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Weight Stigma

Weight Stigma

Weight stigma is any bias, discrimination or stereotyping related to an individual’s weight. It supports the misconception between worth, value, and competence in regards to weight. Research has idealized weight loss and living a ‘healthier’ lifestyle due to the promise of improved overall wellbeing. However, is that really the case? Continuous societal pressure to change and reform the body, in order to fit the standards of research, can cause behavioral changes that have been linked to poor metabolic health and increased weight gain. Weight stigma can be especially harmful when exposed to children at a young age. Children who are perceived to be overweight by loved ones are two times more likely to form irregular and poor relationships with food and self-regard. As these relationships continue to develop, they can become a part of a child’s identity and the cycle of dieting continues. These influences can begin with as little as a comment from a stranger on food choices, or weigh-ins in public schools. It is our responsibility as a member of the community to prevent these influences from causing further consequences. 

While it can be hard to take weight loss out of the picture completely, it does allow the potential for a life of freedom. This does not mean ignoring your body completely, but rather learning to respect and appreciate your present self. Accepting your body entails taking care of your health, both physical and mental. This is a crucial part of making peace with your body, and is the stepping stone for making peace with food, thus supporting one to become an intuitive eater. 

Those who experience weight stigma have been shown to be at an increased likelihood of developing psychological and behavioral issues. Some of which includes depression, body dissatisfaction, and binge eating. This is exacerbated by a culture that idealizes thinness and inundates the public with fatphobic messages. When these fatphobic messages are internalized, individuals can experience self-stigma. Self-stigma has been found to have a strong effect on overall mental health due to the acceptance of weight stigmatized statements as being true for themselves, making it increasingly difficult to challenge these messages.

Unfortunately, healthcare professionals are often guilty of perpetuating weight stigma in their practices. Thus many individuals in larger bodies who choose to seek care often find themselves being treated differently due to their body size. It is important that, as providers, we continue to explore our role in ending weight stigma and work to provide compassionate, unbiased, weight-inclusive care.

We each come in our own shape and size, similar to the unique ridges and whorls that make up our fingerprints. We wouldn’t expect someone who is 5’10 to someday be 5’5. Therefore, why do we assume we must shrink or shape our body to be a size that it shouldn’t be? Spending your life trying to control your weight is essentially a constant attempt to be someone else. We must be kind and accepting of ourselves and who we are meant to be. It can be a slow process to accept a body that has been labeled as ‘not good enough’ but quitting won’t speed it up. 

References:

Emmer, C., Bosnjak, M., & Mata, J. (2019). The association between weight stigma and mental health: A meta‐analysis. Obesity Reviews, 21(1). doi:10.1111/obr.12935

Puhl, R. M., & Heuer, C. A. (2010). Obesity stigma: important considerations for public health. American journal of public health, 100(6), 1019–1028. https://doi.org/10.2105/AJPH.2009.159491

Weight Stigma. (2019, June 27). Retrieved September 23, 2020, from https://www.nationaleatingdisorders.org/weight-stigma

If only I had the time…..

If only I had the time…..

Let's Take Advantage

There are so many things that I would do if I only had the time. Guess what? We do!

We can use this time that we have right now to create positive change in our lives. How will you take advantage of being in quarantine. 

Here are a few of the things I came up with. 

1. Journal

2. Pay attention to our feelings

3. Spend time outdoors

4. Create structure in our lives.

5. Be rested

6. Meal Preparation

7. Read a good book

8. Start a new hobby 

9. Learn something new

10. Create a gentle yoga routine

11. Ask for support

12. Listen to inspiring podcasts

13. Take a deep breathe

14. Create a gratitude journal

15. Order a self-help workbook

16. Pray

 

 

My Confrontation at Starbucks.

My Confrontation at Starbucks

   So I don’t usually post much about work on Facebook but I figure this is a place where a large amount of people can be reached. This is going to be a novel I can already feel it lol OH NO IT’S HAPPENING AND I’M MAD SO STRAP IN.

I’m a Dietitian working in the field of eating disorders, and it has been the most rewarding job of my life. It has also been the most emotionally taxing thing I’ve ever done.

Eating disorders are the number one deadliest mental illness. Every day, I see people muster every bit of strength they have to fight these life-threatening diseases. I see people feeling completely and utterly broken, hopeless, done, sick. I have seen people dance, laugh, scream, and curl into a ball in defeat, all in a matter of an hour.

I see people cry of happiness over their victories in treatment, only to cry of sadness and guilt immediately after. I watch their face shift as they realize this “success” in treatment is (in their eyes, right now) their greatest failure.

Anita Johnston, author of “Eating by the Light of the Moon,” said it perfectly. She describes a person falling into a river. Imagine it is storming, and they are drowning. They are terrified. They grab onto a log in the water, and it saves their life. The storm calms, the water level slowly drops, they are safer now.

Their friends and family are on the shore, waving to them to come in. They try to swim while holding the log, but it is too big and powerful, and it’s holding them back. They cannot swim to shore with the log in their arms. They cannot get to where they want to be while holding the log. But they don’t want to let go of this log. Why would they? What if the storm comes again? What if they aren’t strong enough?

