Non-diet, anti-diet, Health at Every Size (HAES) — these terms are showing up more and more in books, magazines, blogs and social media. Also, many registered dietitians and therapists are practicing using a “non-diet” or even “anti-diet” approach. I hear a lot of questions about what these terms even mean, along with, “Everyone eats some type of diet, so how can anyone be ‘anti-diet’?”
First, let’s explore the deceptively simple word diet. Per the dictionary, diet can mean “food and drink regularly provided or consumed” or “habitual nourishment.” It can also mean “the kind and amount of food prescribed for a special reason,” such as a low-sodium diet, or “a regimen of eating and drinking sparingly so as to reduce one’s weight.”
When someone says they’re “anti-diet” or that they use a “non-diet” approach, they’re referring to weight loss diets, not someone’s “habitual nourishment.” While they don’t support restrictive diets for weight loss or other non-medical reason, they do support eating to support health and well-being. Unfortunately, “anti-diet” and “non-diet,” along with terms like “wellness” and “lifestyle changes,” are increasingly being co-opted by individuals or companies who are actually promoting weight loss.
The next question I hear is, “If not dieting, then what?” The non-diet and anti-diet philosophies stem from an alternative. Specifically, from Health At Every Size®, or HAES®. Like anything that challenges the notion that weight = health, HAES® is frequently misinterpreted or misrepresented. Allow me to debunk some common HAES® myths.
(Health at Every Size® and HAES® are registered trademarks of the Association for Size Diversity and Health. This was a protective step to prevent them from being used to promote weight loss diets / drugs / surgery.)
Myth: HAES® means that everyone is healthy regardless of weight
The fact is that HAES® advocates would say that people of all sizes struggle with illness and disease, and some people are not at a weight that’s right for them. However, dieting is not the answer, for a number of reasons.
Research has found associations between dieting and disordered eating behaviors — meal skipping, severe food restriction, purging, obsessive food thoughts — or even to actual eating disorders in susceptible people. Also, most people who lose weight don’t keep it all off for the long term, no matter what type of diet they followed. Chronic dieters who lose and regain repeatedly may end up at a higher weight than if they had never dieted.
HAES® supports people in choosing health behaviors that are sustainable and improve quality of life, regardless of what they weigh or their current level of health.
HAES® also points out that health is multifaceted and includes physical, social, spiritual, occupational, emotional, and intellectual aspects. Our physical health, specifically, is shaped by not just diet and lifestyle factors, but also our genetics and early childhood development, as well as our socioeconomic status.
Myth: HAES® is anti weight loss
The fact is that while a HAES® approach does not support the intentional pursuit of weight loss, because obsessing over weight often causes more harm than good, it views weight loss itself as neither “good” nor “bad.”
HAES® takes the focus off of weight and places it on behaviors that have been shown to benefit health all by themselves. HAES® promotes eating in a way balances individual nutritional needs, hunger, satiety, appetite, and pleasure—in other words, intuitive eating.
On the exercise front, a HAES® approach would encourage finding types of physical activity that you enjoy and feel good to you, then working them into your life in a manageable way. It would not endorse dragging yourself out of bed every morning to go to the gym if that’s your idea of hell.
This decoupling of food and physical activity from the goal of weight loss is important because if the primary motivation for changing habits is weight loss, and the needle on the scale doesn’t budge, or it goes down—and then back up—the motivation to continue to eat well and exercise often fizzles.
Myth: HAES is about giving up and promoting obesity
The fact is that the HAES® principles were initiated within the fat acceptance movement, but they apply to everyone of every body type and size. People of all sizes can become preoccupied with controlling their weight in the name of health, and HAES® offers a more peaceful path to adopting food and lifestyle habits shown to support health.
Consider this: When people lose weight by eating better and exercising more, the weight loss gets the credit for any health improvements that happen, even though research has separately established that physical activity and good nutrition alone can improve health.
Research has also found that individuals who adopt a HAES® approach experience better health outcomes — such as lowered blood pressure and cholesterol levels, better body image, and fewer disordered eating behaviors — even when they don’t lose any weight, when compared with weight loss dieters.
HAES® practitioners advocate for weight inclusivity, which means accepting and respecting the diversity of body shapes and sizes that naturally happen among humans, without idealizing or pathologizing certain weights.
They also point out that everyone deserves respect and access to healthcare, regardless of size. The unfortunate reality is that weight bias, stigma and discrimination are rampant in society — including in healthcare. Weight bias from healthcare providers reduces access to appropriate, evidenced-based care.
Even when people lose the amount of weight that is supposed to bring about health improvements — anywhere from 3 to 10 percent of highest weight — they may still be considered “overweight” or “obese” range—and still subjected to weight bias. And weight bias — as with other forms of bias — has been shown to directly harm health by increasing stress and contributing to chronic inflammation in the body.
Final food for thought
We have direct control over our behaviors, but not over potential outcomes of those behaviors. How we eat, move and take care of ourselves are behaviors, what our weight does or doesn’t do is an outcome that’s also influenced by factors beyond our control. So decide where you’ll get the most value from your efforts. How can you best care for yourself in your here-and-now body?
Carrie Dennett, MPH, RDN, is a Pacific Northwest-based registered dietitian nutritionist, journalist, intuitive eating counselor, author, and speaker. Her superpowers include busting nutrition myths and empowering women to feel better in their bodies and make food choices that support pleasure, nutrition and health. This post is for informational purposes only and does not constitute individualized nutrition or medical advice.
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