As you might have heard from me around the paleohack-land, I am training to be a dietitian up here in Canada. One of the things that horrifies me about my program and has actually driven me to tears in class is the weight-bias that exists primarily amongst the students in the program (the profs know what's up and how to be sensitive, the students are completely brutal). The quick judgements and characterization of glutton and/or sloth makes me shudder, and I find myself become totally intolerant of the media, friends, and family talking about the eat-less-move-more-you-are-lazy-and-have-no-sense-of-self-worth messages.
The thing is, I'm usually not sure how to address the situations when these messages come up. I am not overweight or obese, so I think people just feel fine telling me slim-person-to-slim-person these ridiculous, unfounded judgements. I've tried posting links on my facebook/twitter to kind of "alert" my friends, family, and fellow students of my zero-tolerance policy (things like http://www.drsharma.ca/inactivity-does-not-explain-canadas-obesity-epidemic.html or http://www.drsharma.ca/why-addressing-weight-bias-is-the-1-strategic-goal-of-the-obesity-network.html or http://www.weightymatters.ca/2011/10/weight-bias-rears-its-ugly-head-in.html etc) but so far no one has "got the hint". It feels uncomfortable that no matter how many times I say "hey guys, not at all cool and completely disrespectful and uncalled for" people will just continue to make the same remarks without even thinking. They just do it automatically and laugh it off when I comment on it.
So, I was wondering how people have dealt with the issue of weight bias in their workplace/home/school. Is it realistic for me to hope that by graduation these to-be-dietitians will be sensitive to this major issue? Is this something that is tackle-able, even on a small scale?
asked byJenny_9 (11577)
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on April 05, 2012
at 12:31 AM
I'm kind of embarrassed to post here because previous postsers are so well written and a writer I am not, but I'll do my best. I have an older sister, she is 4 years older than me. We have the same mother and father, we were raised together in the same home with the same parents. We are very different. My sister has been overweight for as long as I can remember. I have always been the "skinny" one and the "cute" one. I have also enjoyed the perks that come with that status. As young children I noticed that people treated me "better" than her. I'm sure she noticed it too, but I didn't really care, I was busy enjoying it. My parents treated us differently. My mom often made remarks that made me think that my sister repulsed her. We both went to the same school. My sister barely got passing grades. Her teachers didn't seem to care. Then a few years later I would have the same teacher, and they would expect As from me. Of course, I rose to the expectation and produced As. We both went to the same pediatric dentist. When I was 13 the dentist told my parents that I needed braces. I asked them why I had to get braces, when sister's teeth were much much worse than mine, and they said "the dentist said you need them and he didn't say she needs them". I really think the dentist thought there was no sense in investing any money in the "fat" kid. My sister has always been a little less motivated than I, less motivated to bathe, less motivated to keep her hair, skin and clothes nice, less motivated to keep a clean house, yard or car. She lives at the poverty level because she is not motivated to do any better, she figures "this is good enough for me". So, my question is, "is my sister the way she is because society told her from the get go that she was not worth more"? Would she be more attractive, cleaner, thinner and more successful if my parents had treated her as well as they treated me? I almost think she has risen to expectations, it just so happens that those expectations were pretty low.
on April 10, 2012
at 02:27 PM
First, I applaud you for recognizing what is a very big and difficult problem in our society - particularly in our medical communities. Weight bias and discrimination is one of the last socially acceptable forms of prejudice, particularly within the medical profession. You are in a very unique situation to bring to light a problem that definitely needs to be address: the need for obesity sensitivity training in our medical communities. Hopefully, you will see this as a huge opportunity to be on the forefront of changing the dynamic.
I am a formerly morbidly obese woman. Four years ago (and for most of my adult life) I weighed 311 lbs. Because of a growing number of co-morbidities (pre-diabetes, gout, sleep apnea, PCOS, hypertension, and more), I had gastric bypass surgery on 3/25/08 and have since maintained a loss of 150 lbs. As you might imagine, my life has dramatically changed.
