healthateverysizeblog

February 28, 2012

the HAES files: can you tell anything at all by a person’s weight?

by healthateverysizeblog

If you have grown up in this culture, you probably associate quite a few things with fatness and quite a few of the opposite traits with thinness. Almost every audience comes up with the same lists:

Fat:	Thin:
Lazy Depressed Sick Out of control Loser Bad	Productive Confident Healthy Disciplined Sexy Good

Even though these associations are not something people from other cultures (or other times in history) believe, they are so strong and unquestioned in our own time that they form the basis of our weight stereotyping, bias, and stigma.

To test your own associations, go take the Weight version of the Implicit Attitudes Test. The test does not measure whether you inflict weight bias on people, but rather how strongly you have been taught to associate certain concepts with weight.

It might be surprising to know that weight stigma hurts both thin and fat people. In my work with people of all sizes who are struggling with disordered eating, it is clear that a huge factor in their misery is almost always the worry that they will be humiliated and rejected because of their weight – no matter what their weight is. I have had people sitting in my office who look like they walked straight out of a fashion magazine who are convinced they are not thin enough, not perfect enough, and not good enough (and some of them are absolutely accurate about the impossible standards of their world of ballet or modeling or a really bad relationship). Others have endured a lifetime of negative stereotyping and discrimination as fat children or adults, and can’t imagine loving the bodies they blame for the meanness of other people. Still others have witnessed the humiliation of a friend, a parent, a sibling – and are petrified about such a thing happening to them.

So some of them have had actual experiences of weight stigma, some of them give themselves the experience of stigma within their own minds, and some are convinced that it is only a matter of time before the axe falls unless they perfect their bodies to some mythical state. No one feels safe, because everyone has times when we feel something from the “fat” column. Busted!

When I work with clients, we have to figure out a way to handle both the real and the self-inflicted experiences of weight stigma, so that they can get unstuck and recover. Part of this work is for the client to change his/her own mind about what fat and thin means. Part of it is to change other people’s minds.

And so today in the spirit of changing other peoples’ minds, I ask that we stop for a moment and question this weight stigma stuff, and why we keep it around.

It seems obvious that the diet (i.e., the weight cycling) industry wants to keep it around, because how else would you sell a program that never works, over and over again, and not worry about the consumer getting hip to the fact that it is useless? But even though it is a big honking industry (most recently estimated at over $60 billion), most of us are not making money from it and would be fine if it suddenly went out of business. In fact, most of us would be much better off economically with our $500-1000/year safe in our own pockets rather than handing it over to Weight Cyclers.

So what about the rest of us who aren’t profiting off this industry? Why would we perpetuate weight stigma? When you look at the lists of traits associated with “fat” and “thin,” what strikes me is that they are such normal human states and traits. Is there a week that goes by when you don’t feel like some of Column A and some of Column B? But the “fat” traits are painful to experience – they are the things we feel when we miss the deadline, can’t get motivated, find ourselves rejected, or are diagnosed with a health problem. We would prefer not to feel them at all, and when we are promised that just by losing weight, we will become a Whole New Person (free of all the “fat” traits!), we think that would be a pretty great deal. That promise sucks us in. We cave to the illusion that life does not have to sometimes feel bad, and we perpetuate the myth that by changing our bodies, we can avoid feeling bad. In fact, according to the myth, if you feel bad, it must be your own fault for not working hard enough to get the right body.

The truth is, few people live only in the “Thin” column. And actually, when you think about it, doing so might make you pretty insufferable. It may be the reason some people can be so immensely clueless about the weight stigma they are inflicting on others – being cut off from your own human vulnerability makes it more possible to justify “punishing” other people. Only someone who refuses to identify with the person across from her who is suffering, would add to that suffering.

There are people who understand that weight stigma is causing suffering but feel like it is somehow going to make people care about their health. Like a person will start exercising to lose weight, but not to become more healthy, so we have to keep trying to stigmatize higher weight and promote weight loss.

