The Case for Weight-Neutral Self-Care

Heidi Andersen, MS, LCMHC-S, CBTS, RYT on Apr 16, 2022 in Treatment Orientation

Are you thinking of making some shifts in your self-care and health promoting behaviors? Here’s a word of caution: Focusing on weight is harmful to you and those around you. Here are the top four reasons to shift from a weight loss to weight neutral mindset with your self-care practices:

1. Sizeism and weightism are oppressive systems that cause harm

When we focus on weight loss, we are buying into a system of oppression called sizeism and weightism. These systems of oppression demonstrate bias and stigma towards people in larger bodies rather than understanding that size diversity is natural in the human population. This weight stigma and bias is reflected in the science that demonizes fat and people in larger bodies.

Many factors influence a person’s shape and size, including genetics (70% of our weight set range is related to genes), the stress physiology of trauma and oppression, some medications, gut bacteria, disease processes that lead the body to store more fat and burn less sugar, and environmental toxins that may build up in your blood and disrupt your endocrine system in a way that increases fat storage. Weight regulation is NOT a simple energy in/energy out equation.

Like all systems of violence and oppression, people who are in minority groups like those inhabiting larger bodies are at risk for increased health challenges due to the trauma and stress physiology that runs in their nervous system. It is important to acknowledge size diversity and treat people of different shapes and sizes with respect. This understanding supports all people in accepting their body's natural shifts in weight and size over a lifetime.

The pursuit of thinness is also inextricably linked to racism and anti-blackness. Learn the history of the thin ideal, and you will see its racist roots. Fatphobia is racist.

Antidote: Do not call yourself or people "overweight" or "obese." These words carry a lot of stigma. Instead, use language like “people living in a larger body.” Challenge "fat" as a negative word and rather see it as a neutral descriptor like short, tall, thin. Challenge your internalized fat phobia. Develop compassion and respect for people of all shapes and sizes.

2. Focusing on weight loss promotes a diet mentality which is harmful

According to Becca Clegg, author of the book Ending the Diet Mindset, the diet mindset is defined as a way of thinking about your relationship with food through the lens of weight management/loss as the primary motivator behind food choices. Research shows that dieting does not work long-term, and focusing on weight loss can lead to feelings of shame and failure. 99% of diets fail and lead to weight regain for 2/3 of dieters within five years. The majority of dieters will return to their original weight plus about 20% within this five-year period.

People who are able to maintain weight loss often do so with disordered eating and imbalanced exercise habits. Weight cycling, which occurs when someone goes on and off diets, leads to increased health risks, even more than maintaining a larger body weight. Approaching your self-care with the dieting mindset sets you up for failure and shame.

Antidote: Focus on health and wellness goals rather than focusing on weight loss. If you are living in a large body, find safe spaces to grieve the thin ideal.

3. Restrictive thoughts and behaviors can backfire into binging and get in the way of your body being able to trust its hunger and fullness cues

When you have a restrictive and deprivation-based mindset, it is typical to swing into binging behaviors for two reasons. First, if your body is not getting enough nourishment, your biology will cue you to eat. When you are in a dieting mindset, you are more likely to put your body into starvation mode from restriction.

Our bodies have a weight set point range, and our genes and brain work hard to maintain this homeostasis. When our bodies drop below this set point range, our brain senses danger and creates changes in our physiology to regain weight and prevent this weight loss from happening again. These changes include reduction in the fullness hormone leptin, increase in the hunger hormone ghrelin, lower overall energy output, and reduced activity in the thyroid and sympathetic nervous system. These actions are a strong protective force embedded in our bodies to ensure our survival in times of famine. (Thank you, body!)

Secondly, that which we restrict has more value for us psychologically. If things are forbidden, we will seek them out. Moving back and forth between restriction and binging patterns create a dysregulated and chaotic eating pattern that negatively impacts hormone balance, immunity, digestion, and sleep patterns.

Antidote: Focus on nourishing yourself consistently throughout the day to increase trust with your body. Foster a permission mindset and challenge the morality of food choices (seeing foods as good or bad).

4. Internalized fat phobia leads to a violent inner critic that shifts your system into fight/flight/freeze states

When you experience a loud inner critic about your body shape and size, this voice creates an internal state of threat, putting your nervous system into fight/flight/freeze states. According to Kristen Neff and Christopher Germer, the creators of Mindful Self-Compassion, when the threat is internal, the fight response looks like self-criticism and blame in your thoughts, the flight response looks like isolation and avoiding, and the freeze response looks like rumination, over-identification, and fusion with your thoughts. The threat physiology in your nervous system increases the stress hormone cortisol, which leads to increased fat storage.

Antidote: Develop more self-compassionate ways of talking with yourself. Challenge internalized fat phobia, and move towards weight neutrality. Find ways to somatically resource yourself into the ventral vagal nervous system which is where safety, connection, rest, and digestion are available to us.

After all that we went through collectively in 2020, I am even more committed to showing up in the world with compassion, kindness, and respect for diversity. The way we relate to ourselves has a powerful impact on this process. My hope is that this information will support you in moving towards a more compassionate relationship with your shape and size, as well as moving towards motivating change through your health behaviors rather than the number on the scale.

Reference resources and places for further exploration:

Anti-Diet: Reclaim Your Time, Money and Happiness Through Intuitive Eating by Christy Harrison

The Body is Not an Apology: The Power of Radical Self-Love by Sonya Renee Taylor

Body Respect: What Conventional Health Books Get Wrong, Leave Out, and Just Plain Fail to Understand About Weight by Lindo Bacon and Lucy Aphramor

Ending the Diet Mindset: Reclaim a Healthy and Balanced Relationship with Food and Body Image by Becca Clegg

Fearing the Black Body: The Racial Origins of Fatphobia by Sabrina Strings

Nourish: How to Heal Your Relationship with Food, Body and Yourself by Heidi Schauster

Radical Belonging: How to Survive and Thrive in an Unjust World (While Transforming it for the Better) by Lindo Bacon

Related articles:

https://www.scientificamerican...

https://acestoohigh.com/2012/0...

https://elemental.medium.com/i...

https://www.goinvo.com/vision/...

https://elemental.medium.com/t...

https://www.generousplan.com/b...

The problem with our current science on weight:

Selected online communities:

Health At Every Size community: https://haescommunity.com/

Association for Size Diversity and Health: https://asdah.org/

Be Nourished community: https://benourished.org/

Heidi Andersen is a Licensed Clinical Mental Health Counselor Supervisor in Asheville, NC.
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