When is it ok to comment on another person’s body?

image description: an adult and baby elephantWhen is it ok to comment on another person’s body? Spoiler alert: Never!

By Elisha Carcieri, Ph.D.

As a relatively new mom of an 11-month-old, I’m on the tail end of almost two years of a complete metamorphosis. In nine months my body grew to accommodate another human, delivered that human into the world, and has since been slowly returning to its original, albeit changed, form.

Something bizarre happens when you’re pregnant. For some reason, people take this as an opportunity to comment on physical appearance, especially size and weight, perhaps more so than they do with non-pregnant women. Most don’t mean any harm, and most of the time no harm is done. But even so, I ask…why do it? And I beg…please stop! For the most part, commenting on another person’s body size is, at the very least, unproductive and unhelpful, and at worst a triggering assault on the already high-jacked consciousness of an eating disorder sufferer.

Oftentimes pregnant women will receive comments such as, “looks like you’re ready to pop!” or, “any day now, huh?” But what if that’s not the case? Saying this to a woman who has many months of pregnancy ahead of her has the potential to bring up all sorts of emotions and uncertainties. I recall a stranger stopping me on the street to give me her business card for prenatal water aerobics. She asked me how far along I was and promptly added that I was “showing early for being only 6 months along” and could therefore especially benefit from her services.

As a society, we’re generally obsessed with weight loss, wellness, thinness, and, with regard to pregnant women, “bouncing back.” I think there is an assumption that if you’re saying someone is small or thin, then its fine. But my caution against body comments rings true for comments about thinness or smallness just as much as it does for fatness, largeness, bigness, etc. It can be difficult to understand how comments about smallness might affect someone. We all want to be thin, right? But for a woman carrying a baby, being told you’re looking small can be scary and can bring up unwarranted uncertainties and fears. I can recall being told at the end of my pregnancy that I looked small. “What a tiny baby bump,” “you don’t even look like you’re about to have that baby.” (Mind you, this was the same body that elicited the above “big for 6 months” comment.) These comments came after my doctor told me that I was, in fact, measuring small during that particular week of pregnancy. It took some work to cope with and wrangle the anxious thoughts running through my head. I went on to deliver a 9lb baby…further illustrating the fruitlessness of sharing our flawed perceptions of another person’s size or shape.

The truth is that you just don’t know what another human is dealing with at any given moment. You’re also not likely to be telling them anything they don’t know already. So what’s the point?

Experiencing these comments on my body during and after pregnancy has had me thinking about how difficult it would be to tolerate for someone with an eating disorder, and how difficult comments on body shape and size must be for those with eating disorders even in the absence of pregnancy. I do want to clarify here that no eating disorder is caused by comments made by another person or even necessarily by the negative body image that can result from being on the receiving end of body-focused comments. We don’t know what causes eating disorders. Eating disorders are likely the result of a myriad of genetic/biological, social, and psychological factors. However, we do know that for many men and women suffering from an eating disorder, there is often a core overvaluation of weight and shape in the person’s overall self-concept that places them at risk for engaging in efforts to control their weight or shape. This dieting or extreme restricting food intake can result in binge eating and subsequent control behaviors such as vomiting/laxative use/over-exercise/further restriction of food intake, resulting in a vicious cycle.

For a person in the throes of an eating disorder, a positive or approving comment on weight loss can serve as fuel to the already burning fire that is the eating disorder mindset. Also, what is the message we are sending when we comment on another person’s appearance with approval only when there is an observed weight loss? Isn’t the underlying message that that person is not worthy of approval when their weight is higher? Why would you want to send that message to a loved one? Alternatively, for someone in any stage of recovery from an eating disorder, comments on weight gain can be difficult to manage. I’ll also say that even for those of us who are neither suffering from an eating disorder or in recovery, fielding, and processing these comments simply sucks.

So, the next time you feel compelled to comment on another person’s body shape or size, no matter the circumstances, just don’t! Ask them about themselves, share something about yourself, tell them how great it is to see them, or comment on the weather if there is nothing better to talk about. There is little to gain and much to lose from body-focused comments, no pun intended.

Los Angeles Eating Disorder Events for Professionals January 2016

We are so lucky to have two amazing dynamic internationally recognized speakers regarding eating disorders in January via the Los Angeles County Psychological Association (LACPA).  One is a FREE SIG event (members only) and the other is a CE event with a charge (open to all professionals).

