Weight Stigma Awareness Week

  • posted by Marci Anderson
  • Sunday, September 22, 2013

Weight Stigma is judgment or stereotyping based on one’s weight, shape and/or size.

If you don't think that weight stigma has anything to do with you, please keep reading. It's the number one form of bullying and discrimination in the United States today.

A scientific study of 170,000 people showed that feeling fat is worse for your health than being fat
Research has shown that people are less likely to help fat people after a road accident and more likely to find them guilty when on trial
Physicians are less willing to prescribe tests and lab work for fat people
The majority of fat people avoid seeing a doctor for fear of being ridiculed, judged or otherwise mistreated
The likelihood of being bullied is 63% higher for obese children
The #1 source of weight stigma and bullying is from family and friends

Our communal stigmatization of overweight and obese people is exacerbating physical and mental illness. This week is Weight Stigma Awareness Week. Please, take the challenge to look within yourself. Only as individuals can we obliterate weight stigma. 

1. Examine your own biases
2. Challenge your own beliefs
3. Get educated
4. Speak up
5. Refrain from weight talk
6. Take great care of yourself 
7. Diversity, including body diversity, is a beautiful thing

The Binge Eating Disorder Association has created a week PACKED with online events to increase awareness about weight stigma. You can also check out the WSAW toolkits. Yours truly contributed by writing articles specific to weight stigma and nutrition counseling. 

Everyone deserves to feel safe enough to walk outside their house and to be treated with dignity and respect. Commit this week to confront your own prejudice and commit to compassion rather than hate.

Guest Post: Obesity as a Disease

  • posted by Marci Anderson
  • Tuesday, July 30, 2013

This article was written by Joanne Sauer, LCSW.  She currently is taking graduate classes at Plymouth State University to further her knowledge and work to help patients diagnosed with Eating Disorders. She works as a Social Worker at the Albany NY VA Hospital.  She also works part time for a managed care company as a Care Manager.  Her interests include caring for her numerous animals, running, reading, kayaking and spending time with family and friends.

As widely reported on network television, the internet and in major newspapers such as the LA Times and the NY times, after much debate the AMA voted to declare obesity a disease with a primary goal of changing the way the medical community evaluates and treats up to 78 million American adults and 12 million children.  The debate centers around whether this action would help people have better access to treatment or whether it would contribute to further stigmatize a condition that is not always easily defined.

There are no real legal ramifications with this vote.  It is more of a declaration.  It is hoped that physicians will communicate more with patients the health related concerns related to

obesity.   Insurance companies will most likely be pressured to increase reimbursements for medical care said to be related to obesity including bariatric surgery, diabetes management, dietary counseling and weight-loss programs.

As cited by Holes-Lewis and Malcolm, there is research that indicates obesity to be associated with related conditions including heart disease, type 2 diabetes, sleep apnea, stroke and certain types of cancer.   However, there is also research that shows that people who are considered overweight can be healthy.  For example, a 2010 study found that middle-aged men who engage in regular exercise are less likely to suffer an early death independent of their Body Mass index.  A recent study by the Journal of Clinical Endocrinology and Metabolism found that obese individuals are not more likely to suffer from cardiovascular disease or experience early death than normal weight individuals.  22,203 men and women from Scotland and England were followed for an average of 7 years.

Where does this lead in regards to the big business of weight loss, a massive industry where billions of dollars are spent every year?    It can be speculated that companies will step up their marketing efforts for various diet books, foods, exercise equipment and other interventions.  The media will probably add to their marketing campaigns something that attempts to convey the medical imperative importance of losing weight and avoiding obesity.  The pharmacological industry will certainly benefit as weight loss drugs including the most recent additions to the weight loss arsenal:  lorcaserin (Belviq) and phentermine-topiramate (Qsymia) are increasingly marketed and sold.

It would benefit us as Americans as we focus on healthy eating and lifestyle habits, to remember we are all unique and special.  We can be healthy in all shapes and sizes.  The debate still remains whether obesity is considered a disease.   We know our standard measurement tool, the BMI, has flaws and incorrectly measures children, adolescents and the elderly.    We look forward to the benefits that the AMA declaration will afford those who would benefit from medical treatment that will lead to a longer life.  Positive interventions can include increase in physical activity and behavioral modification as cited by Eckel in his article Nonsurgical Management of Obesity in Adults.  Will the AMA declaration also affect healthy, happy Americans who may have a higher BMI in a negative way?  We need to be diligent to ensure people are not judged, stigmatized, directed towards treatment that isn’t needed or made to feel their body is imperfect. 

