Health at Every Size® (HAES®) Explained
One of the modalities that the team at Namaste Nourished uses and believes fully in is Health at Every Size®, or HAES. But what does the phrase mean and how does it influence our work as registered dietitians? Read on to learn all about HAES®.
Explanation
The conversations and thoughts guiding the movement of Health at Every Size® began back to the 1960s and the civil rights movement. In the late 1990s, the name ‘Health at Every Size’ was first used to give a name to the discussions about providing an alternative approach to healthcare that didn’t focus on weight loss. HAES® focused on making health care accessible to everyone, no matter their size, or why they are a particular size.
Health at Every Size® has been heavily influenced by the research around the lack of effectiveness of intentional weight loss efforts, especially in fat people. Attempts at deliberate weight loss can be maintained for six months to one year, but after that, people regain what they lost, and oftentimes, even more than where they started (Mann et al. 2007). The impacts of constant dieting also harm the body, by increasing insulin resistance, causing muscle loss, slowing metabolism, and making it easier to regain weight (American Diabetes Association 2026).
Health at Every Size® works to improve healthcare for all by encouraging folks of all body sizes to engage in health promoting behaviors, in turn aiming to eliminate oppression in healthcare. As HAES®-aligned providers, we work diligently to make all of our patients feel seen and cared for in the way that best serves them.
Principles
There are four principles that guide Health at Every Size®. These were first developed in 2003, revised in 2013, and again in 2024. The HAES® principles are:
Healthcare is a human right for people of all sizes, including those at the highest end of the spectrum.
Care is fully provided only when free from anti-fat bias and offered with people of all sizes in mind.
Wellbeing, care, and healing are resources that are both collective and deeply personal.
Health is a sociopolitical construct that reflects the values of society.
Framework of Care
From 2022-2024, a framework of care was developed for Health at Every Size®, so that providers looking to become HAES-aligned would have support and guides along the way. There are 10 elements, but they do not follow a specific order. Additionally, HAES®-aligned providers must commit to staying up-to-date with their learning, so that care can constantly be improved as new discoveries are made. The 10 elements of the Health at Every Size® Framework of Care are:
Grounding in liberatory frameworks
Patient bodily autonomy
Informed consent
Compassionate care
Critical analysis, application, and execution of research and medical recommendations related to weight
Skills and equipment to provide compassionate and comprehensive care for fat people’s bodies
Provider roles and responsibilities
Tools that support wellbeing and healing without contributing to oppression
Addressing your anti-fat bias
Addressing systemic anti-fat bias
Why HAES®-Aligned Care Matters
As dietitians, we are healthcare providers committed to staying up-to-date with the most current evidence, so that we can give our patients the best possible care. Committing to the HAES® principles fits into this principle, and it further aligns with our commitment to eating disorders care. As Dr. Jennifer L. Gaudiani points out in her book, Sick Enough: A Guide to the Medical Complications of Eating Disorders and Undernutrition, “Weight stigma helps ignite eating disorders, and it also impedes recovery.” As eating disorder dietitians, we know this from experience as well. Practicing from a HAES®-aligned place, and referring our patients to fellow HAES® providers allows us, in a small way, to reduce the weight stigma in our society. When we can help reduce it for even one person, it makes an impact, which we hope will continue to grow. We also know from years of experience that practicing from this perspective allows our patients to recover more fully, as many can understand that their weight does not define who they are as a person, and that good healthcare is available to them, regardless of their body size. If you would like to learn more about our work as HAES®-aligned dietitians, or you want support from a group committed to evidence-based care, please reach out to us today.
To learn more about Health at Every Size® and find other HAES®-aligned providers, please visit the Association for Size Diversity and Health (ASDAH)’s website at asdah.org.
References
ADA Nutrition & Wellness Team. (2026, January 30). The Dangers of Yo-Yo Dieting. American Diabetes Association. https://diabetesfoodhub.org/blog/dangers-yo-yo-dieting
Gaudiani, Jennifer L. Sick Enough: A Guide to the Medical Complications of Eating Disorders and Undernutrition. Routledge, 2025.
Mann, Traci, Tomiyama, A. Janet, Westling, Erika, Lew, Ann-Marie, Samuels, Barbra, & Chatman, Jason. (2007). Medicare’s Search for Effective Obesity Treatments: Diets Are Not the Answer.
American Psychologist, 62(3), 220-233.