1)  Eating Disorder SIG meeting featuring international speaker and fat acceptance activist, Ragen Chastainimage description: photo of Ragen Chastain

Wednesday, January 20 at 7:15 pm 

Title:   Elimination is Oppression – The Ill-Advised Fight Against Obesity

Presenter:  Ragen Chastain

Description:  You can’t have a “War on Obesity” without creating a war on fat people. There is no non-stigmatizing way to say “The world will be better when no one who looks like you exists.” The shame, stigma, bullying, and oppression that have arisen from massively failed attempts to “eradicate” obesity have far-reaching negative health effects on people of all sizes, including those struggling with Eating Disorders.  The solution is not to double down and do more of the same. The research is clear that body size and health are not the same, and that a focus on body size in healthcare does a disservice to people all sizes.  We can, and we should, create complete, thriving public health programs without the use of eliminationist language, without creating a culture of appearance-based stigma and oppression, and without waging war on anyone.

Location:  The office of Dr. Lauren Muhlheim (4929 Wilshire Boulevard, Suite 245, Los Angeles) – free parking in the lot (enter on Highland)

Bio:  Ragen Chastain is an internationally recognized thought leader in the fields of self-esteem, body image, Health at Every Size, and corporate wellness.  She is a sought after speaker on the college, corporate, and conference circuits who has set the stage on fire everywhere from Google Headquarters to Cal Tech to the Models of Pride Conference.  She is the author of the blog DanceswithFat,  the book Fat: The Owner’s Manual, a columnist for Ms. Fit Magazine, and frequently appears as a topic expert on television and in print media. Ragen is a featured interviewee in the documentaries America the Beautiful 2 – The Thin Commandments, Ragen’s More Cabaret, and A Stage for Size.  She lives in Los Angeles with her partner and their adorable dogs and in her free time she is training for her second marathon and her first IRONMAN triathlon.

RSVP to Dr. Lauren Muhlheim at drmuhlheim@gmail.com

SIG meetings are open to all LACPA members.  Nonmembers wishing to attend may join LACPA by visiting our website www.lapsych.org

2)  A CE event (tell your colleagues who are nonmembers; we provide CEUs for psychologists, nurses, drug counsellors, MFTs, LCSWs, and LPCC)

“Unraveling the Enigma of Male Eating Disorders” with Stuart Murray, Ph.D. on Saturday, January 30, 2016 image description: photo of Stuart Murray

10:00 a.m. – 1:00 p.m. CE Credits 3.0 

Held at the NEW LACPA Office

6345 Balboa Blvd. Building 2, Suite 126

Encino, CA 91316

Click here to register online:

http://www.lapsych.org/events/event_details.asp?id=726923

This three hour workshop will provide a historical, theoretical, and clinical overview of eating disorder in males. Dr Murray will provide a historical overview of the development of our diagnostic framework, highlighting how this may be inaccurate in indexing male eating disorder concerns. Dr Murray will also provide an overview of the most recent empirical evidence pertaining to the transdiagnostic array of EDs in males. Finally, this workshop will include an in-depth discussion of the clinical quandaries faced in working with EDs in males.

Stuart Murray, Ph.D., is an Assistant Professor at UCSF, where he leads an international research group dedicated to advancing our understanding of male eating disorders. He also serves as the Director of the National Association for Males with Eating Disorders, and as the Co-Chair for the Academy of Eating Disorders Special Interest Group on Males & EDs. To date, Dr. Murray has published more than 70 scientific journal articles and book chapters, and has conducted workshops and seminars internationally on the topic of male eating disorders.

Winter LACPA Eating Disorder SIG meetings (2015-2016)

Thursday, November 12 at 7:15 pm.

Title: Medical-Legal Aspects of Eating Disorder Treatment with Emphasis on Denial of Care

image description: photo of David Rudnick

Presenter: David Rudnick, M.D., Ph.D.

Learning Objectives:

1) Become familiar with the issues in the treatment of eating disorders that are most likely to trigger legal interventions on behalf of patients.

2)  Understand the meaning of parity and the California Mental Health Parity Act as it applies to the treatment of mental disorders generally and eating disorders specifically.

3)  Learn the current categories of level of care involved in the treatment of eating disorders, their relationship to predictors of treatment outcome and the potential impact of insurance denial of the appropriate level.

Location:  The office of Dr. Lauren Muhlheim (4929 Wilshire Boulevard, Suite 245, Los Angeles) – free parking in the lot (enter on Highland)

Bio:  Dr. Rudnick was born and raised In Los Angeles, California. He received A B.S. in Physics from Stanford University in 1962 and a Ph.D. in Physics from Harvard University in 1968. After 6 years on the UCLA Department of Physics faculty, he switched gears and attended the University Of Miami Medical School in the Ph.D. – M.D. Program. He graduated that program in 1976, and then completed an internship in Internal Medicine at the Wadsworth V.A. Medical Center and a residency in Psychiatry at the UCLA Neuropsychiatric Institute.

