Welcome to Week #9 at The Conversationalist. This week we are talking about the relationship between body image and diet culture, and how diet culture can be invasive and insidious. Let’s define some terms before we dive in. Diet culture is best defined by Christy Harrison, MPH, as a system of beliefs where thinness equates to health and moral virtue, and one must strive to be an ‘ideal size’. It is a culture that promotes weight loss as a means to attaining higher status and is one that demonizes certain ways of eating, while at the same time praises eating habits that are often restrictive or limiting. Diet culture imposes an ideal of health that is based on a subgroup of society’s body types (ie. white women), therefore it is not inclusive to minority bodies.
Diet culture exists because it is profitable. The weight loss industry in the US is now worth a record $72 billion, but the number of dieters has fallen, due to the growth of the size acceptance and body positivity movements. From meal plans, to weight loss supplements, to workout regimes, gym memberships, juice cleanses, and more; the list goes on and on. Our society is constantly selling us ways to lose weight, both directly and indirectly. Polaris Market Research anticipates an even greater rise of mobile fitness and calorie tracking apps, reaching over 14.7 billion dollars by 2026. In 2017, the fitness and activity tracking segment dominated the market, in terms of revenue and North America is expected to be the leading contributor to the global fitness app industry during this period. Diet culture is pervasive and profitable, and unfortunately we are still far from a society where it no longer exists.
Here are six perspectives to consider this week as we unpack the concept of diet culture.
1. Is diet culture to blame for poor body image?
Many people believe that diet culture is at the root of common body image issues because of how socially accepted it is. We have normalized using vocabulary and phrases that shame our own bodies when we do not conform to or obey societal standards of ‘health’, ‘thinness’ and ‘size’. Simply by labelling eating habits under a binary of ‘good’ versus ‘bad’ contributes insidiously to this culture, shares body image therapist Sarah Hertisch. We are taught from a young age that we need three meals a day, and a couple of snacks in between but over the years this mindset has shifted with prominent diets like ‘intermittent fasting’ where one can only eat during a specific feeding window or period. So, it is no longer what you are eating but also when you are eating. With increasingly conflicting ideas about diet and weight loss, it is understandable that it is on the forefront of one’s mind. Studies estimated that women typically think about weight and diet for 21 minutes a day. Over 67 years of life, that adds up to 355 days - almost an entire year and that is a lot of wasted time. Young women (and young men, too) can fall into the trap of wanting to look like celebrities, influencers or models that inspire them. These unrealistic goals can lead to an unhealthy body image and low self-esteem, not to mention disordered eating behaviors. Experts like Kathleen Meehan are trying to spread the message that “The relationship between weight and health is very complex.” She shares that “weight as a proxy for health is extremely problematic, as it often misclassifies [larger] people as unhealthy. We have research to show that being in a smaller body does not automatically indicate better health. Studies also show that weight loss does not automatically increase a person’s health and well-being.” Additionally, current research on weight loss suggests that 95 percent of diets fail and individuals who experience rapid weight loss regain the weight in 1 to 5 years. Diet culture might be a clear culprit to why we feel social pressure to lose weight and change our bodies but it is not the only reason. What other factors do you think influence our body image? We’ll explore those in the weeks to come!
2. Diet culture is so ingrained in our society, we barely notice it
Some believe that diet culture is so ingrained in our culture, that it goes unnoticed and unpronounced. Dr. Jessica Aron offers that our society has accepted weight-focused mentality that keeps us trapped in a destructive cycle where we all feel the conscious and unconscious need to lose weight. She suggests the cycle unfolds as started a structured weight loss plan, losing weight and feeling confident, progress slows, then anxiety about not following the plan, feelings of guilt and remorse for falling back into bad habits and starting a new plan hoping to feel confident again. This cycle is so common that it culturally accepted at the start of every new year, when people flock to gyms and embark on weight loss plans hoping to be more confident the following year. And the media plays a big role in normalizing diet culture. Moguls like Oprah Winfrey have been long-term advocates of weight loss and brands like WeightWatchers, often showcasing weight loss success stories on her talk show and sharing her own weight loss journey. The hosts of the Today Show recently came under scrutiny after weighing themselves on national television before undertaking an intermittent fasting challenge. Many viewers applauded their bravery to share such personal information publicly whilst others condoned their focus on the number on the scale and encourage them to focus on overall health instead. The Today Show hosts offer that the experience taught them a valuable lesson about perspective. Hoda Kotb concludes. “I do think we’re doing this because we want to feel better. We want to feel better for our girls. We want to feel happier.” So whether it’s watching the morning news or scrolling through Instagram, we cannot seem to escape the topic of weight but what we can try to do is put things in perspective for ourselves.
