Weight-Neutral, Anti-Fat Bias Approaches to Eating Disorder Treatment
What is HAES?
The HAES framework, developed by the Association for Size Diversity and Health (ASDAH), is built on five principles that prioritize health and respect for every body, regardless of size. These principles emphasize body autonomy, the value of social and emotional well-being, and the dismantling of diet culture and weight stigma. In essence, HAES is about shifting the focus from weight to overall health, recognizing that well-being can look different for everyone and that health is influenced by a wide range of factors, including genetics, socioeconomic status, and social determinants of health.
Why Weight-Neutral and Anti-Fat Bias Matter in Therapy
Eating disorders don’t develop in isolation; they’re often fueled by societal pressures, stigmas, and internalized biases around weight. A weight-neutral approach means I avoid assumptions about your health, lifestyle, or character based on your body size. Instead of focusing on weight or “ideal” body sizes, we work together to prioritize behaviors, self-care practices, and relationships that support your mental and physical well-being.
Anti-fat bias—discrimination or prejudice against people in larger bodies—can permeate medical and mental health fields, resulting in limited or harmful treatment (Phelan, 2015). This bias can be explicit, like recommending weight loss as a universal solution, or subtle, showing up in body language or treatment plans that implicitly value thinness. As a therapist, I’m committed to recognizing and actively working against these biases, creating a therapeutic environment where all bodies are valued and respected.
Acknowledging Thin Privilege in Eating Disorder Treatment
As someone who lives in a smaller body, I recognize that I hold thin privilege. This means I don’t experience the same systemic bias and discrimination that people in larger bodies encounter daily. Thin privilege allows me to access spaces without fear of judgment or exclusion based on my body size. While I work to understand and counteract fatphobia in my practice, I acknowledge that my perspective is limited by this privilege.
This positionality doesn’t mean I can’t be a strong advocate for body diversity; it simply means I approach my work with openness to learning and the humility to listen to those whose experiences differ from my own. I’m continuously educating myself, seeking supervision, and incorporating feedback to ensure my approach aligns with a truly inclusive and respectful framework.
How a HAES, Weight-Neutral Approach Shapes Therapy
In our work together, a weight-neutral approach means we’ll focus on developing a positive relationship with food, body, and movement—one that isn’t influenced by rigid rules or a focus on weight loss. If concerns about your body arise, we’ll explore them compassionately, considering both the internal and external factors that shape those feelings. Instead of centering weight as a measure of success, we’ll look at indicators of health and joy that are meaningful to you, whether that’s finding pleasure in movement, cultivating self-compassion, or improving relationships with food.
For clients struggling with disordered eating, this approach allows for a recovery process that isn’t bound by societal pressures to “achieve” a certain body type but is instead anchored in authentic self-care and respect. Our focus becomes one of nurturing a body that supports you—mentally, physically, and emotionally—without using weight as the ultimate measure of your progress or worth.
HAES and Anti-Fat Bias as Foundations for Inclusive Care
Ultimately, HAES and a weight-neutral approach are about creating an inclusive therapeutic space where you can feel respected, supported, and valued, regardless of your body size. It’s a commitment to challenging the systemic weight biases that impact mental and physical health and to celebrating the diversity of bodies. In a world that frequently equates worth with size, this framework allows us to work together in a way that values your well-being and autonomy.
Taking a HAES, weight-neutral stance means rethinking long-held assumptions and continuously learning to serve clients more ethically and compassionately. Whether you’re navigating disordered eating, body image concerns, or the effects of anti-fat bias, I’m here to support you on a path that celebrates your whole self.
Note: The Health at Every Size® (HAES®) framework was developed by the Association for Size Diversity and Health (ASDAH). For more information, visit ASDAH’s official resources, which provide the full context and foundational principles of the HAES® model.
References
Phelan SM, Burgess DJ, Yeazel MW, Hellerstedt WL, Griffin JM, van Ryn M. Impact of weight bias and stigma on quality of care and outcomes for patients with obesity. Obes Rev. 2015;16(4):319-326. doi: 10.1111/obr.12266.
Harrison DL. Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness. North Atlantic Books: 2021.
Strings S. Fearing the Black Body: The Racial Origins of Fat Phobia. NYU Press: 2019.