Since the AMA readily admitted concern over the possibility of increased stigma over higher weight with their declaration, it would be to their benefit to include in their recommendations the need for less emphasis on BMI with more emphasis on education regarding healthy diet, lifestyle and choices which contribute to our physical, emotional and spiritual health.   

References

Eckel, Robert H, MD; Nonsurgical Management of Obesity in Adults, The New England Journal of Medicine, 358:18, May 2008.

Hamer, Mark and Stamatakis, Emmanuel; Metabolically Healthy Obesity and Risk of all-cause and Cardiovascular Disease Mortality, Journal of Clinical Endocrinology and Metabolism, 97 (7): 2482, July 2012.

Holes-Lewis, KA and O’Neil, Malcom R; Pharmacotherapy of Obesity:  Clinical Treatments and Considerations,  American Journal Medicine Science, 345 (4): 284-8, April 2013

DIY Vision Boards

  • posted by Marci Anderson
  • Tuesday, March 12, 2013

By Elizabeth Jarrard- Registered Dietitian at Marci RD Nutriton

Do you surround yourself with inspiration? Are reminders of your goals staring you in the face when you wake up, when you head out the door? What would happen if they were that close? What would happen if you were constantly reminded of where you want to go in this life, and how you're going to get there? I wouldn't think of traveling to somewhere unknown without a map (or my gps) in tow. So what if we map out what our dreams look like so that we end up at our destination-not lost forever.

 

Vision boards can be a great tool for getting back in touch with what our goals are and where we are headed. The act of creating them should be meditative, soothing and almost therapeautic, as you find images and words that resonate you with. Then when you have finalized it (for the time being), you can hang it as a constant reminder of where you are and where you would like to go. And of course because we are fluid, and our goals and dreams are ever changing it's important to create new vision boards to serve those changed desires.

Making a vision board is easy.

 

1. Gather a large piece of construction or any other "heavy" paper
2. Find a bunch of magazines (from a variety of genres. Beauty, travel, food, you name it!
3. In a peaceful place scour the magazines for words and images that resonate with you and cut them out
4. Arrange the images and phrases on the paper and use good ol' glue or modpodge to adhere them
5. Hang in a prominent place to be forever reminded of where you are heading


I surround my desk with vision boards of past and present

Have you ever made a vision board? How has it helped you? Care to share? 

The Biggest Loser & Why I Can't Support It

  • posted by Marci Anderson
  • Friday, January 25, 2013

It should come as no surprise to anyone who reads my blog that I do not support or agree with the show “The Biggest Loser” (TBL). I recently shard this article on my personal Facebook wall and it generated a discussion about the show. I decided to write a more thoughtful response here on my blog as to why I find the show so problematic.

1. Our culture is one of extremes and I can think of no other TV show that reflects such extremism better than TBL. Four years ago I attended a talk given by Cheryl Forber who was actually the dietitian behind TBL. The diets designed for the contestants to follow meet the criteria for an eating disorder. My colleague has a very close friend who was a contestant on TBL and reported to her that she spent 3 days prior to the weigh in starving herself, exercising to exhaustion, and sitting in the sauna for a couple of hours to lose as much weight as possible. What is it about our culture that finds this entertaining rather than concerning?
Lesley Kinzel, author of “Two Whole Cakes” says it beautifully: “The reality is that fat people are often supported in hating their bodies, in starving themselves, in engaging in unsafe exercise, and in seeking out weight loss by any means necessary. A thin person who does this is considered mentally ill. A fat person who does these things is redeemed by them…A culture that supports weight loss by any means necessary is a culture that supports eating disorders. It is a culture that supports the sickening and weakening of us all…”
2. TBL’s focus on weight-loss at all costs actually supports a culture of weight bias and discrimination. Please consider reading the compelling research that is being conducted at The Yale Rudd Center for Food Policy and Obesity. Research clearly shows that weight bias is rampant in ALL medical settings and actually INCREASES THE LIKELIHOOD OF CHILDREN AND ADULTS WITH OBESITY to engage in:
  • Unhealthy weight control behaviors
  • Binge-eating episodes
  • Avoidance of physical activities (where stigma often occurs)
We have ZERO compelling evidence that a weight-focused approach actually helps people lose weight. ALL of the long-term clinical trials of weight-loss interventions result in a J-curve two years post-treatment (ie people end up heavier 1-2 years after the intervention). I learned this from Dr. Lee Kaplan (who is an obesity researcher at the MGH Weight Center) at my certification for weight management given by The Academy of Dietetics and Nutrition.
3. TBL promotes a pattern of exercise and eating that is both eating disordered AND unsustainable. In fact, dieting (significantly reducing calories while following a plan someone else gives you) is actually the #1 predictor of future weight gain