Following completion of his residence in 1980, he became Medical Director of the UCLA Neurobehavior Clinic and opened his private practice in Santa Monica. His interest in eating disorders began during his residency, when together with Joel Yager, M.D., he started the first adult outpatient eating disorders program at UCLA. Since completing his residency in 1980, he has supervised this program in its many inceptions. His interest in medical-legal issues began in the context of criminal offenders who were evaluated in the Neurobehavior Clinic for underlying neurological and neuropsychiatric disorders. It extended to the neuropsychiatric aspects of brain injury, leading to multiple assignments as an expert consultant and witness in brain injury cases. It was then a natural evolution to marry the interest in eating disorders to participation as a medical-legal expert in cases involving treatment issues.

Dr. Rudnick has evaluated and testified about many aspects of eating disorder treatment that have come under legal scrutiny, and will talk to us about those experiences with emphasis on the, currently, hotly contested issue of denial of care.

RSVP to Dr. Lauren Muhlheim at drmuhlheim@gmail.com

SIG meetings are open to all LACPA members.  Nonmembers wishing to attend may join LACPA by visiting our website www.lapsych.org

Wednesday, December 2 at 7:15 pm – joint with Sport & Performance SIG

Title:   When Fit Becomes Foe: Excessive Workout Supplement Use as an Emerging Eating Disorder in Men

image description: photo of Richard Achiro

Presenter:  Richard Achiro, Ph.D.

Description:  Dr. Achiro will discuss his recent study which provides preliminary evidence that excessive over-the-counter workout supplement use is a variant of disordered eating in gym-active men. This work—which has received international recognition from sources such as Reuters, WebMD, The Huffington Post, NPR, CBS News, and the BBC—is timely due to the drastic increase in workout supplement use in recent years. Although consuming protein powders, creatine, and caffeinated “boosts” have become standard lifestyle practice for a significant subset of the male population, misuse of these products has remained largely overlooked as a potential risky body change behavior. Dr. Achiro will highlight psychological factors found to be associated with misuse of workout supplements, with an emphasis on gender issues and implications for assessment and treatment.

Location:  The office of Dr. Lauren Muhlheim (4929 Wilshire Boulevard, Suite 245, Los Angeles) – free parking in the lot (enter on Highland)

Bio: Richard Achiro, Ph.D. is a psychotherapist and published researcher who received his doctorate in clinical psychology with an emphasis in health psychology from the California School of Professional Psychology, Los Angeles. He has maintained several leadership positions, including past service on the Los Angeles County Psychological Association (LACPA) Board of Directors. Dr. Achiro provides treatment to individuals and couples as a Registered Psychological Assistant supervised by Stephen Phillips, J.D., Psy.D. in Beverly Hills.

RSVP to Dr. Lauren Muhlheim at drmuhlheim@gmail.com

SIG meetings are open to all LACPA members.  Nonmembers wishing to attend may join LACPA by visiting our website www.lapsych.org

Wednesday, January 20 at 7:15 pm

Title:   Elimination is Oppression – The Ill-Advised Fight Against Obesity

image description: photo of Ragen ChastainPresenter:  Ragen Chastain

Description: You can’t have a “War on Obesity” without creating a war on fat people. There is no non-stigmatizing way to say “The world will be better when no one who looks like you exists.” The shame, stigma, bullying, and oppression that have arisen from massively failed attempts to “eradicate” obesity have far-reaching negative health effects on people of all sizes, including those struggling with Eating Disorders.  The solution is not to double down and do more of the same. The research is clear that body size and health are not the same, and that a focus on body size in healthcare does a disservice to people all sizes.  We can, and we should, create complete, thriving public health programs without the use of eliminationist language, without creating a culture of appearance-based stigma and oppression, and without waging war on anyone.

Location:  The office of Dr. Lauren Muhlheim (4929 Wilshire Boulevard, Suite 245, Los Angeles) – free parking in the lot (enter on Highland)

Bio: Ragen Chastain is an internationally recognized thought leader in the fields of self-esteem, body image, Health at Every Size, and corporate wellness.  She is a sought after speaker on the college, corporate, and conference circuits who has set the stage on fire everywhere from Google Headquarters to Cal Tech to the Models of Pride Conference.  She is the author of the blog DanceswithFat,  the book Fat: The Owner’s Manual, a columnist for Ms. Fit Magazine, and frequently appears as a topic expert on television and in print media. Ragen is a featured interviewee in the documentaries America the Beautiful 2 – The Thin Commandments, Ragen’s More Cabaret, and A Stage for Size.  She lives in Los Angeles with her partner and their adorable dogs and in her free time she is training for her second marathon and her first IRONMAN triathlon.

