These positions are ideal for current graduate students in Public Health, Social Work, Psychology, Higher Education, Health Communication, or related fields. Positions are 15-20 hours per week unless otherwise listed, and anticipated start date is August 7, 2017. To apply please see positions descriptions for links to postings on UNC’s HR website. Please note that you may need to create an account on this system in order to apply, as it is does not use onyen or PID log in. Open opportunities require a Bachelor of Arts or Sciences degree from a nationally accredited institution. Graduate degree in progress is preferred, not required.
For folks who will be a UNC undergrad in 2017-2018:
This position is ideal for a current or incoming undergraduate student with experience in photography and videography, along with an interest in supporting health and wellness at UNC. This is a shared position between Campus Health Services and Student Wellness. To apply, submit a single pdf with your cover letter, resume, 3 references, and a few links and/or images that showcase your photography/videography work.
When discussing health, you’ll notice a trend between two approaches – weight normative and weight inclusive.
The weight-normative approach includes the many principles and practices that emphasize achieving a “normal” weight when defining health and well-being. This approach rests on the assumption that weight and disease are related in a linear fashion, with disease and weight increasing in tandem. Under the weight-normative approach, personal responsibility to make “healthy lifestyle choices” and maintain “healthy weights” are emphasized. The approach prioritizes weight as a main determinant of health and as such, weight management (calories in/calories out) as a central component of health improvement and health care recommendations.
Instead of imagining that well-being is only possible at a specific weight, a weight-inclusive approach includes research-informed practices that enhance people’s health regardless of where they fall on the weight spectrum. Under this paradigm, weight is not a focal point of treatment or intervention. Instead the weight-inclusive approach focuses on health behaviors that can be made more accessible to all people. These are behaviors such as exercising for pleasure, eating when hungry and stopping when full.
So is one better than the other? We’ll look at three questions to figure that out:
What happens when people believe that everyone should reside within a certain body size / weight range?’
What happens when people try to reach that certain body size / weight range?
Does higher body weight / larger body size cause poorer health?
What are the effects of the belief that all people should reside in a “healthy” body size / weight range?
Bad things happen – weight bias, weight stigma, microaggressions and more.
Emphasizing “good weights” and “bad weights” produces the opportunity for weight bias.
Weight bias and weight stigma refer to negative weight-related attitudes and beliefs that manifest as discrimination, stereotypes, rejection and prejudice toward individuals of any size. Common negative stereotypes about higher-weight people include ideas that they are lazy, stupid or worthless – and this results in behaviors targeting them including bullying, harrassment, pressure to lose weight, and weight related microaggressions.
Microaggressions are intentional or unintentional verbal, behavioral, or environmental indignities that communicate hostility or negativity toward people who hold less power in society. For example, a doctor recommending a diet for a patient who presented with an issue unrelated to weight would be a weight-related microaggression.
Complimentary weightism is another type of microagression. Some examples include an anorexic student hearing that she “looks healthy” after disclosing that she has an eating disorder. And really – anyone being told they are “looking good” puts the focus and importance on appearance. The compliment could unknowingly congratulate someone who is using problematic behaviors like vomiting or restricting calories to control their weight.
Another example of complimentary weightism is when thinner people are “hated” for their thinness – “I hate you because you can eat whatever you want.”
Weight cycling alone may be enough of a reason not to recommend weight management because it is linked to adverse physical health and psychological well-being, including higher mortality, higher risk of osteoporotic fractures and gallstone attacks, loss of muscle tissue, hypertension, chronic inflammation, and various forms of cancer.
Weight loss promotion and achieving a “healthy weight” may instill a sense of learned helplessness in the majority of people who are unable to achieve weight-based goals. If attempts to reach and maintain a “healthy weight” continually fail or are seen as impossible given available resources, the practice of healthy behaviors may be seen as futile. If I go to the gym for a week or two regularly and see no change in my goal of reaching a desired weight, I will likely learn that nothing I do helps.
Finally, it’s important to remember that when we attribute weight-related stereotypes to each other, it affects the well-being of ALL OF US. It makes even students who are at a normal weight terrified of gaining weight. The negative effects reach across the weight spectrum.
The weight-inclusive approach focuses on the PROCESS – being active because it’s fun, and eating when hungry / stopping when full. In doing so, it results in reduction of risk factors (like sedentary lifestyle) and improved physiological measures (like blood pressure or blood glucose) in lieu of pounds or BMI. There are four decades of research proving the positive impact of weight-inclusive interventions. One study looked at folks over a 2 year span and included a “diet group” and a health-at-every-size group. Over the 2 years, 41% of the diet group left the study versus only 8% of the weight inclusive group. In the same study, the researchers offered 6 months of weekly interventions and 6 months of aftercare group support to a diet group and a weigh-inclusive group. The health at every size group members maintained their weight, improved in all outcome variables, and sustained improvements. Diet group participants lost weight and showed initial improvement in many variables but by the end of the study, the lost weight was regained and little improvement was sustained.
