Using "Health At Every Size" In Personal Training Without Sacrificing Goal Oriented Coaching

At first glance it may seem incompatible: promoting Health At Every Size (HAES) and working in a fitness industry saturated with imagery, language, and systemic beliefs that suggest “health” and “wellness” are only afforded to those with thin bodies, more aptly white thin bodies. While this appears contradictory to many, there are few careers better positioned to educate and embody these principles and provide compassionate service that facilitates a more comprehensive construct of health. This doesn’t necessitate throwing hard work out the window and haphazardly providing training without a discernible goal. It simply expands the kinds of goals your clients achieve while setting aside those that research suggests may have a detrimental effect on health (i.e. BMI, weight, and other goals that facilitate weight cycling etc.)[1]. It also sets you apart as a more inclusive evidence-based practitioner.

What Is Health At Every Size?

“The Health At Every Size (HAES) approach is an alternative to the weight/size based paradigm upon which much current health public policy is based.”[2] The principles of the approach include accepting and respecting individuals of all body sizes, understanding that health includes not only the physical aspects but also the emotional, spiritual, occupational, and social aspects of an individual, and promoting health for individuals of all body sizes. It promotes eating with the intention of nourishment, nutritional needs, satiety, and pleasure and promotes enjoyable physical activity for the purpose of enriching life rather than for weight loss. A wealth of research points to BMI (Body Mass Index) and weight as poor predictors of health, and weight loss programs as more detrimental to an individual’s health.[3]

Many trainers will most likely find themselves shaking their head in agreement as they already suggest to clients that BMI and weight don’t accurately depict an individual’s fitness level or health status but unfortunately many are still unwittingly complicit in discriminatory behaviors against individuals in larger bodies and encourage potentially detrimental goals that push individuals to change their bodies to look like a certain ideal. In no means is this an indictment of your current approach and the countless hours you spent coaching your clients with the best intentions, rather it can serve as a wake-up call and an acknowledgement that as we learn more, what we knew before can be improved upon. Most importantly we must recognize our role in a system that has colored how we view exercise, nutrition, and health and realize it will take time to change the landscape.

Not Leading With The Weight Loss Paradigm

It may seem blasphemous for a trainer to say stop getting on a scale, but it is imperative to critically examine how the practice affects our clients. We know that incorporating healthy habits results in a decrease in adverse health effects regardless of weight[4]. This presents a terrific opportunity to discuss what health looks like beyond a number on a scale and allows an individual who is seeking training in order to improve their health to broaden their idea of what that means, particularly as it relates to increased lean muscle mass, increased cardiovascular fitness, increased insulin resistance, and improved joint health to name a few.

It is important to remember that the people who come to train with you didn’t develop the feelings they have about their bodies overnight. We are inundated with images of the ideal “fit” body at every turn. This process will most likely have to begin with introspection on your part as you determine where diet-culture, the pervasive way of thinking that encourages “thin”, “small”, or “fit” bodies as the gold standard while encouraging disordered behaviors, has penetrated your own life. While we may have the best intentions, we can be modeling those behaviors for our clients. This will most likely prompt you to reconsider some of the words you use or the practices you might encourage. Recognizing this in yourself will provide an empathetic lens with which you can approach working with your clients.

Setting New Goals

“So if I don’t use weight as a goal, what are my options?” This is where your creativity as a coach and your ability to hone in on your clients’ desires and dreams comes into play. Many in the personal training and strength coaching realms are familiar with tools like motivational interviewing as a means of getting to the genesis of an individual’s aspirations. This can be a great way to start. Continue to ask why when your client tells you what they want to accomplish, and you’ll learn what is at the heart of why they would like your help. Another way to frame your concept of goal setting is to consider the definition of health provided by the HAES approach that is multifaceted and includes physical, social, emotional, occupational and spiritual dimensions. What could your client accomplish in the gym that would allow them to do their job with less pain? What could you train for in order to help your client participate in activities they have been longing to do with their friends?

Below is a list of potential goals that encompass a more size inclusive training atmosphere, but it is important to remember that this is only a starting point. It is also important to be aware of the culturally specific needs of marginalized communities. If you do not identify with a client on these terms, be sure to ask how they feel and take some time to seek out advice from individuals of that community before and during your time working with that client.

-Hit a PR (personal record) in a lift

-Increase squat mobility

-Reduce low back discomfort

-Compete in a race or endurance event

-Get more steps in each day

-Increase fruit and vegetable consumption

-Make more meals at home

Just remember that even if you use this framework and offer these goal suggestions, your client may still be interested in a specific weight loss goal. Body autonomy is very important, so you’ll want to find ways to support their goals safely and provide your expertise, support and, care.

Patience, Compassion, and Encouragement are Key

Your clients’ (and perhaps your own) views on health and weight did not evolve overnight or in a bubble. We are inundated with systemic concepts of what “health” is and it will take time to widen this perspective. Be patient with your client as they navigate these new ideas and remember that their time with you may be the only time in their week that they encounter these inclusive views. Whether it be family, friends, Instagram, or magazine covers at the grocery store, it will be impossible to entirely avoid diet-culture. It is also an important time to be compassionate as you don’t want clients to feel judged for their weight loss wishes. This isn’t a time to belittle someone, rather it is an opportunity to listen, support what they want out of their training, while slowly broadening their understanding of health and what a “good” body is. Find opportunities to encourage your clients as they work to achieve their newly framed goals.

[1] Strohacker, K., Carpenter, K.C., & Mcfarlin, B.K. (2009). Consequences of weight cycling: An increase in disease risk? International Journal of Exercise Science, 2(3), 190-201.

[2] https://haescommunity.com/

[3] Bosomworth, N.J. (2012). The downside of weight loss: Realistic intervention in body-weight trajectory. Bosomworth N. J. (2012). The downside of weight loss: realistic intervention in body-weight trajectory. Canadian family physician Medecin de famille canadien, 58(5), 517–523.

[4] https://www.joyfuleatingnutrition.com/single-post/how-the-goal-of-weight-loss-can-undermine-health/