Size Acceptance: Should We Change How We Approach Obesity?

Occasionally my blog deviates from humor and I write about medicine instead. Today I’d like to dip into the public health well. It won’t be funny, but it will hopefully be enlightening.

Image credit: Microsoft Clip Art

Image credit: Microsoft Clip Art

Shifting Paradigms

Many of you know I have a professional interest in obesity. It’s no secret the issue is a worldwide problem, and it’s no secret weight loss is the best goal.

Or is it?

A session at the American Public Health Association’s national meeting in New Orleans last month forced me to think about the topic in a whole new paradigm. Or at least try to. We all view the world in a systematic fashion. Anything that challenges our established way of thinking chafes like a wet swimsuit. But closed minds get us nowhere. One look at the world shows us that. So for a few hours, I tried to open mine.

Healthy At Every Size®

The session was presented by the Association for Size Diversity and Health (ASDAH), and the discussion centered around an approach called HAES: Healthy At Every Size®.

The HAES® principles include:

  • Weight Inclusivity
  • Health Enhancement
  • Respectful Care
  • Eating for Well-being
  • Life-Enhancing Movement

The HAES® model “endorses size acceptance and health practices pursued for well-being rather than weight loss.” They believe putting the emphasis on numbers and scales only leads to stigmatization and fat-shaming.

Reactions like this lead to stigmatization. Weight loss is not the answer to every health problem.  (Image by Stephen )

Reactions like this lead to stigmatization. Weight loss is not the answer to every health problem. (Image by Stephen Taaffe. Shown in one of the HAES® session slides.)

Therefore, when tackling obesity and its numerous complications, our goal should be acceptance not weight loss.

But that seems counterintuitive, doesn’t it? High BMIs* put people at risk for diabetes, hypertension, stroke, heart disease, sleep apnea, and a host of other medical problems. Weight loss improves many of these issues. So while I abhor stigmatization—in fact, my latest novel explores the issues of bullying and fat-shaming, neither of which help my protagonist get healthy—isn’t weight loss the best way to treat these complications? Shouldn’t weight loss be our goal?

That’s always been the paradigm that guided my readings, research, and clinical practice. It’s also the paradigm that guides most clinicians, researchers, and public health professionals.

Which is exactly what ASDAH is trying to change.

Here is what I learned from their fascinating sessions:

1. Before we can shed the stigma of obesity, we need to remove the goal of weight loss. Only when people feel accepted can they truly alter their behaviors.

2. In a study of obese women, those whose treatment was guided by HAES® principles instead of conventional weight loss measures maintained improved eating behaviors better than the control group (for whom restraint and weight loss were the goals). In other words, the control group’s excessive dietary restraint resulted in a return to binge eating. They simply couldn’t maintain the deprivation.

3. Research has shown stigmatization leads to chronic stress and high cortisol levels, which in turn leads to chronic medical problems such as heart disease and high blood pressure. So it’s kind of like the chicken and the egg. Does obesity alone lead to chronic health problems or does the stress incurred from societal stigmatization contribute to them, too?

So what now?

Of course, the best way to manage obesity is to prevent it in the first place. This requires multi-level interventions, not just individual behavior changes. But for the two-thirds of American adults and the one-third of American children who are already overweight or obese, weight loss has always been the goal, and in my mind, it still is. After all, we can’t change our established paradigms in one sitting.

But that doesn’t mean I’m closed to new ways of thinking, and I agree, we absolutely must end stigmatization and fat-shaming. But should we also stop pursuing weight loss as the best way for millions of people to get healthy?

Hmm, I’ll need some time to chew on it.

Image credit: Microsoft Clip Art

Image credit: Microsoft Clip Art

*BMI is not the best indicator of overweight/obesity, but it’s often the easiest measured and the most often studied for research purposes. But that’s a whole other blog topic…

*   *   *

Rubin4Carrie Rubin is a physician and the author of The Seneca Scourgea medical thriller. For full bio, click here.

