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Miss America

Evidence Based Body Positivity

Evidence-Based Body Positivity: An Idea Whose Time Has Come

Written by Jonathan Bailor, CEO SANESolution & Reviewed by Dr. Matthew Olesiak, MD Chief Medical Director, SANESolution

The Miss America Organization is pleased to help usher in a new era of the body positivity movement with top doctors at the Harvard Medical School and Jonathan Bailor, Executive Producer of the BETTER documentary film and CEO of SANESolution. Evidence-based body positivity is a sane solution to both the obesity epidemic and body shaming. 

The current body positivity movement is extremely popular right now. Social media accounts that focus on body positivity attract millions of followers. The media, too, has gotten involved in this movement with advertising campaigns claiming to foster body acceptance for everyone.

The idea that all people deserve to have a positive body image regardless of their size and shape while challenging society’s view of the “ideal” body — especially the ideal female body — is an admirable one.

But not everyone is pleased with this movement. Critics claim that it does not represent “every body” and in fact tends to exclude those who suffer the most body shaming and discrimination in our society — obese individuals. They claim that only slightly overweight people are represented in body positive advertising campaigns, size 12 at the most, and that obese people are again being shunned.

But it didn’t start out that way.

Brief History of the Body Positivity Movement

The body positivity movement is rooted in the fat rights movement of the late 1960s. Emboldened by the Civil Right movement, activists sought to end body shaming and discrimination against people based on body weight and size.

This led to the creation of the National Association to Aid Fat Americans, which later became the National Association to Advance Fat Acceptance or NAAFA that is still active today. (1)

dThe fat rights movement continued to grow throughout the subsequent decades. Though the term “body positivity” had not yet been coined, activists publicly advocated for body acceptance and the importance of loving your body.

The first time the term “body positive” was used appears to be 1996 with the creation of a website that focused on those with eating disorders. The goal of this website was to encourage people to feel good about their bodies so that hopefully they wouldn’t resort to unhealthy diet and exercise practices to lose weight. (2)

The current body positive movement began around 2012. Like its predecessors, it focused on body weight acceptance for women — initially. Eventually, however, its message changed to “all bodies are beautiful.”

What Does the Body Positivity Movement Get Wrong?

There is nothing inherently wrong with promoting a message that “all bodies are beautiful,” of course. But by making no distinction between a size 12 and someone who suffers from the medical conditions known as obesity and diabetes (diabesity), it ignores the very real emotional, physical, and health risks/challenges faced by this group of women.

In the U.S., more than 41% of women age 20 and older are obese, a medical condition in which the level of excess body fat is high enough to negatively affect health. (3) Many of these women are constantly battling their weight with unhealthy starvation diets that are not only unsustainable, but they may also result in increased weight gain.

Consequently, these women often have a history of frustrating and depressing yo-yo dieting, which makes it even more difficult for them to reach their weight-loss goals. In fact, research suggests that yo-yo dieting may not only increase body fat percentages in the long run, (4) but may also be a “major risk factor for all-cause mortality.” (5)

Why is yo-yo dieting so pervasive then? Certainly, the health risks of obesity compel women to keep trying different diets in the hopes of finding one that really works…but body shaming may be an even bigger factor.

Sadly, obesity is one of the last acceptable biases in society. Body shaming obese individuals is  therefore quite common and is especially harmful for women, who are expected to meet society’s beauty standards emphasizing thinness. They are constantly given subtle and not so subtle messages that thin women are more beautiful and desirable than heavy ones.

As a result, many of these women are caught between the proverbial “rock and a hard place”: being shamed into unhealthy dieting to obtain the often extremely skinny and unhealthy body society demands, or giving up and surrendering their body to the diseases of obesity and diabetes.

Why Shame-Based Dieting Makes Weight Loss Harder

Toxic shame, a state in which you feel that who you are is unworthy and unlovable, is never a helpful emotion. But body shame is particularly counterproductive for weight loss.

Making obese people feel ashamed of themselves in the belief that it will motivate them to eat less, exercise more, and ldose weight has no basis in reality — or in science.

Research shows that body shame induces stress in the individual causing an increase in circulating cortisol. This hormone has been shown in multiple clinical research trials to increase hunger. It may also trigger cravings for sugar, starchy carbs, and other unhealthy and weight-promoting foods. (6)

Excess cortisol is also known to increase the risk for depression and anxiety, which can also lead to food cravings and binge eating.

Research also suggests a link between weight discrimination and weight gain.

