Positive body image won’t make you fat: The case for body positive health promotion

I’m currently designing a social marketing campaign to improve body image among undergraduate women at a major university. On three different occasions, my classmates—a cohort of public health, nutrition, and health communication students in leading graduate programs—expressed concerns about my project, asking “Aren’t you worried that you’re promoting obesity?”

There seems to be a dangerous misconception in the public health community that the goals of positive body image promotion and obesity prevention are at odds. That somehow, by helping people feel better about their bodies, we will inadvertently “encourage” obesity.

But body image promotion isn’t about glorifying fatness, just like obesity prevention isn’t (or shouldn’t be) about the glorification of thinness. More accurately, body image and weight management are interconnected elements of holistic mind-body approach to health and ultimately, the public health community has more to gain by thinking of them as complementary rather than competing interests.

Obesity prevention efforts may appear to benefit from a status quo that stigmatizes fatness and worships thinness, but the evidence just doesn’t support it. We live in a culture that idolizes underweight supermodels and relegates fat actors to fart and food jokes, and yet none of it has done anything to make people healthier.

A lot of people worry—myself included—that without body dissatisfaction, we would lose our motivation to slim down. It’s an easy trap to fall into because, for many of us, negative thoughts are the only motivation to lose weight we’ve ever known. It’s scary to imagine life without our internal “fat talk”; it takes work to imagine using positive feelings as a source of motivation.

But contrary to popular belief, shame is not a good motivator. In addition to reinforcing an impossible, demoralizing standard of beauty, using fat shame as motivation will always backfire. Fear, shame, and self-disgust may prompt people to change their habits temporarily, but once they start to feel better and the bad feelings dissipate, they are bound return to old habits. Motivation-by-fat-shame doesn’t create a culture of health; it creates a culture of yo-yo dieting and January gym memberships abandoned by March.

Not only does fat shaming fail to help people get healthy, it actively hurts people, leaving maelstrom of negative body image, low self-esteem, depression, eating disorders, and other pathological eating and exercise behaviors in its wake. This is no small matter, as these conditions cause pain and suffering for millions of men and women, of all ages, all over the country and the world.

Obesity prevention efforts that reinforce the thin-ideal status quo are doomed to perpetuate a broken system where body image dissatisfaction is normative, obesity rates keep rising, and the multi-billion dollar weight loss industry capitalizes on both. But obesity prevention efforts that embrace positive body image promotion, on the other hand, have a chance to break the cycle.

Meaningful body image promotion encourages women to reject the tyrannical and reductive thin-ideal portrayed in the media, and to understand that pursuing a healthy lifestyle for its own sake is much more rewarding than obsessing about dieting and weight loss. After all, “thin” doesn’t translate to “healthy.”

For example, the Health At Every Size (HAES) movement is based on the understanding that weight does not determine health, and that exercise and good nutrition are beneficial, whether or not they result in weight loss. Instead of using BMI, HAES advocates using more specific measures, like blood pressure and cholesterol, to determine one’s health status.

Instead of relying on body dissatisfaction, HAES teaches us to draw motivation from positive sources, like the desire to explore new hobbies (yoga, archery, kickball), to achieve new goals (run a 5k, learn to surf), or to enjoy the flavor and feeling you get from nourishing your body with healthy foods. This is the kind of lifestyle change that keeps people engaged and motivated for the long haul, and it will keep us healthier, whether or not we’re overweight. Also, it’s fair to say that by letting go of the “impossible dream” of one day looking like the (photoshopped) people on the cover of magazines and by learning to accept and love our bodies as they are, we’ll be happier too.

This type of holistic approach—incorporating positive body image, mental health, physical activity, and good nutrition—is actually sustainable because it promotes an understanding of “health” as a lifelong process rather than a set of restrictions or punishments to be lifted once you reach that magic number on the scale.

We know that there are no health benefits to negative body image. So why would we limit the scope of obesity prevention to exclude the potential benefits of positive body image?

Encouraging positive body image does not “promote” obesity. Rather, it helps people let go of the shame, fear, and unsustainable weight loss behaviors that are keeping them trapped in a state of bad health.

“Shame and Blame: Facing the Unintended Consequences of Health Messaging” on Huffpost

Today my op-ed on shame and blame in health campaigns was published on the Huffington Post. Check it out!

