Contributor: Andrew Walen, LCSW-C, LICSW, CEDS, Founder and Executive Director of The Body Image Therapy Center
If you have not heard of Health at Every Size (HAES), you’re not alone. It is a relatively new concept with early writings dating back less than 20 years. Simply put, HAES proposes that individuals: (1) encourage body acceptance; (2) support intuitive eating; (3) support joyful movement. Who can argue with that?
Why Health at Every Size?
Those who suffer from eating disorders are typically struggling with a fixation on weight or a desire to control and manipulate their body shape, size, musculature, and definition. From those struggling with severe restriction to compulsive binge episodes and everything in between, negative self-judgment for not measuring up is at the core.
And the keyword here is measuring. HAES approaches health from a weight-neutral standpoint. Stop weighing yourself! Your body is not valued based on your interrelationship with Earth’s gravity!
But it’s more than that. Health at Every Size is a social justice movement. Individuals who carry large amounts of adipose tissue have historically been subjected to prejudices, including the assumption of being unintelligent, lazy, dependent, ineffectual, poor, and undisciplined. The results in childhood include bullying, abuse, neglect, less social inclusion, depression, anxiety, and suicidality.
In adults, it leads to lower pay, lowered chances of being hired, getting passed over for promotion, negligent health care, abuse, neglect, bullying, substance use, depression, anxiety, and suicidality. For those who are non-white, those issues are made even worse with the addition of racial prejudice.
The goal of Health at Every Size is not just to help with body positivity and acceptance, but to help educate providers to challenge their internal beliefs about fat. These include:
- Fat poses a significant risk to health and increases the likelihood of early death
- Weight loss will fix those issues
- Anyone who is determined can lose weight and keep it off through diet and exercise
- The pursuit of weight loss is a doable and healthy goal
- The only way for “people living with obesity” to improve their health is through weight loss
- “Obesity-related” medical care costs are a burden on the economic and health system.
How Society Has Changed Our View of Health
This is what eating disorder professionals hear all the time from clients too. They believe the same information because the media, their doctors, and everyone around them has been taught the same thing.
But here’s the rub – the evidence doesn’t bear this out. Weight loss for the sole purpose of weight loss is practically never sustainable.
Weight loss by restriction of calories leads to a correlating response from the body to increase thoughts about food, increase hunger cues, slow the metabolism so more and more restriction of calories and discharge of energy is required to achieve lesser and lesser results, and ultimately both physical and mental health breakdowns occur. Where is the health here?
For anyone who comes into treatment for an eating disorder, unlearning these outdated ideas about weight loss is a necessary part of treatment. This goes for large-bodied individuals and emaciated-bodied folks.
Health is not about the number on the scale. It is determined by a complex series of behaviors that address physical, emotional, and social wellness. And each person has to be able to define it in ways that are reasonably attainable for them.
For those who follow HAES, that includes accepting the body you have, not the one you wished you had. It means doing the things that help you feel strong and have energy. And it means finding joy in movement.
Yes, Health at Every Size does suggest that health involves metabolic and cardiac health. It means taking your blood pressure pills and cholesterol pills if that’s what keeps you alive.
When you are eating intuitively and moving your body, your body may get smaller to some degree, it may stay the same, and it might even get bigger. That’s reality. Living a happy and healthy life doesn’t require perfect health and the perfect body.
You are in charge of choosing to live in the real world or the fantasy one that many medical providers are stuck in, and the weight loss and muscle growth industries peddle in. HAES is there as an option and is a home for every body.
The Body Image Therapy Center in Columbia is a full-service eating disorders treatment program treating both the eating disorder behaviors and underlying causes such as depression, anxiety, trauma, and neglect. Our goal is to help our clients reach full and sustained remission with a comprehensive team approach including therapists, dietitians, and psychiatric and medical services.
About the Author:
Andrew Walen, LCSW-C, LICSW, CEDS, is the founder and Executive Director of The Body Image Therapy Center in Maryland, and D.C. He is a Certified Eating Disorder Specialist, psychotherapist, author, speaker, and advocate in the eating disorders field, with expertise in males with eating disorders.
Andrew is the immediate past-President of the National Association for Males with Eating Disorders (NAMED), which merged with the National Eating Disorders Association (NEDA) in November 2019. He currently serves as NEDA’s Senior Advisor on Males with Eating Disorders. He is also a past founding board member of the Binge Eating Disorder Association (BEDA). He has appeared on The Today Show, was featured in The New York Times, USA Today, Men’s Health, and many other national and local media outlets as an expert in the field of eating disorders and body image. In addition, he has authored numerous articles and presented workshops at national and international eating disorder conferences. His book Man Up to Eating Disorders, which is a memoir and self-help book directed at males with eating disorders, was published May 2014.
Andrew is a magna cum laude graduate of the University of Tennessee College of Social Work in Nashville. He also graduated from the Berklee College of Music and is a published singer/songwriter/multi-
The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Published February 1, 2021, on EatingDisorderHope.com
Reviewed & Approved on February 1, 2021, by Jacquelyn Ekern MS, LPC