Supporting Healthy Bodies at UNC: Navigating Obesity, Eating Disorders, and Weight Bias

When discussing health, you’ll notice a trend between two approaches – weight normative and weight inclusive.

aha-screengrab
Screenshot from American Heart Association, 1/25/2015

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.

weightinclusive
Photo Credit: Prevention Magazine

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:

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How You Can Have a Healthier Relationship…with Food!

A healthy relationship… with food?

You’ve probably heard of a “healthy relationship” with family, with friends, or with a partner, but we talk less often about our relationships with food in terms of their health — beyond simply what we consume and when. A relationship with food is psychological, financial, social, and cultural as well as physical. Like any other healthy relationship, a healthy relationship with food is free of fear or the feeling of being controlled or out of control.

What impacts our relationship with food?

Our relationships with food are impacted by our life experiences and the systems around us. For example, the fad diet industry often uses body-shaming tactics and capitalizes on our desire to be “good” or “healthy” people in its mission to sell more products. These techniques often also promote the idea that some foods are inherently “good” and others are inherently “bad.” You’ve probably heard a friend say, “I’ve been so bad today — I ate (fill in the blank).”

However, there are no “good” or “bad” foods — and furthermore, what we consume can’t make us “good” or “bad” people! Just like eating kale all the time doesn’t make you somehow better or more moral, a bag of chips doesn’t suddenly make you a “bad” or “unhealthy” person. A healthy relationship with food involves knowing that your morality or value as a person is not determined by what you consume.

Our relationships with food can also be shaped by a desire to attain an (often unrealistic) “ideal” as portrayed on TV, in movies, or through other media. This ideal of “health” or “fitness” often depends on visible body shape/size, and provides a very narrow window of “healthy” shapes/sizes. However, research tells us that we cannot tell how healthy a person is — or how healthy his/her/their relationship with food is — by the size or shape of her/his/their body.

Overall, our bodies need different things at different times. Only you can determine what’s best for you based on your body, access to resources, and belief systems. One rule or set of guidelines does not apply to everyone in regards to diet, and people have many different ways of getting the nutrients we need.

Image from Pinterest

What can I do to have a healthier relationship with food?

  • Remind yourself that your value does not depend on what you eat, and that there are many more ways to be healthy than are shown in the media.
  • Listen to your body. To the extent that you are able, try to eat when you’re hungry and stop when you’re full. Don’t wait for your hunger or your fullness to “yell” at you – keep in touch with what your body needs to the best of your abilities based on your access to resources. This can take practice!
  • Don’t be so hard on yourself! Being rigid and restrictive about what foods you “allow” yourself to eat can be harmful to your body and your mind. Focusing excessively on what foods you have eaten, or counting calories obsessively, are often a sign of an unhealthy relationship with food.
  • Pick the foods that give you the energy to do what you do during the day. After all, that’s what calories are — energy! The more nutrients that come along with that energy, the better.

Find more information:

Balanced eating as a vegan or vegetarian

Finding balanced and nutritious foods on a budget

Eating intuitively

Nutrition resources at UNC

If you feel concerned for yourself or a friend, or want to talk more about your relationship with food, you can find more information and contact options here.

This article was originally published September 4, 2014, by Mary Koenig, a program assistant for Student Wellness. She was in the school of Social Work and Public Health at UNC Chapel Hill.

Being healthy is more about what you do than what you look like

This blog post was originally published on March 5, 2015.

If I asked 10 different people what physical health looks like, do you think I would get the same answer? My guess is I would actually get 10 different answers largely because there is no one right answer.

The purpose of this blog is not to try and change your mind about what it looks like to be physically healthy, but rather to suggest that using body image and weight as an indicator of health is misguided. Being healthy is not about how you look, but rather what you do. What you do in your everyday life often plays a very large role in determining your what the real important health indicators like blood sugar levels, triglycerides (fat content in blood), LDL cholesterol, and many others will be.

