• Mckenzie Dow

Body Positivity and Researching Obesity

As you all know, I recently started my doctoral studies investigating the relationships between childhood obesity, psychological adjustment, and treatment outcomes. I split my time between UCD and Temple Street Children's University Hospital (TSCUH) and so far I am LOVING it!!

Though since I started my research in this area, I have noticed that I've been experiencing some cognitive dissonance (that uncomfortable feeling you get when two of your values or beliefs contradict each other) around my beliefs/professional opinion on the body positivity movement. I follow a few body positivity advocates on Instagram and it made me wonder... does this movement perpetuate obesity in a way? Where is the balance between loving the body that you have and working to reduce unhealthy fat to have a healthy body? Can body positivity and the realities of obesity coexist? It's a topic that's quite divided for many, so why not explore it a bit more and maybe clarify some misconceptions (including my own) along the way. So, prepare yourselves, this is going to be a long post!

Also, please note that I do my best to supplement my articles with sources to ensure that the things I talk about are evidence-based and not just me making things up. These sources are throughout the article as hyperlinks, indicated by underlined words.

And one more thing... I am not just writing this post in an attempt to attack overweight people or the body positivity movement. If anyone understands how unfair and disgusting it is for people to attack others just because of their weight, it's me. I am writing this post to better understand the relationship between the body positivity movement and the science around obesity, and perhaps educate others too. I am always striving to learn as much as I can about the complicated topics all around us while making informed decisions and conclusions. Here at Lady Mac Lifestyle, I do my best to come at every topic from an educated and respectful place.

For those of you who may not be engaged in social media too often, this body positivity movement may not be familiar to you so I will try to fill you in. On Wikipedia, body positivity is defined as a movement that "...encourages people to adopt more forgiving attitudes towards their bodies with the goal of improving overall health and well-being..." The movement also "...focuses on building self-esteem through improving one's self image." That part is something I am definitely on board with. Coming from psychology, anyone in our field knows the vast impact that self-esteem can have on our mental health and over all well-being.

So far, I'm on board with any movement that promotes being physically and mentally healthy. It's also important to note that body positivity is not just about someone's weight or fat. It's about other body elements too! This could include being more forgiving to your body hair, physical disabilities, height, acne, being naturally thin, or anything else you could think of! With all of that in mind, do body positivity advocates align themselves to this definition exactly? Does the movement promote unhealthy weight despite its own goal of "...improving overall health and well-being"?

Typically, obesity in adults is when a persons Body Mass Index, also known as BMI, is greater than or equal to 30, which often indicates that a person has excessive fat in their body in proportion to their height and sex (CDC, WHO). It is very important to note that BMI is not the only or primary indicator of obesity/levels of fat as it does not have established comparison norms for people of different backgrounds and is merely used as one of many tools for establishing whether someone is overweight. Often times people will criticize BMI with the impression that it's not valid whatsoever. What they don't understand is that BMI if more useful when looking at populations of people as a whole and it is not used as the sole diagnostic tool for obesity by clinical professionals.

Levels of obesity around the western world have been rapidly increasing for a while now. With this increase, researchers are starting to understand a lot more about how obesity is linked to or increases the risk of a many negative things in our body, as well as other psychological risk factors (especially in children).

This includes:

- Cardiovascular Disease (Diseases of the heart and blood vessels)

- Type 2 Diabetes

- Harmful to joints

- Certain types of cancers

- Sleep and breathing problems

These potential consequences are NO JOKE. Here's a realistic example of how obesity can have serious health consequences: Say that a person is already at risk for cardiovascular disease because it runs in their family. Their grandfather and father both passed away when they had fatal heart attacks. Now, say that this person is obese too. This means that they are at even more risk for suffering the potentially fatal consequences of cardiovascular disease.

I really want to take a moment here to emphasize that fat is not inherently bad for us. In fact our bodies need fat for a number of reasons. We need certain types of fats to insulate us, and to protect reproductive organs in women, as well as for cognitive function. What makes being obese dangerous is that there is too much fat in the body and that's one of the things that brings on the health consequences of being obese.

