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Is thin beautiful?

Updated: Dec 18, 2023

I have been reading a paper from Tracy L Tylka - The Weight-Inclusive versus Weight-Normative Approach to Health: Evaluating the Evidence for Prioritizing Well-Being over Weight Loss. It was eye opening and enlightening furthering my journey into looking at weight inclusive approaches to health and here are my main thoughts if anyone is at all interested!

Health and well-being are multi-faceted. To think that there are people that they believe they can only be beautiful when they are thin is truly heart-breaking to me. I know many people living in larger bodies that I would honestly put among the most wonderful and beautiful people that I know.

Weight stigma data shows that discrimination based on an individual’s weight can have an adverse effect on health and wellbeing.

Data associated with the Health at Every Size movement, for example, one of the most well-known weight-inclusive approaches shows positive impact on things such as blood pressure, binge eating tendencies and depression therefore potentially promoting positive physical, psychological and behavioural health habits – perhaps this could tell us something about our public health messages put out there again, as highlighted in my last blog post?

In the work that I have done in the past year, most especially in my most recent employment where I actually run a weight-management course for full disclosure, I have become increasingly aware of the focus placed on managing weight as a means to improve health markers and that is whether or not it is relevant to a person’s health status or not.

Healthcare guidelines suggest that those that meet a certain BMI threshold, no matter what they may present with health wise, should be given assistance with nutrition and weight management. Equally, those in lower weight bodies may be shown some form of neglect in not being offered certain medical examinations as they don’t meet a ‘high-risk criterion’ that someone in a larger body may. Could this perhaps lead to some misdiagnosis? I’m sure. So is health care, at the moment and public health promotion missing a huge part of the point of what they do, to help people, by fuelling the weight stigma that has built over many, many years?

We can, of course, accept that there are links between weight extremes and health issues however, well-being is possible beyond what you might consider to be an ‘appropriate’ weight. Perhaps we could look to enhance the health of all in a positive way despite what their weight may be? Perhaps we could look beyond weight and more broadly at other factors of health?

Largely, health care practices may remain similar but it is the approach and mindset around these issues that is most important for the population at large. The importance of body weight is diminishing based on the evidence that we now have and that should be reflected in that way that people living with obesity are treated.

It is important to recognise that many people have little choice in their bodyweight due to involuntary genetic and environmental factors – we don’t all have an equal ability to lose weight, we aren’t all neurotypical, not all people have bodies that function optimally in their signals. Some don’t have access to nutrient-dense diets as you do – have a think about that for a moment, and perhaps next time we find weight stigma or discrimination creeping into our minds. Healthy lifestyles are not always a personal choice. Weight is not just a matter of ‘will power’, it is not simply always down to poor lifestyle choices.

There is a super strong biological system within us that evolutionarily reacts to energy balance that promotes weight loss causing hunger to become increased as a result of hormone changes and metabolism to slow to some extent, our responses to food and nutrition is also affected by this.

Perhaps public health messages around maintaining a healthy weight are not helpful then? Do you think we may be leaving those that feel these weight ‘ideals’ are unachievable due to their personal circumstances, feeling pretty worthless? Do we think that feeling is conducive to optimal mental health? Arguably the most important facet of health to me? I don’t think so.

It’s increasingly saddening that many people living in larger bodies are denied access to certain aspects of health care due to this stigma created over time. Granted, I am not a medical professional, and perhaps, in some instances this is for the safety of an individual patient but I have certainly spoken to and worked with people first-hand that this wouldn’t necessarily apply to. Equally, as highlighted above, those in lower weight bodies may experience the same due to bias prevalent amongst healthcare professionals. Now we aren’t blaming anyone here, it is an unfortunate culture that has developed over time that we can merely do our upmost to tackle now.

Scientific data does NOT demonstrate that higher BMI is a CAUSE of poorer health outcomes – there are some correlations but we know here that correlation does not equal causation.

Public health messages have almost come to display that higher weight individuals should always be trying to reduce their body weight, improve their health and they are less deserving of a place in the future – they may some way be a burden to the health care systems and therefore society. The data does NOT support this. How can that be fair? WE ARE ALL HUMAN! WE ARE ALL EQUALLY DESERVING OF A PLACE IN TOMORROW.

Socially prescribed body ideals for both men and women in leanness and thinness respectively have been shown to induce shame, bodily dissatisfaction and at worst, eating disorders and potential harmful behaviours leading to muscle-enhancement too. For me, these aspects of psychological or mental health are of upmost importance and we should get these in check before even embarking on any physical goal attainment for health.

Something really important that I think almost all of us can learn from if you are at an early stage in your education around weight stigma is that there is this thing called ‘complimentary weightism’ – essentially appearance related compliments. These are stigmatising and can be damaging to an individual and also further fuel harmful cultural messages. I know you mean well but telling someone they look great because they have lost weight implies that people are ‘good’ or ‘bad’ based on their weight.

This doesn’t just go for those in larger bodies either – microaggressions like telling someone in a smaller body that you hate them because they can eat what they like and stay thin or not offering someone a cake when doing the rounds because they can’t possibly eat things like that, contributes hugely to weight stigma and I can tell you first hand, that kind of thing can really stick with a person and be seriously damaging.

I truly believe that all people are capable of achieving health given the correct help where needed despite their weight. I am, of course, as a nutritionist and a professional in the health and fitness industry an advocate of approaches around positive nutritional behaviours and moving in a way that is safe and enjoyable for the individual and this should be accepted and available for ALL people. At the moment, though, not all people feel that they are entitled to that and that, for me, is the most upsetting aspect of it all. I want all people to feel comfortable in a health and fitness environment and not feel they are going to be stigmatised or discriminated because of it.

This is why in my practice I have and will continue to strive to implement and approach that focuses on the process of creating positive and healthy habits from day to day to enhance the quality of life of everybody that I work with, to make people FEEL great – things like sleep, exercise recovery, moving well, hydration, vitamin and mineral intake – THOSE are the big ducks to get in a row, forget arbitrary weight goals.

Really, I don’t know what the answer is to all of these problems aside from speaking out and challenging what society has led us to believe for so long is right. I would love it if you could implement something we have chatted about here into one of your conversations today?

Peace and love, A x

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