As national obesity rates continue to rise, there are also various, often conflicting theories about the health effects of being overweight. One such theory is called Health at Every Size (HAES), a weightless approach based on the following principles:
- Acceptance of natural body diversity in weight and size
- Ineffectiveness and risk in diet for weight loss
- Eating in response to Internal Body Signals
- Recognition of social, emotional and spiritual factors in addition to physical factors related to health and happiness (Robison, 2005)
The HAES movement is largely attributed to Linda Bacon, Ph.D. The concept in her book Health at Any Size: The Surprising Truth About Your Weight, has introduced that refutes the notion that obesity and obesity have harmful consequences (Bacon, 201
This article explores the research to support and refute HAES and provides strategies to promote a healthy behavioral change in clients overweight.
Support for health at any size
There is a plethora of evidence suggesting a link between adiposity and many chronic diseases such as diabetes, hypertension, and arthritis (Kearns et al., 2014). Despite this correlation, there is little direct evidence that obesity causes these conditions (Bombak, 2014). The current treatment of obesity-related conditions involves promoting weight loss through diet restriction and increased exercise to improve health outcomes.
However, these common weight loss strategies have little supportive evidence for long-term weight loss. In fact, it has been shown that dieting leads to weight gain in about two-thirds of diets within one to five years after the diet (Mann et al., 2005). Often failing dieting leads to a sense of self-blame and attitude. "If nothing goes, I can just go back to what I did before". Despite the tendency for self-incrimination, numerous mechanisms, such as increased hunger, decreased satiety and reduced energy expenditure, may be responsible for increased weight gain after diet (Bombak, 2014).
Beyond the Bad Effectiveness of the Diet It has also been shown that healthy behaviors such as regular exercise and nutritious food have a positive effect on the health, regardless of any weight change.
(Bacon and Aphramor, 2011; Duncan et al., 2003). In addition, research has shown that people who are overweight but active have lower mortality rates than normal-weight but exercising peers (Blair and Church, 2004).
Given this evidence, HAES suggests that this exercise and medical professionals divert their attention from weight and instead focus on adopting sustainable healthy behaviors. These behaviors include eating healthy foods, following internal hunger and satiety signals, enjoying sports and avoiding fatty stigmata.
Randomized control studies using a HAES model showed improved results in blood biomarkers, eating behavior and psychological consequences, including mood self-esteem and body image (Bacon and Aphramor, 2011)
Arguments against health in any size
HAES critics have two main opponent arguments. First, they argue that there is ample evidence that excessive obesity is associated with chronic diseases, especially those that fall into Class II (medium risk) or Class III (high risk) obesity. Second, that the concept of hearing inner hunger and satiety signals is a challenge in our obese environment. They further argue that the HAES studies, which showed positive results, used small samples in overweight or obese individuals of Class 1, with the exception of Class II or III obesity, where weight loss could be more beneficial (Penney and Kirk, 2015).
While recognizing that the HAES approach could be useful, they insist on more evidence with larger and more diverse samples to assess whether the approach is beneficial to both individual health and public health Here
Whether HAES resonates with you or not, your customers can benefit from a training approach that puts more emphasis than weight. Your customer may never have noticed that there are benefits in addition to weight loss in the form of exercise and healthy diet.
Equipped with this information, there are two important ways to promote healthy behavioral change. First, educate your customers. Let them know that their behaviors are important in terms of their health and quality of life, regardless of whether these behaviors lead to weight loss or not. Second, help them build an expanded view of the benefits of exercise. Rather than just setting a weight-loss goal, encourage clients to track changes related to blood biomarkers, reduce stress or anxiety, get better sleep and energy, or make improvements in sports and activities of daily living.
As customers recognize the power of life, they increase the benefits of physical activity and make it a sustainable habit, regardless of weight.
Learn about healthy behaviors with a behavior modification program.
- Bacon, L. (2010). Health in all sizes: the surprising truth about your weight . Dallas, Texas: BenBella Books
- Bacon, L. and Aphramor, L. (2011). Weight Science: Assessment of evidence for a paradigm shift. Nutrition Journal 10, 9.
- Bombak, A. (2014). Obesity, health of all sizes and public health policy. American Journal of Public Health 104, 2, e60-e67
- Duncan, G.E. et al. (2003). Non-weight-loss training enhances insulin sensitivity and postheparative plasma lipase activity in previously-seated adults. Diabetes Care 26, 3, 557-562
- Haines, J. and Neumark-Sztainer, D. (2006). Prevention of Obesity and Eating Disorders: Considering Common Risk Factors. Health Education Research 21, 6, 770-782
- Kearns, K. et al. (2014). Chronic disease burden associated with obesity and obesity in Ireland: The impact of low population-level BMI reduction. BMC Public Health 14, 143.
- Penney, T.L. and Kirk, S.F.L. (2015). The "Health at Every Size" paradigm and obesity: Lack of empirical data can help drive obesity refraction. American Journal of Public Health 105, 5, e38-e42
- Robison, J. (2005). Health of all sizes: on the way to a new paradigm of weight and health. Medscape general medicine 7, 3, 13.