Health at Every Size – A Misnomer or Simply Misplaced?

Let’s address the Health at Every Size (“HAES”) movement which has, over time developed in the eating disorder community. At the same time, let us also give a forum to the many whispers and voices behind the scenes about which I and many others have heard. And maybe at the end, let’s propose a radical, bold direction for HAES.

After listening to a number of people with experience in the eating disorder industry, the message which keeps being delivered is … The HAES movement is at best lightly regarded if not outright disregarded and/or unknown by mainstream society and is in fact, in some ways, a detriment that is hurting the eating disorder community.

Now in reading up to this point, some people may have spewed coffee over their computer screen, cursed me and every living and dead relative I have, employed the nearest hit man or have already dismissed the message in this missive. But, nonetheless, let’s continue.

If there is any merit behind these messages, the issues presented could be addressed simply by rebranding or something even more radical. This could bring greater credibility and accessibility to its cause. But even that might not be enough.

On the HAES community website, haescommunity.com, the following language appears,

“RESPECT … Honors differences in size, age, race, ethnicity, gender, dis/ability, sexual orientation, religion, class, and other human attributes.”

“CRITICAL AWARENESS … Challenges scientific and cultural assumptions.”

This website then states, “It supports people of all sizes in addressing health directly by adopting healthy behaviors. It is an inclusive movement, recognizing that our social characteristics, such as our size, race, national origin, sexuality, gender, disability status, and other attributes, are assets, and acknowledges and challenges the structural and systemic forces that impinge on living well.”

On the website for the Association for Size Diversity and Health (“ASDAH”), with regard the HAES Principles and Approach it states:

The Association for Size Diversity and Health (ASDAH) affirms a holistic definition of health, which cannot be characterized as simply the absence of physical or mental illness, limitation, or disease. Rather, health exists on a continuum that varies with time and circumstance for each individual. Health should be conceived as a resource or capacity available to all regardless of health condition or ability level, and not as an outcome or objective of living. Pursuing health is neither a moral imperative nor an individual obligation, and health status should never be used to judge, oppress, or determine the value of an individual.

In reading these principles, vision and mission, one can understandably question whether they are reading a mission statement of a political party, a website advertisement for a new yoga/meditation regiment, a follow up outreach contact from a doctor or clinician … or a statement of principles from a social justice movement.

We do know people are not biologically healthy at “every size.” To hold counter to this scientific fact is tantamount to shaking one’s fist at the clouds. Any competent doctor is going to tell you that excess body weight is a risk factor for most major, chronic diseases. The connection between excess weight and conditions like type 2 diabetes, sleep apnea, and arthritis has been scientifically demonstrated. Additional conditions are linked to obesity … heart disease and stroke, cancers of the colon, endometrial, kidney and esophagus. The risk of gall bladder disease or gallstones is increased. Osteoarthritis and gout are more common and linked to obesity. If the HAES movement regards these truisms as mere scientific “assumptions,” they are consciously choosing to ignore countless, objective scientific research studies conducted over a span of decades. And yet, it appears as if the HAES movement wishes to disregard these studies because they do not like the outcomes or their perceptions. If HAES continues to equate scientific research supporting the belief that excess weight is bad because it results in a much greater potential for serious physical health issues with it simply being a moral judgment about people’s bodies, then HAES is doing itself and its followers a tremendous disservice.

If a person does not believe the sun rises in the east and sets in the west, and trumpets this belief, this lack of credibility touches all other issues. And it does not have to be that way.

There are many issues raised by HAES which are legitimate and compelling. Many of HAES’s talking points are supported by the medical industry, clinicians, doctors and scientists. Attacking BMI and the definitions of “obesity” are near the top of these issues. There is no dispute that BMI is coming under greater attack from doctors, clinicians, and scientists. Recent studies indicate it is relatively poor at assessing chronic disease in either direction.

But, where HAES fails is with the realization that proponents of HAES tend to blur the distinction between weight not being the most important measure of health … to weight not being relevant at all to health. And that is a distinction with a difference. And perhaps that distinction is not only being lost but not propounded at all because of the reality that obese people are stigmatized and ostracized by mainstream society.

