What It’s Like To Work With A Health At Every Size (HAES) Dietitian

by | Mar 9, 2024

Food and eating are deeply personal experiences that are intertwined with just about every aspect of life. If someone wants to improve their nutrition, it makes sense that a dietitian could help them with that! And that’s great. Problem is, there is so much confusion, judgment, and moralism in our food landscape, that you might think dietitians are the food police. Will they judge me? They probably eat “perfectly” and will look down on me when I eat fast food, or ice cream. Do I have to tell them everything I eat?

There are a lot of misconceptions about what dietitians do and how they do it. I’ll be myth-busting some but also laying out exactly what it’s like to work with a HAES dietitian. 

What Is A Dietitian?

Dietitians are nutrition and health experts. They are required (as of 2024) to have master’s degrees in nutrition and complete a dietetic internship. For the most part, training to become a dietitian focuses on a few main areas: 

  • Nutrient metabolism
  • Biochemistry, health, and disease
  • Food science 
  • Public health – global and local food system, food access, social determinants of health, and malnutrition issues

Dietitians give tailored advice about nutrition and how to make healthy lifestyle choices. They work in a variety of settings, including hospitals, community health centers, private practices, the media, for food companies, and in research institutions. Dietitians also help folks manage conditions such as diabetes, heart disease, allergies, and metabolic syndrome using evidence-based approaches to help you reach your nutrition and health goals.

Is A Dietitian The Same Thing As A Nutritionist? 

To become a registered dietitian (RD) or registered dietitian nutritionist (RDN) in many countries, including the US, you must complete a master’s degree in nutrition, dietetics, or a related field from an accredited university, do a supervised practice program or dietetic internship (usually about a year long), and big old test. RDs must also do continuing education to maintain their credential.

The requirements for becoming a nutritionist vary significantly by country and, in the U.S., by state. In some places, anyone can call themselves a nutritionist without any formal education or training in nutrition. There are certifications available for nutritionists, such as the Certified Nutrition Specialist (CNS) credential, which requires advanced degree(s), supervised practice experience, and passing an exam, though it is not as uniformly recognized as the dietitian credentials.

That said, literally anyone can slap a “nutrition expert” label on their TikTok handle and voila, they’re a nutritionist.

What Is A Non-Diet, Or HAES Approach? 

The non-diet approach to nutrition is an evidence-based alternative to the traditional belief system of weight loss, weight control, calorie counting, and restrictive eating. A dietitian who believes in HAES and using this as a groundwork for their practice can help you improve your nutrition and health, find balance without rigidity, and feel more comfortable in your body. Good stuff!

Often HAES-aligned dietitians are Certified Intuitive Eating Counselors, consider themselves “non-diet” or “anti-diet”, are committed to using weight-neutral care, or have experience and specialize in eating disorders. There are dietitians in just about every speciality that consider themselves HAES dietitians.

IT’S A HUMAN-CENTERED AND MUCH NEEDED REVOLUTION IN HEALTHCARE

Health and well-being are at the center of a HAES approach, instead of the number on the scale or the aesthetic “results” you may get from a weight loss diet plan or fad diet. 

We understand that many, MANY factors go into the way someone eats: culture, preferences, food access, systems of oppression, income, class, family history, and trauma. These factors are key when helping someone figure out what pattern of eating and exercising are best for them. 

There is no one-size-fits-all approach to health and nutrition. And the size and shape of your body are not an indicator of your worth, well-being, or nutrition habits. The HAES approach puts overall well-being in front of the number on the scale and helps you find lasting habits that not only improve your health, but feel really good to you.

Cleanses, Detoxes, And “Clean Eating” Are Not Helping

Diets don’t just include plans that are explicitly to lose weight. The clean-eating, organorexic, and detox trends have taken a hold of the media wellness landscape. These plans may seem like a simple way to “reset” yourself or “get healthy”, but there is no evidence these short-term cleanses are good for you, so they’re just unnecessary and sometimes can hurt you.

Clean eating (a non-term term) typically means elimination of any processed foods, eating only whole foods, maybe all organic, and sometimes nothing “white” or in a package. It’s really whatever you decide. But micromanaging your diet is not necessary in order to get health benefits from a healthy diet, and at worse, can actually harm your mental and physical health.

Equating your worth with your ability to strictly eat a “clean diet”, or becoming incredibly distressed when unable to eat a certain way are key elements of orthorexia nervosa, an obsession with healthy eating.

Orthorexia is a relatively new term in our food / body image dialogue, but it is also quite common and can seriously negatively affect someone’s life.

While orthorexia is different than other diets or eating disorders that are about changing the size and shape of your body, these diets cause the same amount of stress and anxiety in a person, and therefore are also experiences that non-diet dietitians are skilled at helping you with.

