On Body Positivity

November 21, 2023

opinion

internal family systems, nutrition

What is the debate? 🥊 #

According to epidemiological studies,¹ the threshold for BMI is 20–21 kg m^-2.

💥 yet 💥

We envision a world where BMI does not exist, and is not replaced with another size-based, anti-fat measure of health.²

What is the impulse behind movements like Health At Every Size² and Intuitive Eating³?

Shape of the motivating story 🎭 #

Suppose I have depression 😟. The only thing that fills that void in my heart is ice cream 🍨. If I don’t eat ice cream, I will kill myself 🪓. On the other hand, if I do eat ice cream, I might gain weight 🎈. Which option would you rather I pick? 🗳️

Let’s unpack this 🪆.

Eat ice cream #

sequenceDiagram autonumber participant p as Alice's Pain participant s as Alice's Suicidal Part participant e as Alice's Ice Cream Eater participant a as Alice p->>a: Hey, I'm in pain! Do something! a->>e: We got a problem. Fix it. Note over e: No problem. I'll eat ice cream. 🍨 e-->>p: A belly full of ice cream helps numb the pain. Note over p: Feeling a bit better. ❤️‍🩹

Don’t eat ice cream #

sequenceDiagram autonumber participant p as Alice's Pain participant s as Alice's Suicidal Part participant e as Alice's Ice Cream Eater participant a as Alice p->>a: Hey, I'm in pain! Do something! a->>e: We got a problem. Fix it. Note over e: I've been shamed for eating ice
cream. Sorry, I feel paralyzed 🤐. p->>a: Hey, I'm still in pain! It's getting intolerable! Do something! 🔥 a->>s: We got a problem. Fix it. Note over s: I don't really want to, 🤮
but okay. I got this. 🪓 Note over a: I'm dead, but at least
I'm not in pain.

This is not a good outcome. Alice committed suicide ⚰️. Movements like Health At Every Size² and Intuitive Eating³ want to avoid this outcome at any cost. Let’s try this again with Alice’s friend Bob who subscribes to body positivity.

Intervening with Body Positivity #

This is better than the Don’t eat ice cream scenario. At least Alice stays alive. However, Alice’s Pain still lingers unresolved and her growing BMI is putting her at increased risk of diabetes, cardiovascular disease, and several types of cancer ☣️.¹

It’s really hard to stay in your truth when you really are being abnormalized and you feel socially ousted because we are tribal by nature and need to survive by staying in our tribes, and so there’s so much against us. Further worsening the situation is the normalization of obesity. I am shamed, as a registered dietitian, for talking about healthy weight and weight loss! There are movements trying to stop the conversation, claiming there are no negative health sequelae associated with excess weight, when clearly that is well-substantiated.⁴

Thanks in part to the obesity epidemic, we may now be raising the first American generation to live shorter lives than their parents. This downward trend in lifespan is expected to accelerate as the current younger generation, who started out even heavier, earlier, ages into adulthood. Some predict that, in the coming decades, we may lose two to five years of life expectancy in the United States, or even more. To put that into perspective, a miracle cure for all forms of cancer would only add three and a half years to the average American lifespan. In other words, reversing the obesity epidemic might save more lives than curing cancer (p. 219).⁵

Addiction through an IFS lens 🔍 #

IFS recognizes the value of Alice’s coping parts, but also aims to heal Alice’s pain.⁶ By addressing the root cause, Alice is no longer compelled to eat ice cream and gains more control over her BMI. To get your head around this approach, it can help to watch a recorded session 🖥️. Dick presented a great demo on 2022 Sep 21, where he worked with an addicted system, as part of the IFS Continuity Program.

Intervening with IFS #

If you’re on a wide screen, you may like to make the page full width by clicking the button in the upper right corner of the screen. With more space to spread out, the font may be bigger and easier to read.

