Archive for March 20th, 2012

March 20, 2012

the HAES files: De-Stigmatizing Our Workplaces – A Start

by Health At Every Size® Blog

by Linda Bacon, PhD

Being Linda Bacon, well-recognized for my expertise on weight concerns, author-of what has been called the “Health At Every Size Bible`,” must mean I can use my influence to ensure my workplace is HAESSM-friendly and stigma-free, right? I wish. Instead, like many of you, I regularly see stigmatizing messages in my workplace. Right now, I am mired in a struggle to sway the organization’s official poster-hangers and “health-promoters” from unwitting campaigns against fat people.

This is in many ways a progressive, open-minded place but, like so many bureaucracies, it reflexively broadcasts misguided policies and messages on body size. From my recent efforts, I draw the following set of suggestions and boilerplate text (borrow at will!) for your own efforts to fight weight stigma, and advance size acceptance and respect in the workplace for people of every shape and size.

With slight tinkering, the principles and language below will adapt for letters, newsletter briefs and face-to-face conversations. I hope they empower you to speak up when you encounter body bias and “hate speech masquerading as health speech,” (in Deb Burgard’s elegant phrasing).

Assume Good Intentions

Even if you’re wrong, your arguments will go further (and you may feel less bitter) if you start from the premise that most people mean well:

Because I [know/believe] you to be caring people with the best intentions for the people with whom we work, I hope you will be concerned to know that actions and messages in [our organization’s recent health campaign/ incentive policy/public service messaging] may be unintentionally harming everyone who comes into contact with them.

Be Clear In Your Goals

Yes, this can be a great teaching moment for the long-term, and we all know changing paradigms is more a marathon than a sprint, one-miler or even a 10K, but know what you want to happen and on what time-table and be plain about it. Is it a meeting you’re seeking, or a series of dialogues? A change in the company health plan? In my case, I wanted a damaging poster removed stat:

For reasons I’ll explain, I urge you to [remove the obesity-campaign poster today].  An issue of prejudice is at stake here, with implications for the health, morale and productivity of our [students/employees].

Put the Stakes in Context

Remember, you are speaking for more than yourself. Only a few people will summon the time, courage and information to advocate on this matter, but no one is immune to body anxiety, and bias in the workplace brings down the entire organization.

I hope you will take this as seriously as you would a claim of racism, because it is parallel. Unfortunately, the [current/proposed company policy/poster campaign/incentive program] encourages weight stigmatization. (It should also be mentioned that this stigma falls especially on minority and disempowered groups, including women and people of color.) I realize the harm is unintentional, but so long as you continue this program, you are hurting people – fat and thin alike.

Question the Premises

This is your chance to point out that obesity “science” is far from proven and that efforts to combat it may be counter-productive, possibly even encouraging the behaviors or conditions they mean to wipe out.

Even setting aside the serious issue of prejudice, the company’s new [program/campaign/policy] is unlikely to have the intended effect of helping people. There is no evidence that educational campaigns like this one, based on fat stigma, yield any long-term benefit for people’s health and lives – rather, the evidence suggests that providing this “education” is damaging. Regardless of whether the information is accurate (and I would argue that it is very misleading), consider that it is delivered in a context where fatter people are regularly pummeled with “news” that their bodies constitute a horrifying health crisis, and the “fat is bad” message is already well-established in everyone’s mind.

Even if fat alone does play a role in an individual’s ill health (social inequity, and nutrition, fitness, and other behaviors actually prove far more significant), studies repeatedly find that it’s nearly impossible to banish. Most every diet fails in the long run for almost all people. Biological mechanisms dictate that the majority of us could no more diminish our girth, lifelong, than make ourselves taller or modify the shape of our ears.

Meanwhile, data show that the repeated loss-regain cycles that result from trying to lose weight) are far more harmful, medically, than maintaining a stable weight, even if it’s high. Yo-yo weights are linked to cardiovascular disease, diabetes and other (“obesity-related”) ailments, so implying that the pursuit of weight loss is valuable is just bad medicine.

Focus on Your Organization’s Goals

Ask your reader or listener to think about practical goals and consequences. Focus on the R.O.I. (return on investment), if it’s that kind of an organization.  Issues of stigma aside, if the policy in question won’t yield the desired results, then why bother? Are there other, non-harmful ways the organization could achieve real good?

