You asked…So, here’s what I think about ‘obesity’
I had a conversation with a friend the other day and she mentioned that she was struggling with some of the content on my page.....
We ended up having a chat about it and she explained that some of what I post she just can't get her head around.....
This really got me thinking.
There have been a couple of articles posted in my closed facebook group recently too, that people have said they are confused about and presumably want my take on them.....
There was one called "I lost 13 stone, Now I know the truth about obesity" and another one about whether we 'should classify obesity as a disease.....'
And let’s face it this type of story is EVERYWHERE at the moment. Yesterday I saw a TV ad featuring Robbie Williams (and Oprah of course) advertising WW (I mean Weight Watchers) with the strapline “Everybody has a reason to get healthy”. Grrrrr. They are even running something called “Inch loss Island” on This Morning at the moment. Again, grrrrrrr.
It’s all a bit much to be honest. And I have to admit it feels exhausting at times, to be constantly having to explain. My main frustration is I KNOW how important this work is. I know from my own experience how damaging this type of weight focused, diet centric approach is and how it’s based on weight stigma, fat phobia and misinformation. And yet, this is what most of our Public Health messaging is based on.
But how do I know this? I have a psychology degree. I’ve ALWAYS been interested in weight psychology and eating behaviour. Even my dissertation, back in the 90’s was about Body Image! 😲 I’ve read A LOT. In fact I’m constantly reading. I invested in mindful eating training as a way to fix my own (previous) disordered relationship with food. I’ve immersed myself in the literature. I’ve been on 3 day conferences, and heard the experts speaking. I ‘follow’ many of the academics working in the field (not literally you’ll be glad to know) and I keep up to date with what is going on in my field. In fact just this morning, a new book arrived on my doorstep, which I know will inform my non-diet, food and body image coaching practice and online courses even further.*
This is an ever growing movement, and believe me there are loads of people who think JUST LIKE ME on these issues.
But how to get through to the people questioning my perspective and resolutely holding on to ‘Doctors know best?’
Is it even my job to convince them?
I guess you could argue it is, if I want people to work with me and pay me money for my time…….
The main issue that tends to come up is the ‘health’ question and the unease some people have around whether this approach is suitable for people with higher weight bodies, because, the question goes,
“Surely, those people need to lose weight for their health?”
So, here’s the thing. I don’t judge a person’s health by how they look, because I know that you can’t tell how healthy a person is by weight alone. I don’t look at a person in larger body and assume they must be overeating, lazy, or not looking after themselves. I accept that we are supposed to be different shapes and sizes and that ‘obesity’ (I hate that word) is a complex and multifactorial science. I don’t see it as a disease either because I think that pathologises people in larger bodies. What I mean by this, is I believe that all bodies are good bodies and I support and want to help people of all shapes and sizes.
My approach is based on the ‘Health at Every Size’ (Bacon & Aphramor, 2011) philosophy which doesn’t mean ‘Healthy’ at every size. I’m not saying that it’s necessarily ‘healthy’ to be at either extreme of weight (either in a very low weight body or a very high weight body)….
What I am saying is, our fixation on weight loss doesn’t achieve anything. Nothing helpful anyway.
The health policies that suggest ‘obesity’ is down to an individual’s choice (it isn’t as simple as that), don’t make us more healthy.
GPs referring women to slimming clubs, and celebrities endorsing slimming clubs/slimming products for their own financial gain (yes, I mean you, Robbie Williams and Alexandra Burke) don’t make us healthy. They make us preoccupied with weight, which causes disordered eating and can lead to poor mental health. They also lead to weight cycling, where people lose and then regain weight, this causes an inflammatory response in the body, which is really bad for you health wise, oh, and the fact that
95% of people in a ‘weight management (loss) programme’ will regain all the weight and more by 3-5 years.
Research shows that weight stigma and weight phobia put people in larger bodies under increased health risks, such as increased stress. Stress causes elevated cortisol levels and affects blood sugar levels. Weight stigma also causes low self esteem, depression and binge eating behaviours (Tylka et al, 2014).
And, the worse you feel about yourself the less you look after yourself. I know this because I’ve been there.
How about instead of focusing on the symptom of ‘obesity’ we start to look at WHY people eat in the way they do.
Look at the cause and not just the symptom. Let’s help people in larger bodies feel good about themselves, so they feel more inclined to nourish themselves and maybe move their bodies for pleasure, instead of thinking they can’t exercise because they feel self conscious, or feeling like they’ve failed by being the size they are.
Research also shows that if we let go of the weight focus (‘weight normative approach’) and treat clients with a ‘weight inclusive approach’ as described above, this facilitates engagement in other health promoting behaviours like physical activity, that CAN improve health markers dramatically.
And, as an aside, if they don’t want to that’s fine as well, because having a ‘normal weight’ body is not a moral imperative. Or at least it shouldn’t be.
This is SUCH A complex subject. It’s not about eating less and exercising more. People write PhDs on this stuff. There is so much out there to explore if you want to. And if you don’t want to, that’s fine as well.
I can’t promise to have all the answers and maybe I’ll get things wrong (in fact, I’m bound to do that, because I’m human.)
Just know that I am here for people in all size bodies. I know what it feels like to feel like you aren’t enough. I also know that these feelings affect people in all bodies.
But there is something about being in a larger body that is different, because you aren’t subject to the same level of stereotyping and discrimination. That’s all x
*The book I am referring to is Laura Thomas’ (2019) ‘Just Eat it: How intuitive eating can help you get your shit together around food"
Bacon,L. & Aphramor,L. (2011) Weight Science: Evaluating the evidence for a paradigm shift. Nutrition Journal 2011 10:9
Tyler,T. et al (2014) The Weight-Inclusive versus weight-Normative Approach to Health: Evaluating the evidence for Prioritizing wellbeing over weight loss. Journal of Obesity. Article ID 983495