It is true that people are social animals, and are very punished by being stigmatized. But punishment is famously unpredictable as a motivator. The things people do to leave the stigmatized group are often not at all conducive to their health. Injecting poison into your skin, slicing up healthy body organs, starving yourself, taking drugs, and even repetitive weight loss attempts, are things that make people sicker. Even though I don’t think people would go through half of what they do in the name of weight loss just to have lower blood pressure or better triglycerides or a lower risk of a stroke, I would argue that the net effect of the attempt to leave the stigmatized group is actually less health. Weight loss is not like trying to quit smoking. Weight cycling makes you sicker and fatter. And if your weight loss takes the form of an eating disorder you have a one of the deadliest psychiatric illnesses to battle.

And what about the health burden of weight stigma itself? Historical studies of cultures where higher weight is not stigmatized show that people at higher weights were just as, or even more, healthy than the thinner members of the community. And perhaps the most robust finding in all of epidemiology is that social support is the holy grail of health. How can removing social support – and making people sicker – be a path to making people healthier? How can the US government telling people that we are trying to eliminate them in a generation make them healthier?

The truth is, there is no reason to demonize people of certain weights. The far more effective message is that people can find things to do that support their health at whatever size they are. After all, the same practices and environments support health for thin or fat people. If the same cafeteria feeds the thin kids and the fat kids, why can’t we talk about what is on the menu that supports the health of all the kids? Why do we have to argue that the food has to change so we can have no fat kids? Why can’t we argue that the food should be healthy for the kids – period? We can work to create environments that support people in their efforts to thrive and make lasting efforts to take care of their bodies. Part of creating that environment is ridding it of the pollution of weight stigma.

I grew up during times of great social upheaval, and I have seen a lot of change when it comes to social stigma. Though the world is far from perfect, it is a very different place now than it used to be if you live together without being married, or get divorced, or have a baby as a single parent, or work as a female airline pilot, or get around in a wheelchair, or raise kids as gay parents, or love someone of a different race or religion. Stigma is a kind of fashion. We can change what is fashionable. We can make weight stigma incredibly uncool. Because it is.

So what are you going to do today to end weight stigma, in your mind, and in the world?

National Eating Disorder Awareness Week

is February 26-March 3! Get involved!

Everybody Knows Somebody. Visit the NEDAwareness Week homepage to register today and learn more about how you can do just one thing to help raise awareness about eating disorders and become part of the solution. NEDA’s Helpline number is: 800 931-2237

Posted in Deb Burgard | 7 Comments »

February 21, 2012

the HAES files: you gotta have heart!

by healthateverysizeblog

by Jeanette DePatie, ASDAH Vice President, in consultation with ASDAH member Sandy Dixon, RN, MS, Cardiopulmonary Rehabilitation Manager

Valentine’s Day has just passed us by and February is American Heart Month. So it should come as no surprise that this blog post is going to talk about the Health at Every Size® approach to a healthy and happy heart.

Many of us have had our poor hearts broken by medical professionals who have railed on us to lose weight for the sake of our cardiac health. Fat and heart disease are associated–meaning that people who are fat may be somewhat more likely to experience heart disease. But does this mean being fat causes heart disease? Can you effectively prevent heart disease and maintain a healthy ticker using a Health At Every Size Approach?

There is a lot of new evidence indicating that healthy behaviors have a far greater impact on heart health than weight. In fact a significant study recently published in Circulation magazine (The Journal of the American Heart Association) indicated that healthy behavior—specifically exercise had a far greater impact on heart health and mortality from heart disease than body size. This was not a small or isolated study. It followed over 14,000 subjects for over 11 years. But the outcome was clear—fitness trumps fatness in terms of longevity and heart health.

So, there are a variety of Health At Every Size® behaviors that we can adopt to keep our tickers in tip top shape. Here are five good ones to get you started:

