Can Weight Management and Body Positivity Peacefully Coexist?

Kelly deVos is having a crisis of confidence in her beliefs about body positivity. Writing the in the New York Times, she says:

The problem with today’s version of body positivity is that it refuses to acknowledge that no one approach is right for every person. One teenager might grow up to be healthy at any weight, and another might end up in the hospital. It left my own daughter afraid to approach me about a topic on which I have both personal experience and expertise. It left me feeling that I couldn’t voice the rational concerns I have about diabetes.

I was the “wrong” kind of body positive because I’d been forced to admit that there could be serious health consequences to fatness.

I was the wrong kind of mother because I felt I should support my daughter’s weight-loss goals instead of talking her out of them.

A False Choice About “Acceptance”

On one side of this polarized subject we have a medical ethicist saying that fatness “may be common, but it shouldn’t be accepted as normal.” The underlying thought is that people who carry excess weight must do something about it. “You can’t change your eye color, but you can change what you ingest,” says one person in reply to the deVos commentary.

The problem with that line of thinking is that most people with obesity cannot reverse their condition through sheer force of will. One can lose 5-10% of body weight and maintain it with smart behavioral strategies. They will score meaningful improvements in health. But for most people living with obesity, that leaves them in the range of obesity. That leaves them open to harsh judgments from ignorant bystanders.

Normal has many meanings. Big or small, everyone has the right to feel like they’re a normal human being. This is why body positivity is so important.

False Narratives About Obesity

But over on the other side of this argument lies the thought that it’s never okay to want to manage your weight. It’s pointless and dangerous. It will wreck your metabolism and lead you to an eating disorder. True followers of the HAES® belief system are quick to say that bariatric surgery will damage your body and kill you. Obesity is an artificial construct defined solely by BMI. Thus it has no credibility.

Such distortions get in the way of more people embracing the more important concepts of body positivity. We should not have to choose between loving ourselves and caring for our own health. Obesity has real effects on a person’s health. Evidence-based weight management can be an important tool for addressing those effects. It’s not the only tool, but it’s a legitimate one.

You can indeed love your body and manage your weight for health and happiness. However, you should not presume you know what someone else should do about their weight. That is almost always a grievous mistake.

Click here to read the commentary by deVos. And check out some of the highlighted comments for an understanding of how fraught this subject is.

Shrimp Among the Coral, photograph © Christian Gloor / flickr

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May 31, 2018

10 Responses to “Can Weight Management and Body Positivity Peacefully Coexist?”

  1. May 31, 2018 at 6:56 am, Angela Meadows said:

    The true underpinning of the HAES(R) paradigm is not that “it’s never okay to want to manage your weight.” It’s that it’s perfectly reasonable to want to manage your health, and using BMI as an endpoint is not the way to do that. As you yourself point out, significant health gains can be made through behavioural changes that may have little to no impact on weight. We are all in favour of improving insulin sensitivity, blood pressure and lipids, for instance, but point out that success in achieving this should be measured with a BGT, sphygmomanometer, or lipid panel, not by the number on the scale. Making weight the end point is neither effective nor helpful. If weight loss occurs with increases in health behaviours and self-care, so be it. If it doesn’t, or weight gain occurs, likewise.

    When we say it’s not okay to want to lose weight we are not saying it’s not okay to want to improve your health. We are saying that people who feel that way are coming from a flawed paradigm and may be better served in achieving their goals (if this is improved health metrics) by changing their focus.

    If their goal is to lose weight to avoid stigma, that is another matter entirely. While this is entirely understandable within the current sociocultural setting, I think we all agree that nobody should be obliged to change themselves in order not to be exposed to prejudice and discrimination, and change here is needed at the societal level, rather than in the targets of stigma.

    • May 31, 2018 at 7:13 am, Ted said:

      Thanks, Angela. We do agree on many things. We agree that health behaviors and health outcomes are certainly more important than numbers on a scale. We certainly agree that stigma is one of the biggest and toughest problems to overcome. But weight loss can be a means for improving health for some people.

      Some people should never focus on weight as an outcome. For others, weight is well worth monitoring. One size doesn’t fit all.

