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Can You Be Fat and Healthy? What Practicing Health at Every Size® (HAES®) means.

Fat brown mixed race woman in blue athletic crop top and leggings proudly flexing her biceps and smiling

The short answer is yes, it's possible to be both fat and healthy.

I’ll get into this more in a moment, but before I do, it’s important to make clear that while our behaviors and choices have some influence over our health outcomes, it’s relatively small. There are many more factors that determine health that are beyond our control including genetics, physical and social environments, socio-economic status, access to food and medical care, discrimination based on race, gender and sexual orientation and culture.

Good health is a privilege and the assumption that the closer one comes to conforming to the thin ideal the healthier they are is a false belief that can have harmful, if not fatal, consequences (including serious mental illnesses such as body dysmorphic disorder and eating disorders which affect people of ALL sizes).

Thin people get ill and injured, too, but because weight stigma is a huge problem in the medical community thin patients are offered evidence-based treatments, while too many fat patients are prescribed weight loss (which has a 95% failure rate) and denied access to needed care until they lose weight. (Read this post by Ragen Chastain to better understand what thin privilege is and why it's important to advocate for fat acceptance).

We are all vulnerable to ill health regardless of the shape or size of our bodies, but we’ve been conditioned to believe that:

  • our health is inextricably tied to our body composition (it’s not)

  • that we can somehow shrink our bodies in healthy and sustainable ways (we can’t)

  • that we have a moral obligation to society to be healthy (we don’t).

It requires conscientious work, but we can unlearn these beliefs and join the effort toward building a culture that prioritizes the health and well being of all people, not the ranking of our bodies (this applies to other forms of systemic oppression as well).

This isn’t to say that there is no value in pursuing actual health-promoting behaviors. Quite the opposite! Getting enough sleep and rest, eating enough nutrient-dense food, moving our bodies enough, connecting with others through healthy relationships and engaging in enjoyable activities can benefit all of us whatever our body size and health status.

So what is Health at Every Size® (HAES®)?

As defined here by the Association of Size Diversity and Health (ASDAH):

The Health At Every Size® (HAES®) approach is a continuously evolving alternative to the weight-centered approach to treating clients and patients of all sizes. It is also a movement working to promote size-acceptance, to end weight discrimination, and to lessen the cultural obsession with weight loss and thinness. The HAES approach promotes balanced eating, life-enhancing physical activity, and respect for the diversity of body shapes and sizes.

The five principles that guide this approach include weight inclusivity, health enhancement, eating for well-being, respectful care and life-enhancing movement (visit ASDAH’s website for a deeper understanding of the HAES® movement and principals).

Notice that the H in HAES® stands for health, not healthy.

That’s because we can engage in behaviors that can potentially improve our health and well being, but as I mentioned earlier, the status of healthy is not available to everyone. Pursuing health-promoting behaviors, on the other hand, is accessible to everyone (because those behaviors are relative to the individual’s unique abilities and circumstances, there’s no single, homogenous outcome that we can or should be striving for). For information on a HAES® approach to care for common health conditions, visit the HAES® Healthsheets website.

Bodies thin or fat may be healthy or unhealthy. We have little control over that, AND pursuing health is not a personal moral obligation. But, if we want to, we can engage in actual health-promoting behaviors that add to the quality of our lives--mentally, physically and emotionally--and we can do it without focusing on weight or appearance.

I'm Emiko Jaffe, a weight-neutral fitness coach. If you found this piece helpful, I invite you to subscribe to Sunday Coffee, my newsletter about fitness, culture, being more of who you are and doing more of what you love (all through a weight-neutral, non-diet lens, of course). ⁠

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