What is the connection between weight stigma and eating disorders?

You will be happy to bend your ear (maybe again) for this one!  Julie Church, RDN and Carter Umhau, LMHC talk with Erin Harrop (now doctor Erin Harrop, PhD, Assistant Professor at the University of Denver) about healthism, the use of the word “fat,” fat liberation and intersectionality.  Dr. Harrop shares their personal experience to spotlight problems with the over-focus on weight in eating disorder treatment. The Appetite crew released this interview 3 years ago and it is even more relevant to our cultural conversation today. 

Links:Dr. Harrop’s article in Women and Therapy (2018): https://pubmed.ncbi.nlm.nih.gov/31595100/
For more learning, Dr. Harrop recommends:

1. Fat Girls in Black Bodies by Joy Arlene Renee Cox Ph.D. 

2. The Adipositivity Project: https://theadipositivityproject.zenfolio.com/all

3. Children’s book: Free to be Me: Self Love for all Sizes  by Dr. Leslie Williams

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Youtube: https://www.youtube.com/user/OpalFoodandBody/videos   

Thank you to our team…

Thanks to David Bazzi for editing, Camille Dodson for podcast administrative and social media support. 

Music by Aaron Davidson: https://soundcloud.com/diet75/

Episode transcript:

Lexi Giblin 0:05
Welcome to the appetite a podcast about all things food, body movement and mental health. Brought to you by Opal food and body wisdom. an eating disorder treatment center in Seattle, Washington. I am Dr. Alexia Giblin, a psychologist and executive director at Opal, and today we re released one of our favorite interviews from the appetites early days. At the time of this recording three years ago, Aaron Herrera was a doctoral student in the UW School of Social Work working on their dissertation on the life experiences of people with atypical anorexia. Now they are Dr. Erin Harrop and have taken a post as assistant professor at the University of Denver at DCU. Their research agenda addresses weight stigma as a social justice issue. By examining the systemic factors that impact eating disorder patients access to quality health care, Julie church, Opel’s co founder and nutrition director joins Dr. Herb in this conversation. And many of you may be missing Carter, um, how the appetites previous host, she is in this one to enjoy.

Carter 1:16
So, a few weeks back, we talked about Health at Every Size as a movement. And one of the things I was really struck by was that, to think about that movement, and its place in kind of the conversation around bodies, means that you’re flipping a lot of assumptions on their head, just as the ground groundwork is being laid, assumptions are being flipped. So when you’re talking about kind of doing this, this different kind of exposure or even, or advocacy work, what are the assumptions that you feel like you’re, you’re breaking open?

Erin 1:52
So many?

Yeah I think in the beginning, there’s a lot of assumptions about health, what it means to be healthy, what it means to and whether or not even we should or have a responsibility to be healthy. So I think it’s pretty commonly accepted, at least in this culture in this time, that health means presenting in a certain type of body, you know, a certain type of like, muscular, athletic, toned, toned but not too toned, and like thin but not too thin kind of presentation. And, you know, we have these guidelines that are set forth for us in terms of our body weight and our BMI that let us know, okay, this is this is what health is, and this is the type of body I should have. And I think a lot of the advocacy work that we do kind of questions, some of those assumptions, and also questions, the ethics of kind of prescribing a certain type of body type and a certain type of body, and then and prescribing behaviors to get that type of body. So a lot of our work in advocacy has to do with a, where does this preference for a certain body type come from and a certain body size come from? Does it come? You know, what type of system is supported? By by that? Who benefits from that? And who benefits most from that? Because I think a lot of these expectations that we have benefits certain groups, way more than others. And then thinking about how ethical is it to kind of continue to promote this certain perspective that’s centered on weight at the expense of other things. And I think one of the other things that we’re trying to kind of flip on the head is this, like responsibility to not just thinness but also to health. You know, the Health at Every Size community for a long time is kind of struggled with this idea that we want to shift the focus from weight to something. And I think maybe in the beginning, we thought health Yeah, that’s what we want to go for it because everybody can get on board with that. And then the it sometimes, health and like ability isn’t necessarily a choice that folks have like it’s one of those things that ebbs and flows for all of us. Within our lifetime. We have periods when we’re never sick and periods when we’re chronically ill. We have periods where we can like be that amazing athlete that we want to be and we’re like crushing it on the volleyball court or something and then we have other times where we have a back injury and we can’t move and so this idea that like this kind of ultimate athleticism or wellness or healthiness is not only an option, but also A responsibility. Yeah, that can be super problematic. And it you know, I’m always asking, like, who does it exclude? And who’s left out? And whose experience is are we saying is wrong? So I think some of those assumptions are things that were kind of questioning and pushing back on a little bit.

Julie 5:23
I want to like write those questions. I know I wait, what did you say?

Carter 5:27
Well, I wanted to just ask you that question that you just posed yourself. Like, whose experiences are being excluded? Who is getting forgotten about in this, this kind of mainstream paradigm?

