What is a HAES Dietitian? Plus, What to Expect Working With One.
Written by Isabel Vasquez RD, LDN
When you think of health, one of the first things that comes to mind may be weight. Yet, weight is not the end-all, be-all when it comes to health. In fact, it probably impacts health far less than you think.
If you’re sick of constantly trying to lose weight and never sustaining the weight loss (like the vast majority of dieters), you may be ready for a different approach. There must be another way to promote your health besides disheartening diets! Yes, there is.
Health at Every Size (HAES) is an alternative to the typical weight-centered approach to health. It demands access to quality healthcare and respect for people of all different body shapes and sizes and health statuses.
In this article, learn what a HAES dietitian is, why you might choose to work with a HAES dietitian, what to expect from your appointments with a HAES dietitian, and how to find a HAES dietitian.
What is HAES?
HAES stands for Health at Every Size. It is an approach to health rooted in fat liberation and weight-inclusive healthcare.
People in larger bodies are unjustly oppressed in our society, from receiving poorer quality healthcare to facing job discrimination and non inclusive seating options in airplanes, restaurants, and doctor’s offices.
These are all examples of weight stigma, which negatively impacts mental and physical health outcomes.
Many times, it causes folks in larger bodies to avoid healthcare visits because providers often dismiss their concerns and recommend weight loss when their issue has nothing to do with weight.
We are often told that weight directly impacts health; yet, variables like weight stigma, weight cycling (big shifts up and down in weight that often occur as a result of dieting), and disordered eating aren’t accounted for.
These are also all factors that impact people in larger bodies more than those in straight-sized bodies.
HAES accounts for the fact that different people’s bodies naturally gravitate towards different weight ranges—often called weight set point theory—and that sustainable means of losing weight do not exist, despite decades of research evaluating lifestyle changes (e.g. diet and exercise) aimed at weight loss.
One person’s body may naturally gravitate towards a higher weight, while someone else’s may be lower. That’s normal and natural, despite diet culture trying to convince us we can all achieve a narrow beauty ideal if we just “eat right” and work hard at the gym.
But HAES is about more than just that. It’s also about ensuring that all those who wish to access healthcare can access quality healthcare, particularly people in bigger bodies.
It’s also about ensuring that people have the opportunity to give informed consent and be empowered to practice body autonomy in healthcare settings. It centers healthcare as a human right and accounts for the role that systemic changes must play in a truly just healthcare system.
The Four Principles of HAES
HAES is divided into four principles, as of the Association for Size Diversity and Health (ASDAH)’s 2024 revisions. They are:
Healthcare is a human right for people of all sizes, including those at the highest end of the size 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.
As you can see, this approach isn’t just about 1:1 interactions; it’s about systemic changes that must be made for healthcare to be equitable and effective.
The HAES Framework of Care
Furthermore, ASDAH recently came out with a HAES framework of care that highlights 10 core elements for providers to embrace to provide truly HAES-aligned care. So, if a dietitian is truly a HAES-aligned dietitian, they should be leaning on these 10 core elements:
Grounding in liberatory frameworks
Patient bodily autonomy
Informed consent
Compassionate care
Critical analysis, application, and execution of research & 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
What is a HAES dietitian?
A HAES dietitian is a registered dietitian who leans on ASDAH’s HAES framework of care in their work.
There’s no official certification to become a HAES dietitian, so some people may call themselves a HAES dietitian without fully embracing the HAES principles and framework of care. They also might not have extensive training in HAES.
However, to become a registered dietitian (often abbreviated to RD or RDN), there are extensive requirements including specific coursework, 1200 hours of supervised practice, a board exam, and continuing education.
Related: What is the difference between a registered dietitian and a nutritionist?
HAES dietitian vs. eating disorder dietitian
A HAES dietitian is different from an eating disorder dietitian. While they often overlap, an eating disorder dietitian may not practice from a health at every size approach.
For one, they may still recommend weight loss for some clients despite intentional weight loss running counter to eating disorder recovery. Even if they don’t recommend weight loss, their practice may not be grounded in the 10 core elements of the HAES framework of care.
Similarly, not all HAES dietitians are eating disorder dietitians. Some HAES dietitians work with people with chronic health conditions or general nutrition concerns who don’t have eating disorders.
That being said, the two do often overlap since embracing your body shape and size, regardless of what that is, is central to finding lasting recovery from an eating disorder.
Who should see a HAES dietitian?
Given how prevalent disordered eating, poor body image, and anti-fat bias are in our society, most people could probably benefit from working with a HAES dietitian.
Plus, HAES is associated with real health benefits including improved markers of cardiometabolic health (like cholesterol and fasting blood sugars), reduced binge eating, and better psychological health.
That being said, the following groups may especially benefit from seeing a HAES dietitian:
Those with an eating disorder. Finding a HAES dietitian who is comfortable treating eating disorders can help you heal since most eating disorders are accompanied by an overvaluation of weight and shape. A HAES dietitian can help you separate your weight from your worth while helping you establish a more consistent, adequate eating pattern.
Those sick of being stuck in the diet cycle. If you’re stuck in a cycle of chronic dieting, a HAES dietitian can help you adopt a health-promoting eating pattern that isn’t rooted in restriction. They can also help you explore how anti-fat bias may inform your food choices.