263 Responses to “Size Acceptance: Should We Change How We Approach Obesity?”

  1. Coleen Patrick

    I’ve known a couple people who avoided going to the doctor bc they were afraid to get on the scale. Very touchy subject. But I do believe that there’s less fear and shame when there’s less judgment.
    As for your last question, I’m happy to say I got to live in New Orleans. My dad was stationed there when I was in the fifth and sixth grades. I have great memories. 🙂

    Like

    • Carrie Rubin

      New Orleans was great. I wish I’d had more time to sight-see. I definitely want to go back.

      Yes, less judgment would go a long way toward decreasing stigmatization and allow people to heal and hopefully improve their lifestyles as a result.

      (It’s funny, because I have a bunch of blog posts open from my reader, and yours is next in line, but I thought I’d respond to some comments first. And here I find you on mine!) 🙂

      Like

  2. Diane Henders

    This is a fascinating topic for me, and your insight as a medical professional makes it even more so. I have several friends who are at varying levels of “plus” sizes, and it breaks my heart to see them flinch when someone says the word ‘fat’ even in casual conversation not linked to any value judgement.

    I’ve lived through some pretty miserable times and at one point I was up to 180 pounds (not tremendously obese for my 5’10” muscle-dense frame, but definitely overweight – my normal healthy weight is 150 – 155). I never experienced fat-shaming, but there were lots of other self-esteem-destroying elements in my life at the time.

    I always had healthy self-esteem before then, but I can say from personal experience that it’s virtually impossible to lose weight when you begin to unconsciously internalize hurtful messages. It was only when I escaped the destructive situation and realized its impact on my self-esteem that I was able to alter my self-talk. Once I did, I was able to lose that 25 pounds and regain my fitness levels without suffering or feeling deprived (much – I still hate having to turn down an extra dessert… but I always have one dessert a day. And sometimes beer.) 🙂

    I do think it’s important to focus on obesity as a primary health issue, but I think it’s being approached in an incomplete way. People need to understand the facts about making healthy choices, but without psychological support (and sometimes intensive counseling), knowing the facts about health and nutrition won’t change the deprivation/overeating/guilt/depression cycle (and will sometimes make it worse because now they know better = more guilt).

    The problem with acknowledging the psychological aspect of obesity is that if counseling isn’t done effectively it promotes victimhood, which is yet another self-esteem destroyer: “I can’t help the way I am because (fill in the blank) was done to me.” The key is to develop self-esteem that is tied to positive changes in health (not necessarily weight loss, though that will likely follow) as well as boosting self-esteem by focusing on other positive attributes unrelated to health and appearance.

    I think if the general public understood how complex an issue obesity is, it might help reduce the stigma, but the problem is human beings are genetically hard-wired to offer preferential treatment to tribe members who appear “healthy” (read fit, toned, handsome, etc.) That was an effective survival strategy in caveman days, but It’s not fair today, when contributions to society aren’t directly related to physical prowess. As a society, we need to make a conscious effort to challenge the validity of our mental programming, and I think that’s where social media (for all its downside of cyber-bullying) can be incredibly valuable as a tool for change. Once the messages shared by peer groups begin to change, the ripple effect is unstoppable.

    Sorry; long exposition, but this is an issue I feel strongly about. Thanks for bringing it up, and I hope we (the public and medical professionals together) can figure out a way to effect change. If we can, we’ll have a vast improvement in physical and emotional health for everyone.

    Liked by 1 person

    • Carrie Rubin

      Wonderful comment. Thank you. What you said here: “it’s virtually impossible to lose weight when you begin to unconsciously internalize hurtful messages” is so true, and this was a message the presenters of this session tried to get out. They weren’t arguing against weight loss as much as they were that weight loss will rarely be achievable without dealing with the other issues first. Take the focus off losing weight and put it on living healthy in all aspects of the word.

      I’m glad the American Public Health Association gave ASDAH the forum to present their views. I only wish more people would’ve attended (it was a huge conference with multiple simultaneous events going on), but I was happy to have found it. Clearly, what we’re doing is not making much headway, so listening to alternative viewpoints can’t hurt.

      Obesity is indeed a complex issue, and as you mention, until people understand that, we won’t get far. Too many still believe it’s as simple as eating less and exercising more. Sure, that’s the baseline equation, but so many other factors are involved.

