Imagine you need to see a doctor, or health provider of some description…..what are the first thoughts, or feelings that come to mind and body? Is it “ah ok, well I’ll make that appointment, hope I don’t have to wait to long….” Or is it more feelings of dread, fear and avoidance? Chances are, if you relate to the former, you’re either part of the human race who enjoys privilege (usually smaller bodied, white/anglo, able-bodied, cis-gender) or have had overall positive experiences with providers in the health system. If this is the case, consider yourself fortunate. And most definitely in the minority. The fact is, for many people, seeking medical or health care is a highly fraught and stressful experience based on real, valid, lived experiences of being treated poorly in our health system. We also need to acknowledge that there is so much weight-based stigma in our culture that when a smaller-bodied provider talks about weight to a larger-bodied person that this in and of itself can create feelings of shame, guilt and defensiveness. The very feelings that stop people from getting the care they need.

This needs to change. Urgently. It’s not good enough that people are going in for a rash, and leaving with a diet. Seeking help for a throat infection, leaving feeling coerced into being weighed. And, most importantly, without proper care. Until the time comes when health provider training includes a direct and broad examination of bias and stigma, it’s time to take this shit into our own hands and find space for advocacy and using our own voices to demand the care that we all need, and deserve. I want to be clear that

1. You shouldn’t even have to do this

2. You are under no obligation to do so

3. You may need support in doing so.

How you deal with your own experiences in our health care system is 100%, totally up to you. But it’s very important to remember that even though this may have become an issue for you, it’s not your fault. But if you do want to use your voice, we’ve got some ideas, because you are in a good position to make a difference. Often, providers are unaware of their own language, attitudes and reactions. They have grown up in this culture too where assumptions are made about certain bodies. This doesn’t make it right – it’s not – but until they are exposed to learning opportunities, they too will keep doing what they’ve been doing.

So….what can I say?

To get you started, we’ve come up with 12 things you could say if you’re finding yourself in a situation where your health provider is offering you “advice” which feels counter to your experience or what you know is most helpful for you. Or you simply want more information (which you have every right to ask for!) You don’t need to be an academic to do this – most often, weight-based advice is not evidence-based or coming from a thorough understanding of risks or you as a unique person rather than “n” in a study (no one is an “n”!!)

We don’t know exactly what will help in every situation, and we can only do as much as we have the energy for. Again, I repeat – you are under no obligation to do, or say anything – we get that these conversations can be deeply uncomfortable. But first and foremost, please keep in mind that you (and everyone!) deserves compassionate and respectful care for whatever it is you’re looking to take care of. Full stop.

I know we’ve only got a short time, so I’d really like to focus on what I came here for please.

I’d like to work in a weigh neutral way if that is possible as weight loss efforts have only resulted in weight gain for me (this is also supported by the evidence, which I am happy to provide)

What would you be recommending to me if I had a smaller body? Could we start there?

I have a history of dieting/weight cycling/disordered eating/eating disorder. I’ve tried (what you’re suggesting) before, & it made things worse for me. Do you have another suggestion for me, perhaps one you would give to someone in a smaller body?

Is there any research about health outcomes or sustained success with the amount of weight you’re suggesting that I need to lose? Do people lose that amount of weight, and keep it off long term?

(When referring for WLS) I understand that there can be significant risks with weight loss surgery, including death and severe complications. Can you tell me more about that please?

What does the research say about (X/Y/Z intervention/treatment)? Are there long term studies, 3 years or more?

I have a history of an eating disorder and I’ve been advised that weight loss dieting and/or cutting out food groups is a risk factor for relapse.

(Insert nutrition recommendation) sounds like a diet to me and I’ve done that a lot in my life. It’s not good for me, and I don’t want to diet anymore. Can you refer me to a Non-Diet or Weight Neutral Dietitian who understands my history and make recommendations?

Making me feel bad about my body is something people have been doing for years. Please don’t, it makes things worse for me and I’m less likely to come back to you, although I really need healthcare.