Taking The Focus Off Weight Is A Smart & Healthy Choice

As I’ve written about a lot, the number on the scale is a poor indicator of someone’s health. It’s true there is a lot of correlational research linking body size to health outcomes. But there are a few fundamental flaws in the idea that because of that correlation, we should be prescribing weight loss to everyone over a certain body size.

  1. It ignores their health behaviors (diet, exercise, sleep, stress management, community)
  2. It ignores their body autonomy (what if someone doesn’t want to go on a diet!)
  3. We have zero long-term studies that show significant weight loss is possible for more than 5% of the population. Most people regain weight, or end up weight cycling for years.
  4. Biomarkers, like blood pressure, blood sugar, and cholesterol often end up worse off than they started, causing cardiometabolic harm.
  5. Diets can cause eating disorders such as binge eating disorder (BED), and other eating disorders.

I know it can be hard to wrap your head around these ideas if you’ve been trying to lose weight your whole life. I get it. It’s wild. But if you dip your toes into this way of thinking and talk to an expert, I think you’ll begin to see what so many other people have.

Taking the emphasis off of weight opens you up to find healthy habits that you actually want to keep doing

What Techniques Do HAES Dietitians Use?

There are many techniques that weight-neutral dietitians may use to help people find peace with food and improve nutrition, such as intuitive eating, mindful eating, body image work, meal planning, supplementation, and guidance on food patterns to help with specific chronic conditions. 

We focus on helping you listen to and honor your body’s hunger and fullness signals (intuitive eating), embrace food preferences without judgment, and engage in joyful movement rather than exercising strictly for weight loss. 

This approach challenges diet culture that often leads to cycles of weight loss and gain, body dissatisfaction, and disordered eating behaviors. Instead, it promotes body acceptance, the dismantling of food-related guilt and shame, and the pursuit of health outcomes based on individualized, holistic wellness goals rather than on the scale. 

Should Someone With An Eating Disorder Work With A HAES Dietitian?

My stance on this is that it is VERY important for folks with eating disorders to work with HAES-aligned, trauma-informed dietitians with training and experience. A HAES dietitian is not an official title, so it’s best to ask the dietitian if they work with people with eating disorders, or read what they have on their website about their specialities.

Benefits of Working with a HAES Dietitian

There are so many things you can get out of finding a dietitian who will not focus on your weight, who you really vibe with to help you heal your relationship with food and your body. It can be deeply personal. Here are some of the things that my clients experience after working with me for a while. Remember, this is NOT A DIET. Results happen slowly, with time, patience, and consistent effort.

End your relationship with dieting!

The dieting rollercoaster can really be a thing of the past. It’s hard to rank these benefits because they’re all so awesome, but I think this one is pretty damn great. Dieting is so all-consuming, taking all of your mental space, your time, your money, and your energy. Getting rid of the idea that you might need to start a new diet soon is wildly liberating. In time, you’ll see that you’ve replaced the constant trigger to “get it together” with sustainable, balanced habits and a strong belief that a drastic dietary change will not help you.

Make sure to check out that post I wrote about how toxic diet culture is.

A HAES-aligned dietitian will help you understand why you’ve been prone to some of the thought patterns and eating habits you’re used to, so you can take the blame off of yourself and put it where it belongs. This can be hard work, but is so, so worth it.

Only problem is that you’ll now have to figure out what to do with all your newly found free time. Maybe a painting class?

Seperate your weight from your health

When you’re stuck in the diet mindset, swinging from one diet to the next, binging and restricting, you can become extremely preoccupied with your weight and disconnected from what “healthy eating” even means. As you learn to listen to your body and disconnect your weight from your health, making the choices you want to make will feel easier. There is less self-sabotage when your goal is one that you can actually achieve and one that aligns with your core values.

We can also help you advocate for yourself in the healthcare system, so you can get the care that you need. There are many doctors who have taken a HAES pledge, and who will treat your whole self, and not just your weight. It can be hard to feel confidence advocating for yourself if you’ve been told to lose weight, so a dietitian with expertise in this area can be a huge bonus here.

food confidence!

Almost everyone I work with tells me that they want to feel confident they are doing what’s best for their body. This is especially true for folks with PCOS, hypothalamic amenorrhea (HA), or other hormonal or chronic health conditions. If you have a condition that affects your period, like HA, it can be especially important to make sure that you’re not undereating.

If you have a hard time eating balanced foods on a daily basis, having a health condition can be scary and can make you feel like you aren’t taking good care of yourself.

Working with a HAES dietitian will help you figure out what eating patterns and habits feel best to YOU. With some expert guidance and willingness to listen to your body, you’ll gain the knowledge and confidence that what you’re eating is actually good for YOU, and who cares what other people think.

