Dispelling nutrition myths, ranting, and occasionally, raving


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A smile doesn’t hide your weight bias

 

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I completed an online course on weight bias and stigma for healthcare professionals last week. There was quite a bit that was good but there were a couple of things that rubbed me the wrong way.

If you’re not already aware Obesity Canada states that, “weight bias refers to negative attitudes and views about obesity and about people with obesity. Weight stigma refers to social stereotypes and misconceptions about obesity. These social stereotypes and misconceptions include beliefs that  people with obesity are lazy, awkward, sloppy, non-compliant, unintelligent, unsuccessful and lacking self-discipline or self-control.” 

Weight bias and stigma can cause significant harm to fat people. In fact, they likely cause more damage to people than carrying extra weight itself does.

The course I took was very good about making this clear and provided the facts as well as showing how harmful weight bias can be to patients. However, there was a video with some experts that I felt undermined the message. Here are the quotes that bothered me:

“If weight loss was easy we wouldn’t have the current obesity epidemic that we have.” – Director of Research and Anti-Stigma Initiatives at the Yale Rudd Center

“People think that for someone who’s overweight all they need to lose weight is some self-control and trying harder to eat less and exercise more. If that only worked we wouldn’t have the problem that we have today. The causes of obesity are very complex…” – Director of Research and School Programs at the Yale Rudd Center

The Yale Rudd Center is well-regarded for their work in reducing weight stigma and both of these individuals quoted above are prominent in the field. At first glance what they’ve said seems innocuous. However, the fact that this was a course intended to combat weight stigma, the experts are saying that obesity is an “epidemic” and a “problem” runs counter to the message they’re trying to convey. It just goes to show how deeply ingrained weight bias is when the very experts trying to counter it are inadvertently perpetuating it. When you say that obesity is a problem then you are saying that fat people are a problem. And I don’t see how that’s not stigmatizing.

The other problem I had with the course were the case scenario videos they shared. There would be one video where staff and medical professionals were rude and unprofessional to patients regarding their weight. Then they would show a video that was intended to show a positive interaction. Really the only differences in the “good” videos were that the healthcare professional was all smiles and asked the patient if they could talk about their weight before advising behaviour change under the guise of promoting healthy behaviours rather than telling them directly to lose weight. To me, the message was the same, it was “you need to lose weight” delivered with a smile rather than scorn. There was still no looking at overall health to determine if weight loss was actually warranted, there was still no consideration of other causes of the presenting ailments, and there was still no recognition that simply telling people to eat healthier and move more (especially without first determining what their current lifestyle is like) is not an effective way to get people to lose weight.

Overall, I felt that the message of the importance of not perpetuating weight bias was lost when all the healthcare professionals were still delivering the message to their patients that they should lose weight. And yes, some people can benefit from losing some weight, but this should be determined with appropriate assessment and then weight management options need to be appropriately discussed with the patient. Simply telling someone, on the basis of their BMI, to eat less and move more with a smile is not helpful.

If you do happen to know of a good online weight bias course please let me know as I’m still looking!


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Representation matters and the health care industry is failing miserably at it

Source: UConn Rudd Center for Food Policy & Obesity.

In relation to my recent posts about how a dietitian’s weight is not indicative of their professional capability, I’ve been thinking a lot about weight bias. Specifically, I’ve been thinking about how we portray (or don’t portray, as the case may be) people who are considered to be overweight or obese.

At work, I often find myself advocating for more diversity in our images of people. But by that I always mean “maybe we should include images of some people who aren’t young and white”. It actually kind of blows my mind that every time a draft comes back from a graphic designer that EVERYONE is youthful and white. Anyway… That’s not what I wanted to write about today. It’s the fact that they are also ALWAYS thin. I get it, we’re in the business of promoting health and what would you picture if I asked you to picture someone healthy. You’d probably envision someone who’s trim, youthful, smiling. The fact of the matter is though that health comes in all shapes and sizes.

Representation matters. If you don’t see yourself in an organization’s images, or a magazine’s, or in the media, you’re not likely to relate to the messages they’re sharing. I’m not talking about showing pictures of headless obese bodies when we’re talking about obesity, as a matter of fact, I’d rather we all just stopped talking about obesity altogether but that’s another rant. I’m talking about when we choose an image for a campaign for oral health, or a social media post about sexual health, or a banner promoting your services. Whatever the case may be. Think about it, with more than half the population falling into the category of overweight, our healthy living (and really ALL promotional) messages are missing out on a huge proportion of the population. If we truly want to promote healthy lifestyles for all then we need to include everyone in our messages. Don’t make it about weight though. Weight loss should not be the message. The message should be that everyone, regardless of size, age, ability, or race is deserving of good health and can enjoy a healthy active lifestyle. That everyone is deserving of health care services. That regardless of size, your voice should be heard. It really stuck with me how in Hunger, Roxanne Gay wrote about becoming more invisible the larger her body became. This is not how things should be. Your worth should not be inversely proportionate to your weight.

If you want to start including more positive non-stereotypical images of people with obesity in your work, check out Obesity Canada’s image bank or Yale Rudd Centre’s image gallery.


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Just because it’s “always delicious” doesn’t mean it’s not a diet book

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Last week I attended the Ambition Nutrition Symposium in Toronto, to which I was fortunate enough to win free tickets. The theme of the conference was “bringing it home” and was intended to help translate nutrition theory into the kitchen and onto client’s plates. While I’m not sure the day really succeeded in that regard, I still found it to be an interesting conference with a variety of speakers and delicious food (thank you George Brown culinary students!). That being said, from my perspective, there was an elephant in the room. That elephant was the tension between professions and dietary dogma.