      Again, thanks for sharing your perspective.

  2. May 31, 2018 at 10:43 am, Samantha said:

    I definitely agree that using weight as the only indicator of success or failure is not a good plan. I agree that aiming for health/energy and healthy behaviours is a much better approach. I think where measuring weight can be helpful is when people step on the scale, see that they’ve either gained or lost weight and immediately start thinking about what is different, what behaviours they’ve changed, how their situation has changed, and based on those things decide if they want to continue as they are or make a change. Rather than deciding to make a change (or not) based on their weight. For people who can’t do this or who have significant body image issues still to work out or people who have eating disorders/disordered eating and for whom measuring their weight would trigger unhelpful thoughts, they can skip it entirely and be able to manage their health just as well.

    This argument, this false dichotomy, brings up this idea of excellence versus perfectionism. Trying to do the best you can and being satisfied with whatever the outcome happens to be, versus trying to look perfect, act perfect, be perfect so that you have perfect outcomes.

    • May 31, 2018 at 1:27 pm, Ted said:

      Well said, Samantha. Thanks!

  3. May 31, 2018 at 1:50 pm, John DiTraglia said:

    It all starts with being honest and telling people you are not going to change your weight or shape but you can improve your health…..

  4. May 31, 2018 at 5:04 pm, Anna said:

    Hi Ted, a very thoughtful article on the current two paradigms within our industry. However I would invite you when speaking on behalf of body positivity or HAES to seek an expert in this area.
    I would like to speak about the article you mentioned. The de Vos article was most probably arranged by a book publisher and is more so about an upcoming book launch agenda. De Vos is definitely no expert in HAES but is a kind loving mother doing her best to raise her daughter and also dealing with her own diabetes diagnosis . The reason the daughter started with the dangerous eating behaviours was from being weighed at school, where it was most certainly not an appropriate environment or carried out by a health professional or the complexities of weight changes of a teenager explained . What de Vos was actually able to do because of her understanding of BP/ HAES was ensure that her daughter got appropriate help from a psychologist and stopped with the skipping of meals and put in place some habits in regards to eating for energy and school etc. What that article showed was the danger of inappropriate weighing of young people and would have been better titled “ The problem with diet culture “
    Yes the mother was exposed to weight stigma throughout her life and we can not assume everyone has the same lived experiences etc which I think she was trying to say in regards to placing these on her own daughter.

    Also in regards to Samantha’s comment to do with weighing people, I think anyone working with clients over the years knows that the number when “stepping on the scales” does not necessarily represent any good or bad behaviours by the person as weight loss and gain is extremely complex along with our definitions of health ( and weight being a poor indicator of this )

    • June 01, 2018 at 5:54 am, Ted said:

      Thanks for sharing your views, Anna.

  5. May 31, 2018 at 7:06 pm, Michael said:

    I agree that health and happiness should be the objective rather than BMI. Unfortunately our joints are healthier and happier when the load on them is reduced.

  6. June 01, 2018 at 9:04 am, Vincci Tsui said:

    I find that both DeVos’s article and this blog post seem to lack understanding of what body positivity and HAES® are. The promotional motivation behind DeVos’s op-ed aside, I disagree with the notion that “body positivity” is to blame for “[her] own daughter afraid to approach [her] about a topic on which I have both personal experience and expertise.” In my experience, while people who are newer to the movement might find talk of weight loss triggering, those who are deeper in the movement understand the societal pressures to lose weight and are often able to hold space, explore a person’s motivation to lose weight and whether weight loss is necessary or helpful to achieve their underlying goals.

    This article implies that “the more important concepts of body positivity” revolve around “loving your body”. This is a common misconception of body positivity. Body positivity is not body love. It is a socio-political movement with roots in the fat acceptance movement that seeks to fight for equal rights for *all bodies*. Thus, weight management and body positivity cannot co-exist, as managing one’s own weight upholds the system that devalues bodies that don’t meet societal ideals.

    • June 01, 2018 at 11:28 am, Ted said:

      Vincci, it seems that you agree with DeVos. In your view, she’s the wrong kind of body positive. Thanks for sharing your feelings about this.