      Liked by 1 person

  3. Jennifer's Journal

    There is a ton of info out there about eating healthy and exercising to lose weight, so I don’t believe lack of education is the problem. I think some people use food like a drug when they are unhappy, caving into the loss of self-control just as an alcoholic or any addict does. The addictive behaviour has to be replaced with a healthy behaviour. Do you as a doctor give the idea of emotional eating much credence?

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    • Carrie Rubin

      I do indeed believe in emotional eating, as well as the addictive nature of food. The right combination of fat, sugar, and salt triggers feel-good dopamine in our brains, enticing us to eat more and more. The food industries know this, and they spend millions of dollars trying to find the ‘bliss point’ so we’ll keep eating more. We can’t blame them alone, but I think they play a significant role in the obesity problem. So I agree with you, lack of education isn’t the main problem. So many other issues are in place.

      Thank you!

      Liked by 1 person

  4. Amy Reese

    I know when I dieted and weight loss was the goal, I did indeed lose weight. I recently went on a low carb, high protein diet. It went okay, but toward the end, I felt deprived. All I wanted was my carbs! Anyway, I didn’t stick to this diet. I’m back to my old eating habits now, knowing I need to eat more fruits and vegetables. So, I do tend to think eating to simply improve your diet, eating for well-being, is better in the long run than eating to lose weight. This thing I did was a “challenge,” and age didn’t play into to it this time, which I think is crucial. Our bodies change over time. Maybe it’s okay I’m not at my college years weight, and unrealistic to think I’ll be back at that weight again. I think it’s better to just be healthy and stay away from processed food. There’s so much of it out there! (P.S. For some reason, I didn’t get this post in my inbox. So, sorry. I’m glad I caught it on FB!)

    Like

    • Carrie Rubin

      I’m glad you caught it. Thanks for stopping by!

      Things do change as we get older. Even if we maintain daily exercise, our metabolism slows and we need less calories to fuel us. It’s difficult to make this shift when we’re used to a certain amount.

      Quick diets may shed some pounds, but it’s difficult to maintain longterm. As you mention, we end up feeling deprived. So it really comes down to lifestyle changes, doesn’t it? And everything in moderation (unless it’s something we know we can’t limit; then it’s best to keep it out of the house!)

      Like

  5. aFrankAngle

    I serious issue indeed, so alternative perspectives are good … possible what’s needed. After all, we (especially Americans) are getting bigger.

    Two tidbits … When travelling outside the US, I don’t notice as much obesity. OK … maybe the sights are distracting me, but, I still think it’s true. I also recall a line (I like from ER) – Everything in America is big: the cars, the portions, the stores, the people, …. you get the picture.

    Liked by 1 person

    • Carrie Rubin

      I remember that line from ER. It was the doctor played by Parminder Nagra who said it, and I remember thinking how enormous we must look to people from other countries. When we were in London a few years back, I noticed more heavy people (they were probably Americans…), but aside from that, like you, I noticed how much fewer overweight people there were in Europe than there are here in the US. And as you wisely point out, what we’re doing isn’t working too well, so alternative perspectives should at least be heard.

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  6. leamuse

    The cartoon says so much! Regardless of what you visit the doctor for, the primary issue they want to address is your weight. I remember a doctor who on the first interview asking routine questions one being the size of my bone structure. When I responded, truthfully, that I had a large bone structure he immediately said “That’s what all fat women say.” At that time, I was not that heavy and was working out six days a week at the gym. He grabbed the calipers to show me how wrong I was, muttered something to himself and quickly changed the subject. Half my genes are from Sweden. My paternal grandmother was over 6 ft. She was a large broad woman, not fat, but also not thin. My father was tall. While I didn’t inherit much from my father, I did get his large bone structure but not the height, his rapid metabolism or little else. Even with working out and a good eating habit, it is always a battle. Several years back I was forced into early retirement after an accident at work. It also cut short my workouts. Yet, I continue to try by walking every day. That may not sound like much but if you saw the hills that surround me you would know that nothing here is level and you do get some exercise.
    I might mention that here in France, it hasn’t been the focus of medical appointments. The issues at hand are dealt with first and foremost. I cannot imagine a French doctor even approaching the subject without first establishing a relationship with that patient.

