So I assume, then, it wasn't the "obesity epidemic" that got you into this gig, right?Brene Brown at the University of Houston. She's written a couple of popular books on the subject of shame and guilt, and I'd definitely recommend those to anyone interested in examining how shame negatively affects our mental and physical health. But stigma is more widely studied than shame. A 2010 literature review on obesity stigmatization found that "...weight stigma is not a beneﬁcial public health tool for reducing obesity. Rather, stigmatization of obese individuals threatens health, generates health disparities, and interferes with effective obesity intervention efforts." Approaches that are more oriented toward weight acceptance and empowerment, however, show great promise in helping people increase their physical activity. How would you like to see the conversation change? I’m not prepared to argue that there are no negative health outcomes that stem from obesity, but we all need to question many of our underlying assumptions about weight and how we support people trying to improve their health. In my perfect world, we would advocate for better bike infrastructure and safer neighborhood streets, not because people might lose weight, but because they’d have more fun, sleep better, be less at risk for depression, cancer, heart disease, and a host of other illnesses. And we’d stop, even inadvertently, sending fat people the message that there is something inherently wrong with them. Are there any organizations out there getting it right? I’m a fan of the Health at Every Size model; they have many resources on their site. Health interventions that use weight acceptance as a foundation have been very successful; they have better retention rates and don’t result in as much weight cycling. What is weight cycling? Weight cycling, or yo-yoing, may be responsible for some of the mortality risk that is often attributed to obesity itself. The mechanism by which this happens is still being studied. Obesity research has for too long just assumed as a given that weight loss is a positive and important goal. This even though there is much we don’t fully understand about the impact of obesity on health outcomes, even though much of the research does not account for physical activity or for unhealthy weight yo-yoing, even though overweight has been shown to be protective of health, even though we understand that shame and stigma are not effective ways to help people change their behavior. So does knowing all these things affect the way you live? As an individual struggling with how to translate this information into my daily life, I’ve settled on a few first steps: I try my hardest to not make assumptions about a person because of their weight. Old habits die hard, but the research and my own cadre of fat fit friends make it harder and harder for me to buy into the idea that thin = healthy. I also don’t exercise to lose weight. Even though that little voice in my head still speaks up sometimes to remind me that I’m still the same weight I was yesterday or last month or last year, there’s another voice, too. It reminds me that I’m going to have better sex today and sleep better tonight, that next time I’ll be able to run a little farther or lift a little more weight, and that I’m giving my future body the gift of many more years of riding my bike down forest trails or dancing the night away.
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