Erin 5:39
Yeah. No, I was, I was thinking about this on my way in. Because even in that question of who’s being left out, we still often see it centered around like, then pretty women who show up kind of in that margin speaking for that marginalized voice. So I just saw a Facebook video of like, a really pretty thin woman who had a back injury. And so you know, she, her hair had gotten messed up, and they did this beautiful transformation for her with this haircut. And, you know, she went from like, then beautiful woman with messy hair to like, then beautiful woman with beautiful hair. And, and there was this guy, I was thinking about it, as I was watching it, I was like, Okay, this is acceptable for this woman to be bedridden, and to not take care of herself, partly because of her privilege. And how would this be, if this was like, an older, fat woman, you know, who was disabled and unable to take care of herself? What kind of assumptions would be put in there? And like, how much would this hairdresser be reacting with, like, disgust as opposed to? Oh, we’re gonna get you through this, honey. And so I do think, you know, for sure, there are folks with chronic illnesses that we don’t see that get left out. I think when we talk about body positivity and acceptance, there’s cultures and, you know, people of color are not represented a lot in our, in our white movement. You know, like, we have an I don’t want to ignore the fact that there are a lot of advocates that are people of color that are doing great work, but it’s not being centered in our, in the movements, or at least in in this one, the one that I see is a white woman. Okay, so there’s a lot of work out there that’s being done. And it’s by folks that I don’t have as much contact with in my white world. So you know, and I think also, like, we we see folks with disabilities left out, you know, of course, people of size. And actually, I don’t even really like that term a ton, because we all have size. What we’re trying to say is, is fat people, and I’m kind of saying that from the fat liberation meaning of the word. I sometimes tiptoe around that word with certain audiences, just because people get afraid when I say that people are. But but that’s what I’m talking about. Yeah, yeah. So yeah.

Carter 8:34
And can you say a little bit more about kind of deliberation of that word in this context? I’m familiar with that. But I wonder if everyone would be because it is such a I mean, you say it and there’s like a, it comes with kind of an energy around it, I think, when that word is often in a room, so can you lay that out a little bit?

Erin 8:52
Yeah, I think we, I mean, called the F word a lot. eating disorder treatment circles. And that’s, that speaks volumes, right? That, that this word is something that has been so pathologize that we equate it with cursing. And so yeah, the fat liberation movement, there’s a movement to reclaim this word fat. We see similar things in terms of other places, like for instance, in the queer movement, queer used to be used as a as a slur. And in, you know, working with language, and we talk about like reclaiming the tools of the oppressor. In feminist studies, particularly in feminist studies, from people of color, we see this movement to try and reclaim language that has been used against a group of people when there’s something redeeming about it. Now fat as a term is a it’s a descriptive term, right? It means that there’s more of something. So I think in terms of fat people using fat as a positive, or neutral or descriptive term, that’s that’s the way that I’m using it in kind of that reclaiming way. There are other terms that we don’t necessarily reclaim, you know, that have caused, like so much harm or been used in such a detrimental way that a lot of advocates say no, there there is, there’s no reclamation of that term. And so terms like that are things like obesity, like that’s a term at least that I’ve heard tossed around is like that we’re not, we’re not reclaiming that word that is causing too many, too much harm. So I think, this idea of like, what language we use, how we use it, is a challenge and Like, who do you use it with? Yeah. When is it appropriate to use it? Is it appropriate for me to describe myself as a fat woman, depending on like, how I’m perceived and like, who’s around me. And then, you know, like, watching my thin peers, like react to that can be, you know, a challenge, because that is a word that most people are uncomfortable with. And people will say, anything to avoid, acknowledging, acknowledging it, they’ll say, fluffy and chunky and heavy and curvy, and these are all euphemisms to get around that saying, this person has a larger body than somebody else,

Carter 11:42
right? And it goes back to that idea being it’s pointing to morality would say, right, but if there’s fatness, and there’s squirmish, pneus, around that word, there’s an assumption that it’s a bad thing. Yeah. Instead of like, everyone has some degree of fat on their bodies. And so it’s a thing. Yeah. And it is part of the body. Yeah. And would be more neutral.

Erin 12:06
Yeah. And even more than just fat that we have on our bodies, which is kind of a, like reclaiming that is for sure. Something especially in eating disorder treatment, we talk about like, you’re not fat, you have fat, right? And I think even to push back on that a little bit and say, Yes, we all have fat, and some of us are also fat. And so being willing to, because still in that, the way that we talk about that, then like you’re not fat, don’t worry. Don’t worry, goodness. So I’m not trying to say something’s terrible. With you, I’m just trying to say that you have some fat on you, just like everybody else. Like, we can also push back and say, Yeah, okay, everybody’s got something on them. And some of us have more.