Shame and Blame: Facing the Unintended Consequences of Health Messaging

A solemn black and white poster shows a picture of an obese girl with copy that reads: “Warning: It’s hard to be a little girl if you’re not.” Another poster displays a woman’s naked legs with her panties around her ankles and the word: “She didn’t want to do it, but she couldn’t say no.” The first is part of the Georgia “Strong 4 Life” campaign to prevent childhood obesity; the other is part of the Pennsylvania “Control Tonight” campaign to reduce excessive alcohol consumption. Though the campaigns are unrelated, they have one thing in common: disregard for the effects of shame and blame — the frequent unintended consequences of health campaigns.

The promotion of health and social welfare is one of those noble causes that attracts people who want to “do good.” Physicians are taught to “First, do no harm,” but health communication professionals take for granted that their work is “doing good” without considering that it might cause unintentional harm. For example, stigmatizing sexually transmitted infection (STI) prevention messages may make people with STIs too embarrassed to seek treatment or too ashamed to tell their sexual partners. Not only can health promotion messages lead to such negative health outcomes, they can also promote destructive social values, like fat stigma and rape culture.

Read the rest at the Huffington Post.

Quick hit: Shaming fat kids doesn’t solve anything

Strong 4 Life campaign

According to the Georgia Strong 4 Life childhood obesity campaign website, “Ignoring this problem is what got us here.”

It’s true that childhood obesity is a big problem, but you know what DIDN’T cause the childhood obesity epidemic?

Ignoring the problem.

You know what did?

  • Income disparity
  • Food deserts
  • Fast food advertising
  • The whole fast food industry
  • Corn subsidies
  • Policies like the one declaring that pizza counts as a vegetable in school lunches
  • Lack of safe outdoor play space for inner city kids
  • Video games
  • Lack of funding for physical education
  • Poverty

You know what this ad does?

  • Help families alleviate/prevent childhood obesity
  • Blame this kid for being a fatty fat.

Know what blaming kids for being fat does?

  • Makes them lose weight
  • Encourages a culture of fat stigma and fat shaming that fuels bullying
  • Increases negative psychological, emotional, and health outcomes among overweight and obese children, such as low self-esteem, body image disturbance, eating disorders, and even suicide.

Way to go, Children’s Healthcare of Atlanta.

Well intentioned Facebook meme misses the point

A ‎15 year old girl holds hands with her 1 year old son. People call her a slut. No-one knows she was raped at 13. People call a girl fat. No-one knows she has a serious disease which causes her to be over weight. People call an old man ugly. No-one knows he had a serious injury to his face while fighting for our country in the war. Re post this if you are against bullying and stereotyping. 95% of you won’t

I keep seeing this Facebook status meme pop up from time to time, and every time, it makes me angry. Sure, I’m against bullying and stereotyping (is anyone really pro bullying and stereotyping?) but I don’t at all agree with the message here.

Sure, it’s important not to assume that all teen mothers became mothers by choice. It’s important not to assume that every teen mother became pregnant through consensual sex or irresponsible behavior. Yes, it’s important to understand and recognize that some pregnancies are the result of rapes, and that some young women are forced to carry their babies to term because of shitty barriers to contraception, Plan B, and abortion access. Maybe she was forced to carry the baby to term because of parental notification laws, or the crowds of anti-Choice protesters outside her local Planned Parenthood, or even simply because abortion is too stigmatizing or incompatible with her family’s beliefs or culture to consider.

But even if a teenage girl did become pregnant through consensual sex – even if she was irresponsible – even if she had consensual, unprotected sex with multiple partners – she still doesn’t deserve to be called a slut. Nobody deserves to be called a slut, ever, for any reason. Because there’s nothing wrong with having sex. Even when you’re young. Even when you’re not married. Even if it’s with multiple partners.

Sure, it’s important to realize that there are a myriad of different reasons why a person might become overweight. It could be the result of an illness, or a medication, or a genetic condition and no fault of her own. But it could also be a result of an eating disorder, or stress eating, or poverty, or a lack of education about nutrition. It could be because she’s too busy working 14 hours a day to shop at a grocery store and prepare healthy meals. It could also be because she loves food and doesn’t really care if she conforms to the unrealistic American beauty ideal of the size 2 supermodel. She might be happy with her body exactly how it is.

