Tuesday, October 28, 2014

Fat Girl Costumes

Walmart's Website Features a Section of 'Fat Girl Costumes'

(photo via Jezebel)

This week, Walmart landed itself in the latest controversy involving bodies and advertising. As Jezebel fist reported, the megastore's online catalog featured a section of Halloween apparel called, "Fat Girl Costumes." Jezebel speculated the heading may have been a web developer joke that eluded final editing.

As a joke, this heading is offensive. But, let's look at the larger picture. To start, I commend Walmart for featuring plus-size costumes. Not every retailer offers size-inclusive styles. And the offensive nature of the language itself is only a product of the relative value of fat versus thin in our current cultural climate. The fat acceptance movement, as evidenced by its name, has worked long and hard to reclaim the word "fat," from something offensive to a simple description of body size. If fat weren't such a bad thing, this section of Halloween costumes wouldn't have created such a stir - like clothing for tall women or petite women, we'd just file it away under offerings that cater to the natural diversity of body sizes. But because fat is such a dagger, this title becomes offensive.

So, rather than focusing on some retailer's joke or error, let's celebrate companies that offer plus-size fashions and let's continue to evolve our dialogue so that the use of the word "fat" doesn't fall prey to jokes or mistakes and, when used in earnest, is just a descriptor, not a headline.


You can find Does Every Woman Have an Eating Disorder? Challenging Our Nation's Fixation with Food and Weight on Amazon (as a paperback and Kindle) and at BarnesandNoble.com

Wednesday, October 22, 2014

Weight Stigma and Binge Eating: What's the Connection?

My article appeared originally on Recovery Brands' Pro Corner site.
Karina, a 42-year-old obese woman, put off her annual doctor’s appointment again. The reason for her reluctance? Karina fears her doctor’s judgments and admonitions about her weight. Several years back, her doctor read her the riot act about her weight and since that visit, Karina’s weight has climbed even more.
Karina is not alone. Research indicates that higher weight individuals report experiencing weight stigma and negative stereotypes across a variety of situations and at the hands of family members, friends, doctors, bosses, teachers, and often, strangers.
Last month marked the second annual Weight Stigma Awareness Week. The annual event, hosted by the Binge Eating Disorder Association (BEDA), seeks to raise awareness around weight bias and offers tools for addressing weight discrimination in various settings, including schools and doctors offices. This year’s event was replete with contributions from diverse voices in the weight stigma community, and their messages trended powerfully online.
According to BEDA, biased behaviors include “bullying, hate-speech, and exclusions that limit the ability of a person to gain employment, healthcare, and education.”
BEDA defines weight bias as “judgment or stereotyping based on one’s weight, shape and/or size.” According to BEDA, biased behaviors include “bullying, hate-speech, and exclusions that limit the ability of a person to gain employment, healthcare, and education.” Weight bias is an unfortunate byproduct suffered by many who struggle with binge eating disorder (BED). BED, now a standalone DSM-5 disorder, affects approximately 2 percent of menand 3.5 percent of women. The majority of those with BED are overweight or obese.
Unlike their counterparts who struggle with bulimia nervosa, those with BED do not engage in any compensatory behaviors following binge episodes, such as vomiting, over-exercising, or restricting their intake. The result, for many, is weight gain over time. The DSM-5 notes that BED is more common in individuals pursuing weight-loss treatment than in the general public (APA, 2013).
The experience of weight stigma can contribute to the ongoing presentation of the BED. As with any psychiatric disorder, symptoms can intensify during times of emotional and situational stress. Encountering discriminatory and prejudicial comments, gazes, and practices can contribute to the emotional unrest that triggers a binge episode. So, while the public may criticize those at higher weights in an attempt to bully them into smaller sizes, these efforts often backfire. One study of 2,400 overweight and obese adults found that 79 percent responded to weight bias by eating more.
And thus the cycle continues…
The media presents significant information about the health consequences of being overweight. What it fails to do, though, is parse out the impact that weight discrimination has on patients’ physical health. In addition to increasing binge eating, weight bias can cause negative health outcomes through various pathways. First, higher-weight individuals may avoid doctor appointments due to fear of disrespect from their healthcare providers or shame around being weighed. Large bodies may not be adequately accommodated with respect to certain medical equipment, such as blood pressure cuffs, exam tables, and CT/MRI scans.
Additionally, research has shown that the experience of weight stigma is correlated with reduced exercise motivation, resulting in decreased fitness as a function of stigma and body dissatisfaction. Finally, experiencing stigma and prejudice can result in a chronic, elevated stress response, negatively impacting physical and mental health.
…research has shown that the experience of weight stigma is correlated with reduced exercise motivation, resulting in decreased fitness…
Weight bias can also impact those who don’t meet full criteria for BED. Many individuals, fearing judgments and bias around weight, have internalized their own weight stigma. They are preoccupied with their bodies and may engage in disordered eating in an attempt to manage their weight. Some may fall prey to the diet-binge cycle, in which they attempt to lose weight by dieting, only to gain it back by compensatory overeating. They may be searching for the latest fix – low-carb, gluten-free, low-fat, cleanses, juicing – whatever they believe might help them to control their weight. Some develop problems with compulsive exercise. Many others spend the majority of their lives with the nagging feeling that their bodies simply aren’t right.
So, what can you do to fight weight bias?
  • Adopt a Heath at Every Size® (HAES) approach, focusing on health, rather than weight. Learn to eat and exercise intuitively and to respect your body’s natural size – along with body diversity in the community.
  • If you struggle with BED, get help that allows you to address the behavioral aspects of the disorder without condemning you for your weight. Choose your providers carefully, as even health providers can be weight-biased. Ensure they, too, are proficient in the principles of HAES.
  • Become an activist, even if you aren’t heavy. As Isabel Foxen Duke writes, “When we fight for ‘fat acceptance,’ we fight for our sanity around food and weight, regardless of whether or not we ‘qualify’ as ‘fat.’”
You can find Does Every Woman Have an Eating Disorder? Challenging Our Nation's Fixation with Food and Weight on Amazon (as a paperback and Kindle) and at BarnesandNoble.com

