SIZE INCLUSIVITY: EXPLORING SIZEISM AND ENCOURAGING BODY ACCEPTANCE

SEPTEMBER 2019

PRESENTED BY: ASHLEY MUNRO, RD, CDE

NUTRITION COUNSELOR | CAMPUS HEALTH

DISCLAIMERS

¡ Health at Every Size (HAES®) Dietitian - diversity matters

¡ Intuitive Eating Counselor, which makes me pro-variety and anti-diet (but not anti-health)

¡ Trained in traditional medical model

¡ Aware of lack of lived experience in different size bodies, identify as an ally

¡ I intentionally use different language – examples…

¡ Having the conversation is important, lean in yourself and call others “in”

OBJECTIVES

¡ Explore sizeism and discuss weight stigma

¡ Understand the Health at Every Size (HAES®) paradigm

¡ Understand ways we can support focus on health promoting behaviors and embrace body positive culture

THE SIZE OF YOUR BODY TELLS ME NOTHING ABOUT YOUR HEALTH!

THE TERMINOLOGY

¡ Sizeism – “a form of oppression related to size” [3]

¡ Weight stigma – “...also known as weight bias or weight discrimination, is discrimination or stereotyping based on a person’s size. Weight stigma also manifests in fat phobia, the dislike or fear of being or becoming fat.” [11]

THE COMMENT THAT CHANGED IT ALL

“We are prescribing to people in larger bodies, what we diagnoses as ED behavior in people in smaller bodies.”

POODLE SCIENCE

ASDAH presents: https://www.youtube.com/watch?v=H89QQfXtc-k

STIGMA CAN COME IN DIFFERENT FORMS

- Implicit - Explicit- Internalized https://www.instagram.com/glitterandlazers/

?hl=en

WHAT DOES THE RESEARCH SAY?

“THE PREVALENCE OF WEIGHT DISCRIMINATION IN THE UNITED STATES HAS INCREASED BY 66% OVER THE PAST DECADE”

LARGER BODIED PEERS ARE PERCEIVED AS LAZY, UNEDUCATED, LACKING IN WILLPOWER AND

CONTROL, AND UNATTRACTIVE.

WEIGHT BIAS & THE HARM

Weight bias is common and is associated with negative health consequences

Shaming about weight does not motivate positive behavior change

Internalizing weight bias contributes to negative outcomes

Public health messages, if not mindful can ”perpetuate” weight bias

Weight bias is a manifestation of social inequity

Action on weight bias requires a shift in culture and population-based approach

ARE WE SEEING A SHIFT IN OUR CULTURE?

HAES®

IT IS HEALTH AT EVERY SIZE, NOT HEALTHY AT EVERY SIZE

1. Weight Inclusivity: Accept and respect the inherent diversity of body shapes and sizes.

2. Health Enhancement: Support health policies improve human well-being, including attention to individual physical, economic, social, spiritual, emotional, and other needs.

3. Respectful Care: Acknowledge our biases, and work to end weight discrimination, weight stigma, and weight bias. Provide information and services from an understanding that socio-economic status, race, gender, sexual orientation, age, and other identities impact weight stigma, and support environments that address these inequities.

4. Eating for Well-being: Promote flexible, individualized eating based on hunger, satiety, nutritional needs, and pleasure, rather than any externally regulated eating plan focused on weight control.

5. Life-Enhancing Movement: Support physical activities that allow people of all sizes, abilities, and interests to engage in enjoyable movement, to the degree that they choose.

IT’S ALL ABOUT HOW WE SAY IT…

WEIGHT-CENTRIC

Weight loss/lose weight

Weight management

Reduce body fat

Good/bad foods

Avoid/Limit

Exercise

Portion Control

Calorie Control

Obesity Prevention

WEIGHT INCLUSIVE

Weight concerns

Weight and disordered eating

Health at Every Size

Healthy relationship with food and eating

Intuitive eating

Mindful eating

Make peace with food

Joyful movement and activity

Size diversity

Health Promotion

https://www.eatrightarizona.org/docs/2019%20Annual%20Meeting/Slides/Megan%20Anderson_Dawn%20Clifford.pdf

MOVING TOWARD BODY POSITIVITY

Embrace being unique

Normalize

How we talk about ourselves matters

Understand we are still learning/unlearning

Diversify your media/what you see

SOUNDS INTERESTING, NOW WHAT?

¡ Made on a Generous Plan/ Beauty Redefined

¡ Books/Podcasts

¡ HAES website

¡ Unfollow what doesn’t serve you

¡ Stay curious

ADDITIONAL READING

¡ Body Respect- Linda Bacon PhD & Lucy Aphemorh

¡ Body Kindness- Rebecca Scritchfield

¡ Health at Every Size- Linda Bacon PhD

¡ https://haescommunity.com/

¡ https://www.sizediversityandhealth.org/index.asp

¡ Embody

¡ Intuitive Eating –Evelyn Tribole MS, RD & Elyse Resch RD

¡ Embrace – Netflix

ALL BODIES ARE GOOD BODIES.

IT STARTS WITH RECOGNIZING OUR BIASES AND MAKING STEPS TOWARD CHANGE

QUESTIONS

REFERENCES

1. Alberga et al. Journal of Eating Disorders 4:34, (2016) DOI: 10.1186/s40337-016-0112-4

2. Bacon, L., and L. Aphramor. Nutrition Journal 10: 9, (2011). DOI: 10.1186/1475-2891-10-9.

3. Clifford, Dawn, et al. Journal of nutrition education and behavior 47.2 (2015): 143-155.

4. Maya Vadiveloo, PhD, RD, Josiemer Mattei, PhD, MPH Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine 51 (1), 94, (2017). https://doi.org/10.1007/s12160-016-9831-7

5. Puhl, R, & Heuer,C. Obesity 17, (2009): 941–964. DOI:10.1038/oby.2008.636

6. Puhl, RM, Moss-Racusin, CA, & Schwartz, MB. Obesity 15.1, (2007) :19-23.

7. Tomiyama, A. J. Appetite, 82, (2014): 8-15.

8. Tribole, E., and E. Resch. 1995. Intuitive Eating. 1st ed. New York: St Martin’s Press. 2012.

9. Tylka, T, R. Annunziato, D. Burgard, S. Danielsdottir, E. Shuman, C. Davis, and R. Calogero Journal of ObesityVolume 2014, Article ID 983495: 18 pages.

10. HAES principles: https://www.sizediversityandhealth.org/content.asp?id=152

11. Weight Inclusive language: https://www.eatrightarizona.org/docs/2019%20Annual%20Meeting/Slides/Megan%20Anderson_Dawn%20Clifford.pdf

12. NEDA: https://www.nationaleatingdisorders.org/get-involved/weight-stigma-awareness-week/faqs