    As for the open mind, an old friend use to say: “If you haven’t changed your mind recently, are you sure you can?”
    The present treatment of patients who have weight issues obviously is not working. Perhaps a change is long overdue and it is left to those with the courage to try something new.

    Liked by 1 person

    • Carrie Rubin

      I found myself saying, “Yes, yes, yes” as I read through your wonderful comment. First of all, how awful that doctor said that to you. What a poo head. I have had athletes in my clinic who were in the overweight category based on their BMI but who were muscular and fit. Their low resting heart rates confirmed their physical fitness. They were not fat, but the BMI marked them as so. All healthcare practitioners need to use the number judiciously. For the most part it works okay, but there are other times it doesn’t. Sounds like when that doctor tried to prove he was right with the calipers, he failed, unable to support his assertion. At least you got the last laugh, anyway.

      As for your friend’s quote: “If you haven’t changed your mind recently, are you sure you can?”—-I love that. So simple but so full of meaning.

      And your last paragraph nails it. What we’re doing is clearly not working. We need to be open to other avenues of thought.

      Thank you!

      Liked by 1 person

  7. Valentine Logar

    I will only say this, after my injuries I gained a great deal of weight; nearly 100 lbs in fact. Some of this was stress and misery eating, but much of it was eating the same diet I had eaten when I was an active semi-athletic adult versus being a partially paralyzed and for many years entirely inactive adult. I also know from meeting my biological family, the women tend to be more rounded with hourglass figures, hips, thighs and certainly junk in the trunk.

    When I was young, still dancing, skiing, running and in the gym I was forcing my body to a size and weight it wasn’t comfortable at and I didn’t look good at. Society reinforced my thinness though. When I got to my late 20’s / early 30’s just before I was hurt, I got to a size that was more ‘fit’ but was considered ‘plus’ sized, funny I didn’t look ‘plus’ size to me and thought I looked beautiful. No more bones sticking out.

    Now that I am single, I am eating better. I have lost some of the added pounds but I am still limited in my activities though I am searching for what I can do. The issue truly is are we each healthy, I am. Would I like to get back to a comfortable size for me? Yes, but that would still put me at a ‘plus’ size and considered fat medically.

    I do not believe we can measure each individual on a set of charts. We are each of us different and have to work it out somewhat for ourselves.

    Liked by 1 person

    • Carrie Rubin

      Different body types abound, no doubt, and trying to fit them all into one mold is senseless. We use BMI because it’s efficient, but it’s not the best. I’ve had athletes in my office whose BMI put them in the overweight range when they were clearly not. They were muscular and fit. I also know people who have curvy hips and thighs with extra padding who are healthy and active. And, of course, we all know thin people who have terrible habits and can barely climb a flight of stairs without getting short of breath.

      I like the idea of acceptance, because I think it’s difficult for anyone to lose weight if they’re feeling terrible about themselves. When they have so many hurdles stacked against them–as you did–feeling bad about themselves makes weight loss an illusive goal.

      But obviously, if their health is at risk, that’s still where I see weight loss as a necessity, but regardless, this was a fascinating session with wonderful presenters.

      Thanks for your thoughts, Valentine.

      Like

  8. tomsimard

    My favorite posts are ones like this that challenge the way we think about things. From the little I’ve read, it seems like ASDAH has the right idea.
    Whatever works in order to get happy and healthy people is good in my book.

    Yes, prevention is better than cure. I do wish the American emphasis on meat would be replaced by a more Mediterranean outlook.

    Like

    • Carrie Rubin

      I agree. We do seem to have a fascination with meat in the US. I’m not a red-meat eater, but my kids enjoy a good steak now and then. Since I don’t cook red meat, we’ll go out for it, but in those restaurants that serve massive slabs of beef, I feel like a lone dissenter among a crowd of carnivores!

      “Whatever works in order to get happy and healthy people is good in my book.”—Yes!

      Thanks!

      Like

  9. Polly

    I have little to say about obesity except that size doesn’t make a difference to the person. One of my dearest friends has had a lifelong weight problem – she’s beautiful yet insular – cruel comments of others have made her that way.

