What Does It Mean to Be a PCOS Dietitian Aligned with Health at Every Size (HAES)?

As a PCOS dietitian aligned with the Health at Every Size (HAES) philosophy, I often hear misconceptions about what HAES truly means. Some believe that it dismisses weight loss entirely or it "glorifies obesity," which isn't the case. Instead, HAES shifts the focus from weight as the primary measure of health to a more holistic view of well-being. Let’s unpack what this means for PCOS care.

Why the Desire for Weight Loss is Valid

It’s important to acknowledge that the desire to lose weight is not just about aesthetics or vanity—it’s often rooted in a deeper need to feel safe, accepted, and “fit in” with societal norms. In today’s world, people in larger bodies face discrimination, bias, and judgment, which can make navigating daily life more challenging. For many, the pursuit of weight loss is about wanting to feel safe within their community, avoid stigma, and gain a sense of belonging.

Historically, humans have thrived by being part of a tribe or community. Being “different” from the group—whether due to appearance or other factors—can evoke feelings of isolation or vulnerability. This desire to “fit in” is a natural human instinct tied to survival. Unfortunately, modern society places undue pressure on individuals in larger bodies to conform to a certain size, which fuels the desire for weight loss, even when it’s not the best measure of health.

As a HAES-aligned PCOS dietitian, I recognize the validity of these feelings and understand why the desire for weight loss exists. However, I also aim to create a space where that pressure is off so we can focus on improving your health and well-being through behaviors that support your body, rather than chasing an arbitrary number on the scale. It’s possible to pursue better health without letting the pressure for weight loss dominate the journey.

Weight Loss Isn't the Only Measure of Success

For many with PCOS, weight loss is often presented as the key—or only—solution to managing symptoms. If you're living in a larger body, you may have been told to “just lose weight” to control your condition, a message that can feel frustrating when weight loss has been difficult or unsustainable.

In my practice, we take weight loss off the table as the measure of success. This doesn’t mean I’m opposed to weight changes, but it’s not the primary focus of treatment. Instead, we focus on improving overall health through behaviors that support metabolic balance, reduce inflammation, and improve hormonal health. These include changes in diet, movement, stress management, and sleep—all of which can help manage PCOS symptoms whether or not weight loss occurs.

The HAES Approach to PCOS

Being aligned with HAES means helping clients make peace with their bodies and work on sustainable health behaviors. Many people with PCOS are pressured to lose weight as a way to "cure" their symptoms. The pursuit of weight loss can also lead to unhealthy behaviors like yo-yo dieting, disordered eating, or a damaged relationship with food.

The HAES approach encourages us to stop focusing solely on the number on the scale and instead, shift to goals like:

• Reducing insulin resistance through balanced meals

• Improving energy levels by prioritizing nutrient-dense foods

• Supporting a regular menstrual cycle

• Managing stress and improving mood

  
  

Why Is Weight Loss So Hard for People with PCOS?

One reason people with PCOS are constantly told to lose weight is the well-established link between PCOS and insulin resistance. Insulin resistance can contribute to weight gain and make it harder for the body to lose weight. On top of that, hormone imbalances related to PCOS can impact appetite regulation, making it more difficult to manage cravings and food intake.

But here’s the problem: the pressure to lose weight doesn’t address the root cause of the symptoms. Weight gain in PCOS is a symptom, not the cause of the condition. Simply aiming for weight loss without addressing the underlying metabolic and hormonal imbalances often leads to frustration. In fact, restrictive dieting can worsen symptoms by further disrupting hormone levels and damaging your relationship with food.

A Holistic Approach to PCOS Health

With a HAES-aligned approach, the goal is to help you feel better in your body, manage PCOS symptoms, and create sustainable, long-term habits that improve your quality of life—without the singular focus on weight. This means creating personalized care plans that emphasize behavior changes that work with your unique physiology.

By focusing on body acceptance, mental health, and sustainable self-care practices, we can help you live a fuller, healthier life without the stress of chasing weight loss as the only goal.

Being aligned with HAES as a PCOS dietitian means recognizing that weight is not the sole indicator of health. While weight loss can often occur as a result of healthier habits and improving metabolic and hormonal balance, we focus on improving overall well-being, reducing symptoms, and building a positive relationship with food and your body.