Julie 12:55
I don’t know if this is a good time to go there. But I’m so curious. Because, gosh, okay, so Aaron, I know that you’ve been a part of some of those kinds of discussions around some people using the word fat about them on their own selves. And this is in a professional context. So in the eating disorder treatment world at some national conferences, and like, bigger places where there’s a lot of people serving, learning to be, you know, and growing to be better providers and treatment providers for those with eating disorders. And so I know that you’ve been a part of some of that. And I wonder if there’s anything else to add to it on that layer? Because I know from my standpoint, what I’ve, what I have grown in awareness, right, is that eating disorder professionals, and the eating disorder world is absolutely not immune to having the weight stigma and the size discrimination that is in this world. And even when we opened opal, and we founded it on Health at Every Size, and we were putting that as a stake in the ground. Like, it’s kind of this, like, we say that to some people in the world. And then they look at us like, Well, duh, of course you are. And then I’m like, No, no, no, that actually within the eating disorder world that this isn’t commonplace. And that’s sometimes surprising to people. So I guess back to kind of like in the eating disorder, world, I know that this exact thing that you’re talking about, like people claiming the word fat, and using that, even in a professional context with colleagues of different body sizes, is happening right now. Among the industry in in the in the new sort of field. So I don’t know if there’s something you could give us to help us understand that or if there’s anything else that adds to understanding about what’s going on, and maybe where that’s going to take, I would say a new sort of treatment, but then like, even maybe society, maybe, I don’t know, is it a starting point?

Erin 14:42
Yeah. So I think it’s really sticky when we start using some of these controversial terms. Yeah. And not everybody’s on the same page about how we’re using them. Okay. Okay, and so

Julie 14:55
fat being one of the thing you’re saying, Yeah, the controversial term or the word fat is like the thing Yeah,

Erin 15:01
yeah, I know that in some circles, some folks who are coming from that fat liberation standpoint, identify themselves as fat. And they, you know, they might introduce themselves as Hi, I’m so and so I’m a fat sis woman. And some sometimes people who are less familiar with that react to that. And they they want to say like, Oh, don’t call yourself that. And when we find ourselves asking that I’m like, What is it about me calling myself fat that you’re reacting to that you don’t want me to call myself that? Because what that says to me is that there’s a there’s a judgment that you have about fatness that, that it’s not good. And I shouldn’t call myself something that’s not good. And so I think, especially for thin providers, it can be a challenge to hear people identify themselves as fat, and to kind of own it. And we might have this pushback and say, Oh, don’t do that. Don’t do that. But But really, what we’re saying is they’re like, I’m afraid for you to do that. Or like, I have a problem with this word, or I don’t want you talking down about yourself. And maybe I’m not talking down about myself by calling myself that and maybe I’m using it descriptively. So I think especially for folks within privilege, if you’re uncomfortable with the word, explore it a little bit, talk to people who use it and ask them why, you know, find out why is that the word of all the words that you could use to describe your body? Why is that the one that you’re choosing? And I think another one of the things that comes up, and I actually haven’t had a lot of conversations about this, because this is a really hard thing to talk to people about his like, like, when are you fat enough to call yourself fat? Totally.

Julie 16:53
I that’s I I’m glad you’re saying that. Like, right, yeah,

Lexi Giblin 16:56

Julie 16:57
But what is it in relation to what what

Erin 16:59
is that? Well, I don’t, because this is all kind of a, we’re talking about, like terms that are all kind of By comparison, right? Like, right, my body is larger in comparison to this or according to BMI charts, which are somewhat arbitrary and change occasionally, then I’m this Yeah, you know, and, you know, if I had a BMI of 25, and like, went to bed, then you know, the night before, in the night, BMI shift, you know, and like, all of a sudden, like, I’m overweight in the morning, like, now, now, can I call myself fat? Like, there’s all these? It’s kind of an arbitrary thing, in some ways.

Carter 17:41
It’s arbitrary. And I, and I feel like it could get really complicated. And maybe I’m saying this surrounded by people with eating disorders, yeah, as a clinician, but I feel a little bit worried sometimes that anyone would claim that when actually they don’t have a healthy view of kind of where their body is because of their challenges with their body image. Yeah. And then use it not in a way that is neutral or descriptive. I don’t know.

Erin 18:06
Yeah. You know, and I think I think in the in the fat liberation world, like this has been a conversation, right? We talk about small fats and super fats, and we talk about the spectrum of fatness. And, you know, I think in fat liberation, I’m always a little bit worried when it’s small, fat people that are that are whose voices are centered, whose voices are heard the most when we’re not hearing from other fat folks in larger bodies. I think we run the same risk of centering privilege in conversations where we’re deliberately trying to hear from other voices and from marginalized voices. In terms of the eating disorder, world, yes, we, you know, I’m working with eating disorder clients, we hear that fat word all the time, I feel fat. I am fat. I’m afraid I’ll get fat. We hear this. This fear, fat language. I think as clinicians being able to let our eating disorder folks explore what fat liberation is, I think that’s a great start. And I think if one of your clients starts using that term to identify, I would honestly I’d go with it. I do think that fat identity is something that we kind of find or come to or discover. And I think it would take a lot for an anorexic or I don’t like to say anorexic but a person with anorexia to come out as fat if they weren’t fat. So I do think that maybe in the beginning, it could be too that this is a person who had a higher body weight. Prior to their eating disorder, and they just know, this is where my body is going to go, if I do refeeding, you know, like, you know, I was I looked like this before I stopped starving myself. And that’s probably where I’m headed. So it could be that maybe they’re in a more like ambiguous body weight category right now. And so as a provider, you might be uncomfortable labeling that but I think with as with any kind of identity, when a person starts to claim that identity, especially if it’s something that’s, that’s empowering, I think it’s at least worth exploring and seeing Why are you using this term?

