5/31/2016. The Health At Every Size Approach AFFIRMATIONS. Attuned Eating Body Acceptance Strong science. Health At Every Size by Linda Bacon, PhD

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1 The Health At Every Size Approach Attuned Eating Body Acceptance Strong science Health At Every Size by Linda Bacon, PhD Body Respect by Linda Bacon, PhD and Lucy Aphramor, PhD, RD AFFIRMATIONS Alliance of Eating Disorders 1

2 1 in 5 Children in America struggle with Mental Illness. (Source: Centers for Disease Control 2013 Report) We can (and must) do better. More people die from eating disorders than from any psychiatric illness. (Source: National Institute of Mental Health) Eating Disorders 1. serious mental illnesses 2. biopsychosocial illnesses 3. about safety and control 4. act as phobias and addictions 5. course of illness and outcome 6. hostile recovery environment C. Johnson( 2006) The Cycle of Eating Disorders Brain with Risks (Traits) + Enviornmental Factors = Cycle of Illness Adapted Dr. S. Moseman, Laureate Eating Disorders Center( 2016) 2

3 Anorexia Nervosa is a brain disease, and has the highest death rate of any mental illness. Research suggests other eating disorders are too. Eating disorders are real diseases, NOT CHOICES. Size acceptance in dogs! Why not people? Video 3

4 Biology Genetics is thought to be responsible for much of eating disorder vulnerability, 50-80% in eating disorders. Body shape is largely a matter of biology. Fatness leads to decreased longevity. Several studies, including studies by the CDC, have found people who are mildly or moderately obese live as long as normal weight people*. Overweight people live longer than those of normal weight*. (*Categories as determined by BMI Chart) BMI is a valuable and accurate health measure. Data shows that weight related health issues doesn t typically begin until a BMI of 40. (Overweight is set at 25, obesity at 30). Pharmaceutical companies who market weight loss drugs have played a big part in writing BMI standards.. 4

5 Fat plays a substantive role in causing disease. Association has been established, but cause has not. Cofounders: Fitness: unfit people of any weight have a higher death rate. The stress of stigmatization: Feeling fat is more dangerous than being fat. Weight cycling causes inflammation. Exercise and dietary restriction are effective weight loss techniques. Approximately 95% of people who diet to lose weight will regain it. Dieting triggers a reduction in Leptin. which increases appetite and decreases metabolism. Biology, much more than lifestyle, directs body weight. We have evidence that weight loss improves health. Health improvements occur independent of weight loss. The pursuit of weight loss has a negative impact on overall health. Many studies lack scientific integrity 5

6 Health is largely determined by health behaviors. Health discrepancies are more influenced by differences in social standing, perceived power, control, and discrimination than by diet and exercise habits. Tarlov, A.R. Public Policy Frameworks quoted in Social Determinants of health, Center for Disease Control and Prevention 2014, Science is value-free. Researchers, like the rest of us, are impacted by, and products of, a sizeist society. Implicit Bias Test atest.html 6

7 Childhood Obesity Stigma Rebecca Puhl, PhD, is the Coordinator for Community and Weight Stigma Initiatives at the Rudd Center for Food Policy and Obesity at Yale University. 1/3 of overweight girls & 1/4 of overweight boys report being teased by peers at school. Can we talk about eating disorders, body image, or weight And not talk about weight stigma? 7

8 Four Words Health Discrimination Bullying Trauma Weight Bias Negative judgment based on weight, shape, and/or size. Fuels both explicit and implicit harmful actions by individuals and organizations. Includes social rejection, bullying, hate-speech, fat jokes, and exclusionary behaviors that create inequities in social access, employment, healthcare, and education. Weight Bias Vulnerability for Depression Anxiety Low Poor Self-Esteem Body Image Suicidal Behavior and Thoughts 8

9 Weight Based Most Common Type of Bullying Odds for obese child to be bullied is 63% higher than for a normal weight child. Reflects prejudices and thin ideal Increases stress and likelihood of using food to cope and decrease stress Pediatrics 2010;125; e1301; originally published online May 3, 2010; Corwyn and Robert H. Bradley, Julie C. Lumeng, Patrick Forrest, Danielle P. Appugliese, Niko Kaciroti, Robert F. Body Project Eric Stice,Paul Rodhe,Heather Shaw 2013 edition Body Project Dissonance-Based Eating Disorder Prevention Intervention Check out Resources- list of scripts Bodyprojectcollaborative.com Training Body Project Healthy Weight 9

10 What is your biggest body image pet peeve? Intervention Components Media literacy Body Acceptance Dissonance-based body image contents Self-esteem Stress and coping Healthy eating, exercise weight regulation Dieting Eating Disorders Pubertal Development Family and familybased approaches Icebreaker activity Voluntary commitment Photos of ads Thin Ideal Costs Associated with the thin ideal Role plays Fat Talk Letter to younger girl Mirror Self affirmation Behavioral challenge Quick comebacks Body activism Session wrap ups 10

11 Write 30 seconds: Thin or Body Ideal Female Male Thin Ideal Tall Flat stomach Thin Beautiful Skin Attractive Gorgeous Hair Toned Tiny feet Large breasts Big lips White teeth Results decreased subscription to the thin-ideal reduces body dissatisfaction reduces negative mood reduces dieting reduces bulimic pathology decreases risk for future obesity and eating disorders improves psychosocial functioning Stice, Chase, Stormer, & Appel, 2001; Stice, Marti, Spoor, Presnell, & Shaw, 2008; Stice, Mazotti, Weibel, & Agras, 2000; Stice, Shaw, Burton, & Wade, 2006; Stice, Trost, & Chase,

12 Appears to prevent 75% of the cases of eating disorders that emerged in the control condition over a 3-year follow-up. Suggests for every 100 young women who complete this program, 9 fewer cases of eating pathology over 3 years. Produces superior effects over several alternative interventions Five independent labs have replicated positive effects: (Becker, Smith, & Ciao, 2006; Green, Scott, Diyankova, Gasser, & Pederson, 2005; Matusek, Wendt, & Wiseman, 2004; Mitchell, Mazzeo, Rausch, & Cooke, 2007; Roehrig, Thompson, Brannick, & van den Berg, 2006) Appears to prevent 75% of the cases of eating disorders that emerged in the control condition over a 3-year follow-up. Suggests for every 100 young women who complete this program, 9 fewer cases of eating pathology over 3 years. Produces superior effects over several alternative interventions Five independent labs have replicated positive effects: (Becker, Smith, & Ciao, 2006; Green, Scott, Diyankova, Gasser, & Pederson, 2005; Matusek, Wendt, & Wiseman, 2004; Mitchell, Mazzeo, Rausch, & Cooke, 2007; Roehrig, Thompson, Brannick, & van den Berg, 2006) Tri Delta Fat Talk

13 Fat Talk 1. I m so fat 2. Do I look fat in this? 3.You think your fat? Look at me! 4. Wow, you look great! Have you lost weight? 5. I m way too fat to be eating this! 6. You re so thin How do you do it? 7. She s a little too heavy to be dating that guy. 8. Can you believe how much she let herself go? Conclusion Network effects are important body-image world for those biologically susceptible Triggered by media - traditional and online but, strongly promoted by friends, siblings, power figures, and parents 13