But no one deserves to be discriminated against or bullied for being fat, ever, for any reason. Even if their weight appears unhealthy, even if they just fucking love to eat hamburgers. Because fat people deserve respect, even if they’re fat because they’re lazy, even if they’re unhealthy. Because people come in all different shapes and sizes, for all sorts of reasons. Because there’s no wrong way to have a body. And because someone else’s weight is really none of your business.

Yes, it’s important to realize that sometimes people look different and sometimes they were injured while serving our country. But sometimes people look different because they were injured for some other reason. Maybe it was a car accident. Maybe it was a drunken hang-gliding accident. Maybe there was an accident at work because of lax safety standards. Maybe it wasn’t an injury, but an illness, or a condition that developed over time, or maybe they were just born that way. Maybe there’s nothing wrong with a person’s face other than the fact that it doesn’t look like the faces we see in magazines. Maybe it’s not a person’s face, but their body. Maybe they use a wheelchair or a cane. Maybe they sound different when they speak. Maybe they cannot speak, or cannot hear, or cannot see. No one deserves to be called ugly, no matter what they look like or sound like or how they came to be that way.

Though I can recognize that the meme is well-intentioned, it suggests that while some people don’t deserve to be bullied or stereotyped, other people do. Because they “brought it on themselves” by acting irresponsibly or just because they don’t have a “good excuse” for being the way they are. But nobody deserves to be stereotyped or bullied, for any reason.

When someone falls outside the norm, they become a target for bullying and stereotyping just because they’re different. And everyone is different at least some of the time. There’s no point to trying to determine who “deserves it” and who doesn’t. Because bullying and stereotyping is cruelty, and no one ever deserves that.

So if 95% of people aren’t reposting this status meme, let’s hope it’s because they agree that EVERY 15 year old mother, EVERY overweight person, and EVERY person who’s body is in some way “different,” deserves our respect and compassion.

Too big for a stroller?

Today I discovered Walk, a new Tumblr site sharing photos of kids in strollers who are too old to be using strollers. The sentiment behind the site seems to be that kids who are old enough to walk should walk. The friend who posted it on Facebook wrote “Seriously, if your kid can walk without falling, your kid should walk without falling.” I can see how some might be annoyed by the sight of 7-11 year old squeezed into a stroller, but Walk is perhaps saying more than was intended.

As I looked through the photos, I couldn’t help but notice that a fair few of the kids in strollers were overweight. Considering that childhood obesity is a growing problem in the U.S., this may not be coincidence.  According to the CDC, rates of childhood obesity have more than tripled in the past 30 years. The prevalence of obesity among children aged 6 to 11 years increased from 6.5% in 1980 to 19.6% in 2008. Childhood obesity is a serious problem because it sets kids up for a lifetime of chronic illness and health issues. It also makes kids more susceptible to bullying and fat-shaming from their peers and society at large. While the causes of childhood obesity are multifaceted and complex, one is undoubtedly a lack of physical activity.

I strongly believe that when it comes to obesity, it is unfair to put all the blame on the individual. Our society promotes and condones unhealthy eating and sedentary lifestyles in a number of ways: the fast food industry, an economy based on office jobs, car-based societies, corn subsidies, food deserts, etc. For those who are low-income, a healthy lifestyle is almost impossible considering the lack of access to safe public recreation spaces, lack of leisure time, and high costs of fresh, healthy foods.

Perhaps another way that our culture unknowingly reinforces unhealthy behaviors is through “stroller culture.” Now, I’m not saying that there’s anything inherently bad about strollers (like Maggie Gyllenhaal‘s character in Away We Go), but that perhaps we use them too often and for too long. Looking at some of the images on Walk, it seems that might be the case. What are we teaching our school-aged children when we don’t expect them to walk alongside us? If anything, we’re reinforcing the idea that walking from the parking lot to the store is an imposition, or that physical activity is separate from the experience of living every day – something we only experience at the gym or playing sports.

My mother came out to Boston to visit on Mother’s Day. We were heading from my apartment in “Camberville” into the city, and I suggested that we could avoid the 18 minute walk to the T stop by taking a bus. She gave me a lecture on how walking was part of the urban experience and part of a healthy lifestyle.  At age 25, is my mom still pushing me out of the stroller?

I’m wary that Tumblr sites like this can often become places for fat-shaming (like People of Walmart) and I would hate for this to happen with Walk. Still, it is a reminder that walking is part of a healthy lifestyle for kids as well as adults.