Exercise Joyfully: As indicated by the study referenced above, fitness is one of the most important factors in maintaining heart health. You don’t need to be a marathoner or a professional athlete. We’re looking for a total of 150 minutes per week or 30 minutes on most days of the week. Even as little as 75 minutes per week can have a positive impact on heart health. It doesn’t need to happen all at once, it doesn’t need to be hard core and it doesn’t need to happen at a gym. Work in the garden. Walk the dog. Park a little further away from your favorite outlet mall. Find pleasurable and manageable ways to work fitness into your life.
Manage your Mood: Some studies indicate that your emotional outlook on life can significantly impact your cardiac health. People with Type-A personalities, depression and unexpressed anger seem to be more prone to heart problems than those with a happy-go-lucky approach. Luckily there are positive steps you can take to cope with that stress. One step is mentioned above. Exercise enhances mood and helps cope with both depression and anger. Other techniques include relaxation techniques like breathing exercises and meditation. And if you’re having difficulty managing stress, anger or depression your own, seek the services of a qualified mental health professional.
Care for your Teeth: There is a lot of recent evidence linking dental health with heart health. Gum disease can lead directly to heart disease, infecting the inner lining of the heart (endocarditis). Some research also suggests that heart disease, clogged arteries and stroke may be linked to oral bacteria, possibly due to chronic inflammation. So do like your mom told you—brush, floss and see your dentist regularly.
Know your Numbers: It’s important to be aware of your key cardiac indicators including your cholesterol and blood pressure levels. That means seeing your doctor regularly. And since you’re seeing that doctor regularly, it’s smart to pick one that doesn’t raise your blood pressure through the roof. White coat hypertension is a well documented phenomenon which causes some people to exhibit significantly elevated blood pressure in their doctor’s office. So try to pick a doctor you can respect, who respects you and with whom you can communicate effectively.
Eat Colorfully Close to Nature: I’m not suggesting the dreaded “D-word” here, (You know, the one that starts with “die” and ends in agony and frustration.) But there is a lot to be said for eating a variety of delicious foods, from both land and sea, that are close to a natural state. Heavily processed foods tend to be very high in sodium and other chemicals. For some (but not all) people, high sodium levels lead to higher blood pressure. Fruits, vegetables, whole grains and seafood can help maintain a healthy heart and can also be quite delicious. So make your heart happy while you pump up the variety in your diet with a colorful plate of fabulous foods.

A downloadable version of this Health At Every Size Tips for a Healthy Heart is available here.

Posted in ASDAH, Jeanette DePatie | 12 Comments »

February 14, 2012

the HAES files: journey to acceptance

by healthateverysizeblog

by Judith Matz, LCSW

Remember me?” Beth asked following my presentation at a community-based hospital. “Of course I do!” I responded. Beth had been in my Diet Survivors group about 7 years ago, and had come a long way in breaking the diet mentality and developing a healthy relationship with food. In fact, I was surprised to see her at this event, since the purpose was to introduce participants to a non-diet, Health At Every Size® approach, with the option to pursue an eight-week program.

Beth explained that she had loved my group, and had felt much calmer in her relationship with food at the time that she left. But, she told me, she “just couldn’t handle” the acceptance part of the HAES^SM approach. In the years that had intervened, she went back to Weight Watchers, losing lots of weight, and then, inevitably, gaining it back.

It made me sad to hear Beth’s story. I don’t have illusions that I can help move everyone from the culturally induced body hatred to a feeling of being at home in their body, but I couldn’t stop thinking about the amount of energy wasted by this talented, smart and kind woman as she continued the yo-yo diet cycle.

There’s a term in the field of psychology called disavowal, which means that you know something – but at the same time, you don’t let yourself know that you know it! In other words, you disavow the thing that’s too hard to consciously acknowledge. When it comes to the failure of diets, disavowal occurs not only for individuals, but at the cultural level as well. Think about how many times we hear a report that diets don’t work, “but it’s still good to keep trying,” or a finding that people can be healthy in higher BMI ranges, “but it’s still probably a good idea to lose some weight.” These cultural messages to lose weight despite the lack of evidence for efficacy seep into the individual’s psyche, making it all the more difficult for people like Beth to move toward acceptance.

In coining the phrase diet survivor, my co-author (and sister!) Ellen Frankel and I hoped to encourage people to come out and openly declare that they’re done with dieting. But, we also recognize that people go through a process of loss and grief as they let go of all of the fantasies associated with dieting and weight loss. Here is a summary of how we describe that journey in The Diet Survivor’s Handbook:

Denial

You may find yourself questioning whether you must truly give up on the idea that diets can make you permanently thinner. After all, research shows that diets fail in the long term about 95 – 98% of the time. That still leaves a tiny percentage of people who have lost weight without regaining it back. You might imagine that you can become one of those people, even though experience says otherwise. Dieting is seductive, and you may be in denial about the inherent failure of diets. You may need to engage in another cycle of dieting before being convinced that this is true for you.

