What is Health At Every Size®?
Health at Every Size® (HAES) is a non-diet, client centered, weight free approach to healthcare. All medical and behavioral providers can provide care that is HAES® aligned. Despite getting more attention in the field today, HAES® is not a new movement and was in fact started and named in the 1960s.
In 2003 the first version of the HAES® principles was created based upon the framework of beliefs held for many years prior. The Association for Size Diversity and Health has trademarked HAES® and provides various HAES® resources such as the HAES® Health Sheets for the public. The principles were revised two more times. Once in 2013. And then again most recently in 2024.
The HAES® Principles serve as a guidepost for all providers in the work that we do with clients. You may see many registered dietitians (specifically those in the eating disorder field). As well as therapists, who describe themselves as HAES® aligned. This means that we as providers value a client centered approach that is not based in weight bias, fatphobia, or the significant colonial influence of our healthcare system.
HAES® Principles (taken directly from the ASDAH website):
1. Healthcare is a human right for people of all sizes, including those at the highest end of the size spectrum
2. Wellbeing, care, and healing are resources that are both collective and deeply personal
3. Care is fully provided only when free from anti-fat bias and offered with people of all sizes in mind
4. Health is a sociopolitical construct that reflects the values of society
In recent years 2022-2024 the ASDAH updated the HAES® Principles to now include the Health at Every Size® Framework of Care. These are key points that can help providers understand if the care they are providing is meeting HAES® standards.
Health at Every Size® Framework of Care
1. Grounding in Liberatory Frameworks
2. Patient Bodily Autonomy
3. Informed Consent
4. Compassionate Care
5. Skills and equipment to provide compassionate and comprehensive care for fat people’s bodies
6. Critical analysis, application, and execution of research and medical recommendations related to weight
7. Provider Roles and Responsibilities
8. Tools that support wellbeing and healing without contributing to oppression
9. Addressing Anti-Fat Bias
10. Addressing Systemic Anti-Fat Bias
Through the principles and the new framework of care it is evident that the best way to improve health and health outcomes is to eliminate oppression and oppressive modalities of care. This is why we say that eating disorders are social justice issues. Because oppression is at the core of healthcare when we focus on it from a thin, white, able-bodied perspective.
What does HAES® aligned care look like as a dietitian?
Here are a few things I focus on with clients (and do not focus on) in order to practice from a HAES® aligned perspective:
· Behaviors and feelings/relationship surrounding food instead of a number on the scale
· Vetting new provider referrals
· Acknowledging my privilege in the work that I do and how that can affect my clients who may not hold the privileges I do
· Continuing education regarding lived experiences outside of my own
· Avoiding making assumptions about my clients based on their bodies, cultures, identities, etc.
· Asking permission regarding discussing some vulnerable topics including weight and trauma (these things are asked about in order to learn more about an individual and their history, not to be used in a weight-centric way. This is also asked to all clients regardless of body size)
· Addressing my own anti-fat bias (because we all have explicit and implicit biases) and exploring how it can impact the care I provide
· Listening AND believing my clients
· Continuing to scream from the rooftops that BMI is BS and should no longer be used as a metric of health in the medical field as it was not designed for that purpose
For further information regarding HAES® and/or the ASDAH, please visit: https://asdah.org/haes/
More blogs to come with information surrounding HAES®, the new framework, myths, etc.
We’d Love to Hear From You!
Note to Self Nutrition LLC is an outpatient dietetics practice specializing in the treatment of eating disorders, women’s health and fertility including PCOS, endometriosis, and hormonal imbalances, diabetes and prediabetes, disordered eating, along with other chronic health conditions such as heart health, hypertension, and kidney disease. Owner and dietitian Lauren Hirschhorn-Tieu is passionate about empowering individuals to build trust with their relationship with food and their body. Lauren provides multiple services including nutritional counseling, recovery coaching, supervision and nutrition presentations. In person availability is offered in Denver. Virtual telehealth services are offered in Maryland, Virginia, Washington DC, Colorado, and Florida. We would be honored to join you on your journey to discovering food and body peace!
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