I think it is time that we start to shift our attention from what people look like to what they do when we think about health. There are so many factors that contribute to health and there are also many things out of our control, but what is in our control, at least somewhat, is whether you try and live a healthy lifestyle.

Body Snark Free Zone Sign by Treacle Tart (flickr creative commons)
Body Snark Free Zone Sign by Treacle Tart (flickr creative commons)

So what does this mean? This means that you cannot always tell if someone is healthy or not by just looking at them. But—and I say this with a big but– the majority of research shows that being extremely overweight or extremely underweight can be very harmful for your health. We also should maybe rethink how we look at individuals whose weight falls somewhere in between these two extremes and even reconsider what we would be considered overweight. I say this because last year, a large study showed that people that are overweight actually live longer than people who are “normal” weights. I also say this because in the middle of these two extremes is a very large group of people that could, or could not be very healthy but we really cannot tell just by looking at them. What it comes down to is that the deciding factor is what people do in their everyday lives (and genetics), not what they look like. I think if we started to be more concerned with things like how physically active people are, how much sleep they get, and the food they eat (in addition to many other things) instead of what they look like, we as a society could do a better job at not stigmatizing people for being either over or underweight.

I would like to emphasize that I am not saying to be whatever size you want because as I said earlier, there is very good evidence to show that this can be very harmful to health. What I am saying is let’s worry more about eating real food, food that has not been overly processed, and exercising in moderation among many other daily activities, and let’s worry less about what size we should be. This means that being “skinny” even if you can eat whatever you want without exercising, does not make you healthy. But it also means for people that get the recommended amount of exercise and eat real food in reasonable amounts, but still weigh more than society says you should, that’s ok.

I think the bottom line is we need to be real with ourselves, and stop using what we look like to determine our health. What we look like in a mirror is meaningless if we are not doing what we should be doing to promote physical health, and vice versa. Let’s start trying to live our lives in a healthier way and use that to measure our health instead of the numbers we see on a scale.

Pre- and Post- Workout Nutrition

Protein shakes, whey protein powder… But when do you use these?  Before or after exercising?  How do you fuel up for a workout and how do you help your muscles recover?

Ms. Mary Ellen Bingham, MS, RD, CSSD, head sports nutritionist at UNC, recommends “book-ending”.  This means you eat something small both before and after your workout.  To fuel up and in order to have enough energy to get through your time at the gym, eat within about an hour prior to exercising.  Then, eat again within 30 minutes – don’t wait until lunch or dinner time to eat.  These don’t have to be complete meals, but more so, snacks.

Check out the image below on nutrient timing that Ms. Bingham created. (Click for larger image).

For pre-workout, carbs will give you the energy to push yourself and not get exhausted.  Try crackers or toast with peanut butter, fruit, a small granola bar or a handful of pretzels.  Post-workout, you want to refuel your muscles.  First and foremost, make sure to drink water!  All that sweat is going to leave you dehydrated, so you need to be drinking before, during and after your workout.  Additionally, have a combination of both carbs and protein such as trail mix, a sports bar, a smoothie or – the classic drink that promotes fast muscle recovery – low-fat chocolate milk.

Previously, I interviewed Dr. Abbie Smith, an assistant EXSS professor.  If you read this interview (I don’t want to repeat it all!), you’ll find other similar advice.  Dr. Smith gave me nutritional advice for those trying to gain muscle, those trying to lose fat, what “cheat days” are all about and supplement information.  That blog post is extremely informative and can clear up some further questions you may have about nutrition for athletes.

So, if they’re right for you, continue with your protein shakes, nutrition bars or whatever your usual pre/post workout snack may be!  Remember – carbs before and a combination of carbs and protein after.

 

Workout Wednesday blog posts are written by UNC Campus Recreation. Each Wednesday we swap blog posts with the Tar Heel Tone Up blog so that readers can view more diverse post topics that will benefit their health and wellness. Workout Wednesday blog posts can be found both here and on tarheeltoneup.com.

“What Happens If I Skip Breakfast?”

