The Silent Tragedy: a brief overview of the non-diet paradigm to promote health for people of all sizes (2000)

Title (as given to the record by the creator): The Silent Tragedy: a brief overview of the non-diet paradigm to promote health for people of all sizes
Date(s) of creation: March 4, 2000
Creator / author / publisher: Greg Kline
Location: Northampton, MA, US
Physical description: PDF of archived website page
Reference#: RFH-Speech-Kline
Links: [ PDF ] [ Other items from this event ]

The Silent Tragedy: a brief overview of the non-diet paradigm to promote health for people of all sizes

A speech delivered at the speak-out Resisting Fat Hatred
March 4, 2000, Northampton, MA
by Greg Kline

All across America, millions of women and girls (I will use the word women but include girls as this issue is affecting more and more girls at younger ages) are deciding not to go to the beach, pool, tennis courts or local exercise facility because their bodies don’t meet the current beauty standards. Poor body image and shame keep them clothed, hot, and at home instead of out experiencing the joys of life. These women have been urged to forget that people (men and women) come in a multitude of body sizes and shapes and that one size (thin) does not fit all. We see “beautifully thin” (very often anorexic) celebrities march across the TV and movie screens, magazine pages, and any other medium the image makers can use. Their seemingly glamorous lives suggest that we too must look like them to be noticed, successful, happy, loved and fulfilled. Women have come to understand that unless they look like these thinly sculpted ‘models’, many men won’t look at them, many companies won’t hire them, many bosses won’t promote them, and society will often avoid and discriminate against them. “If shame and humiliation were an effective intervention, there would not be a fat woman in the US.” 

The lives of many women are tyrannized by this cultural madness and the subsequent obsession with manipulating their bodies to be something they are often not meant to be (thin). This obsession with the body often results in an endless preoccupation with food and/or exercise. For many, their creativity, hopes, dreams and abilities are subjugated to this tyranny of thinness. On any given day, over 50% of the women in our country are dieting. Those who have lost weight are putting it back on, often with a few additional pounds. Some women are purging; others are filling up on chemicals and drugs regardless of any known (or unknown) side effects in hopes of change. Some starve to shed a few more pounds, while more and more turn to stomach surgery, wired jaws or lipo-suction seeking more permanent body alteration. In addition to the potential physical harm resulting from these desperate measures, these women become disconnected from their natural, intuitive physical and psychological needs that are so important for promoting and sustaining true wellness.

Something is very wrong with this picture. We have been bombarded with a cultural ideal that does not fit with the reality of female biology and is impossible to attain for the majority of women. Women ignore their natural hunger/satiety, are filled with self-loathing, and spend countless hours and dollars at war with their bodies. The result cannot be conducive to mental and physical well being. Neither are men immune to our cultural fixation with appearance as more and more men suffer from similar cultural discrimination and concerns about how they look; however, currently the pressures on men pale in comparison to those for women (but are increasing). Additionally, men suffer by participating in and often condoning the culture that defines the worth of more than half the population in terms of physical appearance, rather than by the recognition of truly meaningful qualities such as honesty, love, compassion and creativity.

For many women in our culture today, acceptance and love (of self and from others) is grounded in the illusion of thinness. Even women whose weight is considered ‘normal’ or ‘healthy’ are caught in this beauty trap often trying to lose 5, 10, 20 or more pounds. For these women, their human potential and promise has been compromised. The creative gifts of each have been left unexplored and unexpressed. While the world so desperately needs the talent, creativity and nurturing of women, many spend their days bemoaning their fate in front of the mirror, on the scale, and counting calories feeling trapped in bodies they wish to escape. These lives are often bereft of hope and joy.

The “War on Obesity” rages on unabated despite overwhelming agreement on the failure of diets to promote lasting change and the growing evidence of potentially dangerous physical and psychological consequences. Weight-related research and intervention continues to focus on the promotion of weight loss through dietary restriction, and despite almost universal recidivism following weight loss programs and an epidemic of dangerous eating disorders, people continue to spend billions of dollars yearly on weight loss products and services. Furthermore, our culture’s relentless obsession with thinness has spawned a pervasive prejudice that causes considerable suffering and social isolation for individuals of size. Indeed, studies indicate that health & fitness professionals are often extremely prejudicial in their treatment of larger individuals, possibly contributing to the reluctance of fat people to seek health care or engage in the healthy exercise activity so often recommended. The etiology of this obsession with body weight/fat is very complex, but the diet, fitness, fashion, medical and pharmaceutical industries reap enormous financial rewards from the promotion of these unattainable ideals and expectations. The diet and pharmaceutical industries have created an annual 50 billion-dollar ‘gold mine’. Moreover, many obesity “experts” and researchers have economic interests and links to this influential ‘diet/fitness, pharmaceutical, industrial complex,’ creating powerful incentives to maintain the status quo.