Anger

You may lament, “Why me?” You may turn your anger against yourself by berating your body, or you may direct your anger at others. It may seem unfair that some people are naturally thin no matter what they do, while you’ve tried so hard to achieve that body size. As you come to understand the physiology of dieting and body size, you may also become angry when others continue to judge you based on size.

Bargaining

Even though the concepts related to diet failure make sense, you have a wish to diet one more time to lose weight before incorporating principles of attuned eating and acceptance. Your attitude is, “Let me just lose weight first, and then I’ll quit dieting.”

Depression

You’re being asked to live your life without the goal of weight loss when, up until now, your life was focused and organized around this premise. The sadness of shifting beliefs about the merits of dieting and the requisite of thinness is a difficult challenge. You may feel that you’re being asked to give up on yourself when, in fact, the opposite is true. You have the opportunity to live an authentic life based on principles that contribute to physiological, psychological and spiritual well-being.

Acceptance

This is the point where you accept the inherent failure of diets and no longer choose to diet in an effort to become thinner. At this stage, you understand that dieting wreaks havoc on your ability to find your natural weight. You see the cost of dieting in both physical and emotional terms, and you’re no longer willing to pay the price. You’re committed to taking care of yourself the best way you can and allowing your weight to settle in its natural range as a function of attuned eating and engaging in physical activity that suits both your body and your lifestyle.

Last night I met with Karyn, a client that I’ve been working with for about six months. Even as she’s come a long way in breaking the diet mentality and becoming an attuned eater, she’s been struggling with her body image. “Something came to me this week,” Karyn announced with a smile. “I’ve been reading more books and googling for Health At Every Size information. I really get that I need to just accept my body as it is and stop focusing on trying to change my weight. When I can do that first, my eating will really fall into place.”

I still get tingles when my clients have their “aha” moments, and I hope that Karyn will be able to sustain the feeling she had in my office. It’s clear to me that the HAES culture makes a transformational difference in people’s lives as it permeates the larger culture. I don’t know whose website she went to, or which blog she read, but I do know that our collective voices and activism, whether it’s in public forums or private conversations, is significantly breaking through the cultural disavowal of diet failure. Perhaps if Beth were in my group now, she would find that burgeoning support for the Health At Every Size approach in the greater culture would help her to finally feel comfortable in her own skin. I like to think so.

Posted in Judith Matz | 3 Comments »

February 7, 2012

the HAES files: a tale of two billboards

by healthateverysizeblog

by Jeanette DePatie, (the Fat Chick), MA, ACE

Lately the Strong4Life campaign in Georgia has received a lot of publicity and a LOT of pushback. For those of you who aren’t familiar, this is a group of ads that depict fat children in black and white photography and seeks to convey how miserable it is to be a fat child. They claim that this is a “wake up call” for parents who apparently don’t know that their kids are fat and have somehow missed the message in our culture that being fat is a “bad” thing. They insist their goal is not to make kids feel bad (even though the images look like shots of hardened criminals). But it’s hard to imagine that chubby children encounter these ads via magazines, the web, television and even giant billboards and feel GOOD about themselves.

But ASDAHonians should take heart. This week I’ve interviewed two amazing women who are involved in specific pieces of activism aimed at counteracting the negative effects of this ad campaign. Both of these activities are extremely easy to join and both have used new technology and social media to create a groundswell of publicity around and support for the Health At Every Size® approach to health.

ASDAH Member Marilyn Wann has initiated an amazing campaign called “I STAND against weight bullying.” In this campaign, Marilyn has created a design template that imitates the Strong4Life ads and invites people to submit pictures of themselves and positive statements to represent themselves. Marilyn’s amazing design team takes the photos, cuts out the images of the people and puts them as well as the positive statements into the I STAND design template. These photos are then shared via facebook, twitter, tumblr, flickr, and other social networking tools. You can see some of the images submitted by your very own ASDAH leadership team here in this blog post. So far well over 200 images have been created. I caught up with Marilyn in the midst of this extremely popular project and she agreed to an interview:

What gave you the idea for this project?

