Your health program is not weight-neutral if…

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The co-opting of concepts from weight-neutral health community to sell weight loss (or obfuscate the harm it causes) is rampant. We’ve talked about this with the concept of weight stigma and fake anti weight stigma events, PR campaigns, and marketing. In today’s edition of “words mean things” we’re going to talk about the co-option of the concept of weight-neutral.

One of the most clear examples of this is  Sarah C. Armstrong who is one of the authors of the disastrous American Academy of Pediatrics guidelines who claims “I subscribe to a "health at every size" approach to supporting children, teens, and young adults living with ob*sity” on the same webpage on which her title is “Medical Weight Management Specialist.”

In this case, it’s not just weight-neutral health that she is co-opting, it’s Health at Every Size(tm) which is the trademarked brand of the Association for Size Diversity and Health and has a very specific meaning.

That one’s pretty obvious, but the problem is that the industry is getting better at this. And I want to be clear, there are some people who are doing this very deliberately, and make no mistake, they are well funded, well connected, and very good at it. But many others who are doing this are well-meaning but experiencing paradigm entrenchment, self-justification, and confirmation bias (which I talked about in-depth here). The problem is that this co-opting of “weight-neutral” is going to hurt people, including and especially children, and so we have to learn how to spot it and call it out.

At its most basic level (understanding that health is not an obligation, barometer of worthiness, or entirely within our control) weight-neutral health means focusing on supporting health directly (based on people’s individual priorities, values, and circumstances,) in terms of individual behaviors, physical and mental health interventions, and public health campaigns, for people of all sizes, rather than attempting to use weight loss as a path to health.

Here are some quick examples (I’ll note that those that are not weight-neutral are also not proven to be true.)

Weight Neutral:

Social connection has been shown to have a beneficial effect on blood pressure.

Not Weight Neutral:

Social connection may aid in a reduction of BMI.

Weight Neutral:

Reducing weight stigma can help those who want to do so increase health-supporting behaviors.

Not Weight Neutral

Reducing weight stigma can increase weight loss program compliance.  

Weight Neutral:

Getting enough quality sleep has been shown to have physical and mental health benefits

Not Weight Neutral:

Getting enough quality sleep can help you maintain a “healthy weight.”

Weight-neutral interventions by definition do not include a weight manipulation component. Therefore, weight-neutral interventions are mutually exclusive with:

·         Interventions that have a goal of creating weight loss

·         Interventions that have a goal of preventing weight gain

·         Interventions that celebrate weight loss

·         Interventions that celebrate not gaining weight

A weight-neutral intervention has no focus on, or opinion about, weight.  

That’s what neutral means.

Here are some red flags that a so-called “health” intervention is not weight-neutral, no matter what they claim:

Weight or BMI is measured

Sometimes weight/BMI is considered demographic data to be gathered at the outset of a program (though that doesn’t make it a good idea unless perhaps they are using it for something important like understanding the impact of weight stigma.) Still, weight/BMI being measured at the beginning isn’t a sure sign that it is not weight-neutral (though it’s certainly a red flag.) An even bigger red flag is ongoing measurement of weight/BMI. If a health program is neutral about weight, then there is no need to measure it.

The program is only open to higher-weight people

Now, there’s nothing wrong with creating specific spaces for people who are traditionally marginalized and oppressed. So let’s say a weight-neutral dance class is only for higher-weight people - that can be a great experience. But if it’s a “health” program and especially if it’s for kids and adolescents and they are only signing up people/kids with higher weights/BMIs that’s a signal to dig deeper because it very well may be a weight-focused/weight-loss program in disguise.

They use terms like weight management, ob*se, overw*ight, or their problematic person-first equivalents

These are terms that are inherently weight-centric. If you’re trying to “manage” weight, then you’re not neutral about it. The rest of these terms were created for the specific purpose of pathologizing people based on shared size. These terms are a red flag on fire that this is a weight-centric program in weight-neutral clothing and likely run by people who are anything but neutral about weight.

They are run by people/organizations that sell weight loss in other areas of their lives

If the person running the program also runs some kind of “weight management center” or is an “ob*sity medicine” person, or if they take money from the weight loss industry I would be deeply suspicious of the program and dig very, very deeply.

There is a lack of positive higher-weight representation at any/all levels

If the program materials only show thin people/kids (or show fat* people/kids but only in a negative light,) if the program is run only by thin people with no positive representation of fat people among those who are service providers, that is a red flag for both a fake weight-neutral health intervention, and a program may be coming from/perpetuating weight stigma.

The weight loss industry will seemingly do anything to feed their insatiable desire for money. Understanding their tactics is an important step to keeping ourselves safe.

On the East Coast? I’m planning an East Coast Speaking Tour in mid-October so if you’re in that neck of the woods and want to chat about the possibilities of having me come speak, email me at Ragen@WeightAndHealthcare.com!

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More research and resources:
https://haeshealthsheets.com/resources/

*Note on language: I use “fat” as a neutral descriptor as used by the fat activist community, I use “ob*se” and “overw*ight” to acknowledge that these are terms that were created to medicalize and pathologize fat bodies, with roots in racism and specifically anti-Blackness. Please read Sabrina Strings’ Fearing the Black Body – the Racial Origins of Fat Phobia and Da’Shaun Harrison’s Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness for more on this.