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What To Expect Working With A HAES Dietitian

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A HAES dietitian is a nutrition expert that does not promote weight loss as a nutrition intervention for patients.

A HAES-aligned dietitian practices with the understanding that:

  • Lower weights do not equal better health
  • Diet culture and it’s obsession with thinness creates health disparities
  • Clinical illnesses can be managed without nutrition intervention that includes weight loss
  • Long term weight loss is not sustainable for most people
  • Short term weight loss can be damaging to the body, mind, and metabolism

While it is not the goal of a HAES dietitian to prevent weight loss (unless the person is suffering from an eating disorder), this is simply never the primary objective of the nutrition intervention.

A HAES dietitian differs from traditional nutrition professionals in that weight loss will never be prescribed as a treatment measure.

Let’s dig into what A HAES approach is and what you can expect visiting a HAES dietitian,

What is a HAES?

HAES, or health at every size, celebrates the idea of choosing health-promoting behaviors not focused on body weight, shape, or size. 

A few hallmarks of HAES are that

  • Weight inclusivity
  • Celebrating the diversity of all bodies
  • Eating for well being (both mental and physical)
  • Respectful care (care providers should be aware of biases and provide care with respect to diversity and socio-economic status)

A HAES dietitian will still utilize science-based research to address medical concerns, facilitate daily behavior changes to support adequate nourishment, and facility a healthy relationship with the body and plate. 

What Can I Expect At My Appointment With A HAES RD? 

As a dietitian, we have a responsibility not only to provide evidence-based research to our patients. HAES RDs use science-based research combined with lifestyle factors to support you with your nutrition goals.

HAES dietitians will examine factors unique to each person to develop the best nutrition plan. These might include: 

  • Ethnic food choices
  • Access to food
  • Cultural traditions surrounding food 
  • Relationship with food across the lifespan 
  • Disease presence and management 
  • Access to safe spaces for movement 
  • Food environment

A HAES dietitian will be mindful of race, gender, socioeconomic status, disease state or disabilities in our nutrition interventions.

While ethics is in the job description of EVERY dietitian, a HAES dietitian pays special attention to the fact that weight bias can serve as its own oppressive barrier to resources and healthcare.

Can You Lose Weight With A HAES RD?

Yes.

The primary difference in HAES aligned healthcare and mainstream healthcare is that changing the body weight shape or size will not be the focus.

For example, A HAES aligned RD will not:

  •  Prescribe weight loss as a focus to manage blood sugar
  • Create weight loss strategies for managing high cholesterol
  • Focus on weight loss as the intervention for joint pain

A HAES dietitian is focused on helping you make lifestyle choices to fuel the body and mind as well as manage any clinical conditions.  

You may work with a weight-inclusive dietitian to learn the principles of intuitive eating,

Once the principles of intuitive eating are established, you may or may not see weight changes. Your dietitian will support you in nourishing whatever nutrition habits align with your genetic blueprint for weight. A weight-inclusive RD also supports the idea that weights can change over time, and this is perfectly normal and healthy.

Is A HAES Dietitian The Same As An Eating Disorder Dietitian?

It is very common that a eating disorder dietitian is also a HAES dietitian.  However, a HAES dietitian does not always work with eating disorders. 

To work with eating disorders, a dietitian should have a unique skill set and training. 

Eating disorder dietitians are often providing medical nutrition therapy which often includes Interpreting and monitoring lab data and referring to a higher level of care when necessary.

A HAES dietitian may or may not engage in any form of medical nutrition therapy including that of eating disorders.  It really just depends on the RDs specialty. 

However, if seeking an eating disorder dietitian it is important to inquire about whether or not they are also a HAES-aligned dietitian. A HAES aligned ED dietitian can be important for the long term recovery process from an eating disorder. 

How Can A Weight Inclusive Dietitian Help Me Make Peace With Food?

When you work with a HAES dietitian, it will likely feel different then when you work with other providers. 

It is important to note that the primary goal is still to improve your overall health an wellbeing. A dietitian does this by nurturing a healthy relationship with the physical and emotional components involved in choosing food. 

A HAES dietitian will help you to: 

  • Explore food neutrality (the idea that no one food is superior to another)
  • Identify any fear foods you may have (foods that cause guilt, shame or anxiety)
  • Explore any body checking that is occurring and help you nurture body trust
  • Work through eating disorders or disordered eating behavior (where appropriate)
  • Manage a medical condition without a weight focus
  • Practice and nourish for  joyful movement without the goal of shrinking the body size
Forks tied with measuring tape

How does HAES Support Diversity In Healthcare?

For starters, HAES honors all bodies.  

When all body weights are considered equally good and valuable, this shifts the way we talk about and implement healthcare

Through HAES we are honoring that bodies will naturally exist across a spectrum.  A healthy body weight will vary depending on factors such as:

  • Gender
  • Ethnicity
  • Sexuality
  • Genetic Variation
  • Culture

HAES RDs do not use outdated tools such as BMI to prescribe treatment measures.

We know that when people aren’t scrutinized for their body weight they tend to:

  • Seek healthcare more often
  • Participate in preventative care which improves long-term health outcomes
  • Feel more confident and empowered carrying out prescribed treatment

In fact, we also know that people that are made to feel guilty about their weight at healthcare visits may even gain weight as a result of feeling stressed and inadequate.

Shaming people about their body weight in healthcare does not produce smaller bodies. It also leads to potentially missing many health problems and solutions at the visit as a focus on weight loss might take priority over all other things.

What To Know About Working With A HAES Dietitian

Where Can I find a HAES Dietitian?

It’s important to consider the philosophy and training of the provider you choose to work with. While many may claim to be HAES aligned, they may still be promoting weight loss, food restriction, or exercise resulting in body changes. 

A good place to start would be on the Academy of Nutrition and Dietetics find a nutrition expert tool. 

You can also do a simple google search for dietitians in your area. 

Look for practitioners in your area that identify a HAES focus. It’s also a great idea to peruse their website and check for any diet-y related language (e.g. calories, weight loss, getting fit, restricting certain food groups). 

A true HAES dietitian will talk the talk. You will know a dietitian is truly haes when:

  • They aren’t promoting weight loss
  • Good foods and bad foods aren’t in the vocabulary
  • They don’t promote any specific “style” of eating (vegetarian, vegan, keto etc.)
  • Calories and macronutrient counting is not encouraged

You can also often go to a practitioner’s about me page and determine any special training they may have in intuitive eating or HAES aligned healthcare.  Many providers will also allow a discovery call where you can check in to make sure you are a good fit.  

© 2022 Peace and Nutrition

 
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What Is A HAES Dietitian

A HAES dietitian is a nutrition expert that does not promote weight loss as a nutrition intervention for patients.

Is a HAES Dietitian The Same As An Eating Disorder Dietitian?

Many eating disorder dietitians are also HAES dietitians. However, not all eating disorder dietitians practice from a haes approach. Similarly, not all HAES dietitians will treat eating disorders.

Can I Work With A HAES Dietitian and Lose Weight

Yes. However, A HAES dietitian will not work with you on a goal of weight loss. This may be a natural side effect of nutrition counseling related to other health goals.

Does a HAES Dietitian use science-based research?

Yes.

Shena Jaramillo. Registered Dietitian

Hi I'm Shena. I'm an eating disorders dietitian in Washington state. I hold bachelors degrees nutrition & dietetics, cultural anthropology & psychology. I believe in honoring your hunger, having your cake whenever you want it, and that critically analyzing diet culture can change the world!