by Deb Burgard, PhD
Along with the increasing public recognition of the Health at Every Size® model, there is some confusion about what the HAES SMmodel is and is not. Some discussions of the HAES approach are omitting or distorting aspects that are critical to its practitioners. There are several renditions of the model’s tenets (listed at the end), but first I would like to offer some critical questions to ask when you see it being discussed in the media.
If you can answer “yes” to these questions, you may be reading an inaccurate or at least incomplete presentation of the model.
Does the account you are reading:
Perpetuate the Pursuit of Weight Loss, e.g.:
- Promise weight loss?
- Fail to recognize the harms for people of all sizes of the existing interventions for changing weight?
- Create a new set of “rules” about how to eat?
- Shame some aspect of our inner selves by trying to “get rid of it, starve it, cut it out, imprison it”?
Perpetuate Healthism, e.g.:
- Present only fat people who are healthy as “poster children”?
- Create a class of “Good Fatties” vs. “Bad Fatties”?
- Collude with the notion that healthier people are morally better?
- Fail to demand quality medical treatment for fat people with health challenges?
- Fail to critique the moral corruptness of trying to eliminate health costs by eliminating people with health challenges?
Reduce the model to Individual Choices, leaving out the critique of Weight Stigma, e.g.:
- Omit any reference to the environmental sources of ill health, especially weight stigma?
- Fail to propose any policy or institutional solutions to the problem of weight stigma?
- Propose that individuals solve the problem of institutionalized weight stigma and shaming by losing weight and leaving the stigmatized group?
- Fail to connect the dots with weight loss efforts of people across the weight spectrum, including people who have disordered eating from the pursuit of weight loss?
Perpetuate the Misclassification of Diversity as Disease, e.g.:
- Explicitly or implicitly condone the use of BMI categories to classify people?
- View higher-weight people as “diseased” based solely on weight?
- Attribute any health problems at higher weights to being at a higher weight, and fail to treat health problems regardless of weight?
- Overlook the health problems or fail to consider the health status of lower-weight people?
- Assume that thinner is healthier?
Perpetuate a Short-Term vs. Sustainability Focus, e.g.:
- Present as a “makeover”?
- Fail to incorporate the question of what is sustainable for unique individuals?
- Focus on outcomes rather than the quality of day-to-day life?
- Reduce the profound idea of body acceptance to the notion of “confidence”?
Perpetuate “Expertism,” e.g.
- Fail to include the input from members of the community itself, especially members who are trying to change institutionalized weight stigma?
- Place “expert” knowledge above people’s felt, embodied experience?
- Propose a specific eating regimen for all people that fails to incorporate the individual’s physical and psychological experience of food and eating?
- Fail to expose public policy and medical practice to the test of whether they themselves promote weight stigma?
- Present a “one-size-fits-all” perspective that is closed to update and revision, especially to the lived experiences of the community members?
Perpetuate a War with the Body, e.g.:
- Place more confidence in the mind’s ability to regulate eating and weight (ie “discipline”) than the body’s?
- Label normal body processes as diseased?
- Propose as “cure” the disruption of normal functioning of healthy organs?
- Fail to appreciate the biological value of having some members of our species be fatter/more fuel-efficient?
- Prescribe a particular body size that is not attainable through healthy living?
The people who have developed the Health at Every Size model have integrated decades of experimental and epidemiological research and clinical practice, as well as the lessons of many social justice and civil rights movements, to find a path that reconnects us with our bodies, our life purposes, and each other. We ask that presentations of the HAES® model be as complete and nuanced as possible, and avoid the aforementioned pitfalls and mischaracterizations.
Additional sources of information on the HAES Tenets:
- Burgard, D. (2009) “What is Health at Every Size?” in Rothblum, E., and Solovay, S. (Eds), The Fat Studies Reader. New York: NYU Press.
- http://www.haescommunity.org/ See also the extended discussion in Linda’s book, “HAES: The Surprising Truth about Your Weight” at and in Bacon, L., & Aphramor, L. Weight Science: Evaluating the Evidence for a Paradigm Shift, Nutrition Journal, 2011, 10(9).