SIZE INCLUSIVITY: EXPLORING AND ENCOURAGING BODY ACCEPTANCE

SEPTEMBER 2019 PRESENTED BY: ASHLEY MUNRO, RD, CDE NUTRITION COUNSELOR | CAMPUS HEALTH DISCLAIMERS

¡ (HAES®) Dietitian - matters ¡ Intuitive Eating Counselor, which makes me pro-variety and anti-diet (but not anti-health) ¡ Trained in traditional medical model ¡ Aware of lack of lived experience in different size bodies, identify as an ally ¡ I intentionally use different language – examples…

¡ Having the conversation is important, lean in yourself and call others “in” ¡ Explore sizeism and discuss weight stigma ¡ Understand the Health at Every Size (HAES®) paradigm ¡ Understand ways we can support focus on health promoting behaviors and embrace body positive culture OBJECTIVES THE SIZE OF YOUR BODY TELLS ME NOTHING ABOUT YOUR HEALTH! THE TERMINOLOGY

¡ Sizeism – “a form of related to size” [3]

¡ Weight stigma – “...also known as weight or weight , is discrimination or stereotyping based on a person’s size. Weight stigma also

manifests in fat phobia, the dislike or fear of being or becoming fat.” [11] THE COMMENT THAT CHANGED IT ALL

“We are prescribing to people in larger bodies, what we diagnoses as ED behavior in people in smaller bodies.” POODLE SCIENCE

ASDAH presents: https://www.youtube.com/watch?v=H89QQfXtc-k STIGMA CAN COME IN DIFFERENT FORMS

- Implicit - Explicit https://www.instagram.com/glitterandlazers/ - Internalized ?hl=en WHAT DOES THE RESEARCH SAY?

“THE PREVALENCE OF WEIGHT LARGER BODIED PEERS ARE PERCEIVED AS LAZY, DISCRIMINATION IN THE UNITED STATES HAS UNEDUCATED, LACKING IN WILLPOWER AND INCREASED BY 66% OVER THE PAST DECADE” CONTROL, AND UNATTRACTIVE. WEIGHT BIAS & THE HARM

Weight bias is common Shaming about weight and is associated with does not motivate negative health consequences positive behavior change

Internalizing weight bias Public health messages, if contributes to negative not mindful can outcomes ”perpetuate” weight bias

Action on weight bias Weight bias is a requires a shift in culture manifestation of social and population-based inequity approach ARE WE SEEING A SHIFT IN OUR CULTURE? HAES® IT IS HEALTH AT EVERY SIZE, NOT HEALTHY AT EVERY SIZE

1. Weight Inclusivity: Accept and respect the inherent diversity of body shapes and sizes.

2. Health Enhancement: Support health policies improve human well-being, including attention to individual physical, economic, social, spiritual, emotional, and other needs.

3. Respectful Care: Acknowledge our , and work to end weight discrimination, weight stigma, and weight bias. Provide information and services from an understanding that socio-economic status, race, , sexual orientation, age, and other identities impact weight stigma, and support environments that address these inequities.

4. Eating for Well-being: Promote flexible, individualized eating based on hunger, satiety, nutritional needs, and pleasure, rather than any externally regulated eating plan focused on weight control.

5. Life-Enhancing Movement: Support physical activities that allow people of all sizes, abilities, and interests to engage in enjoyable movement, to the degree that they choose. IT’S ALL ABOUT HOW WE SAY IT…

WEIGHT-CENTRIC WEIGHT INCLUSIVE

Weight loss/lose weight Weight concerns Weight management Weight and disordered eating Reduce body fat Health at Every Size Good/bad foods Healthy relationship with food and eating Avoid/Limit Intuitive eating Exercise Mindful eating Portion Control Make peace with food Calorie Control Joyful movement and activity Prevention Size diversity Health Promotion

https://www.eatrightarizona.org/docs/2019%20Annual%20Meeting/Slides/Megan%20Anderson_ Dawn%20Clifford.pdf MOVING TOWARD

Embrace being unique

Normalize

How we talk about ourselves matters

Understand we are still learning/unlearning

Diversify your media/what you see ¡ Made on a Generous Plan/ Beauty Redefined SOUNDS ¡ Books/Podcasts INTERESTING, ¡ HAES website NOW WHAT? ¡ Unfollow what doesn’t serve you ¡ Stay curious ADDITIONAL READING

¡ Body Respect- Linda Bacon PhD & Lucy Aphemorh ¡ Body Kindness- Rebecca Scritchfield ¡ Health at Every Size- Linda Bacon PhD ¡ https://haescommunity.com/ ¡ https://www.sizediversityandhealth.org/index.asp ¡ Embody ¡ Intuitive Eating –Evelyn Tribole MS, RD & Elyse Resch RD ¡ Embrace – Netflix IT STARTS WITH RECOGNIZING OUR BIASES AND MAKING STEPS TOWARD ALL BODIES ARE CHANGE GOOD BODIES.

QUESTIONS REFERENCES

1. Alberga et al. Journal of Eating Disorders 4:34, (2016) DOI: 10.1186/s40337-016-0112-4

2. Bacon, L., and L. Aphramor. Nutrition Journal 10: 9, (2011). DOI: 10.1186/1475-2891-10-9.

3. Clifford, Dawn, et al. Journal of nutrition education and behavior 47.2 (2015): 143-155.

4. Maya Vadiveloo, PhD, RD, Josiemer Mattei, PhD, MPH Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine 51 (1), 94, (2017). https://doi.org/10.1007/s12160-016-9831-7

5. Puhl, R, & Heuer,C. Obesity 17, (2009): 941–964. DOI:10.1038/oby.2008.636

6. Puhl, RM, Moss-Racusin, CA, & Schwartz, MB. Obesity 15.1, (2007) :19-23.

7. Tomiyama, A. J. Appetite, 82, (2014): 8-15.

8. Tribole, E., and E. Resch. 1995. Intuitive Eating. 1 st ed. New York: St Martin’s Press. 2012.

9. Tylka, T, R. Annunziato, D. Burgard, S. Danielsdottir, E. Shuman, C. Davis, and R. Calogero Journal of Obesity Volume 2014, Article ID 983495: 18 pages.

10. HAES principles: https://www.sizediversityandhealth.org/content.asp?id=152

11. Weight : https://www.eatrightarizona.org/docs/2019%20Annual%20Meeting/Slides/Megan%20Anderson_Dawn%20Cliffor d.pdf

12. NEDA: https://www.nationaleatingdisorders.org/get-involved/weight-stigma-awareness-week/faqs