What is Health at Every Size Lifestyle Counseling? How Does It Compare to Weight-Focused Therapies?

Health at Every Size (or HAES) is an approach to lifestyle counseling that promotes mindful eating and lifestyle behaviors to achieve health and well-being, without focusing on weight loss. Weight loss is viewed as beneficial side effectnot the goal.

This Association for Diversity in Size and Health This approach was first developed in 2003 and then revised in 2013 and 2024. basic rules promote:

• minimizing weight discrimination
• encouraging body acceptance
• intuitive eating
• enjoyable physical activities.

It also aims to solve the problem Stigma and discrimination that larger people seeking medical care may experience.

On the international stage range of healthcare specialists have incorporated the HAES approach into their treatment and services. Some organizations, such as Obesity Canadahave incorporated HAES into their obesity treatment guidelines.

How does it compare to treatments aimed at weight loss?

We carried out systematic review and meta-analysis all scientific studies published up to November 2022 that used HAES-based programs.

In 19 scientific articles, we compared the results of people living in larger bodies who used HAES-based programs With:

• conventional weight loss programs (six studies)
• people on waiting lists who do not receive any treatment (six studies)
• groups in which people received weekly social support in groups (four studies).

We assessed the program’s impact on appetite, weight, physical health parameters including cholesterol and blood pressure, and well-being and mental health.

Our analysis showed that HAES interventions were more beneficial in reducing hunger susceptibility than other approaches, meaning that people had less subjective feelings of hunger or eating in response to emotions.

However, compared with control interventions, HAES did not demonstrate superior results in improving any other physical health outcome – weight loss, blood cholesterol, blood pressure – or well-being or mental health.

Given the results to date, the decision as to whether or not to employ a HAES-based approach will depend on the individual’s preferences, needs, and goals.

Don’t get health advice from influencers

Although HAES has been used in clinical practice for many years, the motives of some American and Canadian opponents of the diet have come under scrutiny because of their links with food processing companies.

The spotlight was on a very small number “influencer” dietitians (about 20 of the more than 80,000 dietitians in the U.S. and Canada) promoting “eat whatever you want” and discouraging people from trying to lose weight under the HAES banner. They failed to mention that they are paid to promote products sold by food, beverage or supplement companies.

US Author and Dietitian Carrie Dennet urges people not to seek health advice from influencers. Instead, seek impartial health care from your family doctor.

What might treatment look like?

If the goal of treatment is to improve health, a good place to start is with a medical consultation with your doctor and an assessment of your relationship with food.

A vigorous relationship with food means being able to eat the right amounts and variety of foods to meet your nutritional, health and wellness goals. This can include strategies such as:

• keeping a food mood diary
• thinking about the factors that influence your nutrition
• practicing mindful eating
• the science of nutritional needs
• focusing on the pleasure of eating and the pleasure that comes from preparing, sharing and eating with others.

If you need more support with this, ask your doctor for a referral to a specialist who can support you.

What if your goal is to lose weight?

When it comes to nutritional therapy to treat weight-related conditions such as hypertension or type 2 diabetes, the approach will depend on individual needs and expectations.

Generally speaking, there are three graduated levels of energy intake targets:

1. an energy-restricted diet that aims to reduce energy intake by 2000–4000 kilojoules (kJ) per day by replacing fizzy drinks and other sugar-sweetened drinks with calorie-free or diet versions or water.

2. low-energy diet, which assumes a daily energy intake of 4200–5000 kJ, up to 7000 kJ, depending on individual energy expenditure.

3. the most restrictive approach is a very low energy diet, with a target energy intake of less than 2500 kJ/day, which can be achieved by using ready-made meal replacement products.

The purpose of a very low energy diet is to facilitate rapid weight loss when necessary to improve health in an acute stage, such as poorly controlled type 2 diabetes. Such a diet should be used under the supervision of a physician and dietitian.

When choosing your initial strategy, look for a balance between your energy goals and your ability to meet them. Your approach may change over time as your health needs change.

If you require personalised nutritional advice, please ask for a referral to an accredited practising dietitian. Register of Service Providers via Dietitians Australia allows you to become familiar with their expertise and location.

Whether your doctor uses HAES or not, your healthcare providers should always treat you with respect and care about your personal health and well-being.