3. When weight loss gets dressed up as ‘health’
Another perspective to consider is that weight loss does not always equate to being healthy. Today, health reasons are shown to be at the core of weight loss regimens and plans, but it is important to acknowledge that the weight you are does not indicate how healthy you are. The Archives of Internal Medicine published a study that found that being overweight doesn't necessarily make you unhealthy, according to researchers in both the United States and Germany. Experts argue that sports fans have known this forever because elite athletes can have an appearance ranging from tiny Olympic gymnasts to massive NFL linemen. Athletes at both extremes- and all those in between- are in shape and trained to perform at high levels. A study published in the International Journal on Obesity found that nearly half of overweight U.S. adults were "metabolically healthy." That meant they had no more than one risk factor for type 2 diabetes and heart disease -- including high blood pressure and among obese adults, 29 percent were deemed healthy -- as were 16 percent of those who were severely obese based on body mass index (BMI, a ratio of weight to height). Whilst, more than 30 percent of normal-weight Americans were metabolically unhealthy. The researchers estimate that nearly 75 million Americans would be "misclassified" as heart-healthy if BMI is the only yardstick. "The bigger picture we want to draw from our findings is that the dominant way of thinking about weight -- that higher-weight individuals will always be unhealthy -- is flawed," said Jeffrey Hunger, one of the researchers on the study at the University of California, Santa Barbara. Therefore, this confirms that even if one may ‘present’ as overweight, that does not mean they are unhealthy. Similarly, if someone presents as having a normal weight or even as ‘skinny’, they could be experiencing health problems. This suggests that diets are not the miracle cure that our weight loss culture prescribes them to be. Instead, nutritionists like Dr. Jessica Aaron encourage that studies of non-diet approaches, such as intuitive eating, show numerous positive outcomes and long-term changes that weight-focused approaches simply could not. The take-away here is not judge a book by its cover or health by weight or size.
4. Facts are facts, right?
Another perspective to consider is that many experts believe that diet culture actually promotes better awareness of what a balanced diet looks like. Additionally, some individuals are recommended to start a diet based on a physician’s advice and therefore, dieting can often help their condition. It helps to know the facts: in 2016, the prevalence of obesity among U.S. adults was 39.8% (crude). Overall, the prevalence among adults aged 40–59 (42.8%) was higher than among adults aged 20–39 (35.7%). Researchers have found that obesity is genetic and higher rates exist within certain ethnic groups. Studies show that hispanics (47.0%) and non-Hispanic blacks (46.8%) had the highest age-adjusted prevalence of obesity, followed by non-Hispanic whites (37.9%) and non-Hispanic Asians (12.7%). The prevalence of obesity was 35.7% among young adults aged 20 to 39 years, 42.8% among middle-aged adults aged 40 to 59 years, and 41.0% among older adults aged 60 and older. The World Health Organization released that in 2016, an estimated 41 million children under the age of 5 years were overweight or obese. In Africa, the number of overweight children under 5 has increased by nearly 50 per cent since 2000. Nearly half of the children under 5 who were overweight or obese in 2016 lived in Asia. W.H.O. also suggests that obesity is typically seen amongst low income individuals who live in urban settings and offers that it is caused by an increased intake of energy-dense foods that are high in fat and lack of physical activity due to the increasingly sedentary nature of many forms of work, changing modes of transportation, and increasing urbanization. W.H.O. proposes that obese individuals limit energy intake from total fats and sugars, increase consumption of fruit and vegetables, as well as legumes, whole grains and nuts, and engage in regular physical activity (60 minutes a day for children and 150 minutes spread throughout the week for adults). For this reason, experts believe diet culture can potentially benefit our society by informing individuals of the dangers of overeating and lack of activity. However, the idea that diet culture will reverse these statistics is problematic, because it doesn't take into account health at every size. Instead we should focus on practicing healthy habits, because no matter your size, you should be encouraged to take care of yourself.
