Question

This week we will discuss the topic of energy balance. The CDC reports that obesity has reached epidemic levels and that we have basically lost the war on obesity. Something is wrong in our approach to healthy living, and we see that people can lose weight on diets but almost all regain the lost weight within 2-5 years. As a society, dieting is not working. There is a "counter-culture" movement that is gaining traction called HAES - Health At Every Size. Explore this new way of thinking about health as more than just a number on a scale.

Please respond to the following: What did you learn about HAES, and what do you think of the approach? Include in your post at least two positives to the concept and two concerns that you have on the concept?

Answer 1

HAES - HEALTH AT EVERY SIZE is a really helpful principle for advancement in social justice, creating an inclusive and respectful community and supporting people of all sizes to take care of themselves by finding compassionate ways.

Basic components of HAES includes :

• Respect- differences in size, age, race, ethnicity, gender, dis/ability, sexual orientation, religion, class, and other human attributes are respected
• Critical awareness - body knowledge and lived experiences are valued
• Compassionate self-care - honors internal cues of hunger, satiety, and appetite, while respecting the social conditions that frame eating options

The war on obesity is lost since, fighting fat hasn’t made the fat go away. And even if it is known how to become thinner, it is not permanent. It does not make us healthier or happier. Food and body preoccupation, self-hatred, eating disorders, discrimination, poor health, etc are the results of extensive collateral damage. Whether because we are fat or because we fear becoming fat, few of us are at peace with our bodies. Health at Every Size is the new peace movement that supports people of all sizes.Our social characteristics like size, race, origin, sexuality, gender, disability status and other attributes, are recognized as assets in this inclusive method. The structural and systemic forces that impinge on living well are acknowledged and challenged by this method.

This is a health-focused paradigm shift from weight-focused one. Key assumptions of traditional approaches to weight management are :

1. significant morbidity and mortality risk posed by adiposity

2. weight loss will prolong life

3. anyone who is determined can lose weight through appropriate diet and exercise

4. the only way to improve health for people living with obesity is to lose weight

5. obesity-related costs place a large burden on the economic and health system

HAES proposes alternatives to these challenges :

• encourage body acceptance
• support intuitive eating
• support active embodiment

HAES suggests to promote the development of a healthy lifestyle which is not limited to body weight or body composition. It also suggests that traditional approaches of dieting and restriction are not only ineffective but also physical, emotional, and spiritual distress makers. The failure of individuals in fighting obesity can make them feel that they are not normal or healthy.The concept of intuitive eating, which encourages an individual to respond to internal cues of hunger and satiety rather than external cues of specific meal times or events, is thought to prevent negative body image and disordered eating

Concerns

1. HAES approach alone can reduce weight stigma and bias at a population level is not clear.
2. HAES advocates doctors to stop taking patients’ weight at appointments. The solution is not for them to ignore the weight issue. It is for medical schools to update their curricula and prioritize human interactions.