What's just as important as the physical consequences of obesity, are the mental health issues and other psychosocial problems that have been linked to being obese. It is so important to incorporate these problems into the discussion on body positivity and obesity, because they are vast. Both adults and kids with obesity often experience stigma and bullying around their weight. In our own population of children in the weight loss program at the hospital, we see a number of children and teens experiencing negative mental health issues including emotional health issues, disordered eating and different maladaptive behaviours. Additionally, obesity in adults has been linked to depression and anxiety.

With the definition and discussion of obesity and its consequences out of the way, we can start to truly look at how the body positivity movement and obesity may or may not coexist. Let's take a look at what some promoters of body positivity say about being more forgiving to our bodies.

Tess Holiday, creator of #effyourbeautystandards is a huge body positivity advocate and has a large social media following. She was the first model of her size to be signed to a well-known modeling agency and has only become more outspoken about body positivity since. Tess has incredible fashion tastes and radiates kindness on her Instagram. She often calls out fat-shamers on Twitter and shares peeks into her personal life quite frequently. A lot of her posts talk about body positivity in motherhood. Here are a few of the things she has said on social media in the past.

"...fat women deserve to feel sexy, moms deserve to feel desired & wanted, & if we want to dress 'slutty; then y'all can deal with it or keep scrolling."

I love this quote! I think it perfectly exemplifies what body positivity should be about: loving our bodies for the beautiful and hard work it's accomplished. Just because you've had a child, you shouldn't feel ashamed of your stretch marks and you should be allowed to feel hot as hell. No woman, regardless of their size, owes anyone anything! I'm all about this and I don't think this statement promotes obesity whatsoever. It promotes feeling good about yourself, which everyone deserves to feel.

"...because it's no one's business what I do with my body... It's not my place to tell other's to work out either. My mother is partially paralyzed & would love to move her body in the ways I did on my previous post, but unfortunately that's not quite a reality for her & so many other people. When you start to truly love yourself, you take care of your body the way YOU see fit. Live & let live y'all. Lastly, when I post about working out, then all of a sudden y'all got jokes, everyone is a doctor & trainer. Y'all just can't handle seeing someone in a plus size body that isn't deemed desirable by societies standards THRIVING & it kills y'all. Worry about your own life."

This is an interesting one because it touches on a lot of things. Firstly, she clarifies the fact that her body is HER business and I think this is great. Like I said, she, and no woman or man owes anyone anything in relation to their body and its perception. I also think that this is a great example of how everyone's situations/abilities are individual and should also be considered in the context of physical health. Working out may be viable for most, but it's not for everyone which is why we should not be so quick to pass along negative judgement towards others about their body size.

However, from a scientific perspective, it is really important that people who are able to be physically active do just that (within reason of course). When she says that you can take care of your body the way "YOU see fit" I get a little nervous because you may love yourself oodles and oodles and think you're doing alright with your health, but if your doctor is concerned about your risk for developing diabetes for example, shouldn't you follow the Dr.'s advice? You don't have to be a fitness guru or a perfect eater, but fully loving yourself or your child with obesity doesn't always mean you're taking care of your body properly; putting you at risk for the problems mentioned above.

In fact, one study describes the way that often times, parents may not even interpret their overweight child as being overweight (and thus at risk for certain health concerns). Another study about parent perception of child's weight had similar findings. Regardless, Tess is spot on when she encourages internet critics to worry about their own life. Someone's weight is only the business of themselves and their genuine medical professionals. Internet trolls are just that: trolls.

Another well known body positivity activist is Megan Jayne Crabbe, also known on Instagram as bodyposipanda. She is a lover of everything pastel and has amazing hair!! Megan began her body positivity blog and Instagram when she discovered the body positivity movement while recovering from anorexia. Her recovery from this debilitating and intense disorder is incredible to see. It's admirable the way she has developed a platform with the intentions of helping others recover too. Anorexia is not a joke and should always be taken seriously. It can take a lifetime for someone to recover from it and it often involves hospital stays and intensive treatment cycles.

