You know what bothers me? The idea that anyone needs to change their body to meet someone else’s ideals. That “someone” could be a spouse/partner, a friend, a doctor, a stranger, or society at large. To quote Sonja Renee Taylor, or specifically, the title of her amazing book, “Your body is not an apology.”
I belong to a number of professional Facebook groups related to Intuitive Eating and Health At Every Size® (HAES). I vividly recall one post from a fellow dietitian who was working with a client who was struggling with disordered eating and body image issues. The client had reached a weight that was too low to be healthy for them, personally, even though it was a “culturally acceptable” weight. The client lamented that they were treated so much better by other people at that weight. In other words, they no longer faced weight stigma and discrimination.
This is a sentiment I’ve heard from many of my own clients. Disordered eating and body dissatisfaction can happen at any body size or shape. However, the further you get from society’s aesthetic ideals, or from its perceptions of what “healthy” looks like, the more that you’re dealing not just with internalized weight stigma, but external weight stigma as well.
It’s one thing to feel at odds with your body, but when you have trouble fitting into an airline or theater seat, or worry that a dinky restaurant chair will hold you, that feeling takes on additional weight. Sad pun intended. Those are all-too-real examples of how weight stigma is baked into all corners of society, including the built environment.
The destructiveness of weight stigma
As I write this, it’s Weight Stigma Awareness Week (WSAW). WSAW was founded in 2011 by eating disorder psychiatrist Wendy Oliver-Pyatt and Chevese Turner, founder of the Binge Eating Disorder Association (BEDA). When BEDA was absorbed into the National Eating Disorders Association (NEDA), NEDA took over WSAW. Unfortunately, NEDA, through it’s actions and words (or lack of words) has shown itself to be complicit in weight stigma in recent years, so it’s fortunate that WSAW is now back in the hands of Turner and Oliver-Pyatt, and their respective organizations Body Equity Alliance and Within Health.
Weight stigma is a very real issue, and it’s one that’s affecting people’s health. Those chronic health problems that are “associated” with being at a higher body weight? The bias, stigma and discrimination inflicted against people at higher weights is responsible for at least some of that. That’s especially if people internalize that stigma. (When you internalize weight stigma, you believe you are less worthy because you weigh “too much.” Or, you believe you don’t deserve to do or have certain things because you weigh “too much.”)
Tragically, weight stigma drives far too many people to take drastic steps to reduce their body weight in an attempt to comply with the thin ideal. This includes everything from highly restrictive diets to having part of their stomach and/or intestines removed to taking prescription drugs.
Unfortunately, weight loss surgery can have serious complications, and medications can have uncomfortable side effects. As for dieting? Attempts to diet below the body’s defended set point range is a recipe for rebound weight gain. In fact, many dieters ending up at a higher weight than if they had never dieted. (For more on this, I highly recommend dietitian Rebecca Scritchfield’s podcast interview with Sandra Aamodt, author of “Why Diets Make Us Fat.”)
Who needs to change?
Everything I’ve mentioned so far is so concerning that I’ve written about weight stigma numerous times for various publications — not simply for this blog. (I’ve included links below.) But what really gets a bee in my bonnet is a disturbing comparison that popped into my head a while back:
Someone changing their body weight or appearance to gain acceptance and avoid stigma and discrimination is a little like an abused spouse trying to change their behavior to reduce the amount of abuse they suffer.
Whether we’re talking about stigma or abuse, the onus should never be on the victim to change. It’s the perpetrator (whether it be an individual, a culture or a society) that needs to change.
Each of us is inherently valuable and worthy of the same respect that might be given to any other human being. Our weight-centric and health-centric (read: health is a moral virtue, and if you weigh “too much” you can’t possibly be healthy) society is not making us happier and healthier. It’s making us less healthy and miserable. It needs to stop.
We can all do better. This includes Including parents, partners, friends, co-workers, employers, teachers, personal trainers, researchers and total strangers. It also includes dietitians, therapists, doctors and other healthcare providers, who absolutely NEED to do better.
A little bit more from my soapbox
I do my part every day with my 1-on-1 clients to help them develop balanced relationships with food and body while improving health in meaningful, sustainable ways. Often, this includes learning about weight stigma and how we can reduce it’s effects on a personal level while pushing back against it on a systemic level. Health at Every Size (HAES) and Intuitive Eating are two frameworks I use, because those are the sane counterpoints to dieting insanity and body-based oppression. These are also topics I’ve written about extensively, including:
- “Is being weighed at the doctor’s office bad for your mental health?” for The Seattle Times
- “What do new pediatric ‘obesity’ guidelines really mean for kids?” for The Seattle Times
- “Weight-centric health care is status quo, but it’s not helping patients” for The Seattle Times
- “What will it take to get weight-inclusive health care?” for The Seattle Times
- “What public health gets wrong by focusing on weight” for The Seattle Times
- “Breaking down the negative impacts of weight stigma ahead of Weight Stigma Awareness Week” for The Seattle Times
- “What we mean when we talk about obesity, why it matters and what we can do about it” for The Washington Post
- “The many reasons a British writer was wrong to disparage Nike’s plus-size mannequins” for The Washington Post
- “Thinking about your weight? What you might be getting wrong about the Health at Every Size approach” for The Washington Post.
- “What is Intuitive Eating, and how do you do it?” for The Washington Post.
- ‘“Intuitive Eating’: 25 years in, it’s more relevant than ever” for The Seattle Times.
- “The Health Impact of Weight Stigma“ for Today’s Dietitian
- And this blog series.
And of course, you’ll continue to see posts on HAES, weight stigma and discrimination, intuitive eating and related issues like body image and body acceptance.
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Carrie Dennett, MPH, RDN, is a Pacific Northwest-based registered dietitian nutritionist, journalist, intuitive eating counselor, author, and speaker. Her superpowers include busting nutrition myths and empowering women and men to feel better in their bodies and make food choices that support pleasure, nutrition and health. This post is for informational purposes only and does not constitute individualized nutrition or medical advice.
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