This primarily affects fat people because our current societal norms prioritizes and normalizes slender and thin bodies. Fatphobia has created an environment where even in health care, where we expect people of all ability levels and health statuses should be included, equipment, gowns, and seating is not designed for all bodies.

Most providers believe that fat people become fat through neglect of their health, that fat people are lazy, and that fat people are non-compliant with health recommendations. An area of research that has profoundly influenced the development of the Health at Every Size® Principles is the effectiveness of intentional weight loss.

Efforts to make fat people thin fail over and over. It causes harm. That risk increased with more weight lost and the group that lost over 22 pounds was at 3. Yet, many healthcare providers encourage weight loss for all fat patients despite this evidence. Some healthcare providers refuse to offer care like medication, referrals to physical therapy, and even deny surgery unless patients pursue and attain weight loss.

This unethical approach to healthcare may account for all of the health disparities seen in fat people, and body size may not have any direct effect on health. Health Enhancement covers a huge range of topics from health equity to the social determinants of health to community care to individual approaches to health.

One of the most important aspects of this principle is that one of, if not the, most important ways to improve health is by eliminating oppression. Fatphobia and weight bias are intimately connected to all other forms of oppression, especially racism.

The focus on weight and weight loss disproportionately impacts the health of fat Black people. Discrimination based on weight and size is incredibly prevalent in our current society. Fat people are less likely to be hired, more likely to be fired even when performance is good, and less likely to be promoted.

All of these areas of discrimination not only impact health through greater social isolation and creating additional barriers to healthcare through lack of insurance and less pay, they add to the overall stress of being oppressed allostatic load and contribute to poorer health and worse health outcomes.

Another area of research that supports this principle of Health at Every Size® is the evidence that for fat people who choose to pursue health-promoting behaviors, health improvement is possible without a focus on weight or weight loss.

One study compared risk of death by a number of healthy habits and by BMI. They found people who engaged in 2, 3, or 4 of the healthy habits had no significant difference in risk of death regardless of BMI status. So engaging in healthy habits has a greater effect on health than BMI.

The Health At Every Size® Principle Respectful Care seeks to address the weight bias fat people face when seeking healthcare.

The first, informed consent, is an approach to patient care that is trauma informed and supports the ethical provision of healthcare. Informed consent has two components, the first is consent, in which any procedure involving a patient requires their consent. The informed component highlights that consent cannot be given without a full understanding of the risks, possible outcomes, and what all is involved.

Weight loss recommendations and requirements are almost never given with informed consent. We provide education and resources to providers and patients on this to help eliminate weight bias, discrimination, and fatphobia in healthcare.

Lastly, the principles of Life-Enhancing Movement and Eating for Wellbeing are likely to be removed as principles and instead be included as tools.

These are approaches to health that are congruent with the Health at Every Size® framework. Health at Every Size® should work for all people, regardless of their health goals.

The Health at Every Size® Principles promote safe and equitable access to healthcare for people regardless of size, health status, and health goals first and foremost. The Health at Every Size® Principles also provide a framework of care for both providers and individuals to approach health without a focus on weight or weight loss.

Myth: fat people deserve access to healthcare and are just generally worthy because they are healthy or have the capacity to be healthy.

Even if every single fat person was inherently unhealthy they would still have inherent worth and deserve access to quality healthcare.

We are first and foremost about increasing access to quality healthcare for fat people. We also offer a framework for care to help providers and patients think about health from a lens of fat liberation. Health at Every Size® is a framework for care.

We aim to ground the principles, curriculum, and advocacy in liberatory frameworks that are congruent with social justice. When ASDAH first formed in , the original steering committee Claudia Clark, Miriam Berg, Roki Abakoui, Donna Pitman, Paul Ernsberger, Catherine Shufelt, Veronica Cook-Euell, Judy Miller, Lisa Breisch, Francie Astrom, Renee Schultz, Darshana Pandya, Judy Borcherdt, Joanne Ikeda, Ellen Shuman, Dana Schuster agreed that the work of the organization would be based on a set of Health At Every Size® Principles.

Based on these shared understandings, the steering committee crafted and adopted the five original Health At Every Size® Principles that have appeared on ASDAH materials and the website from through The revised set of principles acknowledged social justice and access concerns while retaining the original intent and wisdom of the Health At Every Size® principles as they had been practiced for many years.

The team leading the revision included Dana Schuster, Shelley Bond, Kathy Kater, Judith Matz, Christine Ohlinger, and Amy Herskowitz. It has once again become clear that a revision is necessary.

The current principles do not adequately support those most impacted by medical fatphobia nor do they reflect ongoing reflection and community discussion.

ASDAH Leadership plans to revise the Health at Every Size® Principles during the board year. Health At Every Size® Principles. About Health at Every Size® HAES. Health at Every Size® Principles. Weight Inclusivity.

Health Enhancement. EATING FOR WELL-BEING. Respectful Care. Life-Enhancing Movement. While getting fully on board with HAES can take some time and contemplation, at least consider the following:. Attie, I. Development of eating problems in adolescent girls: A longitudinal study.

Developmental Psychology , 25 1 , 70— Bacon, L. Weight Science:Evaluating the Evidence for a Paradigm Shift. Nutrition Journal , 10 1 , 9. International Journal of Obesity , 26 6 , — Size acceptance and intuitive eating improve health for obese, female chronic dieters.

Journal of the American Dietetic Association , 6 , — Buchholz, A. The medical and mental health status of children and youth with severe complex obesity. Paper presented at the 3 rd Canadian Obesity Summit, Vancouver, May Stice, E. Role of body dissatisfaction in the onset and maintenance of eating pathology: A synthesis of research findings.

Journal of Psychosomatic Research , 53 5 , — Tomiyama, A. Long-term effects of dieting: Is weight loss related to health? Provisional abstract. Social and Personality Psychology Compass , 7 12 , — Previous Next.

Researchers, journalists, and YouTubers alike all have wildly different and equally strong opinions about the HAES movement and its underlying motivation. Nicole Pearce T April 6th, Share This Story, Choose Your Platform!