Health at Every Size and Intuitive Eating

The pursuit of weight loss has created a billion-dollar industry, but it’s an industry that data trends suggest hasn’t really contributed to creating a leaner or even healthier America. According to the Centers for Disease Control and Prevention’s National Health and Nutrition Examination Survey, the prevalence of obesity in 2015–2016 in the United States was 39.8 percent among adults and 18.5 percent among youth. Traditional diet programs, while perhaps successful in the short term, have largely failed when it comes to long-term weight loss maintenance. Some research even suggests the direct association of frequent dieting with weight gain, begging the question, “Should you ditch dieting for good and try a different approach to improving wellness?”

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This year, instead of focusing solely on weight loss, consider taking a new health-centered but non-diet approach to behavior and lifestyle change. Health at Every Size® (HAES) and intuitive eating are two approaches that focus on creating better relationships with food and one’s body. Some studies found that a non-diet approach to eating and behavior change was not only associated with psychological well-being and improvements in body image but also with improvements in metabolic health — including blood pressure, lipid levels and cardiorespiratory fitness.

Worried that decentralizing weight loss as a focus will contribute to weight gain? Research suggests the contrary and has found that study participants who took a non-diet approach didn’t gain weight. In fact, participants who took a non-diet approach often maintained weight or inadvertently achieved weight loss, although weight change was not a goal. Research has also demonstrated that participants engaging in a non-diet approach alleviate body dissatisfaction while improving eating habits and lifestyle. Creating a more mindful approach and eating by internal cues is a more adaptive eating style and perhaps even “radical” change for chronic dieters. This approach doesn’t disregard therapeutic dietary modifications for health reasons, like incorporating a Mediterranean style of eating to improve cardiovascular outcomes, which is a common misperception. Instead it embraces a holistic approach to eating and encourages learning to eat in an attuned manner. Although more research needs to be done, especially with diverse populations, HAES and intuitive eating approaches are challenging traditional diet culture, embracing body diversity and providing new strategies for self-care and health promotion.

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HAES and intuitive eating principles

HAES principles include:

• Celebrating body diversity.

• Honoring differences in size, age, race, ethnicity, gender, disability, sexual orientation, class and other human attributes.

• Valuing body knowledge and lived experience.

• Challenging scientific and cultural assumptions.

• Finding joy in moving one’s body and being physically active.

• Eating in a flexible and attuned manner that values pleasure and honors internal cues of hunger, satiety and appetite while respecting the social conditions that frame eating options.

HAES resources

● Body Respect: What Conventional Health Books Get Wrong, Leave Out, and Just Plain Fail to Understand about Weight by Linda Bacon and Lucy Aphramor

Association for Size Diversity and Health

Intuitive eating principles include four central themes

• Unconditional permission to eat.

• Eating for physical rather than emotional reasons.

• Reliance on internal hunger and satiety cues.

• Body choice congruence.

Intuitive eating resources

● Intuitive Eating: A Revolutionary Program that Works by Evelyn Tribole MS, RD, and Elyse Resch MS, RD, FADA

● The Intuitive Eating Workbook: Ten Principles for Nourishing a Healthy Relationship with Food by Evelyn Tribole and Elyse Resch
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Dana Sturtevant MS, RD, is a trainer, mentor, yoga teacher and dietitian specializing in Health at Every Size® and intuitive eating. She is the co-founder of the Be Nourished outpatient clinic and professional training institute and the co-creator of Body Trust® — ;a strength-based, trauma-informed, scientifically grounded healing modality that encourages movement toward a compassionate, weight-inclusive model of radical self-care to address body oppression and heal body shame and associated patterns of chronic dieting and disordered eating. She provides her top tips for rejecting diet culture and creating a life that is body compassionate and focused on self-care from a weight-neutral perspective.

Shift your focus to weight-neutral self-care

“It is not possible to heal your relationship with your body and food and develop sustainable self-care practices when the focus is on changing your weight,” says Sturtevant. She suggests decentralizing the importance of weight in the journey to making lifestyle changes. This approach allows one to shift the focus from weight to actionable steps to improve self-care and enhance well-being.

Keep a wide lens

Sturtevant emphasizes looking at your entire life, not just one aspect, like eating habits. Examine your emotional, relational and physical health. How is your sleep? How often do you get outside? See your friends? How is the majority of your time and energy spent? Does this match with what is important to you? These questions require a broader view of life and influence the subsequent self-care goals that one might set.

‘Unfollow’ diet culture

Many social media accounts feature the latest diet trends and reinforce narrow beauty standards, which contribute to feeling bad about ourselves. Sturtevant recommends unfollowing friends and influencers on social media who trigger negative emotions regarding food and body. Start following accounts that fill your social media feeds with beautiful images of larger-bodied people and info that challenges diet culture. Setting limits on time spent on social media might also be beneficial in addition to editing followers and/or friend lists.

Avoid body-checking behaviors

Sturtevant says, “Developing reverence and respect for your body is key to developing a body-compassionate approach to self care.” Become aware of and reduce body-checking behaviors like weighing yourself on the scale, scrutinizing your body in the mirror, comparing your body to others, or measuring the body in other ways.

Pay attention to the meal mix

Develop an understanding of how the meal mix, or combination of different types of food, impacts digestion and even satiety, or that feeling of fullness, suggests Sturtevant. Individuals living with diabetes may also notice how different meal combinations impact blood glucose readings. An individual may choose to utilize that feedback to create combinations at meals that are satisfying, delicious and helpful to blood glucose management.

Set boundaries with the “food police”

Your support system may want to be helpful, but it is NOT OK for people to comment on your food choices, says Sturtevant. Instead, she encourages individuals to set boundaries and tell individuals in their support system specifically what is and is not helpful.

Give the body the consistent message that food is available

Sturtevant emphasizes working toward creating a regular pattern of eating to reduce preoccupation with food and avoid swinging from starving to stuffed. Creating a regular eating routine helps with improving awareness of hunger and satiety cues and provides needed nourishment.

Find out more about the Be Nourished clinic and Body Trust® approach at www.benourished.org.

Want to learn more about intuitive eating? Read “Intuitive Eating: Enjoy Your Food, Respect Your Body.”

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