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long-term behaviour changes whereas a restrictive diet approach does not .
Adopting HAES ® principles can also have positive effects on metabolic health markers . In some studies , ‘ intuitive eating ’ and joyful movement programs have been shown to improve blood pressure , cholesterol levels and overall car-
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Disadvantages of HAES ®
There is no doubt that the HAES ® approach
has shed light on the degree of weight bias and stigma in society , including in the medical profession , and has proposed a new model of care for individuals living in a larger body . That said , there are a number of issues with the approach which need to
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We understand that many of the harms associated with ‘ diet culture ’ are due to the extreme nature of the interventions . However , it is not clear whether some of these issues might be mitigated by a non-judgemental approach ( including many of the principles of HAES ®) while also aiming for moderate weight loss which can result |
approach to obesity given the poor success rates of traditional management . The historic approach of restrictive diets , punishing exercise regimens and blame and shame mentality is ineffective at best , and severely detrimental at worst . It ignores evidence that weight regain after weight loss has a significant physiological compo- |
The principles of HAES ® include eating for wellbeing (‘ intuitive eating ‘) rather than restrictive diets . |
diovascular health . This shows that |
be explored . |
in health benefits and be more easily sus- |
nent and that it is not a sign of individual |
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health benefits may be achievable using |
Firstly , while there is growing evi- |
tained over the long term . 21 |
failure . Individuals living in a larger body |
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a weight-neutral approach , even in the |
dence supporting a HAES ® approach , more |
Then there is the question of where |
experience weight stigma across all lay- |
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absence of weight loss . 18 |
research is needed to fully understand its |
weight management medications and bari- |
ers of society and more work needs to be |
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A further benefit to the HAES ® model is |
long-term effects on health outcomes . At |
atric surgery sit in the HAES ® model , given |
done to remove weight bias , including in |
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that it challenges weight-based discrimina- |
this point , most studies into intuitive eating |
that there is mid- to long-term evidence of |
the health system . The HAES ® approach |
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tion and promotes inclusivity in healthcare |
has clear value , however , further research |
settings . If weight loss is not considered to be the marker of success and failure , interactions with healthcare providers can be enhanced , with improved treatment adherence . A differing approach to management of common presentations in indi- |
While there is growing evidence supporting a HAES ® approach , more research is needed to fully understand its long-term effects . |
is needed to establish evidence to drive this ongoing debate . At this stage , the author believes that the evidence does suggest that we are obligated to follow a HAES ®/ non-diet approach with patients with disordered eating , such as binge eat- |
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viduals living in a larger versus a smaller |
ing disorder . For patients who do not fit |
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body has often been reported . Using knee pain as an example , a smaller bodied indi- |
and weight neutral approaches tend to use small groups of white females with over- |
22 , 23 efficacy of these interventions . It is also worth noting that the HAES ® |
this criteria , the author suggests discussing HAES ® as an option , alongside other |
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vidual is more likely to be prescribed phys- |
weight and class I obesity and often a back- |
principles and guidelines are nearly a dec- |
available modalities such as supported , |
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iotherapy and analgesia whereas their |
ground of chronic dieting or binge eating , |
ade old and have been subject to critique for |
sustainable lifestyle changes for weight |
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larger-bodied counterpart will simply be told to lose weight . 19 It must be acknowledged that , regardless of efficacy , weight loss may or may not be achievable and can- |
with the control intervention being restrictive dieting and exercise programs . 20
This then raises questions as to whether HAES ® is the best approach for those that
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lack of inclusivity . They are currently under review by ASDAH with a view to incorporating evolving evidence and the experiences of a more diverse range of people who have |
loss , medication and surgery .
References on request from kate . kelso @ adg . com . au
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not be seen as the sole treatment option |
fall outside this specific group includ- |
experienced fatphobia , including people of |
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for larger individuals . The accepted standard of patient-centred care should be the |
ing individuals without a disordered eating background . Is a HAES ® approach still |
colour , those with disability and transgender individuals . |
Online resources |
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consideration and discussion of all treatment modalities available , with all people , regardless of size . |
appropriate for those with class II or III obesity , for whom there is stronger evidence of weight-related harms ? |
The current role of HAES ®
There is a need for a paradigm shift in the
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• asdah . org
• sizeinclusivehealth . org . au
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