5. Green means go, yellow means pause, red means a complicated relationship with food?
Should children have to diet? Many experts and health professionals advocate that children should not be forced into a diet because it can lead to long term struggles with food and body image. Weight Watchers recently released their Kurbo weight loss app specifically for children ages 6 years old and up. An online petition calling on WW to remove the app gathered over 87,000 signatures after it’s launch on August 13th. The petition states that it's "irresponsible" of WW to launch an app that could make children develop "life altering eating disorders that will eventually kill some of them." Experts behind the creation of the app say that it is a healthy, and scientifically-backed program to help overweight children learn healthier eating habits. According to the Centers for Disease Control, one in five kids is considered obese in the United States. WW advocates that there are guidelines place to encourage a healthy relationship with food because the app offers a holistic family approach that involves the child, their parents and a specialized coach. Kurbo focuses on a stoplight diet where fruits and vegetables are green, lean protein and carbohydrates are yellow and junk food is red. This diet system does have significant scientific literature and decades of research behind it proving that it's an effective strategy for nutritional counseling when combined with group visits and individual counseling, said Sarah Armstrong, who spoke on behalf of the American Academy of Pediatrics' section on obesity. However, many other nutritional experts have criticized teaching children about food in such a binary way. The National Association for Eating Disorders (NEDA) released a public statement about Kurbo, stating that: “An app-based program that emphasizes and celebrates weight loss is risky for this vulnerable population of children and adolescents at a time when their bodies are undergoing significant changes and are especially susceptible to harm.” So, it is important to consider that making a child focus on their weight from a young age might take away from other aspects of their childhood and might have long term negative impact.
6. Food does NOT have to be Naughty or Nice!
Another perspective to consider is the way diet culture limits us to binary thnking around food, where food is either good or bad. If you have a food allergy, then understandably certain foods will be bad for you and you should avoid them. However, diet culture defines certain foods as off-limits or to be avoided all the time, often without scientific research to back the claim. Diet culture is both explicit and implicit, says Amee Severson, a registered dietitian in Bellingham, Washington, it is explicit in advertisements and our obsession with weight loss “success” stories. But it’s implicit in the language we use to talk about food. A subtle example of this is referring to certain foods as “treats” or “indulgences.” Judith Matz, LCSW, co-author of The Diet Survivor’s Handbook: 60 Lessons in Eating, Acceptance and Self-Care, shares “there’s a moral connotation here that these foods are something that you still shouldn’t have often.” This kind of messaging can make the person feel bad about eating certain foods, and Margaret Ruch, RD offers, “When you eat the [‘bad’] food, you think of yourself as an unhealthy person, and might internalize the idea that you’re not caring for yourself.” Ruch concludes, “Specific foods don’t make up our health. Our health is made up of so much more than just the food we eat, but especially more than just one meal, or one food.” Just as one meal will not make you gain weight, eating ‘junk food’ or processed food once in a while does not make you unhealthy. To counter attack this binary dieting mindset, nutritionists and experts are advocating for intuitive eating, a practice that allows you to “eat what you want, with no rules about what to eat, how much of it, or when.” Intuitive eating has 10 tenets, but the most well-known one is that no foods are off limits, and that there is no such thing as a “good” or “bad” food. Heather Caplan, a registered dietitian shares that Intuitive eating is a response to diets and diet culture, and is not meant to tie adherents to any specific set of eating rules. The 9th tenet of intuitive eating is ‘Exercise - Feel The Difference’ which advocates to forget militant exercise and just get active, to feel better. The focus is shifted towards how it feels to move your body, rather than the calorie burning effect of exercise. Diet culture often promotes excessive exercising or simply exercise as a means to weight loss but part of challenging this mindset is focusing on feeling better. Exercise releases endorphins, aka neurotransmitters that have positive impact on your mood, energy levels and memory. The take-away is that when you listen to your own body’s hunger cues and needs you, you don’t need a diet plan or workout schedule to feel good.
Diet culture is all around us and as we know, it’s not going away anytime soon. So be kind to yourself, know that fighting a system that tells us to take up less space is a marathon and not a sprint. And the fight starts with little acts of kindness to yourself and others! To leave dieting behind and focus on your health holistically (ie. mental and physical), you have to start small with easy, practicable steps like drinking more water and getting enough sleep. Little habits can encourage lasting impact, like changing your language around food and complimenting people for their personality rather than their appearance. All good things take time and care, so be kind to yourself and give yourself the time you need.