They will occasionally let go of the log, to try. A wave comes and they get scared, and grab on again. One day, they summon the strength to tread water for 10 seconds before they grab back on. Another day, they make it to 30 seconds. Eventually, they make a lap around the log before fear launches them back into its’ clutches. Little by little, they gain confidence in their strength to make it to shore without the log.

One day, a long while later, exhausted and close to giving up hope, they let go of the log and begin to swim. They swim as hard as they can, until they reach the shore. They no longer need the log to feel safe. They are ready to rebuild, to renew, to create. They are free. I’m paraphrasing and putting my own spin on it, but that’s the general idea.

The log in this analogy is the eating disorder, as it has served a purpose for everyone struggling. Control, escape, accomplishment, success, identity, communication, fear, numbing, punishment, coping. These are only some. They are also often biological/neurological/genetic in etiology. The rushing river is life, the shore is recovery.

I was inspired to write this post when I overheard someone in the line at Starbucks speaking about how “selfish” and “stupid” their girlfriend was for going into another eating disorder treatment center. “She’s skinny, I’ve told her that so many times,” they said. “What does she have to worry about?” “It sucks for me because I’m never going to see her.”

Eating disorders are not a disease based in vanity or a desire for a certain aesthetic. Their symptoms manifest in food, eating behaviors, and body image, but they are serious, life-threatening mental illnesses and are not to be made light of. They are never alone or without an underlying issue.

A couple years ago, I had a client who was on the 80th percentile for weight on their growth charts, and dropped to the 5th percentile in less than a year. At one point in her treatment, when she reached the 20th percentile, her doctor told me she was “medically fine now” and no longer needed treatment, and I needed to step away from her care and let them “take it from here.” “MEDICALLY FINE”……..LET YOU “TAKE IT FROM HERE”…….oh hell no. My brain exploded.

This teenager was more depressed than they had ever been, not getting their period, heart rate 38 bpm, losing full chunks of hair, and was well on their way to osteoporosis. That doctor no longer answers my phone calls (lol that’s fine good riddance sir) but the child is fully recovered because thankfully, their family trusted me.

How do we validate the seriousness of a condition if many of our medical providers, the very people we trust with our health, are telling some of the sickest people that they are “medically fine?”

How do we help people who are feeling so deeply sad and hopeless feel seen and heard, if we are viewing their disease as “selfish” and “stupid?”

How do we slow the development of these diseases when the “wellness” industry based in pseudo-science is promoting restrictive dieting in our youth? IN OUR CHILDREN.

Why was my 13 year old client congratulated on their “willpower” when they brought a bag of raw broccoli to their own birthday party in lieu of cake?

I am writing a Facebook novel right now because this is important.

I will be going to doctors offices donating the book “Sick Enough” by Dr. Jennifer Gaudiani in hope that someone will read it. I speak to health and PE teacher meetings for Fairfax and Loudoun County public schools about how to safely communicate health and nutrition information tochildren and adolescents, in hope that someone will hear it.

I feel like that isn’t enough, though. Which is why I’ve resulted to a social media post, because realistically more people can be reached this way.

“What is the take-home message?” You may be asking if you have made it this far. I’m glad you asked!

1. Be mindful of your words. Be mindful of your judgements. You never know what people are going through.

2. When communicating nutrition information to people (especially personal trainers, health teachers, and health professionals who are new to working with eating disorders) focus on what to add instead of what to take away. 

For example: “did you get some fruits and vegetables today to give your body the vitamins, minerals, and phytochemicals it needs?” Instead of: “do not eat sugar. It is bad.” Another example: hypertension. Research shows that increasing potassium in the diet is effective in lowering blood pressure. Yes, some people need to be careful of the salt shaker and high sodium foods. However, isn’t it lovely that we can talk to them about what they should include vs. what they shouldn’t, and improve their lab values without promoting dichotomous, black and white thinking about eating?

3. Stop demonizing foods, labeling themas “good” or “bad” and putting a moral value on what people eat. Food is supposed to serve two purposes: nourishment and enjoyment. That’s it. You are not “bad” because you had a dessert. You are not “good” because you ignored your basic biological needs by cutting your calories in half.

4. Let’s stop downplaying eating disorders and simplifying their complex nature by telling people they are “fine.” Let’s listen to people when they talk. Let’s keep comments about people’s bodies in a locked vault, stored in the depths of hell. Let’s help people who we believe to be struggling get help. Let’s check in with people who are exhibiting disordered eating behaviors, rather than asking them what their secret to weight loss is. Let’s stop food shaming other people.

5. Understand that eating disorders do not have a face. They do not have a shape or size. They are not only restrictive eating, or purging, or binging. They come in all shapes, sizes, and forms and manifest in many different behaviors. Men, women, non binary, it doesn’t matter. Eating disorders do not discriminate. You cannot look at someone and determine whether or not they have an eating disorder.

6. Most importantly, let’s talk about mental health, because it’s important.

Thank you for coming to my ted talk ?

