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Disability Care: A Health at Every Size Approach

Individuals living with a disability in Australia endure health inequalities related to a range of factors, including ineffective healthcare. All individuals deserve access to respectful and inclusive care. Healthcare that considers the complex physical, emotional, social and environmental determinants of wellbeing. Healthcare that caters to the abilities of each individual and supports them to engage in health enhancing-behaviours. This, my friends, describes the Health at Every Size approach.

As Liza wrote about in a previous blog, Health at Every Size (HAES) is a registered trademark of the Association for Size Diversity and Health (ASDAH). ASDAH outlines that the HAES approach is composed of 5 core principles:

  • Weight inclusivity
  • Health Enhancement
  • Respectful Care
  • Eating for Well-being
  • Life-Enhancing Movement

You can read more about these principles here.

In working with individuals experiencing physical or intellectual disability, I have come to appreciate how applying these principles can help enhance disability care. In my day-to-day work, some examples include:

  • Learning about how different food groups/nutrients can affect how our body feels NOT looks.
  • Working on self-compassion and body respect NOT body manipulation. 
  • Cooking to build capacity and skills and try new foods NOT to cut out enjoyed foods. 
  • Grocery shopping tours to explore food preferences and food literacy NOT to compare calories on packets. 
  • Interactive nutrition games to promote behaviours such as hydrating when playing sports or eating a varied diet to help with concentration NOT to elevate weight loss as a goal. 
  • Education on weight science and the multitude of factors with disability that can lead to weight changes, such as medications and hormonal adaptations NOT placing blame and responsibility on the individual. 
  • Communication with staff, other health professionals and family to reduce weight bias in practice and language NOT to reinforce stigmatising language and harmful weight-based goals. 
  • Flexible meal and snack guides NOT prescriptive meal plans. 
  • Understanding of disability and related eating behaviours NOT assumptions based on weight and size. 
  • Acknowledging the social, emotional and physical significance of food NOT removing ‘bad foods’ without regard for overall quality of life. 
  • Brainstorming enjoyable movement and community participation NOT forced physical activity.

People living with a disability experience enough adversity in their life. That is why I think it is paramount that I help lift the heavy burden of restrictive diets off their shoulders. HAES helps make this possible by centering self-care, acceptance and empowerment, regardless of size or ability.

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Mali Unahi - Dietitian