The weight-normative approach rests on the assumption that weight and disease are related in a linear fashion with weight and disease increasing in tandem. The belief is that to be healthy and avoid disease means achieving or being in pursuit of a lower weight if overweight or obese. A weight-normative approach believes that recommending weight loss to these individuals is not a function of weight bias but of health imperative.
But data does not support that a higher BMI causes poor health. A higher BMI is associated with various diseases, but causality is not well-established. Interestingly enough, when accounting for socioeconomic status, nutrition, physical activity levels, and weight bias, even the correlation between a higher BMI and disease is vastly reduced or disappears. The risk for all-cause mortality is lowest for people in the overweight category and highest in the underweight BMI range.
In 2013, Flegal’s very well-known and very-debated meta-analysis showed that the risk for all-cause mortality is lowest for people in the overweight category with the highest risk in the underweight BMI range. The U-shaped curve is a well-known image used to describe the obesity paradox.
Many studies show that obesity and healthy are not mutually exclusive. And culture is starting to agree. Joni Edelman, a registered nurse and writer, recently blogged about her own experience of losing weight and truly becoming obsessed with the calorie counting and incessant exercise necessary for her to achieve a BMI in the normal/healthy range. She is an example of someone who feels healthier and happier at a higher weight.
“There is a cultural belief that people have to be dissatisfied with their weight (or any aspect of their appearance) to be motivated to improve it. This belief has not found general support in the literature; in fact, the reverse is supported: people are more likely to take care of their bodies when they appreciate and hold positive feelings toward their bodies.” Tylka et al, 2014
What should we do?
Help your loved ones shift away from habitual appearance monitoring, which is associated with lower self-care and ignoring physical health, to attending to their bodies in more positive ways that emphasize self-care. People are more likely to take care of their bodies when they appreciate and hold positive feelings toward their bodies.
Remind your friends that you’re perfect just the way you are! That unconditional positive regard goes a long way in helping people feel supported and confident in their ability to make changes when THEY are ready.
Reframe body blame and shame as internalized weight bias that has little to with someone’s actual weight or size.
“What does your body provide your life that you enjoy?”
“Be gentle with yourself! You’re amazing!”
“I love you just the way you are. No matter what.”
Appreciate all bodies – don’t compliment them, just appreciate them.
Placing a focus on appearances is problematic. Avoid: “You look great!” “Have you lost weight?” “I can tell you’ve been working out!” “You look really strong!” Again – you don’t know what behaviors your comment is supporting. And on the flip side, negative comments just make people feel bad about themselves.
Some alternatives? If you can’t stop talking about how people look – focus on how they did their hair that day or compliment their shoes. But even better? Tell them what you’re feeling – or ask about their self-care.
“I’m really glad I ran into you.”
“What’s new with you?”
“I could use some new ideas. What do you do to take care of yourself?” and then, “how does it make you feel? Has it impacted your sleep?”
Focus on behaviors
Instead of encouraging a friend to work out more or eat differently, do it with them and make it fun and easy!
“Do you want to go for a run with me?”
“Wouldn’t it be fun to bike to the quarry and go swimming this weekend?”
“Can I make you dinner?”
“Let’s go to bed early tonight so we can play outside all day tomorrow!”
Make it sustainable
Sustainable change means that the behavior is supported, easy, and fun. One easy way to incorporate more physical activity is to move as a part of other activities. If you’re running errands, actually run them (or walk, or bike). If you have to drive, park a few blocks away so you get to move a bit more. Try to eat intuitively and encourage your friends to do the same.
“What if you and I walked to dinner instead of taking the bus?”
“Will you be my lunch buddy?”
“Hey, I got you this water bottle! I’ve noticed how much more water I drink when I carry it with me and fill it up at each water fountain I go by. I feel so much better when I’m hydrated!”
“How can I help you reach your health goals?”
Encourage quality of life as an end goal
Avoid focusing on how exercise makes bodies look, or exercise as a way to “make up for” food choices. And avoid focusing on calorie counting. Help your loved ones reconnect with their bodies – focus on internal body awareness rather than engage in external appearance monitoring. Consider how healthy behaviors make you and your friends feel.
“It feels so good to be outside, doesn’t it?”
“Endorphins are amazing!”
“I love how good I feel after eating a meal like that.”
“Whoa, I’m full. I love this yummy food but I know if I eat more I’m going to be uncomfortable. Let’s save some leftovers to eat for lunch tomorrow.”