Julie 20:39
It’s interesting in the context of get treatment, even today, I was supporting somebody that was really affected by something in body image group. Were you in body intragroup? Today, Carter, okay. I wasn’t there either. But I just heard about it, but, but just one gal reacting to what somebody in a smaller size body stated about, oh, well, I’m just going to be fat and lazy, you know, or I’m just something, something like that. So putting the stereotype with the size using the word like, right, like really derogatory, and then the the woman that was in a larger size, body feeling just Oh, reactive to that. And then and my, like, coaching and support in her panic was, you’re here, you’re in a place you can discuss that, like, be, like, facing it, and kind of in discussing it in community, right, versus just the individual, even like individual client and provider relationship. But what happens in a mill you when these things are like being brought up or being said, then I was feeling like all of this woman like she’s maybe on the cusp of, of potentially claiming something for herself. Right? And like, identifying and going, this is who I am. And wait a minute, like, working to figure out well, wait, why is this person creating or stating a lot of fear of fatness? When, in comparison, she was doing that, right? Like, you know, that Wait, she’s smaller than I am? So how can she say that? and What is she saying about me? And like that whole thing? Right? So I just I think the richness of I feel, I feel like our you know, opal is a safe place that people can have those conversations and like, do that interpersonally in a treatment environment, which I find, I think that’s just a really a gift to be able to do the work and be interacting with people different sizes. And then yeah, maybe like you’re saying, like coming out with that word or naming that claim? I’ve never thought about that way, honestly. So I think it’s nice to think about.

Erin 22:26
Yeah, two things with that, first of all, like coming out of that is totally a thing. Yeah. So it’s, it’s something that folks think about, and if you even fat folks who have been fat all their lives treated as fat their whole lives. There’s this dissonance and this reaction towards claiming this because it is intentionally and deliberately like accepting, you know, a very stigmatized identity, and something that most people don’t accept as a part of a person’s identity most people view as, like a choice, or the result of being lazy or having certain eating behaviors or never moving, like all these stereotypes that we have. So I think that recognizing that, a, it’s a process, it’s not like, I went to bed, and I woke up one morning and realized I was fat. Yeah. But also that, that there is this, like, coming to terms with like, Okay, I’m going to face this very scary thing about myself and potentially, for someone with an eating disorder, that could be their greatest fear. Right, like, their greatest fear could be realized. The, you know, this thing that we’ve been coaching them to, like, not fear might actually be true. So, I think, looking at what that process of coming out and accepting is like, is is important, and that it’s not necessarily that coming out process might not be met with acceptance from people in their community, it could be something that people push back on and, and really are okay with their new lifestyle choice. Right, like, I mean, we I hear this all the time. And I think in the context of a treatment environment, too, I think as providers, we have a really neat opportunity in situations like that where clients kind of go back and forth about well, I’m feeling stigmatized, because my body is bigger than hers, and she said this thing. I think sometimes as providers, we put it back on the clients and we say, hey, this will be a great interpersonal conflict opportunity for you to learn about and recognize and I I think sometimes part of our anti oppression ally work can be to step in in those situations and do some education about weight stigma has

Julie 24:58
happened. Yeah, what was at play? Hear Why does this person think this or feel

Erin 25:01
exactly like what is? What is motivating this fear of fatness? And what is, you know, how does, you know my own discomfort? And my own fears about my body? How does that heap oppression onto somebody else? You know, we think it’s all about us and what we’re experiencing. And the reality is that, like, the body hatred that I harbor for myself, like is mirrored to other people who have bodies that look like mine. And so how much I give voice to that or credibility to that. It makes a statement, whether or not we are intentional, or we think that about others. Yeah, it’s, it’s just part of it. Yeah.

Julie 25:44
And that happens in social situations, too, right? Absolutely. Not just in treatment environments, right how to human beings might interact about their sides and what they might say.

Carter 25:53
You’re objectifying yourself. You’re objectifying someone else inherently. But, yeah, I wanted to shift the conversation, cut the conversation, excuse me, just slightly to kind of what, how all of this plays out in an eating disorder setting. We were just getting into that a little bit. But for those that don’t really know, a ton about kind of eating disorder treatment. Truly, you said earlier that people would be surprised that there would be this groundbreaking thing to do eating disorder treatment from a Health at Every Size. point of view. But are there things that get assumed as well around how I mean, someone’s behaviors based off of their body size? And of how they’re treated within treatment? Yeah. gnosis and know exactly. That is kind of centered around this, these assumptions and these stigmas.