We started the day with a great presentation by Dr. Kelly Brownell, director of the World Food Policy Centre, among numerous other titles. He spoke about the difficulty we often face when addressing food-related issues through policy as something that benefits one area (e.g. nutrition) may cause unintended harm in another (e.g. agriculture). The goal of his new centre is to bring stakeholders from all the areas together to try to develop policies that will benefit all areas. As an aside, one thing I noticed about the list of stakeholders he shared was the lack of the public. As “end users” I think that it’s essential that the public (or specific groups from the public such as those experiencing food insecurity) are involved in these discussions.

Later in the morning we had an excellent presentation by Nishta Saxena, a dietitian. Maybe I’m a little bit biased as an RD but I felt that she did a fantastic job of presenting the struggles we face in addressing healthy eating with clients when they are constantly bombarded by misinformation in social media. How do we combat “sexy” social media influencers as professionals who must provide evidence-based factual information and are less inclined to posed half naked with overflowing mason jars of green smoothies? Several years later and dietitians still aren’t sexy ;)

We also had Saxena and chef Christine Cushing call out juicing and juice diets (while a new cold pressed juice company presented at one of the breakout sessions and provided samples during food breaks). Cushing mocked the caveman diet and then we had a snack break with “paleo” brownies. Saxena belittled meal kits and our swag bags contained a coupon for Hello Fresh. Hello elephant.

Follow-up Saxena’s fantastic presentation with a discussion with Dr. David Ludwig and his wife chef Dawn Ludwig to promote their new book “Always Delicious” which we all got a copy of in our swag bags. Full disclosure, I have been critical of Ludwig in the past. I tried to come into it with an open mind though, I really did but the elephant would not settle down. Despite their protestations that it was not a diet book, if it talks about weight loss, fat adaptation, is filled with testimonials (from readers who have lost weight), and has a prescriptive DIET with three phases, it’s a goddamn diet book. I’m not going to get into the science of his insulin hypothesis here because my point is not to critique his beliefs but if you want to read more about it I recommend this short article by Stephan Guyenet. I’m also not here to question the “success” people have had on Ludwig’s diet. If people are happier and healthier following this plan, I think that’s great. My issue is with the framing of this diet as the best way to eat for everyone and that the best way of eating is one that promotes weight loss. They talked about “NSVs” (non-scale victories) but the only examples I saw in the book and heard during the talk were a reduction in blood pressure and going down a pant size (which while technically not a weight loss “victory” is still a “victory” over an “unruly” body).

For a day that was meant to promote health through food there was a whole lot of talk about The Obesity Problem which is really not the direction that we want to take if we want to encourage people to have healthy relationships with food and their kitchens. I encourage everyone to read this piece about one woman’s “life as a public health crisis”.  If obesity is a “problem” then food is the enemy. That mindset does not lead to healthy attitudes and behaviours. You don’t need to “retrain” your fat cells, they are not disobedient puppies. Rather, we as a society need to retrain our attitudes toward our bodies and our food so that we can once again be friends with both.


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Why do we care how much Trump weighs?

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I know that we all want to clutch onto every piece of evidence we find that Trump is a despicable human, hold them close, let them keep us warm at night, and build bomb shelters from them. I also know that society and popular media have taught us that “fat people” are the villains. That they are lazy and gluttonous and deserving of scorn. It’s incredibly difficult to set aside these biases, especially when we want to believe these things of a person, but that’s exactly what we need to do. Trump has given us ample reasons to believe that he is a garbage human. His objectification of and assaults on women, his racist comments and travel bans, his mockery of people with disabilities, his complete and utter lack of diplomacy, and on and on. His weight is not one of them.

Weight does not reflect ones value as a human. This is true of you, of me, of your friends and family, of famous actresses, of poor people and rich people, and yes, even of Donald Trump.
We don’t get to say that body acceptance is important and that weight is not indicative of health or personal worth for people that we like and then go around making a big deal about Trump’s weight. Sorry but not judging a person based on their weight should apply to everyone, even people we dislike.


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Is having abs incompatible with having a good personality?

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Last week I saw my social media friend Bryan Chung (@DrBryanC if you want to follow him on twitter and you probably do because he also writes the excellent Evidence Based Fitness blog) tweeting at a writer for GQ. The writer had written a column and tweeted it out as: “Stop trying to get a six-pack – try being interesting instead”. Intriguing, no?

Unfortunately(?), the article was didn’t provide any pointers on how to be interesting or how to compensate for your lack of abs with a stellar personality. Instead, it was all about how visible abs are really far too much work for anyone other than a Ryan Gosling or a Zac Efron. Plus, apparently you can’t eat anything good if you want to have a six-pack. Now, I know that having chiseled abs is probably for the minority but they are not impossible to obtain. You don’t have to give up all food and drink and pleasure in life to have abs.

The article seemed to be trying to tell men that they should magically blind women to their absent abs by having charisma. Apparently if you tell some jokes, By the time the T-shirt finally comes up, they’ll be too blown away by your mind to care.” As a woman, I can provide some inside information here: it’s true that most of us don’t give a damn if men have washboard abs or not. A great personality is essential but what defines a great personality (as evidenced by the taste of many of the women on the Bachelor/Bachelorette franchise) is as unique as your body. There is no one perfect personality and there is no one perfect body.

This article reminded me of that meme I saw a while back. Why does it seem like to embrace one body type we have to shun others? Why can’t we be okay with bodies in all shapes and sizes?

If you want to have washboard abs then go for it. If you don’t, then don’t. But let’s not fool ourselves into thinking that abs and personality are mutually exclusive traits. Just because you care about your physique doesn’t mean that you have a lacklustre personality. Conversely, just because you have a beer belly doesn’t mean you have a “perfectly toned personality”. You can have both abs and personality and you can have neither.