Image courtesy of vaguehauntingmassappear.tumblr.com
Image courtesy of vaguehauntingmassappear.tumblr.com

 

We’ve all heard that breakfast is the most important meal of the day. Leslie Knope and Ron Swanson from Parks and Recreation understood it (possibly just for its deliciousness)!  But how many of us actually eat it on a daily basis? And unfortunately, that cup of coffee doesn’t really count as breakfast.

A 2005 study found that 35% of college students do not eat any kind of meal in the morning. This is a bit more common with men than women.

Many students skip this  meal due to lack of time or because it has become a habit to rush to class on an empty stomach.

“I know it’s probably not a good idea, but I’ve gotten used to it,” explains a second-year UNC student. “I usually study late and I would rather sleep an extra 20 minutes than wake up to make breakfast.”

While college students may lack time, it is still very important to eat in the morning. What kind of impact does this have if you decide to skip breakfast?

  1. Your grades will take a hit! Your brain needs food to function, specifically glucose. Things like toast, cereal, and fruit are good sources of this. A number of studies found a link between academic performance and breakfast. Those that ate breakfast scored noticeably higher on tests than those that did not eat breakfast. Other studies have found that when you’re hungry, you tend to be more forgetful. If you want those A’s, you should start with breakfast.
  1. You’ll be cranky. When your body is running on empty, your blood sugar drops and your cortisol (the stress hormone) levels spike. Your mood will suffer, and it’ll make it hard to sit through an entire lecture. Being hangry is a real thing!
  1. Your metabolism slows down. Breakfast helps to rev up your metabolism. Without food in your system, especially at the beginning of your day, your body goes into protection mode and works to conserve calories, rather than burning it. In prolonged cases, it causes wasting of your muscles.
  1. You’ll be more at risk for certain diseases. A number of studies found links between missing breakfast and increased risk of weight gain, heart disease, and diabetes. Yes, skipping breakfast can cause weight gain.

 An ideal breakfast is balanced. The Clinical Nutrition Specialist at Campus Health, Antonia Hartley, often recommends using the MyPlate for just that reason.

 Image courtesy of ChooseMyPlate.gov.
Image courtesy of ChooseMyPlate.gov

“I tell my clients to choose a starch (like toast, a tortilla, or granola), choose a protein (like peanut butter, eggs, or yogurt), and choose a fruit or veggie (like a banana, spinach or berries),” Hartley advises. “Putting together any three of these takes two minutes tops, especially since you can scramble an egg in the microwave.”

If you’re short on time in the morning, there many other quick breakfast recipes. There’s really no excuse to skip breakfast in the morning.

 

Justin Chu is the Information and Communication Program Assistant at UNC Student Wellness and a Master of Public Health graduate student with a focus in Health Behavior at UNC Gillings School of Global Public Health. He previously worked as a nutritionist in the clinical, community, and commercial settings after earning his bachelor’s in Clinical Nutrition at the University of California at Davis.

10 Things We Say That Hurt Body Image

I don’t speak for all women. These are just some comments I have heard and–regrettably–said in my life. Comments delivered with the best intentions that nevertheless sting, because they move me away from a confident, body-positive headspace. Comments I now try to avoid.

1. Don’t worry–a lot of guys really like curvy women.

Heteronormativity aside, this statement reinforces the notion that a woman’s worth lies solely in her ability to sexually attract a man by comforting her with the idea that men still find her body sexy. It’s like saying “all that matters is your ability to get a man to sleep with you, and being fat hasn’t totally compromised that ability.” Ouch.  Try “you’re an amazing/strong/intelligent/ creative/etc woman!”

2. Wow; I can’t believe you weigh that much. But the weight looks really good on YOU.

Weight varies. And the same weight can look very different on different people–I get it. But body-shapebrushing aside our ridiculous standards of beauty and acting like I am a “special case” either comes across as condescending–”don’t worry; you don’t LOOK fat”–or as an indirect, self-inflicted wound–”Your weight would never look as good on me.”