Edit: To everyone who has reached out to me, thank you. Below is a link to the National Eating Disorder Association (NEDA) website. They have a lot of informative resources, along with a treatment finder to get help in your area.

https://www.nationaleatingdisorders.org/

Prosperity Eating Disorders and Wellness Center in Herndon, VA (where I work) has a free family/friend support group for those who have loved ones with eating disorders at 5pm on the first and third Monday of every month. Anyone is welcome.

We also have a comprehensive team of therapists, dietitians, and a psychiatrist/medical director. We have a Partial Hospitalization Program (PHP) Intensive Outpatient Program (IOP) and outpatient services. We offer art therapy, yoga, and acupuncture. If you or a loved one are struggling, give us a call or visit our website.

703-466-5150

http://prosperityedwell.com

Parents as Role Models Around Food and Body Image

Parents as Role Models Around Food and Body Image

  1. Why is it important for parents to model healthy eating?

Social psychologists have long explored how social experiences shape our cognitions and behavior. This type of learning, known as observational learning, provides children with the opportunity to watch a “model” (aka parent, sibling or authority figure) as they react to events in their environment. Observational learning is one of the most natural types of learning that we have available to us. The idea is we watch what the model does in a given scenario and then process that scenario or schema as desirable or undesirable; ultimately our behaviors are shaped by watching how others interact with their environment. We mimic and mirror what we see and have learned is valuable to our family system.

Food is a fundamental aspect of the human experience, we all need nutrients to survive and thrive. Unfortunately in today’s society, we have become hyper aware of image and perfection as a symbol for worthiness, resulting fad diets, preoccupation with weight / image, and a generalized sense of dissatisfaction with ourselves in comparison to a perceived ideal. Despite the negative impacts societal pressures can have on an individual’s image or self-esteem, there are many ways parents can buffer the effects of these pressures, not the least of which is healthy modeling. What does this mean? In short it’s teaching your kids to develop a healthy relationship with food by setting a positive example.

Our kids are watching us all the time (we aren’t as sneaky as we think we are), they see us reading labels and being conscious which is great! It’s a great opportunity for us to teach our children about food, nutrition, and healthy eating. Conversely, they see us cringing at calories, judging ourselves and our bodies in the mirror, and they sense the importance of image. We can be a gateway to a healthy lifestyle or we can inadvertently tell our kids that food is the enemy and image is everything. It’s easy to think this learning would have to be overt, that a dance teacher who pinches her students back would obviously result in an unhealthy relationship with food. But it can, and often does, happen far more subtlety, watching mom choose a salad time and again instead of getting what she really wants because she has attached a value to the food as bad. As with most things, moderation is key, it’s not so much what you are eating or feeding your family as it is the relationship with the food and experiences.

  1. What language should parents use/not use, around kids, to prevent unhealthy eating beliefs and behaviors?

Try to avoid making comparisons or comments, especially image oriented ones. For example don’t say,”Oh, Molly is so small, and I am just fat” or “Your friend Jen is so small and cute” “Comparisons like this aren’t helpful in promoting a positive self-image.

Kids going through growth spurts often grow out before they grow up. When your kids are in these spurts, don’t poke at them or their chubby cheeks. In general, try not to use all or nothing statements. That ice cream will make you fat, or those cookies are going to go straight to my hips. No one has ever died from a scoop of ice cream, just like if you eat a cookie or a few cookies, it doesn’t mean you are no longer loveable because your skinny jeans got a little snug. Kids don’t always have the gift of discernment, that’s another reason healthy modeling is so important. We get to teach them that food can be a wonderful and connecting experience. If you wouldn’t want someone saying it to you, then you probably shouldn’t say it to your child, they’re people too, just younger and more impressionable.

  1. How do our kids (unknowingly) teach us how to eat healthy?

Our bodies have natural triggers that tell us when we are hungry and when we are full. People don’t have to be taught when to eat or not, it’s a natural process that occurs and that we can become mindful of as we develop. Children haven’t yet learned to ignore their inner cues and will often adhere to appropriate portions when they are allowed to choose. Kids listen to their bodies, if they have cravings they typically fulfill them and move on with what they are doing. They don’t assign value or judgement to foods which means they are naturally more healthy in regard to portion control and enjoying the eating experience.

  1. How can we achieve health while feeling care free in the process?

Barring an allergy, one scoop, or cup, or plate of anything is not going to leave an indelible mark on our psyche or bodies. Remaining mindful as you eat and making food preparation a process and an act of love for yourselves and others can be a great way to bring joy and peace to a moment. If you struggle with your relationship with food, affirmations can be a great way to break the negative thought pattern. It may feel artificial at first, but keep saying the words, internalize that sense of peace with the food and the process of being healthy. Exercise can be a great way to mitigate depressive symptoms, as the endorphins released during and after a workout boost mood. Additionally, this can be a great way to channel your energy by doing something positive and active with your body, see what you are capable of, know that you are a blessing and that your body is a gift.

By Ashley Steelman, MSW

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