Julie 26:56
Yeah, hear Aaron’s thoughts on it, what would you What would you want to?

Erin 27:03
Well, you know, in the eating disorder field, we’re not immune. And our mean, our DSM is even written in a way with kind of a hierarchy of diagnoses and how we screen and so you know, when a person presents with a body weight that’s low, we we do a certain screening, when a person presents presents with a body weight that’s higher, we might not ask them the questions about self starvation or purging that we might Firth in or person. So I think kind of right off the bat, depending on the philosophy that you follow in terms of diagnosis and assessment. We have groups of folks that their symptoms might be entirely missed because of how like the common practice in terms of our diagnosing, I see that over and over and research where they’re like cut offs for just being considered to be included in a study. And so like, by definition, we’re excluding some folks from even consideration for having an illness because their body weight is above a certain point or below, we might see that in binge eating disorder studies where people with underweight or normal BMI is like might be excluded from that particular study, like there, you know, and so then that’s skewing handsy. Yeah, it paints a picture that like, everyone with binge eating disorder has this one body type, when that’s not the case, it occurs throughout the weight spectrum. And similarly, we might see studies on restriction, you know, over exercise or something where they, you know, don’t accept anybody with a body weight, or BMI, like above a 20, which paints this picture that everybody with restricting disorders from the from the research side presents in this certain way? Yeah,

Julie 28:53
I know, you’re really passionate about that. So

Erin 28:57
similarly, like, we also see that in recovery studies where they might say they might define recovery by having a BMI between 18.5 and 24. And everyone else is, you know, they don’t meet inclusion criteria. So then that means that we’re only seeing a really narrow excludes the Pon narrow picture of what recovery from an eating disorder could look like we’re seeing essentially, what it means to recover from an eating disorder into a body that’s socially acceptable. Yeah. And so yeah, I think just yeah, in terms of screening, diagnosis, it comes in I can’t remember the initial question that

Carter 29:38
was based. I mean, it was an entry into some large things. But I feel like that’s, that answers it for sure. I think I was also wondering about kind of how maybe within a treatment setting people would get treated differently. Or Yeah, I guess about Yes, how would people get treated differently? And I mean, I’m imagining, like you said that that’s so much of the screening process. Right, but

Erin 30:11
and I, you know, to speak from a more personal point. So, you know, I have experience as a person who presented with what we call typical anorexia, which would be, you know, a BMI that’s underweight. And then also presenting like years later, with atypical anorexia where my BMI was in an overweight category. You know, for myself, I know that my behaviors were exactly the same, you know, I was restricting food. I was throwing up. The actually, the only thing that was different is that when I was underweight, I also had substance use tacked on to it. And then later, I did not. And so in terms of behaviors, from the inside of that diagnosis, like I wanted help for the same things. And, you know, I think about this question a lot, like, how does it impact us if we, if for the one person or a higher weight person, because I went through treatment in two different inpatient centers, it was kind of like my own little, you know, end of one experience? Yes,

Lexi Giblin 31:22
sir. I’m

Erin 31:22
it like, kind of compare them. And the treatment was radically different. You know, when I presented for treatment as a thin woman, nobody questioned my diagnosis, the only thing that I got from peers was like, because I wasn’t as emaciated as some of my peers. That was the whole like, Well, do you have anorexia? Do you have bulimia was kind of this like, like, are you thin enough to be anorexic? You know, it was that those kind of questions as a higher way, anorexic patient, when I presented for treatment, my therapist asked me why I was even in treatment. Well, when I was in an inpatient 24, seven hospitalization setting with, you know, medical complications, which is why I was in an inpatient setting, you know, and in that, in that setting, like, I had a therapist that, you know, not to harp on this poor therapist, you know, but she, she said, Oh, you know, I think your real problem is substance abuse, you know, I don’t think you that you really need help for an eating disorder, I think you need help for substance abuse. And at that point, I’ve been clean for four years. So well, you know, the, the willingness to kind of overlook, like, no, like, I’m here, because I can’t feed myself like, right, I promise. I’m not lying. I didn’t think that impatient was like, such an amazing experience I did I really wanted to come back here and be stripped, searched and yeah, monitored in the bathroom. Like, you know, this wasn’t like, summer camp. So I think Yeah, in terms of the legitimacy with which you’re treated by providers is, is a huge difference. And then, I mean, even things like, you know, then what, what a meal plan looks like, you know, my meal plan, when I was treated as an underweight person, was what you might expect for someone going through refeeding. And as a higher weight person, they put me on a restricted weight loss meal plan, even though I was doing refeeding. So I ended up discharging from a higher level of care and having to do refeeding from my impatient meal plan, which, that’s a challenge, you know, challenge. So that, you know, I think these, you know, are like, you know, when I was presenting as thin, I was restricted from exercise for, until, like, I was orthostatic stable and things like that. And then as a higher weight, patient, I was prescribed exercise and as, like, a part of my treatment, even though compulsive exercise was a part of my disorder. So I think, thinking really critically about like, we want to treat the behaviors and the you know, the, the depression, the anxiety, like we and we want to treat it well, regardless of how a person presents. Yeah, so I do think it can be really different.

