Wednesday, October 9, 2013

Obesity Bias, Weight Shaming, and Attitude Adjustments

As someone who has experienced obesity bias from youth until now, and having experienced the social norms of average weight, it bothers me when I see reality shows that do this:

Extreme Weight Loss

If you can't see what's wrong with this picture in terms of the obesity bias that exists in the world, or you think these shows are great, stop here.



Are you still with me?  You see, when someone with obesity is publicly put on an industrial platform scale to be weighed on national television, the problem is both cultural and personal. Our culture's obsession with intrusiveness on private matters is disturbing.  I know, she's consented to this awful public display, but it's not a far fetch to say that she's seeking attention.  As a therapist, I know certain attention-seeking behaviors are not appropriate or effective in building long-term mental health and wellness.

You see, weight bias and fat shaming are known not to encourage weight loss.  There are more and more studies out there that reinforce the idea that this type of "shame display" does not lead to strong mental health and reinforcement of positive longevity of good behavior development.

So, when I try to point out the negative aspects of a show that people think are "doing good things" it's not me trying to disregard the feelings of anyone or their people, it's me trying to tell you that this is not the most effective way to reinforce positive habits of health.  If you feel the need to put yourself on display to the world, and then you regain, there are deeper seeded issues that need to be addressed. It's not the weight, it's a lack of nurture and a sense of neglect to be a grasp on.  We need to get you to where you love yourself.

I maintain my statement on shows like The Biggest Loser and Extreme Weight Loss, neither show is a practical guide to long term health development.  In fact, both of these shows make "pseudo-celebrity" status of their contestants, and well, if some is already inflicted with a gregarious personality, it could only exacerbate histrionic personality symptoms, which would be a downward spiral once the attention is no longer on them.

More important than teaching people how to lose weight, is how to approach health in a practical manner.  It is not realistic for someone at home to watch a TV show where someone is given a home makeover, $25k on a Wal-Mart gift card, and one-on-one celebrity fitness guru instruction.  There is more power in teaching someone to self motivate, drive their own emotional being (teaching emotional control from outside influences) and guide a self directed, practical search for health.  Light the fire of desire, not the candle for limelight.
Because once the limelight is gone, the drive and desire will fade.  The cycle of negative thinking will ensue, and the person will be worse off, but with a lot of nice gym equipment in their home.  (Personally, that part makes me a little jealous, I need a home gym, damnit! Don't we all?)

Anyway, I digress.  Are you surprised?  If you know me, definitely not.  My message here is that when you work in healthcare you have to have regard for personal feelings, attitudes and bias. You have to break the bias that exist in your own mind.  I once found myself particularly caustic with two dietitians who were waxing poetic about some "skinny girl in their class" and I made the mistake of telling them I thought it was inappropriate to speak about her. #1, she's not there, and #2, what if she struggled with her weight as well. What if, "being that skinny girl" was a negative self perception she had and the result of an eating disorder? 

It's just not appropriate to talk about someone in that context.  We should not use negative adjectives to describe people. "Fat" or "Skinny" are not terms of endearment, "chunky" or "chubby," "thin" or "svelte," people are emotional beings, and weight issues are an emotional subject matter.  Putting someone on display for their struggles is not a way to help.  It's the way of shaming, public humiliation. It is neither useful or helpful, it is plain staging humiliation. 

Now for the attitude adjustment.  I've also touched on this before.  Someone else's weight is not your business unless that person chooses to make it your business.  Believe me, if someone wants your help, they will ask for it specifically and directly.  It will be clear and apparent that you have been chosen as an authority for their considerations for their health.  I am appalled when I hear about clinicians making remarks about patients' obesity.  I am even more appalled when I hear about people intrusively making someone else's health their business.  As this has recently happened to me, and my primary care physician was just as appalled by the behavior as I was.  Thankfully, my PCP understands that this was done out of concern, my doctor called to let me know this was done, and told me he was supportive of me and respects that I know what is best for me.

You know what is best for you.  Don't allow someone to come up to you and make your health their business. And while you may think publicly expressing your concern for a stranger is appropriate, remember, you are not the authority over them.  You may think you are being compassionate, but you are not their doctor, nor do you know where they are in their journey. Be mindful of the people in this community who are still struggling and have other conditions contributing to their weight retention.  Is it true?  Yes.  Is it useful? More than likely, no. Is it kind?     Meh.  Will it come across as KIND?  If no, then proceed to STOP. 

It is time for our to be confidently in charge of our health and stick up for ourselves when people rudely and intrusively make our health matters their problem.  It's not their problem, it's ours.  We own our health, we take responsibility for all matters, whether we can control them or not, we take control by educating ourselves and making good decisions. That means in our actions, words, attitudes and behaviors. 

If you are a member of this community and you are trying to capitalize on other members of this community selling some product or service, it is in my nature to analyze, criticize and be concerned for other people who are not as discerning.  Please do not exploit your own post op success as an authority, work within your education and scope.  If you have a certification from XYZ organization that holds no clout, I have the professional and educational background to back my position that you should not be doing what you're doing in the capacity in which you do it.  End of story.