Rank #1: The Effect of Weight Stigma on Health
Weight Stigma, and stigma in general, is a intricate and complicated subject that permeates the society we live in. We are all affected in some way by stigma, whether we are the subject of stigma, perpetrators of stigma, or both. Stigma also has a significant effect on long term health, making it an important subject for medical professionals to address personally and systemically.
Linda Bacon and Lucy Aphramor described 7 myths about weight stigma in Body Respect. We will be using the myths as an outline and expanding on them with our own ideas and examples.
Rank #2: The Effect of Weight Bias on Care
Because weight stigma is expressed through weight bias, it is necessary to discuss and examine our own weight bias as medical professionals and medical professionals in training. There is a growing body of research showing that weight stigma has a *significant* effect on long term health, making it an important subject for medical professionals to address personally and collectively. So we will spend today’s episode diving into weight bias and what we can do about it.
Rank #3: Patient Empowerment through Fat Acceptance
This will be the last episode for the season and the year! I wanted to spend it talking about the importance of Fat Acceptance and Body Acceptance when it comes to individual health, and also to community health. The Fat Acceptance movement itself focuses on reducing and eliminating fat bias and fat stigma, thus improving overall health. I was joined by Shilo George who really added so much to this episode.
Shilo George is Southern Cheyenne-Arapaho and Scottish international speaker, trainer, and owner of Łush Kumtux Tumtum Consulting, which means “a great awakening of the heart and spirit” in the Chinuk Wawa trade language. She has lived her life in a body that transgresses and violates Western standards of beauty, size, sexuality, and health. Shilo interweaves cultural traditions and spirituality with an anti-oppressive and decolonizing lenses to promote healing and empowerment in herself and others in the communities she is a part of. Her workshops and presentations explore the intersections of race, sexuality, body size, and trauma (both individual and inter-generational). Shilo trains others on systems of oppression, trauma informed care, and proactive ways that businesses and organizations can create policies and environments that that promote diversity, equity, and healing.
Shilo received her Bachelor of Science in Art Practices in 2012 and a Masters of Science in Educational Leadership and Policy with a specialization in Postsecondary Adult and Continuing Education in 2017, both from Portland State University. She was named Higher Education Student of the Year by the Oregon Indian Education Association in 2013 and in 2015 was honored with the Queer Indigenous Scholar Activist & Alumni Award by the Indigenous Nations Studies Department at Portland State University. In addition to her consulting business, Shilo works as a Parent Advocate at the Native American Youth and Family Center and is an Affiliated Adjunct Instructor of the Indigenous Nations Studies at Portland State University.
Rank #4: The Ineffectiveness of Diets
This episode covers the topic of intentional weight loss through restrictive eating or lifestyle changes. We discuss why intentional weight change does not work long term and why it can cause more harm than good for people’s health. I am joined by a guest co-host, Sumner Brooks, RD of Eating Disorder Registered Dietitians & Professionals. Her insight and knowledge were invaluable.
Rank #5: Healthism
Healthism is prioritizing individual health above other things. It is also the idea that individuals have significant control over their health. It does not acknowledge that a great many things outside of an individual’s affect their health, such as oppression, war, hatred, environmental factors, and access to medical care. Ultimately, it is important to address societal inequities that affect individual health. The expectation of maintaining a certain level of health can lead to stress and unhealthy coping mechanisms. It is important to look beyond looks and support individual health as much as possible as we dismantle oppression.
Rank #6: Promoting Health Without the Scale
The seventh episode of the podcast will dive into options for treating patients that do not center on weight change. Significant and permanent weight change is nearly impossible for the majority of the population, so we need to use weight independent, evidence based treatment for people of all sizes.
In this episode:
- Defining weight neutral/weight independent and weight inclusive
- Health at Every Size ®
- Intuitive Eating vs Restrictive Eating
- Well Now
- How to move away from using weight as a determinant of health
- Thinking beyond the individual - how society can change to support health
I would like to thank Julie Duffy Dillon for helping me come up with the title for this episode.
Music by Galynne Davis
Cover Art by Stacy Bias
“Part of our job should not be just doing no harm, but also trying to remove the harm that’s being done outside of our offices.”
