Authors Linda Bacon, PhD and Lucy Aphramor, PhD, RD joined us for an interview on Body Respect: What Conventional Health Books Get Wrong, Leave Out, and Just Plain Fail to Understand about Weight. Our questions are designated in italics, and with their thoughtful responses following.
Early in your book, Body Respect: What Conventional …, you challenge “the obesity mythology” and proclaim, “We don’t have an epidemic of obesity; our epidemic is one of judgment, bias, and hyperbole.” Can you please elaborate on some of the myths you mention?
We’re fatter than our ancestors, and burgeoning waistlines are causing sickness and early death… Government and industry say the pounds are costing us … This generation will have shorter lives than their parents … And what’s the solution to all this? Watch what you eat! (But don’t diet: change your lifestyle.) Lose weight.
How many times have you heard the intonations in that previous paragraph? Those are some of the myths we take on. There is an alternative reality behind all of these statements, even if it can be hard to hear above the societal clamor. Read on for our take.
HAES© – Health at Every Size – promotes a shift in the societal beliefs that focus on weight, shame, and blame. The emphasis then becomes health, self value and body respect. What do you want for our children?
We want a world where all bodies are good bodies, where children learn to feel good about themselves in their own unique and precious bodies and respect diversity.
You present the science behind setpoint and homeostasis. Thank you. Can you briefly describe what dieting does to our bodies’ natural regulatory processes?
We’re a little hesitant to respond to this question because when people learn that dieting is more likely to inspire long-term weight gain, rather than weight loss, it often results in shame and self-blame as dieters consider that they’ve dieted themselves to a heavier weight. And then people try not to diet as a means to control their weight. So let’s reframe the question: what’s the health-enhancing, stigma-stopping and personally freeing alternative to dieting? Attuned eating and self-compassion. Here’s what we mean: read your body hungers and emotions, learn to eat what your body wants, take your needs seriously, be kind to yourself. Drop the rules of should and shouldn’t and tune in to internal signals. You can trust your body’s natural regulatory processes to guide you to choose foods you’ll feel good for.
You define steps that can lead a person from a position of food and weight edicts, shame and body loathing to a place of “joy in eating.” The first step you note is “Accept a Body’s Weight!” We’d like to learn more about this.
Focus in on the word “accept.” It doesn’t mean you have to love what you see in the mirror or that your body is never going to change. What it does mean is that you can learn to be in your body, and take good care of yourself in the here and now. You don’t need to wait until you lose weight to feel better, sign up for the course you’re keen on, buy new jeans, or respect yourself. It also means you are always worthy of respect, regardless of your size or where you are on the body acceptance journey.
In chapter 5, entitled “Health at Every Size: the Body Politic,” you offer compelling information regarding the impact of the social inequities in the US on people’s health. In this context, can you please speak to the effects of chronic stress on metabolism?
Oppression is first and foremost a human rights issue but treating people as second class citizens is also detrimental for their health. It’s not just that the financial implications of social inequity limit food and activity choices or that stress can increase the need for coping behaviors, such as emotional eating. Living with the stress of poverty, stigma and oppression impacts wellbeing through pathways mediated by the stress hormone cortisol. Some of the effects are on blood pressure, atheroma and blood stickiness, and it’s not surprising to see a severe social gradient in heart disease. So tackling health inequalities needs to include but go beyond good food for all and change the social structures that lead to privilege and oppression. As a starting place we can work to become ever more mindful of power, silence and stereotype in our interpersonal relationships, to validate people’s experiences of inequity, and promote respect for every body. Just as oppression rests on stereotype and sets up the stress response, so acceptance, compassion and mindfulness promotes inclusion and fosters resilience and healing.
Help us understand how really getting to know our emotions without judgment or fear can help us feel good about ourselves?
Noticing emotions might bring up fear – what is different is that we don’t judge feeling fear. Letting go of judgment means that in time we’re better able to read our emotions and less likely to get caught up in them or try and repress them. So what?! Well, research shows that noticing without judgment, a practice that is central to mindfulness, helps us gain clarity which supports us in making choices that serve us better, helping us drop the harsh inner critic and find self-compassion, and helping us approach life with an open-mindedness that facilitates problem solving.