Let’s assume for a moment the revolutionary idea that no weight is inherently good or bad and that no body is inherently flawed. Wow. That frees up a lot of room in the conversation for celebrating the attributes of a person that really matter, doesn’t it?

3. Oh my gosh–you’ve lost soo much weight… how did you DO it?”

This goes hand-in-hand with “how do you stay so thin?” A lot of things can cause people to lose weight or maintain a thin frame. Genetics. Diet and exercise. Fasting. Eating disorders. Grief. Depression. Anxiety, and a host of other mental health issues. Not to mention cancer, lupus, AIDS, certain medications, mono, the flu…

Don’t assume that a person’s weight loss or thinness is intentional, and don’t assume they want to talk about it.

If you know a friend/co-worker/family member has embarked on a new diet and exercise regimen and they are losing weight, let them take the lead in talking about it. Reflect their feelings (increased energy, confidence, sense of pride) rather than focusing on weight loss.

And if you just happen to notice someone’s sudden weight loss or petite frame and you are genuinely concerned? Try telling them you are concerned without mentioning weight (“I noticed you haven’t been yourself lately” or “You seem a little stressed/overwhelmed; is everything ok?”). Then give them space to talk.

In the end, it’s not their weight that matters, and focusing on a person’s body or weight loss can detract from appreciating their holistic value as a person.

4. Did you see so-and-so-from-high-school’s new profile pic? She got FAT.

AKA “I can’t believe how much weight she’s gained.” This is fat shaming. Pure and simple. And no good can come if it. Besides, you have no idea what may be happening in that friend’s life beyond her FB pages. Leave her alone. You got your own life to worry about, right?

5. Those jeans make you look so skinny!

As opposed to all my other clothes? This is a pseudo-compliment. It insinuates that I am not actually skinny and thus need a pair of jeans to make me look skinny, and that by pointing out my miraculously skinny look, you are somehow doing me a favor.

Imagine a world where “looking skinny” is no better or worse than looking any other way, and what mattered was how we felt. Well, we can move closer to that world NOW by trading the skinny complement for something more meaningful, like “I can tell you feel confident when you wear that outfit” or “You look really happy today.”

6. I wish I had your arms/stomach/thighs/whatever.

Really? I wish I had 20/20 vision. The power to teleport. The ability to do crazy hard math problems in my head. C’mon, you can wish better than that!

7. I hate it when fat girls wear _____ .

Fat shaming hurts all of us. So, just don’t.

8. She is so anorexic.

Is she really? Because anorexia is a complex, life threatening, mental illness (that’s right, ya’ll, I said “mental” because it’s not just about weight…). Using “anorexic” as a derogatory adjective to describe a thin person is not only offensive to that person, it perpetuates the stigma and stereotypes around eating disorders. Maybe she is anorexic. Maybe not.

If she is a close friend and you are honestly concerned about her mental health, don’t gossip about her behind her back. Read about ways to be supportive and helpful or check out Embody Carolina’s training. And if she’s not a friend or someone you are honestly concerned about? Leave her alone. Get back to living your life!

BLD0851989. I look so fat today!

Look, we all have those days. Even the feminists and the fat acceptance folks and the media image warriors. The days when it gets to us. The fat days. And it’s ok to have that day and let yourself wallow. Lean on your friends. Although thinness is definitely valued in our culture more than fatness, even thin people have body shame, and skinny shaming sucks too. In the end, fat shame and skinny shame are really just two sides of a multi-sided problem. Many women–large and small–bond over a shared body hate, and body shame hurts us all. So instead of feeding it, let’s work to STOP it!

10. You have such a pretty face.

This is almost the flipside of the “butter face” insult. Pretty face, huh? I also have a super sexy brain, a smoking hot personality, and drop-dead gorgeous talent. A woman is more than a body and a pretty face, and there are countless complements you could give a woman that lets her know you value more than the physical features of her face. Try: “you have a great sense of style.” “You are so well-organized.” “I really admire your cool-headedness.” “You have such a way with words”….

What is your favorite non-body complement to give or hear?

Tell us in the comments!