-DeAun Nelson, ND
1. Bacon, L. and Aphramor, L.Weight Science: Evaluating the Evidence for a Paradigm Shift. Nutrition Journal201110:9
4. Aphramor, L. Validity of claims made in weight management research: a narrative review of dietetic articles. Nutr J. 2010; 9: 30.
6. Aamodt, S. (2016) Why Diets Make Us Fat: The Unintended Consequences of Our Obsession with Weight Loss. New York, NY: Penguin.
7. Bacon L, Aphramor L. Body respect: what conventional health books get wrong, leave out, and just plain fail to understand about weight. Dallas, TX: BenBella Books; 2014.
8. Bacon, L. Health At Every Size: The Surprising Truth About Your Weight. Dallas, TX: BenBella Books; 2008.
Rank #7: S2E4 Food Addiction with Marci Evans, RD
Season 2 Episode 4: Food Addiction with Marci Evans, RD
Food Addiction, specifically sugar addiction, has become a hot button topic in recent years. People feel out of control around highly palatable foods and struggle to avoid over eating them. Sugar also lights up the pleasure centers of our brains, similar to drugs like cocaine and heroin. Does that mean that it, and other highly palatable foods are actually addicting? Listen to this great discussion I share with Marci Evans, RD to find out.
In this episode:
- The research around food addiction and pleasure
- Feeling out of control with food is definitely an issue
- The Restrict/Binge Cycle
- How HAES and Intuitive Eating can help reduce feelings of addiction around food
- Yale Food Addiction Scale – is it harmful?
- Cocaine vs Sugar and the Pleasure Centers
Marci is a Food and Body Imager Healer®. She has dedicated her career to counseling, supervising, and teaching in the field of eating disorders. She is a Certified Eating Disorder Registered Dietitian and Supervisor, certified Intuitive Eating Counselor and Certified ACSM personal trainer. In addition to her group private practice and three adjunct teaching positions, Marci launched an online eating disorders training for dietitians in 2015 and co-directs a specialized eating disorder internship at Simmons College. She volunteers for a number of national eating disorder organizations including the iaedp certification committee and is serving as an eating disorder resource professional for The Academy of Nutrition and Dietetics. She has spoken locally and nationally at numerous conferences and media outlets. She loves social media so tweet her @marciRD, follow her on Facebook and Instagram, and check out her blog at www.marciRD.com/blog.
“If we are promoting a paradigm of abstinence or restraint or restriction, we are neurobiologically setting ourselves up, potentially, to act in a way that feels compulsive and out of control.” Marci Evans, RD
Rank #8: S2E3 Weight Independent Diabetes Care with Megrette Fletcher M.Ed., RD, CDE
Is it possible to treat type 2 diabetes without weight loss? It absolutely is. Join Megrette Fletcher M.Ed., RD, CDE and I as we explore treating type 2 diabetes in a weight independent way. Megrette has been been working in diabetes care since 1995 and has a great deal of information to share about caring for diabetic patients using effective tools that shift focus away from weight loss. She is also the co-author of Eat What You Love, Love What You Eat with Diabetes and has authored five books for professionals. This is an interview no one will want to miss!
In this episode:
- 8 Core Defects
- Why weight loss (including bariatric surgery) is not a long term solution
- Behaviors are key to managing diabetes
- Self care instead of weight loss
- Energy Balance, not Energy Deficit
- How to encourage people to access diabetes educators
- How weight independent treatment helps patients cope with diabetes
- Self Compassion
- How having a HAES trained diabetes educator can help providers better manage patients' over all health
Megrette is a registered dietitian and certified diabetes educator who has worked in diabetes care since 1995. Her interest in mindful eating started in 1999 when she began meditating on a consistent basis. In 2005, she co-founded The Center for Mindful Eating, an international non-profit organization that explores the benefits of mindfulness and health. In addition to offering webinar trainings about the scientific benefits of mindfulness and health, Megrette has written five books for professionals including Diabetes Counseling and Educational Activities: Helping Clients without Harping on Weight, The Core Concepts of Mindful Eating, Discover Mindful Eating, Discover Mindful Eating for Kids and co-authored Eat What You Love, Love What You Eat with Diabetes, Michelle May MD. Megrette has recently created a Facebook group for HAES professionals, interested in diabetes care, called Weight Neutral for Diabetes Care. The group can be found by searching for WN4DC.