What I find fascinating is how many "fat jokes" are made in front of me now. The language that people use is appalling, and worse, I am treated much kinder, much gentler, and much more respectfully than I ever was as an overweight person. The difference is night and day, and quite bothersome to me as I know that the way I am treated now is based entirely on my physical appearance. Even my primary care physician - who has always been very kind to me no matter what the number on the scale - asked me, "do people treat you differently now?" She asked because she knows: they do.
Obesity is a very complex disease. In addition to being one of the last acceptable forms of public prejudice, it also is influenced by behaviors, environment, and genetics. While people want to believe that the "eat less exercise more" system works for every person, it doesn't. There are numerous factors that play into obesity, as shown by the epidemic that it has become in this country. (And remember, while YOU may be able to afford a gym membership or personal trainer and nutritionist, there are many, many people who have genetics at play and are far less fortunate socio-econonmically).
For people like me, many of us have used food for years for medicinal purposes. In addition to diet and exercise, I also do weekly cognitive therapy to learn coping skills that will help me avoid going back to old habits. Genetics did not favor me: I am built like everyone on my dad's side of the family with a long history of heart disease, stroke, and cancer. Add to that a very traumatic childhood of abuse where I turned to food for comfort - and continue to medicate myself throughout traumatic events in my adult life - my obesity wasn't as simple as "she's gluttonous and lazy."
What we need now is a dialogue and training within our medical communities to recognize the complexities of obesity and the varying factors that can play a role in the disease. Dieticians and nutritionists in particular need to understand that diet isn't just about being educated about what is healthy and what is not: food has much control over most overweight people. Personally, I think that the need for pyschology and therapeutic programs is key for anyone working with the overweight and that real-life sensitivity and training needs to happen - from patients LIKE me.
I hope you see this as a fantastic opportunity for you to be in the front lines changing dialogue and perceptions. Keep talking about it, keep posting items like you have been, and keep referring them to patient stories and backgrounds. Standing up for what's right isn't always easy, but doing so could play a huge role in changing the dialogue of the medical community.
on April 04, 2012
at 10:34 PM
I just found myself in this situation the other night.
The funny thing is, a few years ago, I would've been saying things along the same lines without thinking I was being judgmental. It's culturally acceptable. I cried my way through Taubes's WWGF realizing how horrible I'd been about it. And the other funny thing? Is that most people who are willing to say those things out loud have weight issues themselves.
The other night, I just nodded and listened. I let the silence get a little uncomfortable. Then I said, "Yes, that seems to be the popular view of it. If the cause of obesity was known, I don't think we'd have the problems we're seeing today. I'm guessing it's far more complicated than that."
on April 05, 2012
at 03:48 AM
Can I just preface this by saying I think you're awesome and am glad you're becoming a dietitian? We need more people that "get" what's going on.
I've been fat since childhood, hit obesity somewhere along the way, and I really suffered from the assumption that calories in, calories out is the key to weight control. I could never keep it up-- I hated the way I looked and on top of that, I disliked myself for not being strong enough to do anything about it. And of course I got shit for it. Kids are brutal, even (especially?) the cute short ones in elementary school. So many complexes, aaaugh
I'm still overweight, though no longer obese... maybe people still judge me for my weight; I don't know. I care a lot less now though, since I no longer see any seeds of truth in whatever ideas the "fat woman" stereotype conjures in people's minds, so it's not threatening. I understand now that food is a complex issue and I think that understanding on its own can be a very freeing thing, even if you're not down to your ideal weight. Even if you just figured it out yesterday. I read WWGF about half a year ago (has it already been that long?)--perhaps the insulin theory is not 100% perfect/complete, but it works better, and the basic idea that weight has more to do with what you eat than how much of it really lifted a burden of self-hate off my shoulders that very night. I really do think the way society deals with weight problems is, like Sunny Beaches mentioned in a comment, a self-fulfilling prophecy. Really sad, really upsetting, really frustrating.
