According to the latest weight loss research, up to 95% of dieters end up regaining the weight they lost within two years. Calorie-restricting diets are often successful at helping people lose weight, but they’re very unsuccessful at helping people maintain that weight loss (Ohio State Chronicles).
When I learned this fact in nutrition school last year I was shocked. That number is incredibly high. As I think about the success of my journey from 2023, I know sustainability must be this years focus. The question is, what framework works? So I began to research various models. I found the HAES model intriguing from the perspective that elevating health in a way that is non-judgmental was the initial catapult of my journey. I didn’t have a name at the time, but I realize it was that sort of softness that = success.
Health At Every Size (HAES) Movement and Weight Neutral Approaches-
While driving to work I heard one of my favorite Podcasters (Food Heaven Podcasters) declare “We use the Health at Every Size Approach for Medical Nutrition Therapy”. I was so intrigued I nearly stopped the car. 💡 I wanted to know more…
The Health At Every Size Movement (HAES) began in 2003 when Members and Leaders came together and created a forum in which health could have many faces, sizes, ect.. More officially, The Association for Size Diversity and Health (ASDAH) is a non-profit organization with an international membership. Their vision is:
We envision a world that celebrates bodies of all shapes and sizes, in which body weight is no longer a source of discrimination and where oppressed communities have equal access to the resources and practices that support health and well being.
ASDAH
I found their vision very intriguing considering the populations I often work with. I can’t tell you how many conversations I’ve had in communities of which often it’s not motivation that limits their well-being but the belief either real or perceived that the tools for better health are inaccessible. This inaccessibility may be by proximity, income, environmental or external messaging. Their focus in delivering equal access to resources is unique in my opinion. The “how” is the next question for me.
I began to research the “how” by looking for HAES trained Providers. I was able to find a HAES trained Providers written perspective below.
Dr. Paula Freedman writes about the Movement from the perspective of becoming an HAES Provider. She writes:
“HAES is a framework that divorces health from weight, and promotes dignity and respect for all bodies. Committing to being a HAES-aligned provider can help prospective patients find safer places to seek treatment, knowing that we as providers are at least making a concerted effort to avoid judgment and discrimination. This is especially important for patients who have been dismissed or minimized by health providers in the past.”
As someone from the BIPOC community, I can personally attest education level and income do not shield you from being dismissed or disregarded in health care settings. To this line I absolutely say “Me Too”. I can recall a specific conversation when describing my angst on a difficult medical decision to which the Provider said to me ” I’m sure it’s not that bad”. To know a medical provider is making a concerted effort to avoid judgement and discrimination would absolutely make me seek them out as a professional. I can relate whole-heartedly to this line and experience.
Weight Neutral vs Weight Loss/Normative Approaches?
After researching the HAES Movement, I had more questions on Weight Loss vs Weight Neutral approaches and if there was any research comparing the two. I came across this article: Effects of weight-neutral approaches compared with traditional weight-loss approaches on behavioral, physical, and psychological health outcomes: a systematic review and meta-analysis. Weight-neutral approaches appear to be at least as effective as weight-loss approaches at improving physical, psychological, and behavioral outcomes inadults with larger bodies. Weight-neutral approaches appear to be
at least as effective as weight-loss approaches at improving physical, psychological, and behavioral outcomes in adults with larger bodies. This review suggests there is no strong evidence to support the use of one approach over the other.
In another article from the National Library of Medicine;The Weight-Inclusive versus Weight-Normative Approach to Health: Evaluating the Evidence for Prioritizing Well-Being over Weight Loss Data reveals that the weight-normative approach is not effective for most people because of high rates of weight regain and cycling from weight loss interventions, which are linked to adverse health and well-being. Its predominant focus on weight may also foster stigma in health care and society, and data show that weight stigma is also linked to adverse health and well-being. In contrast, data support a weight-inclusive approach, which is included in models such as Health at Every Size for improving physical (e.g., blood pressure), behavioral (e.g., binge eating), and psychological (e.g., depression) indices, as well as acceptability of public health messages. Therefore, the weight-inclusive approach upholds nonmaleficience and beneficience, whereas the weight-normative approach does not.
Few, researching this topic definitely triggered past feelings for me from previous interactions. It also gave me so much hope even when completely unknown to me there are advocates working diligently to bring about “Good Trouble” by challenging narratives and approaches. I do not recommend one position over another, in closing my hope is that all of us in the Health Care Field avoid a “one size fit all” model and use curiosity to seek out what may work for all individuals we serve.
In peace,
J