Review again statements made by HAES. “It is an inclusive movement, recognizing that our social characteristics, such as our size, race, national origin, sexuality, gender, disability status, and other attributes, are assets, and acknowledges and challenges the structural and systemic forces that impinge on living well.” The HAES movement also states, “Honors differences in size, age, race, ethnicity, gender, dis/ability, sexual orientation, religion, class, and other human attributes.”

If we review the first three core principles of HAES, we find the following:

  1. Weight Inclusivity: Accept and respect the inherent diversity of body shapes and sizes and reject the idealizing or pathologizing of specific weights.
  2. 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.
  3. 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.

Look at the impactful words being utilized “…Accept and respect the inherent diversity of body shapes and sizes … equalize access to information and services … work to end weight discrimination.”

Now, let’s review goals and mission statements from other organizations. The American Civil Liberties Union (“ACLU”) states, “ … the ACLU has been our nation’s guardian of liberty, working in courts, legislatures, and communities to defend and preserve the individual rights and liberties that the Constitution and the laws of the United States guarantee everyone in this country.

Whether it’s achieving full equality for LGBT people, establishing new privacy protections for our digital age of widespread government surveillance, ending mass incarceration, or preserving the right to vote or the right to have an abortion, the ACLU takes up the toughest civil liberties cases and issues to defend all people …”

Let’s review the principle objectives of the National Association for the Advancement of Colored People (“NAACP”):

… the principal objectives of the Association shall be:

  • To ensure the political, educational, social, and economic equality of all citizens
  • To achieve equality of rights and eliminate race prejudice among the citizens of the United States
  • To remove all barriers of racial discrimination through democratic processes
  • To seek enactment and enforcement of federal, state, and local laws securing civil rights
  • To inform the public of the adverse effects of racial discrimination and to seek its elimination
  • To educate persons as to their constitutional rights and to take all lawful action to secure the exercise thereof, and to take any other lawful action in furtherance of these objectives, consistent with the NAACP’s Articles of Incorporation and this Constitution.

The impactful, powerful civil rights organizations like the ACLU, the NAACP, LULAC all have similar principles in common … equality of life, liberty and the pursuit of happiness free from discrimination and society’s prejudices and presuppositions. And who does that sound like? The HAES movement speaks of an all inclusive movement and acknowledging that “… social characteristics, such as our size, race, national origin, sexuality, gender, disability status, and other attributes, are assets, and acknowledges and challenges the structural and systemic forces that impinge on living well.”

The HAES movement at its core is about fairness and equality. It is about casting off the shackles of prejudice of a society that wrongly places value on the model thin body. It is about non-acceptance of a person. It is about stereotyping a person because of how they look. It is about degrading a person because they are different. It is about casting aside mainstream views of a person based upon incorrect and faulty information. How dare you judge me because of the color of my skin!!! uh wait … How dare you judge me because of my religious beliefs! uh wait … How dare you judge me because of my sexual orientation! … How dare you judge me because I am obese in society’s eyes.

The HAES movement does not belong in the eating disorder industry and community. The two HAES and eating disorders are in many ways, only loosely connected. And quite frankly, the eating disorder industry might not be a powerful enough platform (YET), to spread the message, mission and principles of the HAES movement.

The HAES movement is not at its heart, an eating disorders movement. The HAES movement is a civil rights movement. And perhaps the scientific assumptions from which the HAES movement tries to distance are the very fundamental core beliefs which could provide the foundation upon which the HAES movement could project itself into “a protected class” under the Constitution and laws of the United States.

At the start of this article, I made the statement that perhaps The HAES movement was a detriment hurting the eating disorder community. The equally impactful question should also be, is the eating disorder community and industry hurting the HAES movement?

If the HAES movement is truly a civil rights movement, if it is designed to address the wrongs and misdeeds being perpetrated by mainstream society, then it needs a dynamic, powerful independent voice to give meaning and substance to its message. And make no mistake, HAES has a powerful, substantive message to send. It just needs to find an effective platform and forum for that message.

(Thank you to the incredible Chevese Turner for the correction on the name of the movement… and her insights! Chevese, you are a warrior.)

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