lucyHow do we get from calorie counting and food preoccupation to relishing eating and enjoying body confidence? I’ll share three ways in which putting body respect at the centre can help turn the tide on body shame, weight stigma and rising health inequalities and promote enjoyable eating, and nutrition justice.

A powerful first step is to bring body knowledge back in to view. It’s traditional to teach cognitive restraint and willpower in pursuit of healthy eating, but this all too often backfires. Rational knowledge has its place – just ask someone living with a peanut allergy – but food rules become problematic when they encourage us to ignore body signals. It’s hardly surprising so many people feel out of control around eating when we eat with our heads. All those ‘shoulds’ ‘have to’ ‘mustn’ts’ fuel body-mind disconnect and play havoc with our internal regulation systems.

Tuning into body signals and sensations such as appetite, fullness, gut comfort, emotions and overall satisfaction, can help restore a healthy relationship with food. This means we eat in response to occasion, taste preference, energy levels and learn to trust ourselves to meet our needs. Shifting to this more intuitive, connected way of eating allows food and eating to meet non-nutritional roles, such as pleasure,  values, family and identity. Tuning into our bodies can help us identify emotional aspects of eating which in turn helps us make more sense of our eating behaviours. If we want to change old patterns a key step lies in noticing our thoughts and emotions without judgment. So, rather than berating ourselves for bingeing we learn to speak kindly and soothe ourselves, opening up new avenues for self-care.  Eating in this embodied, compassionate way means we’ll feel more at ease around food, more nourished. In short, body respect involves listening to our bodies and speaking kindly to ourselves. This will be far a more effective way of supporting people develop a healthy relationship with food than learning food facts.

The research shows that honoring embodied knowledge helps people stabilize their weight. This is huge good news as, finally, there’s an exit route from the despair of yo-yo dieting. What we find is that people stabilize at any number of weights from across a wide spectrum on the body mass index (BMI) chart, including but not limited to those seen as “ideal”. This turns upside down the taken-for-granted belief that everyone will be thin if they just eat properly. Instead we can say that when people eat well and are as active as they can be they will stabilize at their set-point weight which may fall in or out of the BMI range considered “ideal”.

This is a radical idea. The ‘thinness equals healthy’ and ‘just eat less move more’ beliefs are so pervasive that querying them can seem nonsensical. In scientific terms, the truth is that despite prevailing messages, there is no study demonstrating calorie control as a reliable intervention for long term weight loss. Really. Guidelines that cite research to back up dieting use short-term studies as if short-term weight loss can be extrapolated to prove long term weight loss is possible. It can’t.

imageAs long as weight myths circulate, dieting will be sought as remedy. Stripped of myth, the underlying issues are a troubled relationship with food and body shame -  both buttressed by bad science. In generating an epidemic of dieting the implications of bad science are far reaching. The joint ideas that you should be thin, and dieting works, continue to condemn millions of children and adults to engage in behaviours that can lead to troubled eating and eating disorders, self loathing, loss of bone mass and increased risk of heart problems from weight cycling. It leads people to feel like a failure when diets fail them. It drives societal norms that oppress fat people and privilege thin people. It also creates the impression that health is mainly about weight. Even a cursory reading of the science shows that health behaviours have a greater impact on health outcomes than weight.  That means that for the vast majority of people, our diet, activity, smoking and alcohol habits are much more reliable indicators of health than the number on the scales. Thus the evidence strongly supports a focus on health-gain, not a focus on weight control. It reminds us to look beyond stereotype, that it is very possible to be fat and healthy, and thin and unhealthy.

And a more thorough reading of the science paints an even more three-dimensional picture. This maps out the ways in which living with chronic stress influences our metabolism making us more likely to experience high blood pressure, artery damage, insulin resistance even if we have exemplary health habits. These metabolic changes lead to hypertension, heart disease, diabetes –all of which are conventionally attributed to weight and/or diet. Certainly, eating well will improve our quality of life and everyone should have access to food as a right.  But presenting nutrition as the be-all-and-end-all of health is unscientific, unhelpful and leads to business as usual. Chronic stress arises from inequity, loneliness, job insecurity, oppression and all forms of stigma. It’s imperative we start expanding the health conversation to keep both self-care and social justice in sight in talk on nutrition-sensitive diseases to avoid victim blaming. The second message of Body Respect is that the personal is the political –is the physiological.

Exploding open the myths on weight and health is as necessary as it is audacious. We can draw hope from a recent parallel shift in the treatment of stomach ulcers. When a handful of researchers suggested a role for the bacterium H. pylori and openly questioned the prevailing belief that stomach ulcers are always caused by acid they were ignored, then ridiculed, then vilified. Then acknowledged and lauded. More importantly, the work of these early pioneers has revolutionized treatment in the field, preventing suffering and improving lives. Science is of its time and in a weight-obsessed culture disrupting dominant views on thinness and fatness in relation to health – and moral worth – will likewise require passion and persistence.

well foundedSo the third message of Body Respect is that every body deserves respect – that our worth as human beings does not alter according to our weight, fitness level, income, ethnicity, age or how many vegetables we eat. We live in bodies of different sizes and shapes, all of which deserve to be treated kindly. Our health is influenced by genetics, luck, pollution, privilege, oppression, physical activity, food, access to medical care, employment, friendship. . .  At a personal level, the best way to support someone to look after their body is to help them respect and value themselves as they are right now. This act of self-care is easier in a world where we all feel respected and valued. Body respect recognizes that good health lies in the relationships we have with food, our bodies and how we treat each other (and, of course, the planet). Could there be a better template for shaping the future of nutrition education?

References

Bacon, L. and Aphramor, L. (2014) Body Respect: what conventional text books get wrong, leave out or just plain to fail understand about weight. USA. BenbellaBooks

Bacon, L. and Aphramor, L. (2011) Weight Science: Evaluating the Evidence for a Paradigm Shift, Nutrition Journal. 10:9. doi:10.1186/1475-2891-10-9. http://www.nutritionj.com/content/10/1/9

Video link : https://www.youtube.com/watch?v=vV9s-e6DIPU

Bio: Dr Lucy Aphramor RD is recognised internationally for her contribution to shaping nutrition narratives that address both self-care and social justice.  Widely published across disciplines her two key nutrition articles have in excess of 160,000 hits and her co-authored book Body Respect brings ten years of her work integrating wellbeing, health behaviours and equity to a wider public. Lucy’s obvious passion for change and her commitment to passing the message on arise from her personal and professional experience that shows how compassionate, socially-just nutrition is the ethical, effective choice for self-care, in talking therapies and in public health narratives.

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