 (scroll down to "studies related to intuitive eating"). The #1 predictor of future weight gain! Why are we doing this to ourselves? 

(I cannot specifically comment on the long-term outcomes of contestants participating in TBL because to my knowledge, reliable data does not actually exist.)

4. We live in a weight OBSESSED world, which is supported by our medical system and our capitalistic economy. If you are interested in a different perspective, I highly recommend that you check out a few articles:
Association of All-Cause Mortality With Overweight and Obesity Using Standard Body Mass Index Categories: A Systematic Review and Meta-analysis
Men and Women with Intuitive Eating Scales had lower BMIs
Weight Science: Evaluating the Evidence for a Paradigm Shift

Often, people say that they find the show inspirational. This makes me question- what in particular do you find inspirational? I have built a career that is the anti-thesis of TBL and have counseled dozens of women who are trying to heal from the trauma of overly restrictive eating and excessive exercise. Don’t confuse what I am saying- I am all for supporting behavior change for health. I just don’t think that yelling, screaming, excessive exercise, starvation diets, or humiliation create permanent lifestyle change...no matter how entertaining you might find it to be.

Defining Self-Acceptance... Or At Least My Definition

  • posted by Marci Anderson
  • Monday, January 14, 2013

This past weekend I was giving a workshop on Intuitive Eating/Intuitive Living with my colleague and friend Amber Barke. During the workshop we were discussing the very challenging topic of self-acceptance and I shared this blog post, which I wrote just over a year ago. I thought I'd re-post it, as the message seems relevant, particularly around this time of year. Enjoy.


My client, whom we'll call Sally, was telling me how she's been reading up on all sorts of positive body image blogs. You know, blogs that encourage you to love yourself and accept yourself as you are right now. And that was just all too far from reality for her to be able to swallow. She told me "I can't love my body. I can't stand living in it. I don't feel good physically in my body. Why would I accept something that makes me so miserable?" 

And I understood what Sally was saying. Often, people confuse self-acceptance with stagnation. Staying miserable, learning to put up with something you hate. Many people wrongly assume that they'll never change if they accept themselves (not to mention love themselves!) as they are right now. But it turns out that isn't true.

ACCEPTING SOMETHING DOESN'T MEAN YOU HAVE TO LIKE IT. The reality is that self-acceptance FACILITATES CHANGE. Acceptance can be defined as "the act of assenting or believing." Once we come to truly accept where we are at in life, what works for us, and what doesn't, we are then able to make decisions based on that reality. Here are a couple of diagrams to show what I mean.

Cycle of Non-Acceptance

Cycle of Acceptance

I share this message with you as a new year is about to begin because it's a time that you might be thinking about setting goals and contemplating how you'd like to improve upon this past year. So  you just might want to consider adding self-love and self-acceptance to the top of your list. Ironically, it just might help you accomplish everything else you had in mind.

I'm going to leave you with a quote from a fabulous book that I stumbled upon while researching this blog post. The quote relates to accepting your body as it is right now.

How can you begin to learn the lesson of acceptance? By recognizing that what is, just is, and that the key to unlocking the prison of self-judgment lies in your own mind. You can either continue to fight against your body's reality by complaining bitterly and immersing yourself in self-deprecation, or you can make the very subtle but powerful  mental shift into acceptance. Either way, the reality remains the same. Acceptance or rejection of your body only carries weight in your mind; your perception has no bearing on how your body actually looks, so why not choose the ease of acceptance rather than the pain of rejection? The choice is yours. "

Found in "If Life is a Game, These are the Rules" by Cherie Carter-Scott PhD

Have you had an experience with self-acceptance? Please share it!