Health At Every Size® Fact Sheet
The Health At Every Size® (HAES®)
approach is an alternative to the
weight/size-based paradigm upon which much
current public health policy is based.
The Health At Every Size® principles are:
Accepting and respecting the diversity
of body shapes and sizes
Recognizing that health and well-being
are multi-dimensional and that they
include physical, social, spiritual,
occupational, emotional, and intellectual aspects
Promoting all aspects of health and
well-being for people of all sizes
Promoting eating in a manner which
balances individual nutritional needs, hunger,
satiety, appetite, and pleasure
Promoting individually appropriate,
enjoyable, life-enhancing physical activity, rather
than exercise that is focused
on a goal of weight loss1
There is considerable
scientific evidence supporting the HAES® approach and
establishing that “obesity” is not the health risk it has been reported to be.
Weight and BMI are poor predictors of
disease and longevity.2,3,4,5,6 The
bulk of epidemiological evidence
suggests that five pounds “underweight” is
more dangerous than 75 pounds
Multiple studies are suggesting that a
focus on weight as a health criterion is
often misdirected and harmful.8,9,10
In a study comparing the HAES® model to
a diet approach, though only dieters
lost weight, both groups initially had similar improvements in metabolic
activity levels, psychological measures, and eating behaviors. After two years,
dieters had regained their weight and lost the health improvements, while the
group sustained their health
The HAES® approach is
based on substantial data which documents that weight
loss programs are not
effective at improving health and often cause harm.
Restrictive dieting is an ineffective
long-term prescription for “obesity,” as up to 95% of
dieters regain the weight
they lost, and sometimes more, within three years.12,13
Restrictive dieting and weight cycling
can lead to physical complications including
slowed metabolism, reduced muscle
tissue and body temperature,
and eating disorders.14,15
Weight-loss surgery (WLS) intentionally
damages healthy organs in order to force
adherence to a restrictive diet and
incurs a host of short- and long-term risks
including death and malnutrition.16,17
The HAES® approach focuses on the empirically-validated
factors that are associated
with health and longevity, for people across the
weight spectrum. The HAES® approach does not waste money.
Using BMI as a proxy for health,
traditional approaches misidentify those who
A recent government survey indicated
that over half the “overweight” adults
(51.3%) being targeted are metabolically
healthy, and one in four “normal weight”
(23.5%) metabolically unhealthy adults
Therefore, even assuming weight loss
were possible, and that it worked to improve
health, half of every dollar is
wasted and one in five people who need help do not get it.
The HAES® approach provides an alternative which avoids the
harmful consequences of efforts to combat “childhood obesity” and the denial of equal access to health care
coverage and service to millions of adults, both of which create additional
health risks for these individuals.
• Singling out larger
children and youth for weight-related interventions in schools
anxiety for the child and stigmatization, prejudice, and harassment towards the
• 81% of 10-year-olds admit to dieting,
binge eating, or a fear of getting fat and we are now
seeing eating disorders
in children as young as five.22
• Insurers deny health care coverage
simply because of high BMI, independent of overall
health, despite research
showing that weight cannot be directly correlated to health status.18
• Routine preventative health services
are denied to people who are of high BMI.23,24 Many
individuals avoid seeking health care due to stigma and shame.23,24
The HAES® approach does not add to the stigma against people
One of the major vectors for weight
stigma is the well-documented bias against fat people among healthcare
providers, policy makers, and those in the weight loss industry.25,26,27
The stress of experiencing stigma and
discrimination is also believed to account for health disparities seen in minority
groups, including individuals of size.28
In health care policy and service provision the implementation of
evidence-based HAES® paradigm will refocus efforts on health practices for
people of all sizes and improve health without perpetuating stigma.
• The HAES® model will ensure that individuals of all sizes are
to healthcare coverage and to quality affordable health care
prevention and treatment services.
• In education and employment, the HAES® model will provide that all youth and adults have opportunities
to learn the importance of eating nutrient rich foods and engaging in enjoyable
physical activity from a weight-neutral perspective.
• In diversity training programs in employment, policy, and school
environments the HAES® model ensures that size-diversity is included in the
human diversities to be valued and respected.