Carter 34:29
Yeah. Oh, my gosh, that makes me sick hearing about the difference that you would be prescribed some of the behaviors essentially that you’re trying to heal from. Yeah, yeah. Which is just making me sick thinking about that. Yeah.

Erin 34:45
And then that offers just more and more legitimacy to that voice that says, you know, your body is unacceptable and it does need to change and you know, like, I mean, it, it strengthens and I think for fatter people that present with eating disorders, this is a challenge because they go to doctors, and they’re congratulated on weight loss potentially in the beginning. Or maybe entirely, you know, they could never get seen

Carter 35:11
as an issue

Erin 35:12
Exactly. Like it’s something to be celebrated as whereas, you know, for me, I, you know, I always look at weight loss, because it normally doesn’t happen unless we’re doing something. I always look at weight loss with, like a little bit of suspicion, like, okay, like, what’s not right, it’s not like, Oh, my God, what are you doing? Tell me about it. It’s like, Huh. You know, usually weight loss happens when like there’s, there’s a major shift there. Like there’s a change, there’s a shift in behaviors or an illness. And so like being curious about that, as opposed to automatically congratulating,

Carter 35:48
because our bodies are working incredibly hard to keep us stable. Yeah. And safe. And so if our body has not done that by losing weight, then something’s happening. Something could be off.

Erin 36:00
Yeah. And maybe not. Maybe not sure. But maybe more times than not,

Carter 36:04
right. Yeah. Yeah. So in what you were just saying, kind of what it what it might feel like for someone in a fat body to be, you know, told and battling in treatment, that they should be losing weight, essentially, thinking about kind of the internalized oppression that you have to be fighting against actively as you’re fighting for recovery. And now I’m thinking to around internalized oppression around race as well, and how all this gets thrown in. And I know that you are part of the you might need to help me with the language around this. But with Asda, you’re working on the inclusivity. Committee, is that right is

Erin 36:51
the best name.

Carter 36:54
What’s that all about? What is Asda, first of all, and what does that all mean?

Lexi Giblin 36:59
What would you rename it,

Erin 37:02
I have thought so much. As to is our association for size, diversity and health. And they’re the organization that has trademarked this Health at Every Size name. And they’re a group that specifically fights for justice, not just in social justice, not just in terms of weight discrimination, but we’re in the process of trying to take what we call a more intersectional approach to looking at weight stigma. And for those of you who are not familiar with that term, intersectionality is a concept developed by black feminists that has to do with the fact that we experience our identities in combination. So I’m not just a woman, I’m not just a white woman, like, I have all these overlapping identities that affect how those other identities are interpreted. And so for me to be fat as a woman means something differently than for me to be fat as a cisgender. Male. And so that’s going to impact me differently. And similarly, we see things like that in terms of people of color, social class. Yeah, all those different identities. So I think, for a long time, the weight stigma, community or fat liberation community was focused just on weight to the, like, exclusion of other forms of oppression, not realizing how it’s different to experience fatness, as a Latino woman versus fatness, as, you know, a sis white male. And so I’m thinking about the fact that we can’t just look at any one of our identities alone. So yeah, anyway, as the for the last several years has been working on becoming a more intersectional organization, which is a challenge to do. And we, yeah, I’m a part of our inclusivity committee. I say that I kind of question that term, because I have a friend who was like, you know, inclusivity makes it sound as if, like, we wanted you white folks here in the first place, as if there was like, we invited you. And, and you know, so I think it’s something really critical for us to consider in terms of like, whose voices are heard. Who gets to lead? Yeah, whose voices are centered.

Carter 39:49
The word inclusivity then suggests, oh, US white people are including you all in our conversation, that kinda what you’re saying. Yeah.

Erin 40:00
We even deserve a place at the table. Not Not Not in a pejorative sense. But there are some places where perhaps we don’t need to hear from another thin white woman, perhaps, you know, now, I am definitely advocate for finding How can we ally ourselves with other groups, other marginalized groups, and what does that look like? But I think anytime that we’re thinking about ally ship, we’re coming alongside someone we need to really be critical about. Am I speaking when someone else could be speaking? And how do I like, What does ally ship look like here? And am I truly being an ally? Or am I just like making myself feel better about something right, like, so I think, kind of, on the ally side, we have to be really critical and self reflective and open to learning. When it comes to trying to make changes that maybe we really feel are good and are all well intentioned, but being able to critically reflect on that as important.