“Body Respect” versus the motivation and power of the diet industry – David and Goliath???
That’s a powerful parallel! And we could read it through the history of social movements too, such as queer rights. It wasn’t until 1992 that the World Health Organization declassified “homosexuality” as a disease and it’s only recently that gays and lesbians are gaining the right to marry in some countries. Let’s all hang in there together! Change is happening.
We’d like to end our book interview by quoting the “Body Respect Pledge” cited on page 187 of your book. It reads –
Body Respect Pledge
Today, I will try to feed myself when I am hungry and honor my body’s signals of fullness.
Today, I will try to be attentive to how my body feels and to choose foods that make me feel good.
Today, I will try to look kindly at my body and to treat it with love and respect.
Today, I will try to practice more mindfulness.
Today, I will try to challenge stereotype, size bias, and thin privilege.
Today, I will show more compassion toward myself and
About the authors:
Linda Bacon, PhD
Linda Bacon, PhD, is a researcher on the inside track of weight regulation science – a scientist whose three graduate degrees, research, and clinical expertise uniquely prepare her to understand and translate the physiological, psychological, and socio-cultural underpinnings of weight control. She is currently a Health Professor at City College of San Francisco and an Associate Nutritionist at the University of California, Davis. An internationally recognized authority on weight and health, Dr. Bacon has published her work in top scientific journals as well as the highly acclaimed bestseller, Health at Every Size: The Surprising Truth about Your Weight. Her recently released book, Body Respect: What Conventional Health Books Get Wrong, Leave Out, or Just Fail to Understand about Weight, is a crash course in what you need to know about bodies and health.
Lucy Aphramor, PhD, RD
Lucy Aphramor Ph.D. graduated from Surrey in 1990 and shortly thereafter bought a one-way ticket to Mumbai. Returning to England several years later she undertook a return to the profession course and her first post was as a community dietitian in Coventry. It was during this time that she became interested in ways to integrate social determinants into clinical practice, and this, combined with concerns about size bias and poor outcomes, led her to investigate alternative responses to traditional weight management. Lucy subsequently specialised in cardiac dietetics and from here pioneered the use of the ‘health for all’ approach, known as health at every size© (HAES©), in the U.K. National Health Service, developing the HAES course Well Now that is now available internationally. As a consultant and trainer her focus remains on advancing “health in every respect” through teaching and expanding HAES theory in and beyond the U.K. , including work with eating disorder organisations. Lucy’s work is characterized by a strong commitment to ethics including naming and addressing the embodied impact of poverty, trauma and oppression. Lucy received her Ph.D. in Critical Dietetics from Coventry University and is a visiting research fellow at Chester University and a visiting lecturer at Surrey University.
Dr. Aphramor has published extensively, often with the Canadian dietitian Dr. Jacqui Gingras, and their papers and chapters appear in a range of publications from the U.S., U.K., Canada and New Zealand. A weight science article and a second ethics and dietetics article have combined hits of over 161,000. In addition she is co-editor of the academic text Debating Obesity: Critical Perspectives showcasing practitioner, social science, researcher and activist contributions. Her latest publication, Body Respect: what conventional health books get wrong, leave out and just plain fail to understand about weight, co-authored with U.S. nutritionist Dr. Linda Bacon, provides the evidence and vision for a progressive health discourse and practice based bridging self-care and social justice. Dr. Aphramor has uniquely contributed a UK perspective to scholarship in critical weight science and is at the forefront of the new international Critical Dietetics movement where her work is hallmarked by critical thinking and compassion-centred care. So too, as a poet, she is delighted to be part of Dietitian as Artist, a movement emerging from Canada that seeks to use the arts to inspire growth in the profession. Her influence extends to coverage in the popular press and her reputation as an outspoken scientist gains her interviews across the board from women’s magazines to the broadsheets.
Dr. Aphramor is a reviewer for several journals, has worked as a Size Awareness consultant for the Welsh Assembly government and has served as an elected member to a research ethics committee, the development group for NICE guidance on adult weight management and as a Council member of the British Association of Cardiac Prevention and Rehabilitation. She has won awards for her innovative work from the NHS and professional organisations, including the BDA Rose Simmonds Special Award, and has a strong track record as an invited speaker.