This is the time of year people lose their minds over Halloween candy and then holiday eating. Health care professionals and the fitness industry are large contributors to diet culture and weight stigma.
I am someone who likes to exercise in a gym and take group classes. This is my preference—others may like to exercise alone or get physical activity anywhere other than a gym. All these things are ok—one is not wrong or better than the other. Everyone has preferences. I have spent the last several years learning about the harm of weight-focused paradigms, taking extra continuing education on weight neutral approaches to well-being, Health for Every Body® facilitator training, certification for Intuitive Eating® and learning about weight stigma as a social injustice. Therefore, when I see or hear weight- stigmatizing things, it really bothers me, and I have learned to say something. To illustrate my point, here a few things I have heard/seen throughout the years while working out in gyms:
“Exercise hard now so you can eat more later”
“It takes x amount of burpees to burn off that piece of pie”
“Join our weight loss challenge so you are beach ready”
“Detox your body with a juice cleanse after holiday eating”
“You look great! Have you lost weight?”
Words such as: “Junk food”, “cheat day”, “good/bad food”,
"Pictures of fit, thin, muscular people only”
To set the record straight, you do not have to exercise to deserve to eat Thanksgiving dinner or enjoy some candy! Nor do you have to detox your body with a juice cleanse to compensate for overeating. If you hear anyone say this or other false information, or you see a sign at your gym stating this—say something! They likely don’t know how harmful the statement is to someone with an eating disorder or how this contributes to disordered eating, exercise addictions, and weight stigma. Exercise should not be a punishment for eating or what you are going to eat. Exercise because you respect your body —not because you hate it.
Environments focusing on weight loss, dieting, and obesity reduction promote stigmatizing and discriminatory practices towards people in larger bodies. This may be in the form of explicit and implicit bias. Weight stigma and weight centered programing is a social justice issue.
Individual’s privileges affect their explicit and implicit bias. For example, if you grew up in an educated, middle or upper class community with access to fitness and nutrition resources, it may be difficult to understand why individuals can’t “just eating healthy and exercise” and solve the “obesity epidemic”.
Acknowledging and understanding how food insecurity and social determinants of health (ie economic status, race, education level, access to health care, stigma, social support, public safety, literacy) greatly affects the ability to “eat healthy and exercise”. Obesity is very complex with many factors involved and in no way should someone be treated with disrespect related to their size. Yet, because of the weight stigma in our society, healthcare professionals, the fitness industry, and people in general have turned health into being a moral issue—which it is not. Our societies’ messages make it seem like weight loss is achievable for anyone if they put in hard work. That simply is not the case.
In addition, weight stigma increases likelihood to poor health outcomes such as increased risk of chronic disease, dysfunctional eating and eating disorders, and delay in medical treatment.
In addition, increased Calorie consumption, weight gain, decreased motivation to exercise are also outcomes. Social determinants of health are by far a larger contributor to someone’s health than their weight.
So what can we do to fight back against the stigma?
Teach from a Health At Every Size® HAES® view point. Criticism of HAES® stems from
misunderstanding of what it actually is. It doesn’t infer that respecting one’s body and accepting it at a higher weight means they are disregarding health.
The Health At Every Size® Principles are:
Weight Inclusivity: Accept and respect the inherent diversity of body shapes and sizes and reject the idealizing or pathologizing of specific weights.
Health Enhancement: Support health policies that improve and equalize access to information and services, and personal practices that improve human well-being, including attention to individual physical, economic, social, spiritual, emotional, and other needs.
Respectful Care: Acknowledge our biases, and work to end weight discrimination, weight stigma, and weight bias. Provide information and services from an understanding that socio- economic status, race, gender, sexual orientation, age, and other identities impact weight stigma, and support environments that address these inequities.
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.
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.
If you see or hear weight stigmatizing language—say something. It is our job to be
an activist or the culture will not change. Note number 3 above in the HAES® principles!
Anytime I have approached a personal trainer or fitness coach about something they have said that could cause harm, it has been met with acceptance and have been thanked for drawing their attention to it. You don’t have to be rude about it and point fingers because then your message will not be heard. Honestly, it is not their fault-- they are simply products of their environment and our environment of diet culture, weight bias is plentiful, and nobody is immune to it. However, it is not an excuse to leave it up to somebody else to worry about. So, here is your challenge. You may already be a weight neutral RD, healthcare professional, or believer—now, take it to the next step. Do some reading; get some education on how you can speak out against weight stigma. The hope is to bring awareness to the problem, plant the seed, water the seed and watch it grow and see the impact we all can make together!
Alison St. Germain, MS, RD, LD is a Clinical Professor at Iowa State University in the Food Science and Human Nutrition Department & a Certified Intuitive Eating Counselor and is passionate about body respect and diversity and non-diet weight neutral approaches to well- being.