Carter 41:11
Critically reflect and step back a little bit. Yeah.

Erin 41:13
Yeah, I’m

Julie 41:14
glad you say that, because I it’s like, one of the reasons I wanted you here, like on this podcast, because I just where I am, I feel like I don’t know if I’m gonna use the right words and conversations or all this stuff. I like feel fearful that I may not have the right way to ally like with somebody and so it I’m trying to navigate that even in my the ways that I might have some roles in the Health at Every Size community right now professionally, I like still feel hesitant and scared that I’m going to say something wrong or do something in this whole thing. So I think I just that’s like, I want Aaron to come and

Carter 41:51
talk about other stuff.

Julie 41:53
Because it’s like, I we care. So I care so much. And I want to keep growing and learning and like be. Yeah, so I feel humbled by it, I guess in that way, because I sit in a place of privilege as a thin white woman. So then I go Okay, well. Okay, what do I do with this? Like, I don’t want to overstep and use my power. Right? I don’t want to so I don’t, I feel more hesitant lately in that way, and like trying to navigate what to what to do with that. So I just say that.

Erin 42:29
I’m glad you brought that up. So there’s a, there’s a great list of like, characteristics of white supremacy. I’m just gonna throw out that word. Yeah, just get there. Okay. But one of the it’s basically like, how do we look at critically look at white culture. And some of the things that that are products of our white culture is like this. And maybe, particularly for white women to like this, like, I don’t want to say the wrong thing or be misinterpreted. And so then I kind of step back, and then I don’t act. And so I think that the willingness to step into that discomfort, like you just did, and say, Hey, I’m still gonna do this messy work, and I might mess it up. And, and, like, perfection doesn’t have to be the only option here. Because I think we can only do ally ship and perfectly. And if we wait for to be perfectly prepared, you know, we are going to be those folks on the sidelines that are silently complicit. And so I think having the courage to step in and say, Hey, I don’t know what I’m doing. I mean, even on this podcast, like, I’ve used the terms, like men and women and not mentioned non binary identities, you know, and that’s like, you’re conscious of that. Yeah, well, I’m growing to be you know, and I have wonderful people in my life, who remind me over and over and over women, and femmes or, you know, here’s how your language can be improved. Or, you know, that was really kind of crappy, what you just said there. But I think part of this ally work is being willing to, to step in and being willing to be wrong and being humble when somebody says, Hey, here’s how to do it a little bit differently. So I think just by those acts of bravery, and being willing to step in with your privilege, and try and make some change that’s important.

Julie 44:38
I distinctly remember when we Aaron and I did a presentation on campus here at the university, Washington, for the staff. And as we were preparing it, and just sort of sort of divvying up the slides, and I felt like even we like in our relationship. We’re sort of trying to navigate this of like, okay, and do you remember this? Yeah, and I don’t I think it may have even been, I don’t know when we were working on it. You were like, Okay, well, I think you should take these slides, because they might listen to you for these reasons. And then I think I’ll take these slides because they, and like just trying to like, figure out what would Yeah, I don’t know, just trying to make sure the audience could take it. Like, and you were like, there’s some of these slides, I think they’re gonna take it easier from a dietitian versus from me and the social worker, and then sort of our body sizes we talked about, like, Okay, I think they’re gonna take it from the thinner of us in this, in this context, and this topic, and like, I mean, I don’t know if that just felt like, Oh, I was grateful for the way that we were able to, I don’t know, just like, name those things. And then like, decide together Wait, we said, we care about the content of this, and getting this out to some of the staff here, there was more of like a wellness program for the YouTube employees, and was like, Oh, I’m so excited about this. And he felt so unified in that. And then we were trying to like together, figure out what was gonna, how the audience was going to receive us and the ways we were and who they were going to interpret us to be based on our credentials, and our body size, and our skin color and our education level. And like, Oh, yes, so many things.

Erin 46:07
And I think that highlights, like, why having multiple voices in this work is important. And, and I, you know, why? ally ship, and then all those things can be like so crucial, because there are things that I can say is if that woman were because of societal stigma, I won’t be believed. Yeah, like, you know, it’s, and there are things that I can say and have, you know, say the exact same thing cite the exact same study, and I won’t have that credibility, I will be seen as either trying to glorify obesity or trying to justify my own body. And so you handed me those slides. Yeah.

Julie 46:42
That’s why I thought, like, Okay, well, I guess I’m the dietician. Okay, if they’ll hear it. I mean, okay.

Yeah. But like, I’m

up here with, you know, gosh, darn it. Are you kidding me?

Carter 46:54
Like Aaron’s got way more to say about that?

Julie 46:57
She knows the study. I’m just what I don’t even know this study, basically.

Erin 47:01
Like, that’s the contrast.

Julie 47:02
That’s how Yeah, I remember feeling that I wanted you to have way more time up there. I just was like, all those things. I remember feeling that.