    As for New Orleans, I would love to visit – the name of the place always reminds me of Kate Chopin. A guy I once knew went there after Hurricane Katrina – he stayed and helped for as long as he could – adored the people and the place. One day…

    Like

    • Carrie Rubin

      It’s a great city. I wish I could’ve seen more, but I was busy with the conference. Plus, traveling alone as a woman put some limitations on what I could do. But I enjoyed touring the French Quarter. I’d like to go back with my husband some day.

      Like

  10. Jilanne Hoffmann

    In another life, I was a personal fitness trainer and wrote about health/fitness issues. I had a client who was severely obese with high blood pressure and borderline Type II diabetes. For awhile we just worked out together once a week. Then I create an incentive program for her. She was a business woman, a very competitive businesswoman. So I rewarded her with prizes when she walked on her treadmill, depending on the number of miles she walked each week. That did it for her. I think she went from a size 20 to a size 12 in a year. Her blood pressure returned to normal and she no longer was no longer considered a borderline diabetic. I was thrilled. And you can imagine how thrilled she was. She was nowhere near “model” size, but she was healthy. And that’s all I wanted for her. She looked forward to living long enough to see her children get married and have children of their own. That’s what it should be about.

    Like

    • Carrie Rubin

      That wonderful example is why I can’t let go of weight loss as the goal, though I agree we should accept ourselves in whatever phase we’re in. How great that must have been to see her achieve that goal and how much better she must’ve felt! I wonder if she maintained her new size and health.

      I didn’t know you were once a fitness trainer. Very cool!

      Liked by 1 person

      • Jilanne Hoffmann

        I know she maintained her program for at least a year after I stopped working with her. After she switched jobs and moved, I received a Christmas card from her, saying how life changing exercise was for her.

        I heard some researcher (can’t recall the name) talk about how changing one thing in your life can create a domino effect. I think it’s true.

        Yes, I was certified by the American College of Sports Medicine among others. I was young and immortal, and I thought I could work out with my clients, do boxing videos, teach classes, and build a 3-ton wall in my back yard in one weekend. I felt fine, but after the weekend was over, I picked up a bottle of shampoo in the shower and blew a disc between L4 and L5. It was so severe, I required emergency surgery. Still feel the residual effects of nerve damage. Moved on to writing full time and exercising in my spare time. 😀

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        • Carrie Rubin

          Oh, sorry to hear that! I’m having a little lumbar disc problem myself, but it’s already healing up. No fun for you, I’m sure.

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          • Jilanne Hoffmann

            No fun, but I had a great surgeon. It’s a distant memory. 😀

            Take care of your back. So often, we take them for granted until they start to go haywire. And watch out for the bend and twist without properly preparing your core for the movement. 😀

            Like

  11. Jennifer J. Chow

    What an interesting model. I’ll have to take some time to reflect on it. I do, though, think that the belief of food deprivation can result in bingeing.

    Like

    • Carrie Rubin

      I agree. I espouse an ‘everything in moderation’ attitude. Unless it’s a food we know we can’t eat in moderation. Then it’s best we keep it out of the house!

      Like

  12. Beth

    Sounds like an interesting conference. I wanted to tell you that I was able to download a Kindle app for a Chromebook that I use upstairs and so was able to get The Seneca Scourge. Read it straight through and enjoyed it very much. What a wild ride! I particularly enjoyed the realistic depiction of life in a hospital and appreciate your kind treatment of nurses (won’t find THAT in a John Grisham novel…..). I’m glad you wrote it!

    I wanted also to mention a newer Catherine Deneuve movie that’s out on Netflix called “On My Way” since it seemed you might watch French films. It’s definitely not a classic French film, but I enjoyed seeing her act at this stage of her life.

    Like

    • Carrie Rubin

      Thank you! What a wonderful thing to hear. So glad you enjoyed the book. I appreciate your support in reading it!

      As for the movie, thanks so much for the rec. I do love French films, and it’s been a while since I’ve seen one. I’ll reserve it from my library and give it a watch. We’ll see how much French I remember…

      Thanks again and have a great weekend!

      Liked by 1 person

  13. Alejandro De La Garza

    I recall when, around 1996, a “study” came out declaring that weight problems – even extreme obesity – are genetic, and therefore, fat people are victims of something they simply can’t control. A few overweight women at my workplace bought into it and used the “study” as an excuse to continuing overindulging. It was part of the then-new fad of self-righteous victimization where people could blame the mishaps plaguing their lives on someone or something else.

