Health at every size?

I had two experiences last weekend that I didn’t realize were related until I started thinking about the theme for this blog post. Saturday night, I had the opportunity to attend a screening of the documentary Fattitude followed by a panel discussion with community members and health professionals. Sunday morning, I attended service at my spiritual home, the Unitarian Universalist Fellowship of Raleigh, where Reverend Osterman spoke about the “Burden of Perfectionism.” It is only in the last day or so that the connection between these two topics hit me and have inspired me to reexamine my long-held beliefs about weight and health.

Rethinking the connection between weight and health

 As I’ve shared before, I was overweight as a kid, so I have firsthand experience with the shame and frustration that comes with not fitting into the preferred norm when it comes to body image in this country. I have spent years on the yo-yo dieting cycle, losing weight only to regain it and start the weight loss cycle over again. It is only in the past few years that I have finally seen the light and realized that my struggle with maintaining a healthy weight has almost nothing to do with health, and everything to do with body image – and striving for the unattainable: a “perfect” body, like the images we are bombarded with daily on TV, the internet and print media alike.

It occurred to me that even when I have been overweight, I did not have any health issues. Blood pressure? Normal. Blood sugar? Normal. Cholesterol? Normal. However, given my family history of diabetes, heart disease, stroke and cancer, I have always been concerned about preventing such problems down the road. As a public health professional, this message was hammered into my brain: educate individuals about the health risks of being overweight/obese and help them modify their lifestyle to achieve a healthy weight. But as I learned the other night at the movie and discussion, the research upon which this message is based is not black and white. Most studies have demonstrated a correlation between excess weight and chronic diseases, not a direct causation. This is an important distinction to make. Being overweight or obese may increase your risk of developing diabetes or heart disease, but it is not necessarily a given. There are plenty of thin people who develop these conditions, just as there are fat people who do not.

Fattitude

The documentary Fattitude was eye-opening for me. As much as I knew that our culture is biased toward thin people, I was not aware of the breadth and depth of discrimination around weight. The movie pointed out that in children’s books, cartoons and movies, the villains and bad guys are almost always fat. In most of our entertainment, the fat person is the butt of the joke. But even beyond the entertainment world, I learned that fat people are often paid less than their thin counterparts and that they face bias in the healthcare environment. Self-report studies show that doctors view obese patients as lazy, lacking in self-control, non-compliant, unintelligent, weak-willed, and dishonest. Wow.

During the discussion after the movie, a teen-aged African-American girl in the audience posed a question to the physician on the panel. She said her pediatrician told her that because she is fat, she will develop diabetes and die. She wanted to know if that was true. The physician assured her that was not true, and the young girl ran out of the room crying – I’m assuming from a sense of relief that she was not doomed to this fate. (As a side note, I would say that this girl appeared to be a little overweight but by no means obese. I’m also happy to report that after being consoled by a few of the event organizers, she eventually returned to the discussion and was smiling and laughing by the end of the night.) I want to assume that this girl’s pediatrician meant well and had her best interest at heart, but we know using fear tactics is not the best approach to motivating people to change.

Perfection is overrated

I was still reflecting on the lessons learned Saturday night when I attended service Sunday morning. As a “recovering perfectionist” (I’m still a work in progress), I was eager to hear what my minister had to say about it. He shared insights about the three most common types of perfectionism:

  • Self-oriented perfectionism: Self-oriented perfectionists have high personal standards, expect to be perfect, and are very self-critical if they fail to meet these high expectations.

 

  • Other-oriented perfectionism: Other-oriented perfectionists expect other people to be perfect and are highly critical of those who fail to meet their impossibly high expectations.

 

  • Socially prescribed perfectionism: Socially prescribed perfectionists believe that other people expect them to be perfect and that these other people will be highly critical of them if they fail to meet expectations.

 

In thinking about it, I’m pretty sure I have a little bit of each type in me (yikes), but when it comes to my weight, I definitely link it to that last one. Although I have technically been at a healthy weight since high school, I have never felt “thin” – mostly because I have not had a flat stomach since I was about five years old (and probably never will unless I opt for surgical enhancement).  And in our culture, thin is beautiful and beautiful equals perfect. It is this external beauty standard that has kept me on the metaphorical treadmill year after year, trying to get that beach-ready body…and failing spectacularly with each passing summer. Why? I’ve come to realize that it is just not worth it to me. I’m not willing to put in the time and effort to achieve – and maintain – that ideal. There are too many other things I’d rather be doing than spending hours at the gym and obsessing over every piece of food I put in my mouth.

So now what?

As I said at the beginning, the events of this past weekend have given me pause and the desire to rethink my own beliefs about weight and health, as well as what this means for me as a health and wellness coach who works with others around weight management. I am inspired to re-read Health at Every Size, a book that challenges all of us to take a second look at the research around weight and health and consider adopting a different approach. I hope to learn more about the body positivity movement and speakers who were featured in the movie. Mostly though, I will be satisfied knowing that I am doing my best to eat a healthy diet and move my body in ways that bring joy and pleasure so that I will remain in good health and be able to enjoy life. Am I perfect? Nope, and that’s absolutely fine with me.