Health at Every Size Counselling Explained

Health at Every Size Lifestyle Counselling: A Revolutionary Approach

Health at Every Size (HAES) is a lifestyle counselling approach that focuses on promoting mindful eating and lifestyle behaviors to pursue health and wellness without focusing on weight loss. Weight loss is seen as a beneficial side effect, rather than a goal.

What is HAES?

The Association for Size Diversity and Health developed the HAES approach in 2003 and 2013 using core principles to promote minimising weight discrimination, body acceptance, intuitive eating, and enjoyable physical activities. The approach was revised in 2024 to address stigma and discrimination that people in larger bodies may experience when seeking medical care.

International Adoption

Internationally, a range of health professionals have incorporated the HAES approach into their treatment and services. Some organizations, such as Obesity Canada, have included HAES in their guidelines for obesity treatment.

Comparison with Weight-Focused Treatments

We conducted a systematic review and meta-analysis of all research studies published until November 2022 that had used HAES-based programs. Across 19 scientific papers, we compared the outcomes of people living in larger bodies who used HAES-based programs with:

• Conventional weight loss programs (six studies)
• People on waiting lists receiving no treatment at all (six studies)
• Groups where people received weekly social support in groups (four studies)

Our analysis found that HAES interventions were beneficial in reducing susceptibility to hunger more than other approaches. However, compared to control interventions, HAES did not show superior results for improving any other physical health outcome – weight loss, blood cholesterol levels, blood pressure – or wellbeing or mental health outcomes.

Choosing the Right Approach

Given the results to date, the choice about whether to use a HAES-based approach (or not) will depend on each person’s preference, needs, and goals.

Diet Influencers: Not the Best Source of Health Advice

While HAES has been used in clinical practice for many years, some United States and Canadian anti-diet practitioners have been scrutinized for their links with processed food companies. A small number of dietitian "influencers" promoting "eat what you feel like" and discouraging people from making weight loss attempts, under the banner of HAES, failed to mention they were being paid to promote products sold by food, beverage, or supplement companies. Author and dietitian Carrie Dennet urges people to not look to influencers for health advice, instead, seek non-judgmental healthcare from your GP.

Developing a Healthy Relationship with Food

When improving your health is a treatment goal, a good place to start your journey is to have a health check-up with your doctor, as well as to assess your relationship with food. A healthy relationship with food means being able to eat appropriate amounts and variety of foods to meet your nutritional, health, and wellbeing goals. This might include strategies such as:

• Keeping a food mood diary
• Reflecting on factors that influence your eating
• Practising mindful eating
• Learning about nutrient needs
• Focusing on food enjoyment and the pleasure that comes from preparing, sharing, and eating with others

If you need more help to develop this, ask your doctor to refer you to a health practitioner who can assist.

Weight Loss as a Treatment Goal

When it comes to medical nutrition therapy to treat weight-related health conditions, such as high blood pressure and type 2 diabetes, the approach will depend on individual needs and expectations. Broadly, there are three graded energy intake target levels:

• A reduced-energy diet where the goal is to lower energy intake by 2,000 to 4,000 kilojoules (kJ) per day by identifying food substitutions, like swapping soft drinks and other sugar-sweetened drinks for zero or diet versions or water.
• A low-energy diet, which uses an energy intake goal in the range of 4,200-5,000 kJ, up to 7,000 kJ per day depending on an individual’s energy expenditure.
• The most restricted regime is a very low-energy diet, has an energy intake target less than 2,500 kJ/day, achieved using formulated meal replacement products.

Conclusion

In conclusion, Health at Every Size lifestyle counselling is a revolutionary approach that promotes mindful eating and lifestyle behaviors to pursue health and wellness without focusing on weight loss. While the approach has its benefits, it’s essential to remember that everyone’s journey is unique, and the right approach will depend on individual needs, goals, and preferences.

FAQs

Q: What is Health at Every Size (HAES)?
A: HAES is a lifestyle counselling approach that focuses on promoting mindful eating and lifestyle behaviors to pursue health and wellness without focusing on weight loss.

Q: Is HAES effective?
A: HAES interventions were beneficial in reducing susceptibility to hunger more than other approaches, but did not show superior results for improving other physical health outcomes or wellbeing/mental health outcomes.

Q: Who developed HAES?
A: The Association for Size Diversity and Health developed the HAES approach in 2003 and 2013.

Q: Can I get a referral to a health practitioner who uses HAES?
A: Yes, ask your doctor to refer you to a health practitioner who uses HAES or visit the register of service providers through Dietitians Australia.

Q: Can I rely on diet influencers for health advice?
A: No, diet influencers may not be the best source of health advice, as some may have conflicts of interest. Instead, seek non-judgmental healthcare from your GP.