Wednesday, October 15, 2014

Practicing Self-Compassion with Jenni Schaefer

Thanks to Jenni Schaefer, who recently featured an excerpt from my book on her blog!

Jenni recently celebrated the tenth anniversary of Life Without Ed, so be sure to check out her book's new edition and to congratulate her when you stop by her site.

Like the excerpt? Read more! You can find Does Every Woman Have an Eating Disorder? Challenging Our Nation's Fixation with Food and Weight on Amazon (as a paperback and Kindle) and at BarnesandNoble.com

Wednesday, October 08, 2014

How to Parent Healthy Body Image and Why it Matters

Check out my recent article on parenting and body image on recovery.org.

You can find Does Every Woman Have an Eating Disorder? Challenging Our Nation's Fixation with Food and Weight on Amazon (as a paperback and Kindle) and at BarnesandNoble.com


Wednesday, October 01, 2014

How Much Do We Know About Purging Disorder?

I'm posting this on behalf of K. Jean Forney, a graduate student who studies eating disorders at Florida State University. She's researching purging disorder and looking for support for her project.

The Diverse Presentations of Eating Disorders

K. Jean Forney, M.S.

Typically, when people hear “eating disorder,” they think of anorexia nervosa, the eating disorder characterized by low weight. People sometimes think of bulimia nervosa, which is characterized by binge eating (eating a large amount of food while feeling out of control) and compensatory behaviors, like self-induced vomiting or intense exercise. Awareness is growing about binge eating disorder, the eating disorder characterized by recurrent binge eating without any sort of compensatory behavior.

It turns out a significant portion of people with eating disorders don’t meet criteria for these disorders, but still have clinically significant eating disorders. These clinically significant eating disorders cause distress, impairment, and medical complications. These individuals typically fall into the “eating disorder not otherwise specified” or “Other specified feeding or eating disorder” group. This is problematic, because that group is pretty heterogeneous. Some of those people engage in binge eating, some people eat most of their food at night, others only exercise excessively but aren’t underweight or binge eating. Because it’s heterogeneous, it’s hard to generalize any research findings on this “other specified” group. Things that are true of someone who excessively exercises without binge eating probably aren’t true of people who eat most of their food at night. Without naming and separating these conditions, it’s hard to study and develop treatments, because they are too diverse.

Another member of this “other specified” group is purging disorder. Purging disorder is characterized by purging behaviors, such as self-induced vomiting or laxative abuse, in people who do not experience binge-eating episodes. Estimates range from .5% to about 5% of women experience purging disorder in their lifetime, and there are few estimates available for men. The research available right now suggests that individuals with purging disorder have a higher mortality rate than the general population. It’s a serious condition to have.

Problematically, because purging disorder isn’t a “full” diagnosis like anorexia nervosa or binge eating disorder, no one has studied treatments for it. We are starting to collect evidence about how purging disorder is different from other disorders, but we need to know more about the prognosis and course of the illness, and factors that influence prognosis, in order to better develop treatments.

That’s why I am raising funds to study the long-term outcome of purging disorder and to compare it to the outcome of bulimia nervosa. I will identify what factors (attitudes about shape and weight, feeling out of control while eating, and hormones related to eating) predict outcome, providing clues as to where we can intervene. Please consider taking a moment to share my project and consider donating.

https://experiment.com/projects/long-term-outcome-of-women-with-purging-disorder


You can find Does Every Woman Have an Eating Disorder? Challenging Our Nation's Fixation with Food and Weight on Amazon (as a paperback and Kindle) and at BarnesandNoble.com