Extremes aren’t realistic

For years, the Healthy at Every Size (HAES) movement dominated conversations about weight and health, arguing body fat wasn’t necessarily a barrier to well-being. Many advocates rejected the idea weight loss was essential for improving health, promoting instead the belief self-acceptance was the key to living a fulfilled and healthy life.

But now, some of the loudest voices in that space have gone silent — or, in a surprising twist, are openly using weight-loss medications like Ozempic and Wegovy.

So, was it really about self-acceptance or was it about not wanting to put in the work required to lose weight?

The HAES movement

To be clear, the core principles of HAES — that health isn’t solely dictated by body size and that all individuals deserve respect and access to care — are valid and worth supporting. The movement correctly pointed out factors such as fitness, sleep, stress management and diet quality matter more than a number on a scale.

However, in more recent years, some of the movement’s messaging veered into denialism — downplaying the well-documented risks of obesity and, in some circles, even encouraging habits that led to poor health outcomes. The discussion became less about health at every size and more about justifying poor lifestyle choices.

Social media didn’t help. Viral food-challenge culture — where influencers would consume astronomical amounts of ultra-processed foods for views — was often cloaked in the language of “body positivity.” Self-care was redefined as eating an entire box of Oreos in one sitting rather than prioritizing movement, nutrient-dense foods and overall well-being.

And now? With the rise of weight-loss medications, the landscape has shifted dramatically.

Despite what some HAES advocates claimed, the science remains clear:

● Obesity significantly increases the risk of chronic diseases. Studies show carrying excess body fat raises the likelihood of Type 2 diabetes, cardiovascular disease, sleep apnea and some cancers.

● Even modest weight loss improves health outcomes. Loss of just five to 10 per cent of total body weight can lead to significant reductions in blood pressure, cholesterol and insulin resistance.

● The longevity sweet spot isn’t “any size.” A 2022 study found that men with 22-27 per cent body fat and women with around 35 per cent had the best longevity outcomes — far from shredded, but also far from obesity.

So, while being overly lean isn’t necessary for good health, neither is pretending that carrying excess weight has no consequences.

A wake-up call?

The emergence of GLP-1 receptor agonists like Ozempic and Wegovy has provided an undeniably effective tool for weight loss. Unlike fad diets and short-term solutions, these drugs alter appetite regulation and metabolic processes, leading to significant and sustained weight loss for many users.

However, what’s interesting isn’t just the science — it’s the cultural shift.

Many influencers and HAES advocates who once denounced weight-loss efforts are now taking these medications themselves. Some admit to it openly; others remain quiet but show visible changes.

If weight loss was never the goal, why the sudden shift?

Maybe the real barrier was never about rejecting weight loss — it was about not being able to do it.

Effort still matters

While these drugs are effective, they aren’t a magic fix.

● 70 per cent of users discontinue them within two years, with majority regaining weight lost according to the New England Journal of Medicine.

● 40 per cent of the weight lost can be lean muscle and bone.

● They don’t replace the fundamentals of good health; strength training, cardiovascular fitness and balanced nutrition are still necessary.

● They’re only going to work as long as you take them, they’re expensive and there can be side effects. A legitimate question to ask is, “Do I really want to be taking this injection for the rest of my life?”

● Ozempic was recently linked to increased risk of developing non-arteritic anterior ischemic optic neuropathy and diabetic retinopathy, which can lead to blindness.

● They come with common side effects, including nausea, insomnia in some, and digestive issues in varying degrees.

Ultimately, even with Ozempic, people still need to learn how to eat well, build muscle and stay active if they want to keep the weight off long-term.

A more rational approach

The rise (and fall) of HAES as a dominant cultural movement shows us that extremes don’t hold up to reality.

The healthiest approach lies somewhere in the middle: Acknowledging self-worth is not tied to body size while recognizing excess body fat does increase health risks. That doesn’t mean you need to be “magazine-cover” lean to optimize health outcomes. Understanding that weight loss where needed, when done sustainably, improves overall health.

Weight-loss drugs may be a tool in the toolbox, but they’re not a replacement for the basic principles.

At the end of the day, body positivity should be about empowering people to live healthier lives — not about denying the impact of obesity or using it as an excuse for unhealthy habits.

Health isn’t just about acceptance — it’s about action.

Mitch Calvert is a Winnipeg-based fitness coach.

Visit mitchcalvert.com for more information.