Erin 47:13
And they’re also you know, sometimes when I want to step into that space, and I’m willing to take it and other times where Yeah, I feel like

Julie 47:21
that day, actually, I think I remember you saying that.

Carter 47:23
Yeah, you can have to sort through all those different waters just to give a lecture.

Julie 47:27
Yes. Yeah, that’s not.

Carter 47:33
I was just reflecting on last podcast, we were talking about body image of time, just kind of generally. And I don’t think that we got to as much depth, of course, around this topic of intersectionality. But we were talking a little bit about kind of what it what it’s like to go on a process with yourself around developing healthy body image and what is that? And what is body neutrality versus body positivity? Etc. Do you have any, any sense or anything that you’d want to add to the conversation around on how to develop kind of body image and these terms? It’s a big another big question.

Erin 48:20

You know, it’s the whole concept of body positivity is a really charged topic right now in fat communities, because body positivity can be a place where fat liberation can be kind of hijacked a little bit, and we focus on acceptance and positivity for like a certain slice of the fat community, you know, this kind of hourglass? Them fashion, actually, grandma. Yeah, this kind of, you know, that that’s acceptable. And that and, and that the idea that having body positivity means I put all this time and money and resources into presenting my body in a certain way, or that I have a responsibility, a moral responsibility to making myself as palatable as possible as a fat woman, right, that if I can present in this certain way, like my fatness will be you’ll see that I care about myself really, that I’m trying I’m really working with what I’ve got here.


it’s, and I think we kind of run that risk of body positivity becoming something where like, as long as I can, I still want to see myself as pretty. Right? I still want to be beautiful, and that that’s part of accepting my body is seeing how beautiful I really am. And I think there’s this other kind of pushback that like, I don’t owe you prettiness. I don’t owe you a certain presentation. I don’t owe you money that spent On products or clothes, you know, I think there’s a lot to be said for fat equality in terms of like access to clothing and, you know, things that we consider like really basic human rights. And then on the flip side, that, at least for me in, in my journey, I’m really trying to get to a place where I can, like, sit in my body and be cool with it. You know? So for me, it’s not just about, like, Oh, I can, like now appreciate this about the shape of my legs, or I can appreciate my hair. Like, you know, the kind of kind of the go to things that we talk about in eating disorder treatment. Well, like what can you like about yourself? Like, you know, even that, like it’s parceling our body up into pieces, right, like, and how often are we really talking about like, like the bulge of my belly? Or like the folds in my back? Like, how often are we talking about those things that are like, really pathologized? In our culture? It’s all about like, well, this thing most closely aligns with what society says is beautiful. So I guess I like that thing.

Carter 51:20
Still, how are you most palatable? Are you most fitting into this idea of the male gaze upon you at all times? and etc?

Erin 51:29
Yeah, so yeah, just like this. Like, I think of steps and I’m thinking like, I don’t know, like I’m wearing, I’m not wearing sleeves right now. Like, that’s a huge for me, for like, this woman who had to, like, unveil my arms one day in, like, 120 degree treatment in Arizona, because I was so terrified of like, how my arms looked, like, to be like sleeveless here, because I’m a little warm. And this is how I’m most comfortable. I mean, that’s, that’s huge, right. And, like, I My arms are, like, way bigger now, than they were when I was there. Like, I even have like, this little like, crease here, my, my, I’ll call that a bicep, like, right like to, like, be able to, like, be here. And like, like this kind of like, I want to be able to accept this with as much like, gentleness and like comfort that I can. And then also look for those places where, like, I get to use my body as a tool for expression, like, you know, my tattoos or my hair color, or you know, how I present my gender, you know, in terms of like, my style, how I show up all those types of things. So I think those kind of steps towards comfort and safety and self expression are all things that are important for me, and things that are really hard to teach, but I think, you know, exposure, practice all those things.

Carter 53:08
I love that idea. I’m just like, my mind is popping in all these different directions around what it means to be embodied in a way that’s not objectifying, but also allows you to kind of claim personality and style and all these things that are so significant.

Lexi Giblin 53:23
In case you want to learn more about Dr. Harris work, you could find one of their publications in the journal women and therapy in 2018. on their own experiences, a difference in treatment between typical and atypical anorexia, and you could find the link to this article in our podcast notes. And they have been working on developing a weight stigma training for healthcare providers to help educate about weight stigma and how it impacts clinical care. For this, Dr. Harrop is working with Dr. Lisa early anger at the University of Washington, as well as several colleagues from the interprofessional education program. And if you are a University of Denver student you are lucky this spring, Dr. Harris is teaching a social justice course on the intersections of weight stigma with other forms of oppression. And in case you want to connect up with Dr. Harrop, through Facebook, they host a community called recovery at large, which provides peer support for higher weight folks with eating disorders. Thanks for listening. You can learn more about opal at www dot opl food and body calm. And thank you to David bazi for editing Camille Dodson for podcast support and Aaron Davidson for the appetites music. See you next time. Thanks

Transcribed by https://otter.ai