Embracing Health at Every Size: A Compassionate Approach to Well-Being

What is Health at Every Size (HAES)?

The Health at Every Size (HAES) movement is a research-backed, weight-inclusive approach to health that challenges societal assumptions about body size and well-being. Developed as an alternative to the traditional weight-centric model of health, HAES emphasizes body diversity, intuitive eating, movement for joy rather than punishment, and the reduction of weight stigma in healthcare and therapeutic settings. The HAES principles encourage a focus on holistic well-being rather than weight loss as a marker of health.

For therapists, particularly those specializing in eating disorders, being HAES-informed is essential in providing ethical, compassionate, and effective care. Without this framework, therapists risk reinforcing fatphobia, inadvertently exacerbating disordered eating patterns, and alienating clients in larger bodies who are already navigating significant societal stigma.

Why is HAES Essential for Eating Disorder Therapy?

Eating disorders are complex, deeply rooted in emotional, psychological, and societal influences. Traditional therapeutic models have often failed clients in larger bodies by aligning with diet culture rather than addressing the true underlying issues—restriction, shame, and body distrust.

1. Preventing Collusion with Disordered Eating

One of the most common ways non-HAES therapists inadvertently harm clients is by colluding with the eating disorder (ED) brain. A client with binge eating disorder (BED) might come into therapy expressing a strong desire to lose weight, convinced that weight loss is the key to their happiness. A therapist who is not HAES-informed might validate this goal, encouraging restrictive behaviors under the guise of "health."

However, restriction is often a major contributor to binge eating, and reinforcing a weight loss goal only fuels the cycle of guilt, shame, and disordered behaviors. A HAES-informed therapist recognizes that the true work lies in healing the client's relationship with food, reducing body shame, and challenging internalized fatphobia, not pursuing weight loss.

2. Addressing Weight Stigma in the Therapeutic Space

Many clients in larger bodies experience medical trauma—repeated encounters where their health concerns were dismissed because of their weight. If a therapist unconsciously mirrors this bias, they risk deepening the client's feelings of invalidation and alienation.

For example, a therapist might assume that a client in a larger body is physically inactive or has poor eating habits, without taking the time to understand their lived experience. This bias not only erodes trust but can also reinforce harmful narratives about body size and health.

A HAES-aligned therapist challenges these assumptions, recognizing that people of all sizes engage in health-promoting behaviors and that weight alone does not determine well-being.

3. Encouraging Sustainable, Compassionate Healing

Diet culture has conditioned many individuals to see health as a moral obligation and weight loss as a prerequisite for self-worth. When therapists operate within a weight-normative paradigm, they risk perpetuating this mindset.

A HAES framework shifts the focus from external control (weight loss, calorie tracking, dieting) to internal attunement (self-care, emotional regulation, and intuitive eating). It fosters an approach to health that is inclusive, sustainable, and rooted in self-compassion rather than shame.

The Research Behind Health at Every Size

The HAES movement is not just an ideology—it is supported by empirical research. Studies have demonstrated that HAES-based interventions lead to improved physiological and psychological health outcomes without the harmful effects associated with weight cycling (i.e., yo-yo dieting).

• A 2005 study published in the Journal of the American Dietetic Association compared a HAES intervention to a traditional weight-loss approach. The HAES group showed improvements in blood pressure, cholesterol, eating behaviors, and psychological well-being, whereas the diet-focused group had no significant long-term health improvements.

• Research has consistently shown that weight stigma itself is a greater risk factor for poor health than body weight, contributing to increased stress, disordered eating, and avoidance of healthcare settings.

• A systematic review in Nutrients (2020) found that HAES-based programs increase self-esteem, body satisfaction, and intuitive eating, while reducing disordered eating behaviors and depression.

Common Myths About HAES

Despite the evidence supporting HAES, several misconceptions persist. Let’s debunk a few:

1. "HAES Promotes Obesity."

HAES does not "promote" any body size—it challenges weight stigma and promotes evidence-based care. It acknowledges that body diversity is natural and that people in all bodies deserve respectful, effective healthcare.

2. "HAES Ignores Health."

HAES actually prioritizes health by focusing on behaviors that improve well-being, rather than fixating on weight. Research shows that health behaviors—such as movement, balanced nutrition, stress reduction, and social connection—are better predictors of health outcomes than BMI.

3. "HAES Means Giving Up."

HAES is not about resignation; it is about liberation. It encourages individuals to build a positive, sustainable relationship with their bodies and health behaviors, free from the damaging effects of diet culture.

How to Find a HAES-Informed Therapist in NYC

If you're looking for a HAES therapist in NYC, it’s essential to ask specific questions to ensure they truly align with this approach. Some useful questions include:

• "How do you approach body image concerns in therapy?"

• "Do you integrate HAES principles into your work?"

• "How do you address weight stigma in your practice?"

A truly HAES-aligned therapist will recognize the harms of diet culture, validate your lived experiences, and support you in healing your relationship with food and your body.

Final Thoughts

The Health at Every Size movement is a crucial paradigm shift for eating disorder treatment and mental health care as a whole. A HAES-informed approach ensures that therapy is inclusive, ethical, and genuinely supportive of clients' well-being—regardless of their body size.

If you’re searching for a compassionate, HAES-aligned therapist in NYC, I’d love to help. My practice is rooted in the belief that all bodies are worthy of respect, care, and healing. Let’s work together to redefine health in a way that is liberating, not limiting.