Drs. Angela Alberga and Sara Kirk answer viewers' questions following their webinar 'EveryBODY Matters: Challenging Weight Bias & Discrimination in Our Everyday Lives' (May 24, 2016).
Is there a chance to access the "Potential Contributor's to Obesity" diagram. It was fuzzy and not easy to see or read. It would be an excellent resource.
You can find the Obesity Society’s diagram here: http://www.obesity.org/obesity/resources/facts-about-obesity/infographics/potential-contributors-to-obesity
Another great resource is the UK Foresight obesity system map - https://www.gov.uk/government/publications/reducing-obesity-obesity-system-map. It highlights the complexity of obesity and illustrates the need for multi-level, multi-component approaches to prevention and management.
Are there plans to advertise and thus reduce weight biases on TV etc.
Not at this stage. We would need to secure additional funding for this type of activity which is out of the scope of our current research. However, it may be an area that CON can take a lead in.
Have there been any recent studies that look specifically at weight bias in youth in the Canadian context? All the research I've seen is specific to the U.S.
Thanks! Great question! Most recently, one of the EveryBODY Matters collaborative members, Mary Forhan, has been involved in a cross-national study that included Canadian youth - https://www.researchgate.net/publication/279863303_Cross-national_perspectives_about_weight-based_bullying_in_youth_Nature_extent_and_remedies
Dr. Kirk - I would like to have more information about an upstream discussion about obesity. What do you mean by this?
In the context of our research study, the concept of an upstream approach to obesity refers to the need for society to consider the broader influences on individual behavior. In other words, when we only focus on individual behavior change or view obesity as a personal problem (lack of willpower, etc), and if social, environmental and psychological aspects are disregarded, those seeking help may not be given the comprehensive and ongoing support they are looking for. So taking an upstream approach means challenging the prevailing societal narratives that blame people for having excess weight, and shifting a focus to health, rather than weight, as an outcome. This means asking the question how do we support everyone to achieve optimal health, regardless of body size?
Dr. Alberga - I would like to learn more about how to talk with people who say things that are weight focused like "I need to lose 5 pounds" or "I was good today, I had a salad for lunch" or "you lost a lot of weight."
Great question. I still find it difficult myself to approach this in conversation and I don’t think there is one way to do this. I find myself adapting what I say depending on who I am speaking to (i.e. it will be slightly different if I am speaking with a colleague vs. a friend and/or family member) and in what context. I think the first step is being empathic. Because these types of conversations are so common, it is important to understand where the person is coming from and that it must be quite difficult to feel this way. I think it’s important to keep open lines of communication so that the person doesn’t feel judged when these topics are brought up but also bringing about awareness that this type of ‘fat talk’ might be negatively affecting their body image and mental health. Promoting self-love and body acceptance and complimenting each other on other aspects than appearance are some other things we can do to avoid negative talk about our bodies.
What is the content of the book and what is the definition of a "fit and healthy dude"?
My apologies but I’m not quite sure what this is comment is referring to. Perhaps you are looking for the children’s books I mentioned in my presentation? I discussed ‘Maggie goes on a diet’ (a book fraught with weight bias that I would NOT recommend) and ‘My body is awesome’ (a book by S. Danielsdottir that I know can be purchased online). The other teacher’s resource that was changed from ‘Bob the Blob’ (weight-biased) to ‘Skitter the Alien’ is not a book, it is an activity lesson plan that was created by the online resource‘Teacher’s Pet’.
There is a lot of talk about "fat acceptance" and "HAES"? How you you define these? Can you please provide further reliable resources for both?
This is a great question, and not easily answered in a short comment. The fat acceptance movement has been around for quite some time, and seeks to change the conversation around anti-fat bias. It therefore does have some similarities to the work we are doing in the EveryBODY Matters Collaborative, which seeks to raise awareness of the negative impact that weight bias has on physical and mental health and wellbeing. The Health at Every Size or HAES approach can be viewed as a way to organize the principles of the fat acceptance movement. Both are focused on reducing weight-based discrimination. One of the challenges with both fat acceptance and HAES is that they seek to remove weight from the conversation and in doing so, there is a danger that people with weight challenges that are impacting their health may not be able to access the support that they need for fear of being seen to “betray the movement”. From an equity perspective, it is important that we reduce weight bias and stigma, but also respect that there are people with obesity who wish to receive support in managing their weight and therefore deserve to have access to appropriate support.
There are various sources of information on both approaches. I have also published a commentary on the topic – see the following link http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2015.302552
In my profession, there seems to be a movement towards HAES but then with that influence many (people) then refuse to talk about weight at all. Can you suggest some respectful ways to talk about weight with patients? Do you think there is a balance?
Yes, this is something that I have noticed as well, and I absolutely think there is a balance to be struck. This is one of the criticisms of the HAES approach, which seeks to take weight out of the equation which is not always helpful or possible. Otherwise, all that we do is further perpetuate weight bias and stigma across the spectrum. The Canadian Obesity Network (CON) has the 5As of obesity management and the first A is ‘ask’. In agreement with this, I think the first step in respecting the patient is asking if they would like to discuss their weight (without judgement).
How do we get the government to fund/recognize there is a need to provide access to health care for people living in bigger bodies? It's a issue that seems to be lost.
It is a challenge, and the prevailing weight bias that exists is a key factor. If we can reduce weight bias in society, we may also be able to advocate more effectively for support for people living in bigger bodies. This is a goal of the EveryBODY Matters collaborative.
Are there any plans for EveryBODY Matters or CON to organize a campaign to reduce weight stigma? It would be great to have a unified message that we can all use.
CON hosted the third Weight Bias Summit a few weeks ago and this focused on developing those unified messages. Keep an eye out for this – there is more to come.
We all have weight bias, some of us are more conscious of this then others, can you suggest methods for the more enlighten to help educate our peers?
The first step to addressing weight bias is to recognise that it exists, and as you note, that we all hold weight biased attitudes. This recognition makes the bias explicit, rather than implicit. Implicit bias is harder to address as we are not even aware of it – this is one of the problems that exists with the prevailing societal discourse around weight. Once we have an awareness of these biased attitudes, we can start to change them, by calling them out, by challenging our own assumptions and by (gently) challenging them when they are expressed by others. I find it really helpful to frame the conversation around equity – it is not fair that people living in bigger bodies face discrimination, it is not fair that external forces (back to those messy obesity systems diagrams) are undermining healthy behaviours and then we blame individuals for this. It is also really important to listen to the voices of those that this affects and that is why it is great that CON is doing so much outreach and engagement so that we are able to hear the voices of everyone, because EveryBODY Matters in this conversation. The research I shared in the webinar was designed to give voice to people living with obesity as they sought support. You can view the paper here - http://qhr.sagepub.com/content/24/6/790.full.pdf+html