RSVP to Dr. Lauren Muhlheim at drmuhlheim@gmail.com

SIG meetings are open to all LACPA members.  Nonmembers wishing to attend may join LACPA by visiting our website www.lapsych.org

Ten Facts About Weight Stigma – Guest post by Liliana Almeida, Ph.D.

image description: pile of tape measures

  1. Weight stigma is a bias or discrimination relating directly to weight. Despite the fact that more than half of U.S. citizens are larger-bodied, our society holds a strong negative bias against fatness.
  2. The media reinforces weight stigma. The media, such as news media, displays persons in larger bodies in stigmatizing ways by depicting them sitting and eating unhealthy foods, wearing ill-fitting clothes, headless, or with their abdomens showing.
  3. Weight stigma is based on the belief that weight is under one’s personal control. This belief suggests that larger persons are undisciplined and inactive. However, when weight is attributed to uncontrollable factors such as diabetes or hypertension, people’s attitudes change. 
  4. Weight stigma exists in romantic relationships. Romantically, people in larger bodies are less preferred.  They are less preferred in comparison to those who are in wheelchairs, mentally ill, or those who have sexually transmitted diseases.
  5. Weight stigma starts as early as preschool.  Children ages 3-5 negatively characterize larger children as mean, ugly, stupid and sloppy. As children get older they start believing their larger peers are lazy, less popular, and less happy. College students report that their peers in larger bodies are lazy, self-indulgent, and less attractive, with low self-esteem and deserving less attractive partners.
  6. Teachers have a weight bias towards heavier students. They believe their larger students lack self-control and are less likely to succeed.
  7. Health professionals are also biased. Health professionals treating individuals with eating disorders report believing that larger patients do not comply with treatment recommendations and perceive poor treatment outcomes. Those strongly biased believe larger body sizes are the result of overeating and lack of motivation.
  8. Individuals in larger bodies have internalized stigma. The most common anti-fat bias among larger individuals is the belief that they are lazier and less motivated than thinner individuals. The failed attempts of individuals in larger bodies to lose weight may cause them to begin to internalize society’s beliefs that they are lazy and lack willpower.
  9. Weight stigma increases binge eating. Weight stigma causes psychological distress such as depression, anxiety, and low self-esteem. It is also associated with poor body image and increased fear of fat.
  10. Weight stigma experiences are as common as other forms of discrimination. In women, it is as common as racial discrimination. In some cases, it is more common than gender and age discrimination. 

References 

Ashmore, J.A., Friedman, K.E., Reichmann, S.K., &Musante, G.J. (2008). Weight-based stigmatization, psychological distress, & binge eating behavior among obese treatment-seeking adults. Eating Behaviors, 9, 203-209.

Chen, Eunice & Brown, Molly. (2005). Obesity Stigma in Sexual Relationships.  Obesity Research, 13, 1393-1397.

Cramer, P., & Steinwart, T. (1998). Thin is good, fat is bad: How early does it begin? Journal of Applied Developmental Psychology, 19, 429-451.

Friedman, K., Reichmann, S., Costanzo, P., Zelli, A., Ashmore, J., & Musante, G. (2005). Weight stigmatization and ideological beliefs: relation to psychological functioning in obese adults. Obesity Research, 13, 907–916.

Latner, J., Wilson, T., Jackson, M., & Stunkard, A. (2010). Greater history of weight-related stigmatizing experience is associated with greater weight loss in obesity treatment. Journal of Health Psychology, 14, 190-199.

Puhl, R., Andreyeva, T., & Brownell, K. (2008). Perceptions Of Weight Discrimination:Prevalence And Comparison To Race And Gender Discrimination In America. International Journal of Obesity, 992-1000.

Puhl, R., & Latner, J. D. (2007). Stigma, obesity, and the health of the nation’s children. Psychological Bulletin, 133, 557-580.

Puhl, R., Latner, J., King, K., & Luedicke, J. (2013). Weight bias among professionals treating eating disorders: attitudes about treatment and perceived patient outcomes. International Journal of Eating Disorders, 1-11.

Puhl, R., Lee Peterson, J., DePierre, J., & Luedicke, J. (2013). Headless, hungry, and unhealthy: A video content analysis of obese persons portrayed in online news. Journal of Health Communication, 1-17.

Stice, E., Presnell, K., & Spangler, D. (2002). Risk factors for binge eating onset in adolescent girls: a 2-year prospective investigation. Health Psychology, 21, 131-138.

Tiggemann, M., & Wilson-Barrett, E. (1998). Children’s figure rating: relationship to self-esteem and negative stereotyping. International Journal of Eating Disorders, 23, 83-88.

Wang, S. S., Brownell, K. D., &Wadden, T. A. (2004). The influence of the stigma of obesity on overweight individuals. International Journal of Obesity, 28, 1333-1337.