Health at Every Size is not a new diet.

by Michelle

I would like to state that I am firmly in favour of Health at Every Size. I am a healthcare practitioner and student of nutrition, so that I find HAES an interesting and attractive concept should come as no surprise. That is my bias, as a healthcare nerd.

But I would also like to make it clear that I believe fat acceptance and the rights of fat people are in NO WAY contigent on believing in, agreeing with, or practicing Health at Every Size.

IN NO WAY.

Quick fat history moment:

I think it is very important that as a movement we do NOT adopt elitist attitudes which tend to weed out the very people most in need of what we claim to support. It is one thing to have as our goal the right of every person, regardless of size, to have access to the resources to become more physically fit. It is quite another to base the acquisition of our civil rights, individually or as a community, on being or becoming “fit”. To do this would be healthist.”

Karen Stimson, 1983

Fat acceptance has been wrangling with this issue for a while now. However. I do think that, commonly, people who are uncomfortable with the idea of Health at Every Size, are likely uncomfortable due to a misunderstanding of one sort or another.

The misunderstandings are various, but include:

1) the definition of “health” itself — there actually isn’t an official, universally agreed-upon one, and I believe a fundamental aspect of HAES philosophy is to try to create a newer, more inclusive, more compassionate definition of health

2) the fear that HAES must be classist in its practical requirements (it doesn’t; I am dreadfully poor and would never be able to claim a HAES badge if I had to do certain things like join a gym or buy special foods)

3) the assumption that a certain eating style (most often classical ‘demand feeding’ or the newer concept of ‘intuitive eating’) is absolutely required

4) the assumption that a certain type or amount of exercise is absolutely required

5) the assumption that, if you have a limiting or pre-existing health condition of some sort, you are excluded from practicing HAES (most people I know who are HAES-boosters actually have fairly limiting health issues, myself included, in that I have a history of disordered eating which precludes me from practicing demand-feeding, and including my very good friend, aerobics enthusiast, and extreme heroine of all situations, Dee, who has a serious physical injury.)

In my opinion, the behaviours of HAES are much less important than the intentions and beliefs behind those behaviours. The behaviours are simply tools, and there are a plethora from which to choose. Many of those tools have been totally co-opted by the weight-loss establishment, and so have taken on a pungent flavour of negativity and neuroticism — but, if sincerely divorced from the context of weight control, I really believe some or all of them could be adapted and put to good use.

So, in rough format, the essential beliefs of HAES are as follows:

1) You are fat accepting — both of yourself and others. You may not be perfect at it, but you make an effort to be aware of your own biases and to challenge them, both in regard to yourself and other people. You value size diversity.

2) In view of item 1, you are therefore not making any intentional attempts to lose weight. There are situations in which a person might need to purposely try to gain weight (cancer, recovery from an eating disorder, post-surgery, etc.), and I do think this can be done within a HAES framework. But weight loss cannot be intentionally pursued within HAES. If weight loss happens (and it might), it only happens incidentally — NOT intentionally.

3) You are interested, within whatever physical or mental limitations you may have, in pursuing “health” — using a definition of health that means something like “the ability to live a meaningful life, balancing optimal physical functioning with optimal mental and emotional functioning, within whatever inevitable health challenges I will, at some point, have to face.” (I believe Jon Robison has a similar philosophy — “Health can be redefined as the manner in which we live well despite our inescapable illnesses, disabilities, and trauma.”)

It should go without saying that, if #3 does not apply to you, and if you are not at all interested in considering health, no matter what definition is used, then that is your entirely legitimate choice, and you are still eligible to have human rights, and to be involved in fat acceptance, and everything else. For many people, health is simply not something they are interested in thinking about, period. I was that way myself for many years, before I was clotheslined by a love of nutrition, and I can entirely understand and respect that choice.

But, if you sincerely believe in the above, and are not fooling yourself (and this can get tricky) about being on some kind of “HAES lifestyle plan” in order to lose weight — then I don’t really care what tools you use to help you eat and move in ways that work best for you, and that give you the best quality of life, whatever your limitations may be.

If you are diabetic, you may count carbohydrates. Even though this smacks of some kind of Atkins-style ridiculousness to the average fat activist, it is a legitimate tool for some people. If you never end up finding your hunger and satiety signals (and it can happen! It is hard to find them, especially if you’ve dieted for years!) and feel most comfortable using some method to estimate an intake that allows you to function physically without driving you crazy, mentally — then I don’t care. Only YOU can know what your true intentions are. Only you can decide whether you are interested in HAES, and whether or not you “qualify,” based on your sincere beliefs and intentions. Behaviours are, largely, irrelevant.

Everyone is limited, physically or mentally, to a certain extent. HAES must work within those limitations. And because humans come in all shades of disease — from Crohn’s, to diabetes, to cancer and chemotherapy, to eating disorders, to fibromyalgia — there is no tool that can be definitively excluded from being used within HAES.

But ANY tool, no matter how innocuous and HAES-friendly it seems, if used to flagellate yourself, becomes instantly outré. Even intuitive eating. Even yoga. Even anything, if done with the slightest shade of self-hatred.

I would rather someone count calories while truly believing in fat acceptance and HAES, than practice intuitive eating in the secret hope that they will lose weight, or in competition with someone they look up to as a perfect disciple of HAES, and beat themselves up when they ‘fail.’

HAES is a paradigm shift, not simply a new diet. Without the underlying beliefs, the behaviours alone are meaningless.