Like Tess, Megan often writes inspirational things on Instagram to her many followers. For example:

"Okay everyone, who's ready for the annual diet culture holiday shitstorm? If you're already worried about: 🌸 How to deal with body shaming family members 💐 How to cope with the constant diet talk, calorie counting & food policing 🌷Being bombarded with diet culture bullshit online like 'How To Lose Christmas Weight Fast!' Or 'NEW YEAR NEW YOU - GET YOUR BEST BODY YET!' 🌻Keeping up your eating disorder recovery when the whole world seems obsessed with weight and numbers and restriction YOU ARE NOT ALONE. Diet culture is EVERYWHERE this time of year telling us that our bodies are wrong and that we need to feel guilty for every single mince pie we eat. But guess what? THE NUMBER OF CALORIES YOU EAT IS NOT A REFLECTION OF YOUR MORAL CHARACTER OR VALUE..."

I love this first lengthy quote! Megan calls out diet culture (research tells dieting can actually be a BAD thing anyways, see chapter 17 of the book Eating Disorders and Obesity) and the way that the holidays can impact recovery for someone with an eating disorder. I think this is just the kind of post that might help someone get through a tough holiday dinner with a potentially snarky family. At the end of the quote, Megan captures the notion of how our moral character or value doesn't come what what we eat. That's just one part body positivity, but it's so important.

"The world is better with you in it. You are loved, even if it doesn't always feel that way. You deserve the space you take up, even if you sometimes doubt it. You're doing better than you think you are, and I'm glad you're here. 🌺 Be kinder to yourself. 💜💙💚🌈🌞"

Again, this quote from Megan's Insta captures the idea of being more forgiving and kinder to ourselves, which is something we could all probably do more of. It's so nice and kind!! I love it!!

Overall, none of these quotes from Megan and Tess feel to me like they are promoting or supporting obesity. It feels more like they are encouraging us to be more loving to ourselves and remember that our worth does not stem from our appearance, even if it sometimes feels that way. Though with all these quotes, it's still so important to listen to what your doctors tell you about your health.

So, we've gotten a clearer definition of body positivity looks like, along with clarity about obesity and its consequences. But now we should look into what the critics of the movement say, and whether their criticism perpetuates fat shaming, or whether it comes from a kinder and educated perspective.

One article from the Odyssey by author Vianka Cotton states that "But what about health? The movement is promoting a sedentary lifestyle" then quotes a tweet from Tess Holiday in which she says that she is not the girl to preach health over self-love.

But is that statement fair? From what I have explored so far, I've never read or seen a statement in which a body positive activist tells their followers to spend more time in front of a screen, or to avoid regular physical activity on a regular basis.

In an article by Areo Magazine about how body positivity is harmful to women, it states "You don’t get fat by running, you get fat by over eating and not moving enough. Laze and greed to be mercilessly honest. Two genuinely appalling attributes that should not be revered, and is not positive by any means."

The same article also states "#EffYourBeautyStandards is a misleading line, again, blaming the standards in which society and the fashion/beauty industries are making everybody envision what real beauty is like. I’m pretty sure we all have brains, and understand Photoshop/airbrushing etc., right? I don’t look at Kim Kardashian and wonder why I have a Buddha belly to match my big bum and she somehow embodies the most “perfect” curves without a sight of a stretch mark or a quiver of cellulite."

Do you think these statements are fair? I'm not so sure that I do. I think the first one perpetuates stereotypes about people who are obese. From a psychological perspective, I think the author fails to consider other reasons why someone may not be physically active, such as severe self-esteem issues when entering a gym, or being unable to afford the running shoes the author mentions, or perhaps living in an environment where it is unsafe to even go for a healthy walk around the neighborhood.

The second statement assumes that we all have brains and understand that models are photoshopped. However, I don't think this is exactly true. In fact, a 2013 study linked social media usage and negative body image constructs in young girls. Another study investigating the role of Instagram suggested that people who followed more strangers on Instagram were more likely to negatively compare themselves to others. There are loads more studies investigating society's portrayal of men and women and its potential to have a negative impact people (just go to Google Scholar and read more studies if you are interested).

