How do we talk about weight?

You may have seen James Corden’s response to Bill Maher talking about how fat shaming is a good thing – it has made the news and people are talking.

Then there was Piers Morgan and a fitness celebrity backing up Bill Mahr on Good Morning Breakfast suggesting that fat shaming was the way to get people motivated to lose weight and get healthy. It wasn’t a very comfortable watch. They need to do a bit of reading of the evidence. Fat shaming is weight stigma and the evidence shows that stigmatising people or fat shaming does not lead to better health even if it does push someone to lose weight. The evidence is there to show that stigma of any kind has a powerful negative effect on both physical and mental health. It leads to stress and promotes destructive behaviours, it raises stress hormones which are associated with raised blood pressure and other markers of poorer health.

All this going on in the news in the last week or so made the timing of this week’s @AfNutr Twitter Chat ‘Let’s Talk About Weight’ perfect. I learnt so much both in researching the chat as a moderator, preparing scheduled tweets in advance and through the comments and shared information from participants of the chat. Check out #TalkWeight if you are on Twitter or head over to the website where there will be a link to the archived chat very soon.

In among the tweets there are links to peer reviewed articles highlighting the negative effects of weight stigma, guidance on discussing weight with groups and individuals, links to photo banks with approved photos that are not stigmatising and so much more. Well worth a little look through and it counts as CPD if you are a dietitian or a nutritionist if you read it and then reflect on what you have learnt.

The overarching message for everyone here is to focus on health rather than the absolute number on the scales. We should be encouraging changes in behaviour that translate into real measurable improvements in markers of health like blood pressure, Hb1Ac, fitness, etc. People should be working towards improvements that they can feel. Feeling less tired, more energetic, stronger, less susceptible to illness, more stamina etc. Get in touch with your feelings of hunger and satiety, take time to eat without doing other things and take your time to eat.

Losing weight rapidly might seem wonderful, seeing the results in the mirror and on the scales with people commenting on your progress. However, this kind of weight loss is generally less sustainable and often the weight returns. It also means that you restrict more than just energy in your diet and can often feel hungry and deprived. And you may not feel the benefits. It is hard to maintain a good relationship with food if you are stuck in the trap of diet culture. Gradual weight loss needs patience but can feel good, it tends to stay off longer and you feel better with it.

Weight is affected by so many factors – it is not a behaviour in itself. Yes, it can be and is affected by things we do and positive change for some will see a stabilising of weight or even a reduction. However there is so much more to weight than personal choice and responsibility. Using weight as an absolute marker of health and reducing weight at all costs will not always translate to health improvements.

So make positive changes to what and how you eat, focus on good sleep hygiene, improve you levels of activity and combat stress. If weight doesn’t come off but your health is improved then the changes have been worth making. I will say that again. Positive change is worth making even if you don’t lose weight. Doing those things should make you feel better in yourself, you will know you have made positive change so don’t stop because weight hasn’t come off. The benefits are still being gained from positive health behaviours.

We need to change diet culture. We need to not refer to people’s weight as a point of conversation or as a compliment. It’s not helpful – for people at either end of the spectrum. People struggling to gain weight are victims of weight stigma and bias too. We need to stop talking about the current diet we are on or saying that we feel fat. We need to be careful how we talk about beauty and shape and size in front of our children. The diet products and the diet plans promising the earth with before and after photos do not promote health or healthy relationships with our body or our food.

So it was great to see that Instagram are clamping down on posts that promote diet products that promise miracles and other irresponsible diet and cosmetic posts – making some only available to over 18s and others being removed completely. More needs to be done about the content on social media in the area but this is such an amazing step in the right direction.

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