Critically evaluate the evidence for weight loss treatments and communicate them
Reading this blog is a good start. Question what you see and hear about health. You’re going to see body-focused health messages everywhere! Start talking about them and actively work to change the culture.
“Did you see that article about achieving a “spring break body”? What a crock! All bodies are beach bodies! And it’s not possible to do something that is healthy and sustainable but changes someone’s body over the next two weeks. I wrote a letter to the editor to ask them not to publish misleading and body-shaming articles like that anymore.”
Work to increase access, autonomy and justice for individuals of all sizes
There are several body-positive groups at UNC and lots of simple steps you can take to advocate for more weight-inclusive practices on campus.
“I noticed that my department’s offices don’t have chairs that would fit people of all sizes, so I asked the office manager to add a wider chair to the room. The next time I went in, there was a new, larger chair!”
Trust that people move toward greater health when given access to stigma-free health opportunities
UNC is a great place for this. Campus Rec, Campus Health, and Student Wellness staff have all been trained on body-positive principles. And our community offers so many ways to stay healthy!
What do you think about this article? What ideas do you have to support health at every size on campus?
Sara Stahlman, MA, is a marketing and communication coordinator at the Campus Health Services at the University of North Carolina at Chapel Hill. She is also a member of the ACHA Healthy Campus Coalition and the ACHA Health Promotion Section.
Toni Hartley, MPH, RD, LDN, is a clinical nutritionist with Lutz, Alexander Nutrition Therapy. Antonia specializes in medical nutrition therapy for people with disordered eating patterns. She promotes Health At Every Size® principles both in her office and in her speaking engagements and practices a non-diet approach.
Do you have what it takes to be a paid Healthy Heel? We are seeking 2 undergraduate student employees with creative experience for 10 hours per week of paid work from May 2017 – May 2018 or August 2017 – May 2018. If you are fun, engaged, collaborative and ready to gain experience spreading health on campus, click below to learn more.
Patterns. Sleep is all about patterns – we do it every single night, and our ability to sleep relies on the patterns we create with our daily lives. What else do you do every day that you could shift to help your sleep become a more regular pattern?
Exercise routine: A tired body usually means a tired mind. Make it a goal to move your body every single day.
Meditation: The main requirement of meditation? Focusing your thoughts – either on your breath or a mantra, something simple, like “I will be more mindful.” Beyond that – the where and the how long and pretty much everything else is up to you. Even a few minutes a day can help. Schedule it in – perhaps first thing when you wake up and right before you fall asleep. You can even meditate in your bed – that’s absolutely allowed.
Eat a variety of nutrient dense, processed-as-little-as-possible foods. These are less likely to have caffeine nor high amounts of sugar and are more likely to nourish your body the way it needs.
Create a routine of when you go to bed and wake up. College makes this difficult, but really – we all could use more regular sleep and wake times. Ideally this includes weekends as well. Is there a wake time you could imagine working for your weekdays and weekends? Try it out for a week and see how it goes.
Create a sleep sanctuary. What’s your bedroom like? Cool it down at night, try to keep it quiet (now’s a great time to try earplugs and white noise at night if you have loud roommates), keep it dark (a sleep mask or blackout curtains might help!). Do anything you can to make your bedroom a place of relaxation and relief from the stress of the outside world.
What do you do right before you try to fall asleep?
Screen use just before bed: consider installing a filter to add red to the visual. Research has shown that blue lights of screens can mess with our brains, where the red filter helps our brain think of sunsets and sleep. Or consider keeping all screens out of your bedroom. Make your room a space reserved for sleep.
Exercise just before bed: consider doing more flow yoga or a chill walk just before bed and scheduling your hardcore cardio and lifting to earlier in the day or early evening. But – your bigger priority should be to get exercise at some time each day. Movement helps our bodies be tired and ready to sleep.
Good options before bedtime: book reading, meditation, writing down things from the day that are running through your brain so you don’t have to think about them anymore, really any sleep routine. A good example of a sleep routine? Take a warm shower, put on pajamas, brush your teeth, read a chapter of a good novel, earplugs in, sleep mask on, nightymcnightpants.
After you have put in some effort into sleep hygiene (that’s a real term describing steps like those above), and you’re still having trouble, come see a provider at Campus Health. Some providers may recommend further changes to sleep hygiene, medication, or the use of a phone app (CBT-i Coach on Play and iTunes), which can be used alone and in conjunction with a medical provider to improve your sleep. Make an appointment at CHS to learn more.
Check out all the places we found where you can eat healthy on campus! This week’s Minute Monday takes us to places where we don’t have to sacrifice taste for health benefits. There are lots of delicious options for a healthy lifestyle!