Rather than focussing on my weight, I’d rather focus on health behaviours. Can you refer me to a health care provider (eg Dietitian, Podiatrist, Physiotherapist, Exercise Physiologist, Occupational Therapist, Psychologist) who might be able to support me without focussing on my weight?

(In response to being asked to step on scales)
I’d rather not be weighed thankyou.
I’m OK for you to know, but I don’t want to know the numbers thankyou.

DOWNLOAD THIS HERE

12 helpful phrases

As parents, we want our kids to be healthy and happy, right? But these days you’d be forgiven for being confused beyond an inch of your life to figure out exactly what this means. Many parents are struggling with their own relationships with food and eating, or have done so in the past and do not wish that for their own child. In addition, we’re bombarded with fear-mongering messages about so-called “nasties” in foods which only serves to heighten anxieties about the impending damage we’re inflicting on our children. As a parent myself, I understand how difficult to can be to navigate the challenges of raising this new generation, where the pressures seem similar in some ways, way worse in others (you could not pay me a million bucks to be a teen these days…..). So, I want to present you with a scenario – a very common one, as it turns out – about the complexities of health, weight and bodies.
Scenario: Your child or teen says “I want to be more healthy/eat more healthy/eat less “junk” food”

Step on up folks, and choose your own adventure. You respond by:
1. Saying nothing, or not much. Surely they’re too young to be thinking about all that!
2. Saying “that’s great!” (because it’s a good thing to want to be healthy, right?) and actively helping your child make those changes.
3. Asking for more information about what they mean by “health” or “healthy” and where they got the idea from
4. Feeling alarmed, maybe because you may have had a pretty rocky relationship with “health” or your body yourself or understand that “health” is pretty complex!
5. Hitting the proverbial roof and panicking that your child is heading towards an eating disorder.

If your child or teen makes a claim to “want to be more healthy” or “eat more healthy” or similar (and I’m well aware that it’s not always terribly overt), I’m going to be straight – the most appropriate reaction in today’s culture is somewhere between response 3 and response 5. I’m not saying this to create panic where panic is not due but young people today are getting very, very confused when it comes to health, and bodies. It’s also fair to say that statistically, many parents are too. If you sit somewhere between heightened vigilance and panic, you’re roughly in the ball park.

What’s the problem with supporting a child or teen to make “healthy changes” if that’s what they want to do?**

There’s two main issues as I see it.

Because health is conflated with body shape, size and weight. And we’re all part of this very messed up culture which bombards us with messages and images about what “healthy” looks like.

When your child says “I want to be more healthy” what they’re most likely telling you is “I’m not happy (about something), and I want to change my body (because I think that’s what the issue is).”

Your childs desire to “be more healthy” most likely has something to do with wanting change their appearance, and their beliefs about doing so. They may wish to be larger, thinner, smaller, leaner – and making the (incorrect) assumption that “health” has a direct connection to body size. They may also have internalised the idea that if they’re more “healthy” (aka a different size) then that may come with other benefits such as having more friends, not being teased, feeling more comfortable in clothes. And, sadly, this may be the case. But it’s not their fault, there’s nothing wrong with their body. It’s our culture that is so very messed up and if we lead them to think that yes, if they change then that will make life better, then we are colluding with the very idea that they are grappling with. Yikes. We ourselves may have, or may still be, putting a lot of effort into “health” or our appearance and kids have ears and eyes. They notice. They hear. Again, it’s not your fault either, we have all grown up in this culture and it takes an enormous amount of courage to step away from the status quo. We all need support. But in effect, your child is offering you a red flag in telling you what they *think* is the issue, when in fact it’s something else altogether. But they’re not alone, are they – they’re just picking it up very young.

So what’s this got to do with food and eating?

Diet culture sends us strong messages that the way we can focus on “health” is to put more emphasis on food choices …when in reality, food choices are only a piece of the “health pie.” What we actually understand that is many different factors, including genetics, stress, stigma, and our emotional experiences play a very important role in our physical health outcomes…not to mention our general sense wellbeing which, in my opinion, has a lot to do with overall health.