I’ve been aware of these awful billboards since they went up last year. I always thought they were a hateful blight on the Georgia landscape very much like the 1-800-GET-THIN billboards are a blight on the California landscape. I tend to think visually and so I was aware of how much damage these negative images can do. But I started to wonder about how I could take the negative charge of their images and turn it into a positive charge for people of all sizes. What if we could create and share positive images of people of all sizes who are comfortable and happy in their bodies? How powerful would that be?

How did the project start?

The project started with a single STANDard. (I call these images STANDards.) I just wanted to create one of me with a powerful image and statement. I had a friend snap a few quick cell phone pictures of myself, and then Nicole Peirce helped me create an image that looked very similar to the Strong4Life versions. But the image had large red letters on it. Those letters made me feel tense. I realized that the color red usually implies warning or danger or fear. This is the opposite of the feelings I was hoping to convey. So we changed the red to hot pink, which to me symbolize health and happiness and joy. Once we did that, we realized that we had a very powerful image and we posted it.

So then you invited others to join you?

Yes! The moment I posted the picture, I realized it was something other people could do too! Almost immediately people started asking if they could submit images too. So we just developed it as a “meme dream” and put out invitations. And I want to say something about those invitations. They are open to EVERYBODY. I have had people email or call and say they want to do an image, but they have a health issue or they are in a wheel chair or they have some other reservation. This is an open invitation. If you have a picture and something positive to say, you’re welcome. And the images have just been pouring in!

Why do you think this has been so popular?

There are plenty of us that are good and angry. But we want to express our anger while doing something good. This effort unites people in our movement. It’s hard to feel powerful when you feel like you are completely alone. But when you see hundreds of images of people of all sizes standing up and saying, “hey I love myself and I love my body and my life rocks!” well, how powerful is that? We take the finger pointing and finger wagging and blaming of Strong4Life and turn it on its head. Instead of spreading fear and prejudice, we stand AGAINST bullying and FOR joy and life and health.

How do you think the “I STAND against weight bullying campaign” represents the Health At Every Size® approach to wellness?

I think this represents the HAES^SM model mostly in terms of its positive approach. It takes the approach of the pleasure principle as opposed to the punishment principle. It’s the difference between motivation and eagerness. When we are asked to do something we may not really like (which for me might be to go to the gym and get on an exercise bike) then we have to be continually motivated. But when we do something healthful we like (which for me is going for a fabulous bike ride outside) we feel a sense of eagerness. When it comes down to it, people are eager to like their own bodies. They are eager to engage in pleasurable activities. They are eager to eat delicious and sustaining foods. A HAES approach is about connecting with this eagerness. These images from dozens and hundreds of people are coming from their own hearts and express the eagerness experienced in a Health At Every Size life. People end up avoiding exercise or nutrition when those goals are motivated by shame. Enjoying eating well and exercising can come from loving one’s body and not hoping to change one’s body–core values, I imagine, of these photos and of the HAES principles.

ASDAH Member, Blogger and Fat Activist Ragen Chastain has worked with several other members of the size acceptance community to create a campaign to raise money for billboards that feature a size-positive response to the Strong4Life ads. She spearheaded the Support All Kids Billboard Project and kicked off the fund raising last week. Since last week’s launch, she has raised over $12,000 for size-positive billboards in Georgia. She only needs about 250 more donors to make a contribution (at any size) to unlock a $5,000 matching grant from More of Me to Love. You can help by making a donation. I caught up with Ragen this past weekend and she graciously agreed to an interview.

How did you come up with the idea for the billboard campaign?

I had been thinking for a while about how powerful it would be to have positive images of fat people on billboards as a way to give people of size a chance to see ourselves positively represented in the media. I talked about my frustration about Strong4Life on my blog and someone from wellroundedmama.blogspot.com left a comment saying that she wished we had enough money for our own billboards. I felt that this would be an amazing response to the Strong4Life campaign. The next day did a poll of my blog readers and people were excited about it. The only negative comment I got was that I shouldn’t bother because there was no way we could raise the money (which the commenter estimated to be $3,000). I felt like our community was ready to do something big, and I didn’t want to be held back by the notion that we shouldn’t try something big because it’s difficult or because we might fail.

