We’ve been told for decades that how much you weigh — or more specifically the ratio of your weight to height, known as body mass index (BMI) — is a predictor of your health. It’s common practice for doctors and other health professionals to prescribe weight loss for health concerns. Most of the time that means dieting in some capacity — whether that’s following a fad diet, counting calories, or restricting food intake in an effort to shrink one’s body. But many health professionals are questioning this approach, suggesting that the constant pursuit of weight loss may actually be more damaging to health than staying at a higher weight. In fact, most people that “successfully” lose weight by dieting will regain the weight within six months to three years and many end up gaining more than they lost, leaving them at a higher weight than they started. Dieting in adolescence has been shown to be a predictor of obesity later in life. Some chronic dieters may go on to develop disordered eating habits or full fledged eating disorders, and research associates weight cycling to negative psychological consequences.
So, if dieting and trying to lose weight isn’t the answer to getting healthy, what is? Some believe the answer is rooted in the Health at Every Size® (HAES®) movement. HAES® takes the emphasis off the number on the scale and instead focuses on self care. HAES® is rooted in the following five principles, which have been written for health care providers but offer useful insight for us all:
- Weight Inclusivity: Accept and respect the inherent diversity of body shapes and sizes and reject the idealizing or pathologizing of specific weights.
- Health Enhancement: Support health policies that improve and equalize access to information and services, and personal practices that improve human well-being, including attention to individual physical, economic, social, spiritual, emotional, and other needs.
- Respectful Care: Acknowledge our biases, and work to end weight discrimination, weight stigma, and weight bias. Provide information and services from an understanding that socio-economic status, race, gender, sexual orientation, age, and other identities impact weight stigma, and support environments that address these inequities.
- Eating for Well-Being: Promote flexible, individualized eating based on hunger, satiety, nutritional needs, and pleasure, rather than any externally regulated eating plan focused on weight control.
- Life-Enhancing Movement: Support physical activities that allow people of all sizes, abilities, and interests to engage in enjoyable movement, to the degree that they choose.
The HAES® approach, which emphasizes intuitive eating over dieting, is linked to positive metabolic outcomes such as improved blood pressure and cholesterol, healthier behaviors including regular movement and eating more health-promoting foods, and positive psychological outcomes such as improved self esteem. Research has also shown that people can improve their health and lower their overall risk of death by adopting health behaviors such as eating more fruits and vegetables, getting regular movement, and not smoking, independent of body size.
Does that mean that you are automatically healthy at any size? Not necessarily. But it does suggest that we cannot determine whether people are healthy just by looking at them or calculating their BMI. HAES® indicates that health is more about your habits than your weight and when we focus on healthy behaviors over weight, people are more likely to improve their physical and mental health. If you’re interested in learning more about how you can integrate Health at Every Size® principles in your daily life, consult a HAES® aligned health care professional and read more about how you can be healthy at any size.