5 Principles of Health at Every Size

Did you know that people in larger bodies often do not receive the same quality of health care compared to people in thin bodies? Read on to learn more about the “Health at Every Size” movement which is aimed at improving health care and quality of life for people of all sizes.  

Much of mainstream medical care uses a weight-centered approach (weight-centered care). With this type of approach, providers mostly focus on a patient’s body weight. When health care is focused on body weight, other things that contribute to overall health are overlooked. This type of approach can create fear around going to the doctor. In fact, the larger a person is, the less likely they are to seek medical services [1].  

A weight-centered approach can be harmful for those in larger bodies. Often, the health concerns of larger patients are not taken seriously because providers focus more on recommending weight loss. This can be especially true even when a patient’s health concerns have nothing to do with weight. A patient may have a serious medical condition such as hypothyroidism (underactive thyroid), that goes untreated, leading to negative health problems.  

A weight-centered approach is also harmful because it can make patients feel judged and/or shamed for their body size. This too can lead to negative health problems. Feeling shamed and/or judged may cause people to avoid or delay health care appointments. This can include preventive health care screenings and/or routine bloodwork. Some conditions such as diabetes or heart disease can be more difficult to treat if they are diagnosed at a later stage.       

There is a better way to approach medical care for larger bodied folks. Health at Every Size (HAES) is an approach that removes the focus on weight. Instead, providers encourage people to improve their health, regardless of their body size. Providers who practice HAES offer care that is effective, but also respectful and accepting of body shape, no matter the size.  

There are five main principles that make up the core of HAES [2]. When you see a HAES provider, you can expect that their medical care will be guided by the principles below.   

1. Weight Inclusivity

Providers are accepting and respectful of the natural differences of body shapes and sizes. They will reject the preference for specific body weights and sizes. They will reject body shaming.   

2. Health Enhancement

Providers will support health policies that work to improve access to health information and services for all individuals.  

3. Eating Well for Being

Providers will encourage a way of eating that is flexible and focuses on nourishment and individual needs.  

4. Respectful Care

Providers recognize their own individual biases and work to end weight discrimination, stigma, and bias.  

5. Joyful Movement

Providers will support exercise that allow people of all sizes and abilities to choose movement that is enjoyable to them. 

These principles help to provide the best possible care for all people, no matter the size or shape of their body. Removing focus on body weight in medical care will help to improve the quality of care for all people. It helps to make all people feel comfortable to get medical care when they need it. The change that HAES is creating is one that will continue to improve the health of many people for years to come.  

There are multiple providers within the Bastyr Center for Natural Health and Bastyr University Clinic who utilize a HAES approach. If you feel that seeing one of them might be a good fit for you, schedule an appointment with us. 

Brittany Hovsepian is a current Bastyr University dietetic intern with a deep passion for helping others cultivate a peaceful relationship with food and body. She is an advocate for Health at Every Size and Intuitive Eating and intends to utilize these modalities in her future practice.  

Citations

1. Alberga AS, Edache IY, Forhan M, Russell-Mayhew S. Weight bias and Health Care Utilization: A scoping review. Primary health care research & development. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6650789/. Published July 22, 2019. Accessed November 6, 2021.  

2. The health at every size® (HAES®) approach. ASDAH. https://asdah.org/health-at-every-size-haes-approach/. Published May 2, 2021. Accessed November 6, 2021.  

3. Bacon L. Health at Every Size: The Surprising Truth about Your Weight. Dallas: BenBella Books; 2010. 

4. Bacon L, Aphramor L. Body Respect. USA: Ben Bella; 2014.