctor, who shares that your biometrics have also improved.

With this mini-story in mind – consider a couple of questions:

1. Was it the weight loss that improved your health biometrics, or was it the diet and exercise changes?
2. If someone made the same changes but had no weight loss, would you predict that their biometrics would still improve?

The answers:

1. Diet and exercise changes are what improved your health biometrics.
2. Yes! Weight loss or weight gain is not inherently a measure of health!

What does this mean? Why share this incredibly common scenario? I share this because this sequence of events that happens to so many people is leading many, many individuals to false conclusions and faulty science.

This sequence of events where individuals are told to “lose weight for their health”, seek weight-loss behaviors, lose weight, and become healthier makes many believe that their weight is the operative factor in this equation. When in reality, it is the lifestyle changes that are making the real difference.

In other words, it’s not about the weight – It’s about what we think the weight means.

The weight loss myth

Many of us believe this:

Weight Loss = Healthier

But believing weight loss equals better health sets many people up for frustration and failure. For those that are “doing all the right things” but can’t seem to make weight budge, they believe they aren’t getting healthier. Or put another way, many people hold the assumption that getting healthier means there needs to be some weight loss attached. If we then hold this pattern to be true, the logical next step is to then operate on the reverse:

Weight Gain = Unhealthier

From this perspective, many people feel they are failing every time they step on the scale and see an increase. Regardless if they are staying consistent with new healthy behaviors, they believe they must be doing something wrong.

The issue is that there’s more to the formula, but our culture’s focus on certain body types (read: thinner) being considered “healthier” than others makes it hard for many of us to see past the numbers on the scale.

Think of the first scenario. Instead of Weight Loss = Healthier the formula actually looks like this:

Health-Giving Behaviors = Weight Loss AND Healthier

With this pattern, we can acknowledge that the middle “weight loss” piece just doesn’t always happen (to many people’s dismay). Regardless, we can reduce this pattern and find it still holds true (and is painfully logical, as well):

Health-Giving Behaviors = Healthier

This then brings us to the Health at Every Size framework for health. While there is much more complexity behind the HAES principles and framework, the foundation of the HAES message states that a person’s health cannot be determined by their size.

For many, weight is not a predictable path. For many, weight change is not as simple as “calories in, calories out”. There are many people out there believing that they are not “healthy” until they lose a certain amount of weight or fall within a certain classification of BMI, despite a healthy lifestyle and having objectively good health biomarkers and biometrics (e.g. blood pressure, blood sugar, etc.).

The HAES message basically states that you don’t have to wait until you weigh a certain amount to be considered healthy.

Health at Every Size myths and misunderstandings

In my experience working in the fitness world, the main arguments against the HAES model are founded on a misunderstanding of what HAES actually is and stands for. First and foremost, do not mistake “Health at Every Size” for “Healthy at Every Size”. That single “y” makes a huge difference.

HAES does not state that anyone and everyone is healthy, no matter the weight. Instead, HAES is suggesting that anyone can have the capacity to be healthy, no matter what size they are. There are plenty of individuals that could be considered objectively unhealthy at a variety of body sizes across the spectrum (here’s where you think about that one family member you have that eats nothing but fast food and never exercises but doesn’t seem to ever gain weight).

HAES aims to simply distinguish the fact that one’s health is not determined by their size but by their lifestyle and behaviors (as well as various environmental and biological factors that we can dive into more deeply in another Wellness Corner blog).

Another misinterpretation of HAES is the belief that it is a social justice movement. HAES is a model for care, or how individuals should be observed and treated by healthcare and fitness professionals.

While some of its messaging does coincide with social justice movements–both HAES and the body positivity movement emphasize inclusion, well-being, and respect–the HAES approach is focused on recognizing someone’s health status for factors not including weight. This means that as a doctor, nurse, personal trainer, dietitian, or any other provider, recommending weight change for the sake of “health” isn’t always justified and needs to be scrutinized more closely.

In other words, providers should be careful to cast aside inherent biases and be asking themselves, “Will weight loss or gain authentically make this person healthier? And if so, how?” Ascribing to the HAES principles means thinking outside the “weight-loss” box and seeing someone’s health and needs as a multifactorial issue and not something that can be solved with the cookie-cutter “weight-loss” prescription.

HAES ultimately is an effort to personalize care, whether it is a medical prescription or a fitness plan, to ensure that someone is truly getting healthier and not just on a lifelong journey of weight loss (that might never come or if it does, might not bring with it all the promises of health and happiness they think it will).

A dietitian’s perspective of Health at Every Size

So, what really is HAES, and how can it be used in a nutrition counseling setting? From the perspective of a fitness dietitian and personal trainer, HAES is a message encouraging everyone to pursue health and fitness, if you so choose, and do it without the looming dread, doubt, or fear that is caused by the belief that you must also start a diet or aim for weight loss.

HAES messaging means that the number on the scale doesn’t decide if you can be fit, healthy, happy, or confident. You get to decide that.

If you’re interested in learning more about Health at Every Size or talking with registered dietitian Tad Taggart, check out all of our Nutrition Services at Western today and see how Tad can help you start reaching your fitness and wellness goals.