Regarding the alleged association between weight and health, a closer scrutiny of obesity research suggests that the health community has overstated the case, by a selective reading & interpretation of the research literature. For example, in the recent (and by now infamous) Nurses health study, though the data showed no meaningful increase in health risk for women with BMI’s between 21 and 27 compared with the lowest BMI of 19, the message emerged that a BMI of 19 or below was the ideal for which women should strive. A BMI below 19 often translates to a body weight which is sufficiently low to meet the criteria used by eating disorder experts as an indicator of anorexia nervosa. These researchers seem to ignore the fact that BMI is distributed normally in the population of men and women and that BMI for only a very small proportion of people naturally falls at or below 19. Unknowingly these health researchers are contributing to the pressure to be (too) thin. Dr.s Jerome Kassierer and Marcia Angell, NEJM, had this to say in an editorial dated Jan 1, 1998: “The data linking overweight and death, as well as the data showing the beneficial effects of weight loss, are limited, fragmentary, and often ambiguous.” “Until we have better data about the risks of being overweight and the benefits and risks of trying to lose weight, we should remember that the cure for obesity may be worse than the condition.” After a thorough review of the research literature, Glenn Gaesser, author of Big Fat Lies concluded that “The majority of body weight mortality studies published since the 1950’s find weight to be irrelevant to health and mortality issues (except perhaps at the extremes of the Body Mass Index).” 

An additional question that is hotly debated is: can fat people be both healthy and fit? I believe the evidence suggests that the answer is clearly yes (Dave Alexander). ” If you’re fit…overweight is perfectly healthy, and if you aren’t fit, being slim gives you no protection whatsoever. I am convinced that you can be fat and fit.” Steve Blair, Director Aerobics Institute Lead Scientist & author of Surgeon General’s report on physical activity and health.

Fortunately, a new vision is emerging which questions this thinness trap, rejects dieting, and promotes acceptance of beauty and health regardless of size and shape. More and more women are rejecting the shallow promise of glamour, success and happiness; instead seeking wholeness and expression of their ideas, talents, dreams and beliefs on their own terms. This health-at-any-weight, non-diet approach offers health care providers and the people of size whom they serve an alternative for compassionate, health-enhancing care. This approach: 1) encourages self-acceptance and feeling good about yourself by honoring the natural diversity in body shape and size, and exposing societal prejudice and discrimination against larger individuals; 2) promotes the benefits of physical activity by encouraging social, pleasure-based movement for enjoyment and enhanced quality of life in place of externally driven incentives such as calories burned and weight lost; and 3) helps to normalize eating by discarding externally imposed regimes and reconnecting eating to more intuitive internal hunger, appetite and satiety cues, leading to a more harmonious, peaceful relationship with food. 

These principles can be succinctly summarized by advice given to many of us by our mothers when we were children: 1) eat your grains, fruits and vegetables; 2) go out and play with your friends; 3) learn to accept and feel good about yourself; and I have added a 4th) contribute usefully and compassionately to making a better world. Although simplistic, I believe these three principles summarize about 30 years of research in nutrition, exercise science and mental health disciplines. Fat prejudice, as almost every fat person will tell you, is not new. I would like to end with a quote from The Dieter’s Dilemma, written nearly 20 years ago by Dr. William Bennett (at the time he was editor of the Harvard Health Newsletter) & Joel Gurin: 

“Even if every American followed the admonitions of the government and health communities to eat well and get more physical activity (an unlikely event), many people will still remain fatter than others (due to the obvious and natural variability/diversity of body sizes and shapes). If attitudes do not change, no matter what these individuals do they will be regarded as too fat and will be discriminated against. What may be needed more urgently than changes in diet and exercise patterns (important as they are), is the realization that size is not a reflection of health, fitness, character or worth; there is nothing shameful about fatness; that compassion and acceptance (towards self and others) will help far more than contempt and discrimination.”

copyright Greg Kline, March 4, 2000 (used with permission)

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