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.
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
Prosperity always offers individualized services that are gender, race, sexuality, religion, age, eating disorder, and body size inclusive.
A personal message from one of our staff:
A deadly pathogen is running rampant through the world, undetectable and unstoppable, middle class families are waiting in mile long lines at food banks, and those who were already a paycheck away from disaster are now homeless. The political divide is deeper than ever, no longer about differences in policy, it is now an appraisal of morality. Wearing a mask has become a partisan statement, with both sides shaming and accusing each other of ignorance.
The murders of Ahmaud Arbery, Breonna Taylor and George Floyd in close succession have shocked those who had come to accept racial bias as an unpleasant truth to be denounced, yet tolerated. The long simmering resentment of African Americans has passed the boiling point, and we are witnessing a revolt against a society that has oppressed and stigmatized their race for centuries, the type of which has not been seen since Dr Martin Luther King lit a fire for equality more than 50 years ago.
Then there are those who used to lurk in the shadows and hide under hoods, who have become emboldened to voice their hatred and hostility towards people of color over the last three years. For them, the stakes are now higher than ever; they are desperate to cling to their vision of a whiter America peering over the horizon.
All are clamoring to be heard, and the resulting cacophony of rage threatens to dissolve America. To say these are frightening times would be a ludicrous understatement. Growing up, political discourse was something I rarely witnessed. I was raised in a religion that preached neutrality, and it was considered futile to attempt to influence societal issues that could only be solved by a higher power. An independent streak and a passion against injustice brought me into frequent conflict with my family and religious leaders, but I struggled to reconcile those principles with my conscience. I saw neutrality as pacifism, and pacifism was complicity.
In 1992, as the Rodney King riots shook Los Angeles, I graduated from high school. I remember watching the riots on television and not really grasping what they were about. It was undeniable that the police had brutally and unnecessarily beaten a man, but I failed to recognize that the rage over that was fueled by a systemic problem. I lived in an all white community in the mid-west, and while I was aware racism was still prevalent, I rarely witnessed it and certainly had no concept of how it permeated the everyday existence of people of color.
I was raised to accept people of all races and nationalities, and have never felt hatred for another race, yet still, unconscious racial and class bias was cultivated in me. My relationships were filtered through the lens of how much their lives mirrored mine. I felt compassion for the less fortunate, yet my efforts to help them revolved around making them more like me. I subconsciously divided the “good blacks” from “bad blacks”- usually based only on their speech and style of clothing. I held strong opinions on homosexuality and abortion, and consideration of other viewpoints or contemplating different reasoning was not allowed by my religion. Effort was made to reduce exposure to outside influences that might contradict those beliefs, so education beyond high school was strongly discouraged. My mind remained closed because my world was.
A complicated series of events, too lengthy to detail here, slowly unraveled my faith, and I eventually discarded my religious beliefs. The consequences of that decision were personally devastating, causing me to spiral into a deep and unrelenting depression, and I sought counseling as a means to cope with my grief, disillusionment and fear. However, with the loss of what was familiar and comfortable came the gift of freedom of thought, and I embraced the opportunity to re-learn what I believed. I sought to educate myself on issues that I had been ignorant of, I listened to others’ opinions with an open mind, and I worked to envision myself in the difficult situations that others faced, so that I could develop empathy. I became aware of the judgmental lens I had unconsciously filtered others through, and began to engage with those who I would have previously avoided. I saw beyond their clothes, mannerisms and diction to the person inside, and discovered that where once I saw vast differences, now I saw sameness.
There is a video currently circulating on social media that has sparked furious controversy. In it, a young, black woman named Candace Owens expresses her disgust for the seeming martyrdom of George Floyd, due to his violent criminal past. While she condemns the actions of the officers, some of what she said seems to enforce the entrenched belief that black men being shot in some way have it coming. I was infuriated by many of her comments, but I forced myself to listen to her, and to try to understand her point of view, some of which was not without merit. She emphasized that George Floyd had not lived an honorable life- he had hurt and traumatized individuals for life. She reasoned that the victims of his crimes surely are angered and hurt that he is suddenly being treated as a hero.
I considered at length how despite her facts being accurate, millions of people were not only angered by his death, but truly grieved, even driven to tears, as I was. Why are we mourning George Floyd? It is because when we watched him die, when we listened to him gasp for air, when he cried out for his mother- for those 8 minutes and 46 seconds, we didn’t see a black man, and we didn’t see a criminal- we saw a human. People worldwide had seen past their filter and saw their human brother suffering, and it hurt. For 8 minutes and 46 seconds, we were not white or black or or any race other than the human one. That brief glimpse was enough to shock many people awake, and opened their eyes to how fellow humans are being treated. The reality of what it means to be black in America has finally resonated and made us painfully aware and ashamed of our white privilege. It is apparent that this can no longer be treated as a “black problem”- it is a human problem.