With all of that in mind, I'll finish with my own thoughts about the movement now that I've roamed all around the internet to learn more about this controversial topic.

Firstly, I would like to emphasize that my own concerns about health in overweight/obese individuals are not "faux health concerns". I am a researcher, a scientist, an assistant psychologist and an aspiring clinician who tries to view the world and society though a lens of constant critical thinking (not critical as in negative, but critical as in evaluative and investigative). Any heath concerns I would have for both adults and children with obesity are genuine, scientifically founded, and come from a place of love and a desire for every good person to have a life of happiness and longevity. My concerns come from a place within my own research, which tells me that obesity can and often does have implications for psychosocial health. I am not uncomfortable with obesity and I myself certainly do not fit society's mold for what women are supposed to look like. I just want everyone to have the best mental and physical health as they are able. There are absolutely people out there who attack body positivity advocates based on faux health concerns that are a disguise for their own feelings of being uncomfortable. However, I am NOT one of those people.

Secondly, this idea of body positivity brings up the issue of how we define "healthy". Perfectly skinny does not equate healthy, and neither does obesity. Being healthy means living a balanced lifestyle: getting the nutrients your body needs, keeping your body strong the best you can, taking care of your mind, and understanding that a slice of cake or a bag of crisps is not the end of the world because our bodies are resilient and awesome.

As the body positivity movement moves forward, activists should always be considerate of what health actually means, based on scientific research and knowledge. Financially, there is no denying that obesity is costly to our healthcare system, and that hurts us all. Medically, being obese is unhealthy most of the time. For example, how can we keep our joints strong if they are under too much strain all of the time? If our weight makes it harder to breath, that's abnormal. If we are only eating junk food, we are not fueling our positive mental health and resiliency. If were are not being physically active, we are not doing any favours to our heart and lungs. If someone's weight is negatively impacting their sleep, that is not good for the brain. Overall, it's clear that if we don't watch what we eat, get proper sleep, self-care, and try to exercise to the best of our ability in a balanced way (not disordered), then we may not be healthy. The science on obesity and health is all there.

HOWEVER, being obese does NOT indicate that someone is lazy, or a slacker or unmotivated. It often means that a person may not have the resources to live a healthy lifestyle, or may have a medical or psychological condition that impacts their weight. They may have just had a child, or be on certain medications. Someone's weight does not change or reflect personality or self-worth and I think this is what the body positivity movement is all about. The whole point for me is that YES obesity is inherently unhealthy, but NO obese people are not any less hard-working, sexy, attractive, kind, loving, strong, and wonderful as normal weight people. People with obesity should NOT be bullied, stigmatized or made to feel less than what they are worth. The same concept applies to super tall gals, or lads with high voices, or women with hairier arms. These are all things that don't fit society's "mold", but all of these people are just as worthy and valued. What matters more than our weight is that we each do our best to be the best person that we can be.

Body positivity is about our value coming from our positive actions, kindness, strength and whatever other positive qualities a person might have, rather than coming from what we look like. We should all strive to be healthy, because health and happiness go hand in hand, but we should always remember what it actually means to be healthy. Most importantly, we should always consider what is most important in the present moment for ourselves and no one else (looking at you internet trolls). Sometimes what we are eating, or being physically active just isn't a priority due to circumstances, and that's okay.

So, to answer my question from the start (can body positivity and obesity co exist), YES I think they can, as long as we are genuine and serious about what science and medicine (not society) says to us about health while remembering that what the science says does not define our worth. Obesity is inherently not normal, but there are so many perfectly normal reasons for someone to be overweight, and no one should be shamed for their own experience. I would never shame a client for having a lack of access to educational materials about health, being surrounded by fast food chains, having a medical disorder that impacts mobility and physical activity, or for being on medications that alter their body. All of that is perfectly okay. It is perfectly okay because it is human.

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