Can you be healthy at any size? Ex­plore a new ap­proach

Do you re­ally need to lose the ex­tra weight to help man­age or re­duce the risk of de­vel­op­ing di­a­betes? DL di­eti­tian and di­a­betes ed­u­ca­tor Dr Kate Marsh ex­plains

Diabetic Living - - Contents -


Health At Ev­ery Size (HAES) is a weight-neu­tral ap­proach to health. HAES prac­ti­tion­ers be­lieve that, re­gard­less of your size, it’s more im­por­tant to fo­cus on healthy be­hav­iours than weight loss.

HAES is based on ev­i­dence that di­et­ing for weight loss is in­ef­fec­tive (most peo­ple even­tu­ally gain back the weight they lose) and of­ten harm­ful (some weight loss meth­ods and re­peat­edly los­ing and re­gain­ing weight can have their own health risks).

The HAES ap­proach, de­vel­oped by the As­so­ci­a­tion for Size Di­ver­sity and Health (ASDAH) also en­cour­ages work­ing to end weight dis­crim­i­na­tion, weight stigma and weight bias.


Sev­eral stud­ies have com­pared the HAES ap­proach to con­ven­tional treat­ment

(fo­cused on weight) and the find­ings are in favour of HAES. Chang­ing the fo­cus from weight to health is as­so­ci­ated with sig­nif­i­cant im­prove­ments in health mea­sures (such as blood pres­sure and blood fats), health be­hav­iours (such as diet qual­ity and eat­ing and ac­tiv­ity habits) and psy­choso­cial out­comes (such as self-es­teem and body im­age). Th­ese im­prove­ments are greater than with weight­fo­cused treat­ments and with­out the neg­a­tive ef­fects. And stud­ies don’t show that tak­ing the fo­cus off weight leads to weight gain.

Ad­vo­cates of HAES also point out that, apart from at the ex­tremes, there is lit­tle ev­i­dence to show car­ry­ing ex­tra weight re­duces longevity. In fact, in many cases the re­search shows that those who are over­weight live longer.

Fi­nally, di­et­ing to lose weight, par­tic­u­larly weight cy­cling (re­peated at­tempts at los­ing weight and then re­gain­ing) can have neg­a­tive ef­fects on both phys­i­cal and men­tal health. Plac­ing an em­pha­sis on weight con­trol can lead to dis­or­dered eat­ing and body dis­sat­is­fac­tion and there is ac­tu­ally ev­i­dence to sug­gest that di­et­ing pre­dicts fu­ture weight gain.




It’s true that car­ry­ing ex­tra weight is as­so­ci­ated with an in­creased risk of type 2 di­a­betes,

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