These are unprecedented and turbulent times, but also, the beginning of a new era. Just as my life changed when my unconscious prejudices were torn away, the entire country is experiencing the same. It is not enough to just not be a racist- because silence is complicity. It is no longer enough to portion shares of equality to those we feel have earned it, it has to be granted upon birth. What we are witnessing is an entire nation recognizing and acknowledging their mistakes, and actively taking measures to change. Emotions are high, and conflicting, but we have the choice to continue stripping away our ignorance and educate ourselves, with an open mind, without bias. We can stop focusing on our differences and work to see sameness. We can look at the destruction of what was familiar and comfortable with fear, or we can see it as an opportunity to start over and to re-make our country into something better. Right now, we can choose to be scared, or we can choose to be strong.
I did not write the following, but it says what I am feeling in my heart: (see below)
“WHAT IF 2020 ISN’T CANCELLED?
WHAT IF 2020 IS THE YEAR WE’VE BEEN WAITING FOR?
A YEAR SO UNCOMFORTABLE, SO PAINFUL, SO SCARY, SO RAW-THAT IT FINALLY FORCES US TO GROW.
A YEAR THAT SCREAMS SO LOUD, FINALLY AWAKENING US FROM OUR IGNORANT SLUMBER.
A YEAR WE FINALLY ACCEPT THE NEED FOR CHANGE.
DECLARE CHANGE. WORK FOR CHANGE. BECOME THE CHANGE.
A YEAR WE FINALLY BAND TOGETHER, INSTEAD OF PUSHING EACH OTHER FURTHER APART.
2020 ISN’T CANCELED, BUT RATHER THE MOST IMPORTANT YEAR OF THEM ALL.”
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.
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.
We live in a media driven culture with an endless supply of TV shows, internet sites, and phone apps to keep us busy every minute. These platforms are used to deliver messages meant to persuade, inspire, and entertain. Many of these messages contain images of men and women airbrushed to perfection….and it is that very image of perfection that haunts us as we study our own bodies and make comparisons. To say that the internet has influenced body image is an understatement. In recent years, the rise of pro-anorexia and pro-bulimia websites has glorified eating disorders and praised the behaviors that keep sufferers locked in the illness. The Social Issues Research Centre (www.sirc.org) reports that these “pro-ana” websites target individuals who consider their eating disorders to be lifestyles, something to maintain and celebrate. Users share tips on how to engage behaviors and provide support for each other’s illnesses. For individuals who are in recovery, websites like this can be seriously detrimental. Some people in recovery refuse to engage in social media at all, citing the prevalence of hashtags like #thighgap and #thinspogram as just a few of many reasons to shelter themselves from the social media revolution. USA Today (www.usatoday.com) shares the story of Donna, who is in recovery from bulimia. Afraid to expose herself to the kinds of comparisons that fueled her illness, Donna has decided to stay away from popular social media sites like Facebook and Instagram. While it’s clear that social media and pro-eating disorder websites have played a part in our global obsession with obtaining perfection, more and more websites dedicated to positive body image and recovery are beginning to pop up. Someone searching for eating disorder tips may stumble upon a recovery website or blog and be drawn into a story of hope….leading to the inspiration to begin recovery. The National Eating Disorders Association (www.nationaleatingdisorders.org) shares the story of one woman who came across the NEDA website in her search for a pro-eating disorder community….a lucky accident that turned out to be the catalyst for her recovery. Nonprofit organizations dedicated to awareness and advocacy use the power of the internet to spread positive body image messages. Eating disorder treatment centers are also getting involved in the awareness movement, offering blogs, webinars, and professional events designed to educate and inspire. Instagram is also proving to be a powerful recovery tool. An online photo-sharing service, Instagram users can visually communicate their lives to their followers. Some individuals in recovery have turned their Instagram accounts into recovery accounts. The Atlantic (www.theatlantic.com) describes this type of account as a place where users can gain support while maintaining as much anonymity as they would like. Some people don’t use their real names, and others find that it’s easier to open up and share initially in an online environment. Recovery accounts document the progress users are making through pictures of meals, inspirational messages, and even pictures of users’ bodies as they work toward weight restoration. Support from followers during the recovery journey can be motivating and provide comfort during difficult periods. Although social media can be a positive recovery tool, users must be vigilant and pay attention to their triggers. Any concerning thoughts and behaviors should be taken seriously and addressed with a treatment team. Totally In Control: The Rise of Pro-Ana/Pro-Mia Websites. Social Issues Research Centre, www.sirc.org Rojas, M. (2014). Social Media Helps Fuel Some Eating Disorders. USA Today, www.usatoday.com Kay, J. (2014). How Social Media Led Me to Recovery. National Eating Disorders Association, www.nationaleatingdisorders.org Mirhashem, M. (2015). Overcoming an Eating Disorder with Instagram. The Atlantic, www.theatlantic.com