Then we compound it by a lack of consideration for potential food intolerances that can cause the physical imbalances of depression, anxiety, so on. There's just way too much work to be done. I'm so glad I found this stuff and improved emotinally and physically, but I'm also frustrated that it's so... underground. I can't really deal with it when I think about the psychological damage that our attitudes towards both weight AND food cause; the pure emotional destruction compounded by physical mental health issues is super painful.
It can be super easy to be arrogant and laugh off the idea that overweight/obesity is NOT just the punishment for the sins of gluttony and sloth unless you've been there... the paradigm shift can be pretty uncomfortable. But I hope you can get through to your classmates! At least keep spreading the right info and hopefully someone will listen and stop beating themselves/other people up.
on April 04, 2012
at 11:03 PM
Body weight isn't necessarily related to gluttony or being a "sloth"...being thin does not mean that someone is in perfect control of their eating. Also, who said that gluttony only comes in the form of food? What about other behaviors like shopping, taking more than one penny out of the "leave a penny, take a penny tray"? Anyone at any weight can be "gluttonous."
It is extremely frustrating when people make judgments based on weight. I'm pretty sensitive to the issue. Obesity and weight control are about more than just "hey, eat healthy and exercise!" Obesity doesn't happen overnight. It doesn't happen because people are stupid. Genetic predisposition, cultural and social norms intersect to influence human behavior. Did you know that the mother's food intake during the prenatal stage has been hypothesized to influence food preferences in toddlers? It starts young. Familial attitudes toward food, trauma, marketing targeted towards children (e.g. YOU'LL BE HAPPY if you buy X cereal and get a prize) and the pressure to look perfect all play a role.
I think the problem with (at least here in the United States) the prevention initiative of this country is that it focuses so much on "LET'S EDUCATE" others about healthy food and begin active. Sure, that is a step in the right direction but there are many issues that are left out. What about how we use food as a punishment and reward in schools? We celebrate with pizza parities for good grades. We have free breakfasts for star students. Parents tell their children that they get "no dinner" if they misbehavior. Using food as reward and punishment creates unhealthy attitudes towards food. What about the old WIC (Women, Infants and Children) guidelines that made little room for varied and healthy choices for low-income families?
Many people know about healthy eating (although that can be argued because of the paleo perspective vs. traditional guidelines) and the importance of physical activity. Starting at the sources of WHY people are not partaking in healthy lifestyles (despite having the knowledge) would be a great start. Is it lack of resources and support? Perceived association between "bad" foods and happiness? Food addiction? Cultural disapproval (e.g. for some cultures, food is a big part of culture and now indulging in mom's giant tacos might be heavily frowned upon OR for those cultures valuing curvy body figures, they might be afraid to go against the norm by losing weight)? Is it that they are trying too hard to be rigid and not eating enough fat/calories? It's not just as simple as "Gosh darn it, it's Ronald McDonald again."
on April 10, 2012
at 05:04 PM
I am a living example of that bias. Currently, I eat very little and my friend eats three times the calories I do. I need to loose body fat (160lbs) and she wishes more than anything that she could gain a few pounds (108lbs).
Here is another example, my daughter and I are extremely sensitive to carbs. My son can eats tons of food and calories, even carbs all day and he is underweight. He is 13 and 78lbs and she is 11 and 114lbs. When my girl started eating more fat and less carbs (more calories) a few months ago she stopped gaining weight every month (which she had for a year prior - at a rate of about 4-6lbs a month).