What does our organization gain by shaming some of us for how we look? How will we measure the success of this [campaign/policy]? Unlikely as it is, suppose stigmatization worked and some people started exercising more as a result of seeing this poster: If they lost no fat (the typical outcome of exercise programs), would the poster have failed? If each managed to lose just five pounds (hard to do but still a medically insignificant amount), would that be a “win”? If the weight loss resulted from disordered eating or had no effect on health, what then? And would results be measured over time (given that most lost weight is regained and sometimes more), or would it be forgotten by the next cycle of [posters/incentives/policy revamps]?

This campaign will succeed in little more than shaming the larger members of our community and making the rest of us feel insecure about becoming like them.  The fact is that anti-obesity efforts have been shown to discourage the very types of behaviors –good nutrition and exercise – they try to promote. Fat people already know they’re fat.  “Obesity awareness” efforts are not just pointless but counter-productive; no psychologist would argue that shame – or even fear – stimulates positive long-term behavior change. Thin people, meanwhile, may wrongly conclude they’ve got a “free pass,” that fitness and nutritional considerations don’t matter for them.

Propose Alternatives and Offer Information

Here is where you can talk about the missed opportunities in substituting anti-fat campaigns for health-positive messages.

The worst part is, by pursuing a misguided strategy, we may be missing the chance to do good. Evidence increasingly shows that a focus on health and health habits, rather than weight, can do a world of good. The weight-neutral, body-positive Health At Every Size® movement has shown that people who accept the bodies they’re in are far more likely to care for them through good nutrition and exercise. If our organization truly wants to improve the lives of its members, greater acceptance is the way to go, not stigmatization.

There’s more we can do. I would be glad to provide more information about the data and support behind the Health at Every Size approach and happy to brainstorm with you on ways our organization could encourage better health for our [students/colleagues].

Return to Your Goals

Cutting bait time: Are you going to end the harmful policy, or not? If not, this isn’t going away. Obviously, office politics will determine how far you are able or willing to go in setting conditions. But to the extent you can, this is where you ask for concrete change or, short of that, a detailed explanation. This will force your colleagues to consider your concerns and help you to identify further information that may be valuable.

For all these reasons, I ask you to [take the poster down/rescind the policy/change the incentive program]. If you don’t think that’s appropriate, then I would like to meet with you [include colleagues if you have allies] in person and/or hear your justification, addressing the points I’ve made, for perpetuating stigmatizing “education” likely to have damaging results.

Again, please know that I do not question the motives behind this program. I believe we share a desire to benefit our organization and do what’s best for its people. That’s why I feel sure we can work together to more find positive, affirming ways to advance those goals. Thank you.

Provide Follow-Up Information

For more information on weight and health, and Health at Every Size, check out Health at Every Size: The Surprising Truth About Your Weight by Linda Bacon. The HAES Manifesto, taken from the appendix, is a short user-friendly synopsis of these issues. Bacon and Aphramor’s peer-reviewed article, Weight Science: Evaluating the Evidence for a Paradigm Shift, provides academic support.

Humanity Hooks

Consider ending with a personal story of your own.  Here is an example of one I use from my experience:

I can never forget these words I heard from a student named Juanita, age 17, tears streaming as we walked down the a hallway emblazoned with messages for Childhood Obesity Prevention Month:

“Can they imagine what it’s like to walk down the hall and see posters essentially blaring, “We don’t want anyone to look like you?”” Do they really think that’s going to motivate me to eat better? Sure, I eat junk foods sometimes, but so do my thin friends. Why am I the only one for whom that matters?  The only result I’ve seen from this campaign is that I feel worse and kids are even more mean to me.”

Before Clicking “Send,” Consider the Outcome and Prepare Your Defenses

Choose your battles wisely. Know that walking away is always an option and nothing to be ashamed of. Recognize that you do not have the power to control others’ reactions. Your message may not be heard, and could actually increase your feelings of alienation. Their actions are culturally sanctioned, and yours is a challenging message for others to hear. It will be too easy for them to rationalize what they do and marginalize you. Even I, with all the confidence of my expertise and experience and community support, feel considerable trepidation as I submit this letter to the powers that be.

Being confronted with stigma is painful, and we all experience it. Whether we choose to speak out or remain silent, whether we get the desired outcome or not, we can all benefit from cultivating our defenses and using the community for support.  (Not an ASDAH member? This is a great reason to join!) Please take advantage of the comment board to add to the dialogue.

Click here for boilerplate text that you can adapt for your purposes.

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