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  • Writer's pictureLouise G

b words and other stories | health at every size - what is it?

Hey it's me! Lou!


Today I want to talk to you about Health at every size (HAES) or size inclusive health (SIH). It has increasing created a bit of buzz, and that is because it's a concept in the health care world that is so incredibly overdue. I’m almost astounded that I'm presenting this to you, as it feels like it is just common sense, but we live in a diet culture obsessed society that is fat-phobic, and so common sense just isn’t that common. And as I type this, I digress because it’s also not our fault. We are exposed and absolutely saturated in it from an early age, conditioned to value being thin and “conventionally” attractive (whatever that even means). It is everywhere we look, and we say and do things frequently that perpetuate this toxicity and torture ourselves, without even realising it.


“Oooof. I’m off to the gym to burn off that pizza I had for dinner last night!”

Burn off? Exercise can be for so many amazing reasons, but not a compensatory measure.


“Oh it’s ok if I just let myself go today because I’ll start my diet tomorrow.”

Nope. That is called disordered eating.


“I didn’t eat breakfast or lunch today, so that means I can have a cheat meal.”

No. There is no such thing as a cheat meal. There are just meals. Enjoy your life.


“Ugggh. I FEEL fat today.”

Nope. Fat is an adjective, it is not a feeling.


“I know that I’d be happier if I could just lost 5 more kilos.”

Not bloody likely. The scales measure your relationship with gravity. That is all.


Are you picking up what I'm putting down?


And maybe now you’re thinking - well how is she even qualified to comment on this?


Well actually, those are my old quotes. There are many more.


Today, I currently live in a larger body. I have also lived in an even larger body. And, I have also lived in a much smaller body. I have loathed my body before and I have dieted. I have been on ALL the diets. I have experienced weight stigma from others, including health professionals, related to my body shape, size and weight. I have been told to lose weight. I have been told to stop losing weight. I have been to the dark side and experienced disordered eating in the quest for acceptance, and it was a terrible time.


I have also fully recovered, and I can tell you it is so amazing to see the world through a completely different lens.


I’ve also worked in mental health for a long time. And now, I work with clients of all shapes and sizes, and while I trust that I have imparted my own wisdom, I have equally learnt a lot from them, and I continue to do so. I have a special interest in treating eating disorders, disordered eating, and disturbances in body image, and I am a strong advocate for BODY NEUTRALITY (another conversation for another day).


So anyway, I really get distracted easily. What is HAES or SIH? It’s simple really. Check it out.


It’s this concept of providing equally great health care to every BODY. This is regardless of their shape, size and weight. Whether the person is larger or smaller, shorter or taller, round, square or triangle shaped, they deserve support for their health and wellbeing, in the absence of stigmatising their BODY.


There are 5 underpinning principles [taken from HAES Australia Inc.], which are:


1. Weight inclusivity.

Accept ALL BODIES, reject idealising or pathologising specific weights.

2. Health enhancement.

Support equity of access to information and resources that improve wellbeing,

with attention to unique individual needs.

3. Respectful care.

Acknowledge our own biases, and work towards ending weight discrimination,

stigma and bias. This includes understanding the many factors that can create inequity

in healthcare.

4. Eating for wellbeing.

Promoting eating that is based on hunger, satiety, nutritional needs, and pleasure.

Not regulated eating that is focused on controlling weight.

5. Life enhancing movement.

Supporting inclusive activities that allow ALL BODIES to engage in enjoyable

movement to the degree that they choose.


You can find heaps more info on this by visiting www.sizeinclusivehealth.org.au.


So the question then is – why are we even talking about this? Why is it, that letting people just live their lives, in their bodies, without judgement, and with access to equitable resources, has to be served up this way as though we’ve forgotten how to afford the same respect to every BODY?


Because of this:


We (society) have been conditioned to believe that ALL people living in a larger body must be unhealthy, and need to conform to be acceptable, and the only way to do this is by losing weight. We (society) hold this belief that fat is bad, food is to be feared and controlled, and that people in larger bodies must be unhappy. When in actual fact, and this may surprise you, there are many people who are technically in the ‘normal BMI range’, some are even elite athletes, who are in the absolute worst health of their lives. And that is also a whole discussion for another time!


So in summary, my general advice is:


1. If you’re a health professional – this is just a reminder.

Don’t make assumptions about any BODY.

Be curious, ask questions, get educated, but never assume.

Check-in with your own biases and how this might influence the care you provide.

2. If you’re living in a body - that is ALL of us.

Whatever your shape, size or weight – unless you have genuine concerns and need to seek support for something impacting on your health (eg. I’m talking about things such as an eating disorder, diabetes, osteoporosis, pancreatitis, heart disease), give yourself full permission to focus your energy on other more important, meaningful things.

3. If you care about someone who is living in a body - I think that is ALL of us.

If you consider them to be “outside the norm” or “unacceptable”, ask yourself why are you thinking this? Why does it matter to you? If you’re discussing this with your loved one, what is your intention? What assumptions are you making about them? Do you think that what you’re doing is helpful or harmful? What could be the outcome of maintaining this conversation with them? Is there a better way to engage your loved one in more helpful conversations about health? Take a little time to reflect on this.


Disclaimer: I am in no way suggesting that someone who is unwell should be ignored or avoided when there is clear or apparent danger to their health. An example of this – someone with an eating disorder, whereby early intervention is vital.


I’m really keen to hear any thoughts you might be willing to share with me on this topic. Feel free to leave a comment or send me an email.


Some reflective questions to finish on:


1. Does this discussion make you feel uncomfortable, and if so, why is that?

2. Does this discussion resonate with you, and give you hope about the direction of healthcare?



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