She is very active in the cycling community, and in 2011, her passion for biking prompted her to form the largest and top-grossing cycling team in the Tour de Cure (for diabetes) Kennebunk fundraising event. Megrette, a dog lover, passable cook, and terrible bowler, is blessed to live and laugh with her family in beautiful in New Hampshire, outside of Boston. To learn more about Megrette, please visit her website at Megrette.com or follow her on Facebook or Twitter.
Rank #9: Eating Disorders with Jennifer Gaudiani, MD, CEDS, FAED
During this episode, Dr. Jennifer Gaudiani joined me to talk about eating disorders and her experiences with them. She recently wrote a book: Sick Enough: A Guide to the Medical Complications of Eating Disorders. She has been working with patients with eating disorders for 11 years and has also incorporated Health at Every Size and weight inclusive principles into her practice over the last few years. She has found that it has made a great deal of difference, not only in recovery, but also in identifying patients who might have otherwise had a delay in diagnosis, or not been diagnosed at all.
In this episode:
How Dr. G got involved with eating disorder patients and HAES,
How starvation affects patients’ bodies.
Things to be aware of as a physician who might be encountering patients with eating disorders and “atypical” eating disorders.
Metabolism and fertility.
Rank #10: S2E1 Interview with Dr. Jon Robison
Welcome to Season 2 of the Do No Harm Podcast! The first episode of the season is an interview with Dr. Jon Robison, a national leader in the Health At Every Size Movement for more than 2 decades.
Jon Robison holds a doctorate in health education/exercise physiology and a master of science in human nutrition from Michigan State University where he is Adjunct Assistant Professor. Dr. Robison is also Adjunct Associate Professor in The Holistic Health Care program at Western Michigan University. He has spent his career working to shift health promotion away from its traditional, biomedical, control-oriented focus, with a particular interest in why people do what they do and don’t do what they don’t do.
Jon has authored numerous articles and book chapters on a variety of health-related topics and is a frequent presenter at conferences throughout North America. He is co-author of the book, “The Spirit & Science of Holistic Health - More than Broccoli, Jogging and Bottled Water, More than Yoga, Herbs and Meditation,” a college textbook and a guidebook for practitioners who wish to incorporate holistic principles and practices into their work. This book provided the foundation for Kailo, one of the first truly holistic employee wellness programs. Kailo won prestigious awards in both Canada and The United States, and the creators lovingly claim Jon as its father.
Jon has implemented Health for Every Body® — a unique alternative to weight loss programs at the worksite in over 20 cities across the United States in the past 3 years. He is also one of the featured health professionals in the powerful documentary America The Beautiful II: The Thin Commandments and has been helping people struggling with weight- and eating-related concerns for 25 years.
His new-released book: How to Build a Thriving Culture at Work: Featuring The 7 Points of Transformation, written with co-conspirator Dr. Rosie Ward gives organizations a realistic, step-by-step blueprint to accomplish the difficult task of transforming their cultures to be healthier and more productive — “from the inside out.” The book was selected by Employee Benefit News as one of the top must reads for 2016.
As a Certified Intrinsic Coach, Jon understands that behavior is the outward manifestation of thinking and feeling – and that behavior modification approaches that focus on extrinsic motivation rarely result in sustained change and, in fact, often inhibit intrinsic motivation.
Aside from his work Jon’s passions include his wife Jerilyn, music, humor, an 11-lb living Teddy Bear named Ginger and watching his gifted son Joshua play soccer.
In this episode:
- How Dr. Robison found HAES®
- The research that shows that significant and sustained weight loss is not possible
- The CDC article about Physical Activity at Every Size
- His program Health for Every Body
- And so much more...
“Do we really need more research that prejudice and stigma are health minimizing?”
Resources mentioned in the podcast: