Integrating Health at Every Size principles into adolescent care

Abstract

Purpose of review Weight trends continue to increase in adolescents, but current weight-focused interventions have not demonstrated any lasting impact on overall health. Among adolescents, experiencing weight bias increases risks of harmful weight-related behaviors and decreases engagement in health-promoting behaviors, thus leading to worsened health outcomes. The Health at Every Size (HAES) approach may be an avenue to promote health holistically among adolescents without eliciting harmful weight-related behavior and improving provider-patient rapport. The purpose of this review is to summarize the literature on integrating HAES principles into healthcare and to generate recommendations for healthcare providers. Recent findings Research among adults shows that HAES-informed care can improve some physical health measures and generates improvements in behavioral and psychological outcomes, as well as promotion of social justice and equity. HAES-informed recommendations for adolescent care de-emphasize weight loss and focus on removing barriers to engaging in health-promoting behaviors at the point of assessment, in the diagnosis and management of medical complications, and in treatment. Summary HAES principles can be an invaluable tool for providers who aim to improve overall health whilst avoiding a focus on weight among their clients.

“I Want Different for My Child:” An Interpretative Phenomenological Analysis of Mothers’ Histories of Disordered Eating and the Impact on Their Parenting Approach

“…Given the importance of systemic factors highlighted in this study, counselors should also consider offering a more systemic and holistic approach drawing on systems theory by including both spouses/partners as well as working alongside other relevant systems, such as Health at Every Size-trained pediatricians (Raffoul & Williams, 2021). As Sandler et al (2015) assert, there is a need to focus on preventative interventions for mothers, helping them prepare and manage the forthcoming stressors, as their children navigate issues related to food and body image.…”

A framework for conceptualising early intervention for eating disorders

“…As EDs frequently develop during adolescence, research on developmentally appropriate care is essential. This includes sensitive assessment and treatment processes for young people going through puberty and developing their sense of self and identity, with consideration of gender identity and sexuality, culturally appropriate body image assessments, and experiences of discrimination around size and shape (e.g., Hartman‐Munick et al., 2021 ; Nowaskie et al., 2021 ; Parker & Harriger, 2020 ; Raffoul & Williams, 2021 ). In 2011, the American Institute of Medicine emphasised research on the needs of sexual minority populations with EDs as being a public health priority.…”

EASO and EFAD Position Statement on Medical Nutrition Therapy for the Management of Overweight and Obesity in Children and Adolescents

“…Non-dieting approaches have been reported to improve some physical health measures, behavioural and psychological outcomes in adults with obesity [ 135 ]. Although little research into non-dieting approaches for adolescents has been conducted, the concepts of focusing on health-promoting behaviours at all stages of the medical nutrition care process, rather than a weight-centric approach, are consistent with clinical guidelines [ 49 , 136 ]. Adolescent obesity treatment improves self-esteem and body image in the short and medium term, with improvement to self-esteem independent of weight-related outcomes [ 137 ].…”