Holistic health approach reduces hunger, but that's about it

The popular Health at Every Size (HAES) practice was established over a decade ago to address stigma and discrimination people with larger bodies can experience when seeking health and medical advice.

Hunter Medical Research Institute and a University of Newcastle research team conducted a review and their research found no significant improvements in cardiometabolic health indicators, depression, restrictive eating behaviours or weight outcomes across interventions using HAES-based approaches.

University of Newcastle Laureate Professor of Nutrition and Dietetics Clare Collins, AO, said the study showed HAES interventions had a role to play in addressing people's relationships with food and eating, but for managing medical aspects of weight-related health, additional treatments were needed.

"When people have diet-related chronic health conditions, like elevated blood fats, or high blood pressure, they need to be referred for medical nutrition therapy for management of those specific risk factors," she said.

"When people are seeking to improve their relationships with food, particularly susceptibility to hunger, then referring to a HAES practitioner, is appropriate."

Professor Collins said interventions have been very popular, especially while few effective treatment options existed for obesity treatment.

"We're now revisiting the best interventions for optimising weight-related health, given there are medical treatment options that the latest evidence is showing are effective, such as medication and bariatric surgery."

She said in addition to managing hunger, the review found a HAES approach showed promising positive trends in the domains of body image, well-being, and eating behaviour - but not for other physical or psychological outcomes.

"Our review confirms that while there may be benefit for people around food behaviours, it's not a health or chronic disease risk factor intervention.

"So, you may improve your psychological relationship with food through treatment with a HAES intervention, but you may also need a medical nutrition therapy with education and information to improve your blood pressure."

Professor Collins said it was advisable to use the HAES-based intervention as an add-on to other effective treatments.

"Further research, in more diverse populations, is needed to extend it to other applications."