OK, so what to do?

If your child talks about “health”, rule number one is to make it clear to your child that health is NOT just about what we eat, how we move and is DEFINITELY not about what our body looks like. It’s also about how we feel about ourselves, about how easily we can get stuff done in this world, much of which is not totally in our control. It’s important that you emphasise that there’s NOTHING WRONG with their body as it is, and it’s important we care for our body as it is by speaking kindly to it and treating it nicely.

A question you can ask yourself is “what is my child’s intention?” If the intention behind their pursuit of “healthy” is to change their body, and their dissatisfaction is coming from a place of feeling unworthy or unacceptable, they are going to get plenty of strong support from a culture which perpetuates the narrative that certain bodies and more worthy and valuable. And that this has a direct connection with what you eat. How can you tell if this is the case? A child who is expressing body dissatisfaction might speak unkindly towards their body, express a desire to want to look like someone else (perhaps a friend), compare themselves to others or start to appear uncomfortable at times eg. pulling at clothes or body, changing clothes, becoming upset or generally just “not themselves.”

DO:
– Take some time to examine how your child has got this message – from home, from school, from media, our culture? It’s probably a combination of the above.
– Take it easy on yourself – it’s not your fault so please don’t head down the blame path. But you can play an important and positive role in shifting the direction of your child’s concerns.
– Sit down and take the time to talk with your child about their concerns. Take them seriously.
– Be aware if this is hitting your own soft points – try to react calmly but clearly if you can.
– If your child has had messages from a particular source, follow up. Teachers and schools are often unaware that well-intentioned projects or assignments can trigger off these thoughts for kids.
– Get support – from a Non Diet Approach Dietitian who is specifically trained to talk through these issues with you. They can also equip you with some skills to speak with your child, or school. It will be best to make the first appointment for you, rather than your child so that your child doesn’t get the message that there’s something wrong with them, and they’re being “taken to the Dietitian” (take it from a Dietitian, we really dislike it when people set us up to be the “food police!”)

DON’T
– Dismiss your child’s concerns
– Panic. It’s a good thing that your child or teen is talking to you!
– Collude with them if they have plans to cut out foods, or engage in activity that you suspect has roots in poor body image (such as wanting all of a sudden to go running). These are early warning signs that your child is experiencing body dissatisfaction, which can have a myriad of serious physical and emotional consequences.

In summary, the most important messages you can share, in your own way, are:

1. Health is not a moral issue. You are not a “better person” if you are healthy. You are not less worthy is you do not enjoy good health. Every human being deserves respect and care regardless of their degree of health.
2. Health doesn’t “look” like anything in particular. You can’t tell how healthy, or unhealthy someone is by looking at them.
3. All bodies are valuable, and we can take good care of our bodies in our own way.
4. There is no such thing as a “good” body or a “bad” body
5. Changing your body, or not, does not say anything about you as a person.
6. Your body is your business. Other people’s bodies are their business.

*(See downloadable PDF below for all tips)

I just want to reassure you that it’s perfectly normal that “choosing your own adventure” when it comes to the body concerns of your child or teen (along with all the general challenges of parenting other humans) can feel daunting. It’s OK to reach out for support in communities like ours, or others online such as Dare To Not Diet Society or Moderation Movement group. We also offer talks to schools (parents, staff) on the topic of “Body Positive” which can support your community to send strong, consistent messages about bodies.

Deep breath. Doing the best we can can feel like a tough slog against the tide of cultural pressures, but please know there are lots of people doing hard work in the activism space. Everyone, in every body has an important role.

**If your child has had a diagnosis, like an intolerance or a disease of some description then I want to be clear – it makes sense that changing the way they eat/move/rest my assist health and wellbeing.

Download Body Positive Lessons for Kids

“Is it possible to honour your spiritual practice, and honour your body at the same time?”