Reduce food anxiety

If you have a buildup off all the rules from every diet you’ve been on in your head, it’s no wonder you’re anxious about food! Those rules contradict each other constantly. Not knowing which rules to follow can understandably lead to food anxiety.

Carrots are great, they’re vegetables! Healthy.

No wait, too much sugar.

Fruit is one of the healthiest things you can eat!

No, wait, too much sugar.

It’s 8pm but I’m hungry! I can’t eat now. Or wait, can I?

It’s a lot. Working on intuitive eating or healing disordered eating without being overly focused on your weight can help you understand what thoughts in your head are based in nutrition science and which are bogus nonsense. Once you make peace with all food and gain trust in yourself, you won’t have to worry so much about eating the wrong thing. That confidence you’ll gain will directly reduce your food anxiety.

Get better at listening to your body

A key part of intuitive eating is getting in touch with hunger and fullness signals. We go based on hunger and fullness signals. Your body does not lie and it will not guide you wrong.

It is possible, however, that your hunger and fullness signals are “off”. If you’ve been dieting on and off for 20 years, have an eating disorder, or have significant trauma or neurodivergence, it is very normal for you to have a hard time hearing and responding to hunger and fullness.

A non-diet dietitian will give you exercises and guidance so you can reconnect with these signals, at your own pace an in an individualized way. No two bodies are alike.

feel better about your body, and yourself

A key part of working on intuitive eating or using a weight-neutral approach is working on body image.

Many folks come to see me who are unhappy with their body. They want to lose weight, but they also know that trying to lose weight for the past 20 years has been really miserable. A non-diet dietitian who is HAES-aligned and skilled in body image work can work with these difficult feelings and help you accept your body as it is, while taking actions that increase your connection to it and respect for it.

That doesn’t mean that your body will never change. All bodies do. Accepting this and working toward body neutrality can significantly skyrocket your progress with food.

Build self-COMPASSION and patience

While self-compassion is not a nutrition-related outcome, it is DEFINITELY an outcome that you can expect if you find a good, compassionate, weight-inclusive dietitian to work with. The traditional, weight-centric (and dare I say it male-centric) healthcare world and the “obesity epidemic” rhetoric use blame, shame, and scare-tactics to inspire behaviors change. But this is not a good strategy.

Research shows that self-compassion helps health behaviors stick.

By working with a non-diet dietitian, you’ll learn to understand yourself better. In fact, I say this to all my clients:

“My job is to help you understand yourself better. To understand why you relate to food and your body the way that you do, to help you see what thoughts are holding you back and which ones are helpful. Then, to help you explore your body and eating so you can find out what feels really good to you. Nourished, balanced, and satisfied as hell.”

me

heal Disordered eating

Disordered eating is very, very often the result of years of restrictive dieting. As you look at how all of those diets have disconnected you from your body, you can begin to heal. Just the act of letting go of dieting can immediately decrease some disordered eating. In time, as you have a place to process your thoughts and feelings about food, your body, and the pressure from the outside world, you’ll find more ways to respond to your inner cues and find balance and peace.

chart showing the benefits of working with a HAES dietitian.

Improve your nutrition 

And of course, non-diet dietitians can help you improve your nutrition! Some folks might lead you to believe that we don’t care about nutrition, but that is very much untrue. We just aren’t drinking the kool-ade. We know nutrition matters, but we also know that kale is not a miracle cure. But really what we know is that it’s very hard to make lasting changes to your eating patterns and habits if the only reason you’re doing it is to lose weight. If you’re caught up in thinking about what every food will do to your body, it could be hard to make healthy food choices that actually feel good.

CarE for chronic conditions

If you have diabetes, heart disease, PCOS, or a range of other health conditions, you may have been given simple advice to lose weight or to follow a strict diet plan. Yes, it’s wise to improve your nutrition, but small, bite-size changes that feel good instead of punishing can help these changes stick.

A HAES-aligned dietitian will help you navigate and manage your condition in evidence-based ways, but that are not focused on you losing weight.

Unlearn the body oppression industrial complex

I don’t think that all HAES dietitians consider this a fundamental part of their work, but I do. I believe that my life’s work is to help people love themselves more and to therefore take care of their nutrition better. Understanding just how insidious diet culture is, how racist, homophobic, and much it harms women’s liberation is incredibly helpful for us to heal our collective body shame.

I don’t force any of my clients to work with me on this stuff, I just gently drop it in and see if it peaks an interest. After we get to know each other better, if we’re still not talking about it, I may dangle it in a little more. Asking difficult questions and urging you to dig deep.