1. ASDAH, Health at Every Size® (HAES®)
2. Gaesser, G. (2002) Big Fat Lies: The
Truth About Your Weight & Your Health. Carlsbad, CA: Gurze.
3. Flegal, KM et al. (2005). Excess deaths
associated with underweight, overweight, and obesity. JAMA, 293(15) 1861-1867.
4. Flegal, KM,
Graubard, BI, Williamson, DF, Gail, MF (2007). Cause-specific excess
deaths associated with
underweight, overweight, and obesity. JAMA, 298(17), 2028-3037.
HM, et al. (2009). BMI and mortality: Results from a national longitudinal
study of Canadian adults.
6. Tamakoshi1 A, et al. (2009).
BMI and all-cause mortality among Japanese older adults: Findings from the
Japan collaborative cohort study. Obesity, doi:10.1038/oby.2009.190
7. Campos P (2004). The Obesity Myth. New York: Gotham Books.
8. Kang X,
et al. Impact of body mass index on cardiac mortality in patients with known or
artery disease undergoing myocardial perfusion
single-photon emission computed tomography.
Amer Coll Card, 2006; 47(7):1418-26.
A et al., Body mass index and mortality in heart failure: A meta-analysis.
Amer Heart J,; 2008; 156:1, 13-22.
10. Olsen, TS, et al., Body
mass index and poststroke mortality, Neuroepidemiology 2008;
11. Bacon, L,
VanLoan M , Stern JS, Keim N. Size acceptance and intuitive eating improve
health for obese
Female chronic dieters. J
of Amer Dietetic Assoc
Garner DM, Wooley S. Confronting the failure of behavioral and dietary
treatments for obesity.
Clinical Psychology Review, 1991; 11:729-780.
13. Mann T, et al. (2007). Medicare’s search
for effective obesity treatments: Diets are not the answer.
Psychologist, 62(3), 220-233.
14. Bacon L. (2008). Health
at Every Size: The Surprising Truth About Your Weight. Dallas, TX:
Benbella, pp. 47-49.
15. Karelis AD, et al. (2008). Metabolically healthy but obese
women: effect of an energy-restricted diet.
16. Omalu BI, et al., Death
rates and causes of death after bariatric surgery for Pennsylvania residents,
1995 to 2004,
Arch Surg. 2007; 142(10): 923-928.
17. Flum, DR, et al., Early
mortality among Medicare beneficiaries undergoing bariatric surgical procedures,
Wildman RP, et al. (2008). The obese without cardiometabolic risk factor
clustering and normal weight with
cardiometabolic risk factor clustering: Prevalence and correlates of 2 phenotypes
among the US population
(NHANES 1999-2004). Archives of Internal Medicine,
Aug 11, 168(15):1617-24.
Latner JD, Stunkard AJ, Getting worse: The stigmatization of obese children. Obesity
Research 2003; 11(6) 452-456
National Education Association, “1994 Report on Discrimination Due to Physical
21. Puhl RM,
Latner JD. (2007). Stigma, obesity, and the health of
the nation’s children. Psychol Bull. 133(4), 557-80.
Sacker, Md, Ira, Dying to be Thin: Understanding and Defeating Anorexia
Nervosa and Bulimia – a Practical
Olson CL, Schumaker HD, Yawn BP. Overweight women delay medical care. Arch
Fam Med.1994;(Oct) 888.
Andreyeva T, Puhl RM & Brownell KD. “Changes in perceived weight
discrimination among Americans,
1995-1996 through 2004-2006.” Obesity 2008. 16(5),
25. Puhl RM,
Brownell KD. Confronting and coping with weight
stigma: An investigation of overweight and
Obesity (Silver Spring). 2006 Oct 14(10):1802-15.
26. Puhl RM,
Wharton CM, Heuer CA. Weight bias among dietetics
students: Implications for treatment practices.
Journal of the American Dietetic Association.
M, et al. (2003). Weight bias among health professionals specializing in
obesity. Obesity Research,
28. Fontaine K, et al. (1998). Body weight and health care among
women in the general population. Arch Fam
Med. 7, 381-384.
First Distribution July
Click for PDF