This was the topic of conversation with my young adult Muslim client this week about navigating the holy month of Ramadan, part of which is the abstaining from food from sunrise to sunset each day. For the many people who struggle in their relationship with food and eating, or who are recovering from an Eating Disorder, yet wish to express their spiritual practice and participate in the social aspects of Ramadan it can be a very difficult time of year. As someone who has navigated Ramadan annually, both with and without an Eating Disorder, she had some amazing ideas which she generously agreed to share with you all.
You may feel, for a variety of reasons, that it’s nearly impossible to avoid the fasting and feasting that may actually be quite problematic for your physical or mental health. This is a special and important time for your community and you may or may not have the support that ideally you need. These suggestions are neither exhaustive nor a new set of rules to follow. Please honour your own needs and treat yourself with the compassion that your spiritual practice invites of you. If you, or someone you know, is struggling to navigate the difficult and unique combination of medical, spiritual, emotional and social factors inherent in the decisions around fasting, please make sure you make time to talk it through with a trusted health professional.
If you do decide to participate in (some or all of) the fasting aspects of Ramadan and you’re also healing your relationship with food, here are some tips from us, to you:
Honouring your spiritual practice alongside honouring your healing might mean:

Nourishing your body:
If your behaviours tend to be restrictive, please take care. Your good work towards recovery and peace can be undone quickly, and it’s OK if you need to take a break from fasting
Wake up prior to sunrise to have a meal, taking the pressure off having the “perfect” meal (don’t consult the internet too thoroughly on this one!)
Set up some structure for yourself in the day that may usually have been around mealtimes
Find ways of supporting your body in fasting rather than giving it more work to do – be mindful of how much activity you do.
Aim to still have 3 meals each day, but you might need to change the times around eg. 5:30am, 6:30pm, 9:30pm
Develop a mid-day ritual to break up your day at a time when you may usually have eaten your meal
Try not to feel under pressure to eat more than you feel comfortable
Have some easy and convenient meals ready to go at the end of the day

Getting support:
Speak to a trusted friend or health professional if you have any worries or concerns through the month
Pull in a support buddy (perhaps another Muslim friend) who can support you during the month
Stay connected with your health team and GP, make appointments in advance throughout the month
Know your red flags, and act earlier rather than later
Expressing your spirituality:
Abstaining from food during the day is only one aspect of Ramadan. Develop some personal spiritual intentions that are not around food – my lovely clients calls Ramadan “spiritual bootcamp” which I think is a wonderful way to look at it!
Develop your own Ramadan “mission” – what does your faith mean to you?
Actively look for opportunities to enact kindness towards yourself, and others.

Coping skills:
Take time before going to family celebrations to spend some time quietly contemplating any coping skills you may need to enact eg. difficult conversations, large amounts of food available.
There’s going to be days where things go better than others – be kind and compassionate towards yourself
Pace yourself – it’s a marathon, not a sprint
Have a plan for shitty days
Keep a list of coping strategies handy

There are lots of ways to express your spirituality and celebrate this important time of year. You might like to get festive! Make some decorations, put on some music, celebrate in ways that feel good to you. Surround yourself as much as possible with people who either understand what you’re going through, or respect your dilemmas around participating 100% in the fasting aspect of Ramadan.
And one last piece of wisdom from my spectacular client, from one person healing to another –

“You’re not unholy if you stuff it up!”

Don’t you just love it when someone pulls together all the BEST, most awesome bits of the internet and hands it to you in a lovely package which essentially reads “here take this – wrap it around you like a big fluffy blanket, grab yourself a cup of tea & immerse your body in some genuine kindness from some of the worlds most incredible experts in body acceptance….”

Well, I’m going to take that! Which is why I’m so thrilled when one of my colleagues, fellow Health At Every Size, Non Diet Approach Dietitian Morgan Faie from Adelaide said “here you go, spread this piece of love far and wide!” And so from Morgan, to us, to you here is your one-stop shop for finding more body positivity online. You’ll find lots of different sites, podcasts and platforms here (including us, and Sarah’s Fat Yoga!) from all over the world. . Enjoy!

Download HERE:

Body Positivity Online Resources