This example is offered to suggest a therapeutic direction, not as an instruction manual. Alice is in a vulnerable place. A safe IFS intervention demands enlistment of a trained professional 🦺. Alice should approach a Certified IFS Practitioner 💐 to discuss her situation.

sequenceDiagram autonumber participant p as Alice's Pain participant s as Alice's Suicidal Part participant e as Alice's Ice Cream Eater participant a as Alice participant b as IFS Practitioner
Bob p->>a: Hey, I'm in pain! Do something! a->>e: We got a problem. Fix it. Note over e: I've been shamed for eating ice
cream. Sorry, I feel paralyzed 🤐. p->>a: Hey, I'm still in pain! It's getting intolerable! Do something! 🔥 a->>b: Hey Bob, I've got a problem.
I'm in a lot of pain. Note over b: I hear you're in pain.
I know how to help. 🧙‍♂️ b->>a: How do you usually
cope with the pain? a->>b: I have an ice
cream eating part. b->>e: Hey ice cream eater, how are you? e->>b: I have been shamed for eating ice cream. b->>e: I declare: There is no shame in eating ice cream.
By eating ice cream, aren't you helping Alice cope with the pain? Note over e: Good point. b->>e: If Alice and I could help the part that is in
pain, would you be interested in that? e->>b: Sure, that would be great. If that part felt
better than I wouldn't need to eat so much ice cream. b->>a: Can you thank the ice cream eating
part for giving us permission to
help the part holding the pain? a->>e: *Graditude* 💞 Note over e: You're welcome. b->>a: Do you have any other
parts watching the
part holding the pain? a->>b: Yeah, I have a suicidal part. Note over b: Okay, I got this. b->>a: Can you appreciate your
suicidal part? a->>b: Huh? b->>a: Yeah, if your ice cream eating part
gets paralyzed then you still
have a way to not be in pain. s->>b: I really don't want to kill Alice. b->>s: Yeah, I get that.
If Alice and I could help the part holding Alice's pain, would you be interested in that? s->>b: Sure, go ahead and try. b->>a: Can you appreciate your
suicidal part now? a->>s: *Appreciation* 💞 Note over s: Thanks, but get to work. b->>p: Can I talk to the part of Alice holding the pain? p->>b: Yeah, I'm here. b->>p: What happened to you? How did you get all this pain? Note over p: *Describes a recent trauma.* b->>p: That's horrible. I'm sorry you had to experience that.
What is your earliest memory of feeling that way? Note over p: *Describes the earliest trauma.* b->>a: How do you feel toward
the part holding the pain
when you hear that? a->>b: I feel a lot of compassion. b->>a: Let the part feel that. a->>p: *Compassion* 💞 Note over p: Somebody cares
about me. ❤️‍🩹 Note over b: *Bob continues to guide ⛽
Alice to help her young part
that is holding the pain.* b->>p: Are you feeling the compassion from Alice? What is it like to feel that?

Postscript #

Do some healthy shape women cynically encourage the body positivity movement to reduce competition?⁷ 🧌

I hope not, but intrasexual competition is a thing.⁸ 🙈

Hey wait! It’s hard to lose weight! 😤

Stop 🐓 eating 🐔🥚 chicken 🐣
Visit my Health Audit page

References #

Fontana, L., & Hu, F. B. (2014). Optimal body weight for health and longevity: Bridging basic, clinical, and population research. Aging Cell, 13(3), 391-400. doi: 10.1111/acel.12207
Also see What’s the Ideal BMI? ↩︎ ↩︎
Association for Size Diversity and Health ↩︎ ↩︎ ↩︎
Tribole, E., & Resch, E. (2012). Intuitive eating. Macmillan. ↩︎ ↩︎
Williams Sr., K. A., & Hever, J. (2023). IJDRP Interviews Julieanna Hever. International Journal of Disease Reversal and Prevention, 5(2), 7 pp. https://doi.org/10.22230/ijdrp.2023v5n2a403 ↩︎
Greger, M. (2023). How Not to Age. Flatiron Books. ↩︎
Sykes, C., Sweezy, M., & Schwartz, R. C. (2023). Internal Family Systems Therapy for Addictions: Trauma-Informed, Compassion-Based Interventions for Substance Use, Eating, Gambling and More. PESI Publishing, Inc. ↩︎
Victoria’s Secret ditches prioritizing wokeness over ‘sexiness’ after sales drop ↩︎
Sulikowski, D., Williams, M., Nair, G., Shepherd, B., Wilson, A., Tran, A., & Wagstaff, D. (2024). Off with her hair: Intrasexually competitive women advise other women to cut off more hair. Personality and Individual Differences, 216, 112406. ↩︎