    There’s actually a group called National Association to Advance Fat Acceptance, which was founded in 1969. I first heard of it about 20 years ago. There’s a big (no pun intended) difference between being large and fat. Some people are truly just big-boned or larger-sized. As long as they have moderate blood pressure and no heart disease, then they’re fine.

    But obesity is NOT acceptable. It’s true some people have a genetic predisposition towards physical heaviness; something that needs to be addressed medically. In the past I’ve often told people with problems I’ve known to view it as a health issue and not a cosmetic one. They should lose weight, not to make others feel good about them, but as a matter of personal well-being. When they did that, they suddenly realized how critical a matter it is.

    But I don’t believe the epidemic of obesity is solely the result of some abrupt genetic mutation in the human race. It’s because a lot of people in the U.S. are simply too lazy to take care of themselves. Americans are notorious for wanting pills to cure anything and everything. We’re already seeing resistance to some medicines because of excessive anti-biotic prescriptions.

    The most egregious aspect of the obesity epidemic in America is its impact on children. We’re now seeing alarming rates of Type II diabetes in youngsters. I think you know, Carrie, that Type II diabetes was also called adult onset diabetes because it usually occurred in adults over 40 who had led rather unhealthy lifestyles. That we’re now seeing it in kids as young 9 or 10 is a disgrace. It’s also a threat to our future. If these kids continue like that, they’ll develop heart, lung, liver and / or kidney problems before they’re 30. Such complications may disable them and place a burden on both our national healthcare system and financial well-being. It’s also not fair to those kids who really don’t know any better and will end up suffering shortened life spans because of irresponsible and inattentive parents.

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    • Carrie Rubin

      I agree that the medical complications of obesity need weight loss as their mainstay of treatment. That’s why I can’t completely let go of weight loss as the ultimate goal. But as you point out, some people who are larger don’t have medical complications. They eat well and exercise, and for them, body acceptance over endless diets that don’t work may be a better option. But extreme obesity is not healthy for anyone, and it incurs large costs to society. Of course, that notion only increases the stigmatization of it, so it’s a vicious cycle.

      The boom of type 2 diabetes is sobering. When I was a pediatric resident in the 90s, we barely ever discussed type 2. It was so rarely seen in kids, that we put our focus on type 1. Nowadays, I regularly screened for it in clinic. Amazing (and scary) how much changed in less than two decades!

      Like

  14. Helen Devries

    And to think of my last blog post…..

    Women have enough shaming in their lives….not just their appearance but their perceived achievement levels, their parenting, their compliance with societal norms in general. Shaming into conformity is negative, confining, and coercive.

    Think historically too…in times of scarcity, weight indicates wealth…you can afford not just to eat but to eat well. Now, in a time of glut, wealth, status, is shown by shunning food…food is available to all (in theory but food stamps tell us otherwise)so you show your status by rejecting what is available to the common horde and aim to imitate a stick insect.

    I’ve always cooked food from scratch…don’t like sweet things..but if I don’t have heavy exercise I put on weight. It’s just how it is….so I’m taking up riding again. Great exercise from the hour you spend catching the horse to the next thirty minutes grooming him then heaving yourself into the saddle….

    A superb post with much to chew over…and so much interest in the comments too. Always the mark of a good blog, the comments.

    Liked by 1 person

    • Carrie Rubin

      Thank you. I appreciate your kind words as I do your insightful comment. I remember your post about what that man said when you returned from vacation. I wonder if he would’ve said the same thing to a man. Likely not.

      I imagine horseback riding not only helps your fitness, but you must feel so invigorated during and after it. Fresh air, a beautiful animal, motion. I’ve never ridden a horse, but I suspect that once one has, they never want to give it up.

      Like

  15. memyselfandkids.com

    Interesting back and forth and take on this issue. I suppose the goal is ultimately the same but the path to it is not and the feelings along the way are not.

    Like

    • Carrie Rubin

      “I suppose the goal is ultimately the same but the path to it is not”—Good point. The path is different, but I suspect that somewhere along the HAES program the goal of weight loss is still there, at least in part.