The best response I have heard to Wieght Bias was by Gary Taubes in this interview.
http://www.kuow.org/program.php?id=25964 (about a super tall teenager must have a tumour in his pituitary but a super heavy teenager must be eating too much = storing vs eating)
After studying paleo/low carb for over a year (and living it) I think that this bias is at the root of the perpetuating bad information from the Canadian government and medical system. Once you get over the "one solution" theory of calories in calories out, you can deal with the real individual bodies and stop creating so much psychological damage by blaming rounder people for not being slim.
when I see severely obese people, I do not judge, I see their pain, their attempts to make it different by following bad medical and nutritional advice, their deep wishes to look and feel different, and in some cases their disappointment with themselves is just plain heartbreaking!
No being fat is not just a product of being lazy. I went to the gym three times a week and did weight watchers with no success, but when I went low carb and grain free I lost 25lbs during while I sat on my ass for the most inactive few months of my life.
thank you for raising such an important issue.
on April 04, 2012
at 10:28 PM
i hate these situations! awful! i've found that once i stopped engaging these people AT ALL when they made these comments, it was so awkward, that eventually they got it: don't talk to meret about this stuff. i just kinda give them a wtf-look and it's enough of a reminder. people generally leave those topics alone now when they speak with me.
on April 11, 2012
at 12:22 AM
Jenny, I am finishing up my dietetic internship here in the US, and active, unabashed weight-bias is very prevalent among my peers - even in front of one of my good friends in the program who would fall into the "obese" category. They seem to ignore her while they talk about "fat" this or "lazy" that with regard to patients - she has said that she sits there wondering if they are thinking "oh, [my friend's name] is so fat and lazy." It hasn't been so bad at the healthcare facility I'm working at because the RDs who work there are not particularly thin, and the attitudes seem to mysteriously get turned off. To be fair, some of my peers are kind, empathetic individuals who will make excellent, reflective practitioners - but some are just awful. It also seems to be a running competition to determine who has had to care for the "fattest" patient. So far I have been told I am "winning" because I had a female patient with a BMI of 98 - but my only concern in the matter was ensuring she was fed properly due to some absolutely wretched attitudes among nursing.
As a related note, one of the first studies I ever ran across as a newly-minted nutrition student was one discussing weight-bias among dietetics students. The results were not promising.
on April 10, 2012
at 06:55 PM
I do not agree the below poster's tone or choice of words. Neither helpful nor informative. Certain ideas that were touched on briefly do have relevance to this discussion.
Modern American lifestyle combined with readily available junk foods has created an epidemic of overweight and obese people in the United States. I am all for positive body image and people having high self esteems but being overweight/obese is not healthy. It is the combination of lack of activity combined with high calorie diets that leads to this epidemic.
While there are those among us that are blessed with superior genes, something called the Danish Twin Studies established that less than 25% of how long the average person lives is dictated by genes. That means 75% of your well being is determined by lifestyle.
Eating healthy and exercising are part of overall lifestyle changes that everyone should partake to take care of themselves. The focus should be on fitness and functionality NOT on looking like 'name your celbrity/model.'
To be personal, I am a 5'8" small framed male. I have always wanted to be 'big.' Most of my friends are over 6' tall and built like linebackers. They also eat whatever they want. I walked around for years at an unhealthy 180 pounds (28% body fat) in my quest for big. I supplemented, consumed 180 grams of protein per day, but could not add more muscle to my frame. I refused to do steroids. It ended with a blown out shoulder, pulled hamstring, and strained back. There is no work out to make my frame bigger. No exercise to make me taller. So I went to an all organic, unprocessed diet under 2000 calories per day. I hike an hour every day and lift weights for strength (not bulk) 3 times per week. I am now 167 pounds and still dropping. Oh, I can out squat and deadlift my friends now too. lol. My fitness journey was about realizing what my body should be and not what I wanted it to be.
on April 04, 2012
at 11:39 PM
in the end of the day, being fat is undoubtedly a product of being gluttonous and lazy - no one can refute it! ----- the thing is what makes the unhappy ones to be so: modern food environment, big business-sponsored state-propagated CW, and fat acceptance attitude -----
----- so, fatties are victims indeed, but not entirely innocent for among their perpetrators is their own stupidity and resignation