Can we be healthy at any size? (Health at every size concept)


24 Feb
24Feb

Our society has become far too focused on being ‘thin’ rather than being healthy. And there will always be those that will rebel against this and say that you can be healthy, beautiful and happy even if you are overweight. Can this be true? The answer is however not as simple as ‘yes’ or ‘no’, but is rather a combination of the two.

When answering the question it is vital to remember that health is not (only) determined by weight. Health is multi-dimensional and therefore needs to be assessed holistically. This involves looking at other health indicators (in addition to weight) such as energy levels, digestive health, mood, sleep, physical fitness and lab values such as insulin sensitivity, blood pressure, cholesterol, triglycerides and blood sugar levels. So part of the answer is yes, we can be healthy even if we are overweight.

The health at every size (HAES) concept was created by Linda Bacon to help eliminate the stigma and bias in individuals living with obesity. The focus of the HAES approach is on healthy behaviours rather than weight loss i.e. to be as healthy as you can no matter what your weight. Weight is not an entirely useless metric to use to assess health, but what’s important is to put the focus on healthy eating behaviours, intuitive eating, physical activity, getting enough sleep, mental health and stress management rather than weight loss and the number on the scale alone. And what we’ve seen over and over again, is that when people actually do stop worrying about the number on the scale and focus on healthy eating habits and physical activity instead, their health improves and weight loss tends to follow naturally anyway. To extend on the yes answer then, we can be healthy even if we are overweight, but ONLY if you have healthy eating and living behaviours. The problem is that obesity is associated with a number of chronic diseases such as hypertension, cardiovascular disease, type 2 diabetes, some cancers and gallbladder disease. However, an individual who falls within the overweight or obese category but has healthy eating habits and good physical fitness levels could still be metabolically healthy (have normal blood glucose levels, normal blood pressure, normal lipid profiles), and similarly, a person who is thin or within a healthy BMI range with poor eating habits and physical fitness levels may not. This stands to show that healthy eating and regular physical activity, independent of weight loss, produces good health outcomes. It is also good to remember that many other complications that are obesity related could still occur irrespective of the individual being metabolically healthy or not. This includes medical conditions such as joint pain, some cancers and mood disorders. Another important point to be made is that acceptance of yourself is a vital part of health. Most people struggle with this, and believe that they are not perfect enough because they are not thin enough. They hate thier bodies, and are not accepting of all the lumps and bumps. But we all have them, and we are all uniquely perfect. This is where I believe that the HAES concept is so powerful. We should all love ourselves, no matter the shape and body we were given. Genetically not eveyone can be a perfect 10, but if you know you are eating well and exercising regularly you will be at your perfect weight, no matter what that is.
It is for this reason that the question ‘Can we be healthy at any size’ does not have a simple answer. Weight should never be looked at in isolation when assessing the health of an individual. Multiple factors need to be taken into consideration and interventions that aim at losing weight should be ones that promote healthy lifestyles rather than weight loss alone.

Although the concept that health at every size supports acceptance of individuals regardless of body shape and size, the value of a modest weight reduction (5-10%) in improving health outcomes should still not be forgotten. However, how this weight loss is achieved is important too. Doing a quick-fix fad diet will not result in health of the body as weight loss is mostly short-lived. Yo-yo weight cycling is very unhealthy for the body and it too can increase the risk of chronic diseases such as heart disease, cancer, high blood pressure and osteoporosis. Bottom line, the goal should be to focus on healthy lifestyle interventions that result in long term weight loss rather than putting full focus on weight loss interventions that are not sustainable. The concept of health at every size should not be misinterpreted to mean ‘Let it all go and eat whatever you want’. With professional guidance we can assist and support you with healthy eating and regular exercise for long term health and wellness at your perfect size.

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