Health at Every Size®, A Series Part 1: 4 Reasons to Adopt a HAES Philosophy
What is HAES?
HAES stands for Health At Every Size®, an evidence-based approach towards healthcare that focuses on health-promoting behaviors rather than intentional weight loss. At its core, HAES advocates that health is not defined by weight and that weight itself is not a behavior. It rejects the use of BMI (body mass index), weight, and size as metrics of health. The HAES philosophy views health as available and achievable to all, outside of the weight paradigm.
More broadly, HAES is also a social movement working to eliminate diet culture and size discrimination and to promote a more holistic view of health, encompassing not only physical but also social, emotional and spiritual health.
What’s the evidence?
Diets don’t work. Studies show that attempts to intentionally lose weight have demonstrated no consistent health benefits, including sustained weight loss. In fact, some research suggests that our endocrine systems actually prefer to regain weight. And even if it were true that weight loss positively affected health outcomes, up to two-thirds of people gain back more than the weight they initially lost.
Weight cycling can have harmful effects, both physical and mental. Weight cycling may increase the risk of diabetes, high blood pressure, high cholesterol, and heart disease. A recent study confirms these effects over a longer-term period. It may also have a detrimental effect on mental health, with higher rates of depression reported among chronic dieters.
The Body Mass Index (BMI) is extremely flawed. Fun fact: the BMI is a 200-year-old metric that was created by a mathematician to, in essence, help the government allocate resources. It does not account for bone density, muscle mass, or different body shapes, not to mention age, gender, race, or ethnicity. Yet it continues to be used by doctors as a means of diagnosis and by insurance companies as a way to charge higher premiums.
Health-promoting behaviors improve health outcomes regardless of weight status. Data do not support any causal link between weight status alone and disease. In fact, several large-scale studies have repeatedly found that “overweight” or “obese” individuals do not face any meaningful increased risk for early death except for at the statistical extremes, including those with very low BMIs. Additionally, studies (shown here and here) provide evidence that healthy habits such as improving cardiorespiratory fitness and avoiding smoking were associated with lower mortality, regardless of BMI. Another study even demonstrated that weight loss in otherwise healthy “obese” study participants actually led to increased mortality, noting that “prescribed weight loss as a target for all-cause mortality reduction… is a failed concept both in terms of evidence for benefit and in terms of implementation.”
Citations
https://asdah.org/health-at-every-size-haes-approach/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1681635/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3935663/
https://haeshealthsheets.com/why-we-dont-recommend-intentional-weight-loss/