Health at Every Size Challenges Weight-loss as Way to Health

Diet and Weight Loss

Did you resolve to watch your diet, shed some weight, and get healthier this year?

A growing trans-disciplinary movement called Health at Every Size (HAES) is challenging the value of promoting weight loss and dieting behavior. This movement argues for a shift in focus to weight-neutral outcomes.

Individuals who lose weight through diet, exercise and other behavior change often do so only short term. The majority of individuals are unable to maintain weight loss over the long term. Short term weight loss does not achieve long term benefits of improved health.

There is a growing concern that this weight focus is not only ineffective at producing thinner, healthier bodies, but may also have unintended consequences, contributing to food and body preoccupation, repeated cycles of weight loss and regain, distraction from other personal health goals and wider health determinants, reduced self-esteem, eating disorders, other health decrement, and weight stigmatization and discrimination.

Linda Bacon, an associate nutritionist at the University of California, Davis Department of Nutrition, and Lucy Aphramor, an NHS specialist dietitian and honorary research fellow at the Applied Research Centre in Health and Lifestyle Interventions at Coventry University have written a review article presenting compelling evidence that calls into question many of the long-held assumptions underpinning weight-focused public health policy. Their paper is published in the January 2011 issue of Nutrition Journal.


The two researchers conclude that fatness is highly exaggerated as a risk for disease or decreased longevity, and that money would be better spent on campaigns that help people develop a healthy relationship with food and that advocate respect for every body - fat and thin.

“For decades, the United States’ public health establishment and $58.6 billion-a-year private weight-loss industry have focused on health improvement through weight loss,” Bacon said. “The result is unprecedented levels of body dissatisfaction and failure in achieving desired health outcomes.”

Aphramor runs a HAES course, called Well Now, in Coventry innovatively funded as part of Coventry's Health Improvement Programme, an £18million partnership programme between Coventry City Council and NHS Coventry, to improve health levels of people in the city.

The basic tenets of HAES include:

  1. Accepting and respecting the diversity of body shapes and sizes.
  2. Recognizing that health and well-being are multi-dimensional and that they include physical, social, spiritual, occupational, emotional, and intellectual aspects.
  3. Promoting all aspects of health and well-being for people of all sizes.
  4. Promoting eating in a manner which balances individual nutritional needs, hunger, satiety, appetite, and pleasure.
  5. Promoting individually appropriate, enjoyable, life-enhancing physical activity, rather than exercise that is focused on a goal of weight loss


The researchers suggest the weight-focused approach to health is unsupported by the scientific evidence and has in fact been detrimental and costly. They encourage the government and the health care community to adopt a more ethical, evidence-based approach toward public health nutrition; one that instead encourages individuals to concentrate on developing healthy habits rather than concentrating on weight management.

Weight Science:Evaluating the Evidence for a Paradigm Shift ; Linda Bacon, Lucy Aphramor; Nutrition Journal 2011, 10:9 (24 January 2011)
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