      Liked by 1 person

  16. sknicholls

    I’m seventy pounds overweight. I’m also on bipolar meds that slow metabolism and increase weight gain by 33%. Too quickly, we assume that people are heavy because they over eat and don’t exercise without taking into account other issues/factors the person might be dealing with.

    I grew up with the nickname Twiggy because I was so skinny, (I was 115 pounds AFTER my third child was born) so being heavy is not something I am familiar with. I was devastated when I started packing on the pounds after being diagnosed seven years ago.

    Age, menopause, the bipolar meds are not excuses, but facts of life, and adjustment hasn’t been easy. I eat healthy foods, like a bird, swim almost every day in summer and walk all winter, and still the scale creeps up. Stopping smoking (briefly) when I was trying to get healthier resulted in gaining 60 pounds in 7 months, I’ve only been able to lose 30 of that and just recently gained another ten of it. It’s a battle.

    The stigma associated with heavy weight, is worse than that of mental illness. It shows more readily and people are quicker to judge.

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    • Carrie Rubin

      “The stigma associated with heavy weight, is worse than that of mental illness. It shows more readily and people are quicker to judge.”—Agreed. People think nothing of making uninvited comments about someone’s weight.

      Psychotropic meds such as antidepressants can indeed affect the weight. And when we gain weight, we never lose those fat cells. They may shrink, but they’re always there until they die, just waiting to accumulate more lipids. So what you’re describing is a true effect. This only gets more difficult to deal with as we get older, what with decreased metabolism, menopause, etc. But while we should be adjusting our intakes as we get older, society in all its food-rich glories entices us to do just the opposite. It is a complex equation for sure. Thanks so much for sharing your own experience with the issue.

      Like

  17. Letizia

    What an interesting topic, Carrie. I noticed when I moved to the States that a lot of people were on diets, compared to my home country of France, but that people were more overweight. I’m sure there are a lot of factors for this (health issues, less people living in cities and therefore not walking as much) but something I did notice was that there was less knowledge about cooking and food. I’m making a sweeping generalization based on my personal experience, but a lot of people I’ve met here don’t enjoy cooking day to day and often don’t know what foods are good to eat that are tasty as well (also, funnily enough, people seem to drink more wine here – because of the HUGE glasses, haha!).

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    • Carrie Rubin

      “less knowledge about cooking and food”—Excellent point, and I think you’re right. When I lived in Paris, I saw people go to the market every day for fresh produce to make the evening’s meal. Even the family of two lawyers I worked for made a fresh meal every night. Well, the mother did. The father was of no help… I’d help her with the prep, but she cooked the meals (which was good since I didn’t know how to cook then and she treated me poorly!). Maybe things have changed in the couple decades since I’ve been there, but from what you’re saying, it doesn’t sound so. Over here it’s so easy to stop for takeout on the way home or pull something from the freezer. Convenience often trumps health.

      Like

  18. My Inner Chick

    Carrie,
    such a delicate subject.
    Our society is such a Shame/ Blame society, isn’t it?
    It seems one is not considered worthy unless one is thin, beautiful, and young.
    Perhaps, this is part of the problem here.
    We, no matter what, will NEVER be good enough.
    We need to change the mind-set of the younger generation.
    PS. New Orleans is no my LIST!!

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    • Carrie Rubin

      We do tend to shame and blame in our society, and from what I’ve read from people’s comments and what I heard from the presenters at this particular session, some people think nothing of saying hurtful things about a person’s weight to them. Complete strangers on the street injecting their two cents when their two cents wasn’t sought. Shameful indeed.

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  19. The Writing Waters Blog

    Hi Carrie, my feeling is everyone’s body is a different set of genetics, chemicals, environment, etc. Every body processes food differently, needs more or less of different nutrients to be healthy and our popular fascination of putting everyone into the same formula is ridiculous. That being said, of course there are unhealthy extremes. Just like reading and basic math, children should be taught the fundamentals of nutrition, but we’re a country of obsessions and juvenile standards.

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    • Carrie Rubin

      Well said! There are indeed many factors that contribute to overweight/obesity, and every individual responds differently. I completely agree with our need to educate children better, starting at an early age. And, of course, we need to educate the parents, too, since they’re the ones buying the food.

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