Dispelling nutrition myths, ranting, and occasionally, raving


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How pregnancy has made me confront my own weight bias

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Two months to go! Photo credit: Randall Andrews

I have a confession to make and I’ve gone back and forth about whether or not to write about it because I’m not proud of this. However, I’m taking a deep breath and going for it because I think that it’s important to acknowledge these things.

During the first trimester as I started to gain weight but wasn’t yet obviously pregnant I found myself struggling with the thought that people might think I was *gasp* fat. As someone who has always had a small body I have lived a life rich in thin privilege. Despite my support of HAES and firm belief that people should not be judged by their weight I realized that I wasn’t comfortable extending this mindset to my own body. My body is small, my body has always been small, and therefore, my body should remain small. It’s great for other people to accept their own larger bodies but I, I am ashamed to admit, am not willing to accept that my own body could be anything other than small.

When I would go running at the local indoor track, as my clothes became a little tighter around my belly, I imagined people thinking “good for her, trying to lose weight”. I also imagined people who knew me thinking “looks like she’s not running as much these days”. or passing other judgements on my physique. I was pissed at these people for judging my body. I wanted to wear a sign to tell the world that my imperceptible weight gain was due to the fetus growing inside of me, not because I’m incapable of taming my unruly body. And then I was ashamed and disappointed in myself for not extending the courtesy of body acceptance to my own body as it changed. I was also ashamed because this was how I envisioned others thinking about strangers bodies. Do people really pass these judgements on each other? On themselves? Why did I care what people were (or weren’t) thinking about my body? How have I allowed so much of my identity to be tied to my size? And how self-absorbed of me to presume that others are spending any time judging my body – given the number of people who expressed surprise upon learning I was pregnant when I thought it was pretty obvious people are not nearly as attuned to my body as I imagined. 

As my belly grew and it became more obvious that it contained a tiny human and not just one too many cheeseburgers I became physically less comfortable but mentally more comfortable. People started to compliment me on my “adorable bump”. It feels good to have an acceptable larger body but I’m still carrying that extra guilt around too. It’s not right that women in larger bodies should be shamed while I’m praised for my belly. I truly have no more control over the shape and size of my “bump” as this fetus grows inside me than I have over my height or the size of my feet. 

I truly believe that we do people, particularly women, a disservice by not talking more about how our bodies change over time. It’s as though we all expect to reach a certain size and then remain there permanently. This is not realistic. Our sizes and shapes changes over time for myriad reasons. This is part of being a human in possession of a body. Some people may remain a similar size and shape for decades while others will evolve by the season (winterspeck anyone?). This is all natural.

As I previously wrote, women don’t need to “get their bodies back” after pregnancy. Our bodies have not gone anywhere, they have simply adapted to meet current demands. My new philosophy (during pregnancy and postpartum): my body is going to be the size it wants and needs to be right now.


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Response to: The Rise of the Anti-Diet Movement: Is it No Longer P.C. to Want to Lose Weight?

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Someone I follow on twitter recently shared this blog post: The Rise of the Anti-Diet Movement: Is it No Longer P.C. to Want to Lose Weight? by another dietitian, Janet Helm. In the post she mused about dietitians promoting themselves as “non-diet” and what this might say about other dietitians. She agreed with many points made by dietitians, quoted in RD/writer Cara Rosenbloom’s recent excellent piece for the Washington Post about non-diet dietitians, but seemed unwilling to go so far as to embrace the philosophy herself. She ended her post with the following questions: “Can’t we all get along? Can’t intuitive eating and body positivity coexist with losing weight?  Why must we line up on two sides?  Why the conflict?” I’m going to do my best to respond to these questions.

First, I too have asked that same question: “Can’t we all get along?” at times. Remember craisingate? Personally, I don’t think that as dietitians we have to agree on everything. It’s okay for us to have different perspectives and approaches. Also, in the case of diet vs non-diet, I don’t see it as an issue of getting along. Maybe I’m blissfully unaware, but I haven’t seen any “non-diet” dietitians attacking other dietitians for promoting weight management. I don’t see dietitians referring to themselves as “non-diet” as lining up on an opposing side or creating conflict. Rather, I see this identification as a way for dietitians to let prospective clients know that they do not promote weight loss as a goal. In a profession which so many believe our sole mission is to help people lose weight I think that it’s necessary for RDs who do not promote weight loss diets to make this clear up-front. I don’t believe the intent is to pass judgement on other dietitians who haven’t embraced the same approach, or to create a professional divide. However, I can see how a dietitian who has built a career around weight management counselling might see this new-ish movement as a personal judgement.

My friend Cheryl Strachan, aka “Sweet Spot RD” wrote an excellent blog post last week (while I was mulling over how best to respond to Janet’s post): Why I can’t help you lose weight. This heartfelt post explained why she would no longer work with clients on weight loss. Providing the current evidence on weight loss and health and the struggle she went through to reach this position. Rather than having me regurgitate all of the evidence here, I recommend you take a few minutes to go read it and then come back.

Done? Okay, great. So you’ll note that Cheryl mentions that when she studied nutrition in 2003 it was accepted without question that weight management was a significant part of being a dietitian. I can tell you that it was the same when I went back to uni to study nutrition in 2006. I’m not sure if things have changed since then. I suspect that they haven’t, at least not completely. It takes time for institutions and society to change. As a dietitian who has worked in weight management in the past I too have struggled to fully embrace health at every size. I understand why a fellow dietitian would ask: Can’t intuitive eating and body positivity coexist with losing weight? It’s an incredibly tough question and the answer is nuanced and it may not be the same for everyone.

I do believe that intuitive eating and body positivity can peacefully coexist with weight loss. However, I think that this can only be the case when weight loss is not the ultimate goal. For me, body positivity is appreciating your body as it currently exists and continuing to appreciate it if you gain weight or lose weight. It’s about treating yourself with respect and compassion and providing your body and mind with the nourishment they need. If you are doing these things with the clandestine goal of losing weight then you are doing yourself a disservice. That being said, it’s okay to want to lose weight. We live in a society that has conditioned us from a very young age to believe that being thin is important. It’s unrealistic to except this engrained belief to vanish overnight. It takes time to relearn to listen to your body and to treat it with respect when you’ve been viewing it as the enemy, a captor, keeping the real you the thin you hidden away. So, no, body positivity and weight loss can’t coexist but yes, body positivity and weight loss can coexist.

I think that as time goes on and nutrition programs update their curriculums, as old-school dietitians are more exposed to evidence regarding the harms of weight bias and weight loss diets, and the hold-outs retire, that things will change. After all, as dietitians we are supposed to provide evidence-based best practice and the evidence against weight loss diets is mounting. Eventually there will be no non-diet dietitians because that will be the approach we all take.


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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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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.