In one study, researchers interviewed over 6,000 individuals who had reported weight discrimination. At the time of the first interview, 4,193 participants were not obese and 1,964 were obese. By the follow up interview, 5.8% of the non-obese group had become obese, while every member of the obese group had remained obese. (7)

As researchers concluded:

” Weight discrimination was associated with becoming obese between baseline and follow-up: Among participants who were not obese at baseline, those who reported weight discrimination were approximately 2.5 times more likely to be obese by follow-up than those who did not report weight discrimination.” (8)

Understanding the Reasons for Obesity

Besides body shame, there are other reasons for obesity and the inability to achieve a healthy weight. Certain medications may cause weight gain, as well as medical issues like hypothyroidism. A slowed metabolism due to advancing age can also play a role.

But perhaps the main reason for the inability to lose weight long term and the ineffectiveness of yo-yo dieting is the calorie-deficit theory of weight loss most people have followed for decades. This theory basically says that all you need to do is to eat less and exercise more to lose weight. According to this theory, it doesn’t matter whether you eat a couple of donuts or a big juicy steak. As long as you stay within a certain calorie limit, you’ll still lose weight.

We know this is untrue. Research shows that the quality of calories consumed is far more important than the quantity of calories for weight management. (9)

The types of food you eat have vastly different effects on your body, hormones, and metabolism. For example, that big juicy steak triggers your long- and short-term satiety hormones, thus filling you up fast and keeping you full for a long time. This can prevent overeating and aid weight management.  

A donut, on the other hand, triggers a spike in blood glucose levels. The pancreas releases the fat storage hormone insulin to clear the excess glucose from your bloodstream. Most of these calories will probably be sent to your fat cells. In about 20 minutes after eating that donut, your glucose levels plummet, leaving you hungry for another donut. 

In addition, the body works hard to keep you within 10-15 pounds of its set point weight. This is why weight loss slows down so drastically when you’re on a low-calorie diet and why your body seems to fight you for every pound you lose!

Yes, calories matter. But it’s not your job to count them. Rather, your body regulates calorie intake and adjusts metabolism to keep you within range of your set point weight.

To lose weight permanently, then, you need to lower your set point with a high quality diet and lifestyle. You’ll then lose weight safely and easily…and permanently. No calorie counting, deprivation, yo-yo dieting…or shame!

Combining Science with Love and Self Acceptance

This is why we’re so excited about this new wave of body positivity.

With Evidence-Based Body Positivity, we now have a more sensible solution to the obesity/diabetes epidemic and body shaming.

This new movement is about loving yourself so much that you choose to nurture your body with quality foods and quality habits…because you truly are worth it!

You choose to live BETTER through proven science, practical habits, and powerful love. You don’t “eat less to lose weight” you “eat SANEly to live BETTER”… no starvation or shame ever!

References

1- Bitesize. From New York to Instagram: The history of the body positivity movement. BBC. Accessed Aug 19, 2021. https://www.bbc.co.uk/bitesize/articles/z2w7dp3

2- Cherry K. What Is Body Positivity? Verywellmind. Nov 21, 2020. Accessed Aug 19, 2021. https://www.verywellmind.com/what-is-body-positivity-4773402

3- Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of Obesity Among Adults and Youth: United States, 2015–2016. NCHS Data Brief No. 288, October 2017. Accessed Aug 19, 2021. https://www.cdc.gov/nchs/data/databriefs/db288.pdf

4- Mackie GM, Samocha-Bonet D, Tam CS. Does weight cycling promote obesity and metabolic risk factors? Obes Res Clin Pract. 2017 Mar-Apr;11(2):131-139. doi: 10.1016/j.orcp.2016.10.284. Epub 2016 Oct 20. PMID: 27773644.

5- Rzehak P, Meisinger C, Woelke G, Brasche S, Strube G, Heinrich J. Weight change, weight cycling and mortality in the ERFORT Male Cohort Study. Eur J Epidemiol. 2007;22(10):665-73. doi: 10.1007/s10654-007-9167-5. Epub 2007 Aug 4. PMID: 17676383.

6- Ramirez D. Stress Can Make You Crave Unhealthy Foods, Study Finds. Stillness in the Storm. Jan 30, 2021. Accessed Aug 17, 2021. https://stillnessinthestorm.com/2021/01/stress-can-make-you-crave-unhealthy-foods-study-finds/

7- Sutin AR, Terracciano A (2013) Perceived Weight Discrimination and Obesity. PLoS ONE 8(7): e70048. https://doi.org/10.1371/journal.pone.0070048

8- Sutin AR, Terracciano A (2013) Perceived Weight Discrimination and Obesity. PLoS ONE 8(7): e70048. https://doi.org/10.1371/journal.pone.0070048

9- Gardner CD, Trepanowski JF, Del Gobbo LC, et al. Effect of Low-Fat vs Low-Carbohydrate Diet on 12-Month Weight Loss in Overweight Adults and the Association With Genotype Pattern or Insulin Secretion. JAMA. 2018;319(7):667-679. doi:10.1001/jama.2018.0245.