Our practice was using the Health at Every Size® (HAES®) model before I even knew it went by that name. My personal and academic backgrounds, the legitimate research I had read, and my clinical experience all pointed towards a health-centered, rather than a weight-centered, model of care.
Earlier this year, we learned about the Association for Size Diversity and Health (ASDAH) from Green Mountain at Fox Run, a program to which a colleague had pointed us. Because we happened to agree with everything we knew about the association, we became proud members. Then I discovered one point on which our opinions differ: the requirement that the ® symbol must follow mention of the HAES® approach.
I understand the advantage of having a title for our approach. By naming it, we can succinctly communicate in a universally-understood fashion how we go about our work, find like-minded individuals in online communities, and separate ourselves from others who take a different approach to health. Entitling different approaches has precedent, just as labels like cognitive-behavioral, interpersonal, humanistic, and psychodynamic denote different techniques that fall under the umbrella of psychotherapy. Notice, however, that none of these names have an ® attached.
Know who does use the ®? PointsPlus®, Nutrisystem®, Medifast®, FirstLine Therapy®, Atkins®, HMR®, and similar ilk. By including the ®, we take the HAES® approach out of the realm of legitimate, evidence-based models of healthcare and put it smack in the middle of gimmicky programs that sacrifice health for money. Call it guilt by association; in essence, the HAES® community loses credibility because of the company we are inadvertently choosing to keep.
Concern and confusion lies on both sides of the counseling room. From the patients’ perspective, the ® makes some of them feel like they are being sold a program, as if their practitioners are nothing more than local distributors for a product so standardized it bares no discernible differences if bought on one side of the world or the other. From my perspective as a practitioner, I have chosen to align myself with ASDAH because of our common approach to healthcare, but at the same time we are separate entities with neither one of us speaking for the other. In that sense, the ® feels like a threat to my professional independence.
Because of the ® and the concerns and confusion that it brings, I stay away from using the term HAES® on our website. Instead, we have come up with our own synonymous language to convey the same concept. In doing so though, we lose the universal recognition of the HAES® name and its associated benefits. How nice it would be to able to write HAES and just leave it at that.
If my understanding is correct, the founding members of ASDAH took a great deal of professional risk by going against widely-held beliefs, building the association, and formalizing the HAES® approach. For everything they did, they have my gratitude and admiration. However, just because ASDAH can require the ® does not mean it should. There is a better approach, a solution that will convey the same meaning yet decrease patient confusion and increase practitioner credibility: Drop the ® requirement.