Health Professional's Guide to Treatment of Overweight and Obesity

patient or client permission to eat is thought to reduce guilt and emotion-driven eating, thereby reducing the cycle of restriction and overeating as well as eating in the absence of hunger.72,74

Unlike mindful eating approaches, the importance

of rejecting dieting or weight loss is essential to intuitive eating, as diet culture is believed to trigger the cycle of restriction and subsequent emotional eating and binge eating. Thus, intuitive eating interventions focus on repairing a patient or client’s relationship with food and with their body so that they are able to eat in a way that is more attuned to their hunger level and tastes.77 intuitive eating are summarized in Box 13.3.77

BOX 13.3

Guiding Principles of Intuitive Eating77

1. Reject the diet mentality. 2. Honor your hunger. 3. Make peace with food. 4. Challenge the food police. 5. Discover the satisfaction factor. 6. Feel your fullness. 7. Cope with your emotions with kindness. 8. Respect your body. 9. Movement—feel the difference. 10. Honor your health with gentle nutrition.

The main tenets of

Health at Every Size

The Health at Every Size (HAES) approach was popularized in research and weight-management literature in the early 2000s, although the origins of the HAES movement date back to the 1980s with the development of the National Association to Advance Fat Acceptance and the work of feminist scholars throughout this era. The movement emerged partially in response to perceived failures of traditional weight loss interventions to achieve or sustain prolonged weight loss, as well as increasing recognition of the negative impacts that weight-related stigma and sizeism can have on the health of people with obesity.78,79

The HAES philosophy involves

moving away from weight-focused strategies for health in individuals with larger body sizes and toward a health-focused paradigm that encourages body acceptance, intuitive eating, and intuitive exercise or “active embodiment.”80,81

Traditional

HAES treatment programs include five key components: body acceptance, physical activity, nutrition, psychosocial support, and eating behaviors. At the initial phase of treatment, and continuing throughout, emphasis is placed on self-acceptance and self-worth, with the goal of enjoying life to the fullest, regardless of one’s weight or shape.82

Subsequently, psychoeducation on nutrition and exercise are provided

through an intuitive eating lens (eg, relying on hunger, taste, and satiety cues). Like intuitive eating, HAES is a more radical approach to healthy eating and

activity, as it focuses not only on weight management but on the rejection of diet culture and the concept of health as defined by a “normal” weight.83

The modern

HAES movement also includes a focus on social justice—including the understand- ing of how systemic societal inequities contribute to health care inequities—as foundational to personal and societal health management.84

distinctions, HAES requires practitioners and participants alike to reject the notions of “healthy” and “unhealthy” weights and sizes, to recognize the inherent dangers of dieting, and to promote acceptance of body diversity.85

A key principle of HAES is

the belief that any obesity intervention should, first and foremost, support and pro- mote the development of health; thus, some weight-management techniques may

238 SECTION 3: Interventions for the Treatment of Overweight and Obesity Among other important

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