Who else is working on it with you?

This has been a massive team effort. Marilyn Wann from Fat!So?, Shannon Russell of Fierce Freethinking Fatties, and Rachel Adams who did our web design were absolutely instrumental in this effort. Jay Solomon (ASDAH member) and the folks from More of Me to Love also extremely generous in offering a $5,000 matching donation that was half of what we needed to raise to put our billboard up, as well as getting the word out.

Why is this important to you?

They are kids. They are kids and they are being shamed and stigmatized by an organization that purports to care about their health. All the while that organization is taking hundreds of thousands of dollars in donations from corporations of which they claim to be critical (Pepsi, Coke, Golden Corral etc.). They are kids standing on the front lines while adults humiliate them and call it healthcare, and we need to get their backs.

What has surprised you the most about the campaign so far?

I was most surprised at the speed of the response. I believed we would hit our goal of raising $5,000 in the first day but I thought that it might be a mad dash at the end of the 24 hour Big Fat Money Bomb. Then, as I prepared to get everything posted at midnight people were e-mailing me asking for the link so that they could donate. Once we launched it the support literally poured in – we raised $1565 in the first hour, when I went to bed (at 4am!) we were at $3,290. By the end of the 24 hours we were just over $12,000.

If you had your dream come true, what would the outcome of this campaign be?

If my dream came true every kid who has ever been bullied or made to feel less than because of their weight would find this campaign and realize that they are worthy and valued and deserving of respect in the body they have now. Their new understanding would be supported when First Lady Michelle Obama stood at a microphone and said “I had the best of intentions when I focused on the weight of kids as a way to improve their health, but I now know that was a mistake, I was wrong and I’m sorry to all of the kids who were hurt when I confused their weight with their health. We are going to support developing healthy habits and high self-esteem in kids of all sizes using a Health At Every Size® approach. This is Dr. Linda Bacon, she’ll explain the research and talk about our new campaign…”

What one thing do you most want people to know about this campaign?

Right now I want people to know that we have raised enough money to put up our billboard and we are now raising what we need for other media including bus shelter signs, smaller billboard in downtown Atlanta etc. following the model created by Strong4Life to make sure that we get this message out. The More of Me to Love Matching grant is a challenge grant and to unlock it we need to get 1,000 individual donors. We are currently running a Solidarity Dollar campaign and if people want to support what we are doing. No donation is too small!

Do you think this is a good way to spread a Health At Every Size message?

I think that this is a great way to spread the message. Since CHOA’s controversial billboards have made it into National Media, our response is has the opportunity to earn National Media as well. In fact we’ve already been contacted by a major network news program, BBC News, and we’ve had an article in SF Weekly. We are getting the message out that shaming is bad for children’s health, and that we can be for developing healthy habits in kids of all sizes without stigmatizing any kids at all. The Health At Every Size paradigm is an evidence-based way to do just that.

Is there anything else you’d like to share?

Thank you. I’m reticent to start listing people lest I miss someone but thank you to Marilyn, Shannon, Jay, Rachel, everyone at More of Me to Love, NAAFA, ASDAH and everyone who is involved in this campaign. I’m so excited about what we can do for kids in Georgia and the reverberation it could have. We have accomplished something huge and we should be incredibly proud of ourselves.

This is a remarkable time in the Health At Every Size movement. Ragen, Marilyn and their amazing partners (and that includes many of you!) have created unique opportunities to create positive, HAES messages for kids, parents and other people of all shapes and sizes. I encourage you to take a moment to contribute just a little of your time, money, energy, voice, creativity, publicity or other resources to these amazing efforts!

ASDAH President Deb Lemire blogged about the Strong4Life website video campaign that accompanied the billboards.

ASDAH’s Leadership Team Supports the I STAND project!

Not pictured: Jennifer Copeland, Education Co-Chair; Paul Ernsberger, Research

Posted in ASDAH, Jeanette DePatie | 3 Comments »

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