People in larger bodies. Weight stigma is all too common in healthcare settings. A HAES dietitian can provide a space for you to focus on your health—mental, physical, social, and emotional—without centering weight.
Those with a nutrition-related health condition. If you have a health condition that is impacted by nutrition, a HAES dietitian can help you learn how to manage your condition without dieting. They can help you work on adopting sustainable, health-promoting behaviors, rather than just focusing on the number on the scale or restrictive food recommendations.
Why you might choose to work with a HAES dietitian
Lots of people could benefit from working with a HAES dietitian, but if you’re going to invest the time in working with a HAES dietitian, it’s worth knowing what you might get out of it. Here are some reasons you might choose to work with a HAES dietitian:
Improving your body image. While HAES dietitians are not therapists, our sessions often bring up emotions that you may not expect from working with a dietitian. Part of that is because we often explore your body image and what shapes your beliefs about your body.
Making peace with food. Disordered eating is super common these days. If you’re constantly preoccupied about what to eat, have obsessive thoughts about food, or feel lost when it comes to nutrition, then a HAES dietitian may be able to help. They can help you find food freedom and make peace with food in part by dismantling anti-fat bias.
Setting sustainable health goals. Weight-centric healthcare is short-sighted since most weight loss attempts don’t lead to sustainable weight loss anyway. A HAES dietitian can help you adopt health-promoting behaviors to support your health in the long run. That includes things like adding nutrition, finding movement that feels good for you, and reducing stress associated with dieting.
What happens at a HAES dietitian appointment?
If you’ve never worked with a dietitian before, you may think that you just go in, tell them what you eat, and walk out with a meal plan to follow. While that may be the case with some dietitians, HAES dietitian sessions will look very different.
I do want to highlight that dietitian sessions are meant to be individualized, so they won’t look the same for everyone. In my work as a HAES dietitian, I always adapt sessions around where the client is emotionally, what their goals are, and what their challenges are. However, here’s a general overview of what to expect.
In your initial visit, your dietitian will conduct an in-depth assessment, so be prepared for a bunch of questions. We want to understand what prompted you to seek out a HAES dietitian, what your goals are, your health history, and more about your background including your relationship to food and your body. Every dietitian will have a slightly different intake format.
In the following sessions, you will likely discuss your goals more in-depth. The dietitian can provide nutrition education and offer individualized recommendations to help you manage chronic health conditions; this is called medical nutrition therapy (MNT).
If you don’t have any specific health conditions to manage, they can offer general nutrition education without centering weight as the goal result. They’ll also probably ask you a lot of questions to help you process your relationship to food, your body, and exercise. They’ll get to know you better and in the process, maybe even help you get to know yourself better.
Many clients find that they have a newfound freedom when it comes to their food choices. They learn to connect with their bodies and become caretakers of their bodies, rather than suppressing their bodies’ needs and feeling shame about their body size.
They learn to set boundaries around food and body comments and when comments do happen, they don’t set them off as much as before.
It usually takes at least a few months of working with a HAES dietitian to reap these benefits because the decades of programming around weight don’t change overnight, nor do society’s biases regarding weight.
As HAES dietitians, we can help you navigate challenges and mental blocks that arise as you’re absorbing this new information and trying to implement it in your life.
Can you lose weight working with a HAES dietitian?
When you stop working towards intentional weight loss, three things can happen:
You can gain weight
You can lose weight
Your weight can stay the same
Since we aren’t trying to control your weight anymore, there’s no guarantee as to which of those three results will happen. The idea is to stop centering the number on the scale as an indicator of health.
We work on viewing any of those three results neutrally rather than putting weight loss on a pedestal and feeling shameful about weight gain.
We process the fears you may have around weight gain and work towards body acceptance. We support you in developing more tools to navigate weight stigma outside of our sessions. If you do want to lose weight, we compassionately help you process where that desire is coming from.
Related: Can I practice intuitive eating if I want to lose weight?
How can I find a HAES dietitian?
HAES dietitians are becoming more and more common (YAY!). However, most dietitians still practice from a weight-centric approach.
To find a HAES dietitian, look for descriptors like HAES, weight-inclusive, or anti-diet. These are all words dietitians may use to signal that they’re HAES-aligned.
However, if you aren’t sure, it’s helpful to reach out to the dietitian and ask if and how they incorporate HAES principles in their client work.
Here at Your Latina Nutrition, we are a team of Latina HAES dietitians. We meet with clients virtually, and we accept insurance in a bunch of states. We would love to support you in promoting your health without centering weight! Learn more about working with us through your insurance here.
Other healthcare providers including doctors, therapists, and physical therapists can also take a HAES approach to health. You can find a list of Health at Every Size providers through the Association of Size Diversity and Health (ASDAH) provider listing.
Final Thoughts
Health at every size offers a breath of fresh air for people sick of hearing their healthcare providers dismissing their health concerns with recommendations to just lose weight. Working with a HAES dietitian can help you improve your relationship with food, develop a better body image, and promote your physical and mental health.
For education on how to ADD nutrition to your favorite Latine cultural dishes, make peace with food, and focus on your health without dieting, join our nutrition library for just $27/month.
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