My 6-month group intuitive eating support group & program, The Love Food Again Program, has a significant body oppression and feminist component. We meet together, a diverse group of women, to talk openly and process how diet culture has harmed us and learn how to heal, eat well, and thrive in the face of this. Check it out and join the waitlist for the next enrollment.

My Path To Becoming A Health At Every Size Dietitian

As someone who went into the field of dietetics knowing that I wanted to be on the “untraditional” side of things, it was an easy choice to become a non-diet dietitian. I always felt a little “anti”, so it just made sense to me to challenge the status quo and pursue a path that felt authentic, honest, and justice-centered. I saw people in my family struggle with their relationship with food and saw many friends (and myself) dealing with the constant pressure to be as thin-as-possible.

When I was in grad school for nutrition and doing my classes to become a dietitian at Texas State University, I learned about Intuitive Eating in my spare time. I read the book, got the workbook, and started thinking about how to integrate this into my career. I was hooked. It showed me exactly what I’d experienced in years past and really laid out what I’d known all along – diets cause harm.

Diet backlash is a real thing. This is likely what has caused so many people to gain weight throughout their lives. This is part of the reason why it’s essential for us to embrace a body liberation mindset, to destigmitize larger bodies, and to protect body size under the anti-discrimination acts.

Being in a larger body isn’t a bad thing. It’s wise to listen and learn from fat activists like Aubrey Gordon. It’s important to learn from those in the most marginalized bodies, which are often black, fat, and queer.

What To Expect When Working With A HAES Dietitian

I form relationships with my clients. I do this because I love working with people, but also because the more I get to know you, the more I can understand your motivations, mental and physical barriers, and what the underlying issues and goals are. Here is a short list of the wonderful things that you can expect when working with a non-diet dietitian:

  • Compassionate listening 
  • No finger wagging – we’re not here to shame you
  • No foods are off limits (I really won’t tell you to cut out sugar, sorry but you’ll thank me later)
  • A different perspective into food and body habits
  • All bodies are welcome 
  • All mistakes are welcome

This isn’t nutrition bootcamp. It’s a safe place to find really joyful, balanced, and lifelong habits with food, exercise, self-talk, and self-care.

How To Find The Right Person For You

There are a lot of ways to explore what different dietitians values and practices are like. There are really a lot of options these days as more and more practitioners see the beauty in this approach. Here are a couple places to look for someone in your area (or far away!) who you connect with and want to work with. Schedule a couple discovery calls and see who fits.

Intuitive Eating Counselor Directory

This is a wonderful directory of all the health professionals who have competed the certification to become “Certified Intuitive Eating Counselors”. This list includes dietitians, therapists, trainers, nurses, doctors, and other people who believe in this system.

Health Professionals Listings

With this one, you’ll need to enter your zip code and then look through the listings of dietitians. Look for people who have HAES-aligned on their page, or are certified intuitive eating counselors.

Google ‘HAES dietitian” near me

You can also try “haes nutritionist near me” or “intuitive eating nutritionist” and see what comes up.

After you collect a few names, read through their about page. See how you feel about what they say about themselves, their approach, and their training. Most dietitians in private practice will offer a free consultation or discovery call. I’d suggest setting up 2-3 of these with the people who seem the best to you.

Remember – someone’s body is not an indication that you will look like them once you’ve worked with them. <3

You Got This

Navigating the complex landscape of nutrition and body image can feel insane. But I promise you, there is a wonderful version of you that is not burdened with restriction, guilt, or confusion. Working alongside a Health At Every Size dietitian is a beautiful journey toward food freedom! You can work toward understanding and appreciating your body, having a harmonious relationship with food and bucking society’s oppressive beauty standards!

You can discover a more joyful, sustainable approach to health that celebrates your unique needs and experiences. So, take the first step towards liberation from dieting constraints and explore what it means to truly nourish your body and soul with compassionate, evidence-based support.

If you want to work on your relationship with food with a badass group of women, check out my 6-month group Intuitive Eating coaching program and sign up today! We’d be honored to have you.

About Emily

Emily Van Eck, MS, RDN specializes in Intuitive Eating, eating disorders, body image, women’s reproductive health, and healing from years of weight-bias and disordered eating. She helps people find balance, consistency, and peace with their eating habits so they can feel confident to get outta their heads and into their bodies. Emily is a registered dietitian and certified Intuitive Eating counselor with a master’s degree in nutrition science. Read more about her practice, values, and experience here.

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Hey there, I´m Emily

A non-diet and weight-inclusive dietitian, intuitive eating coach, and body image healer. Here on the blog, I focuses on exploring intuitive eating, gentle nutrition, the complex arena of body image and feminism, anti-oppression, and all the ways these things intersect. I want us all to be free to own our appetites, and our desires, and eat really, really well. 

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