Social justice as the route to health.

If your January has been anything like mine, then no doubt you’ve been surrounded by the standard New Year’s deluge of gym leaflets through the door, diet promotions and articles in glossy mags,  and of colleagues and friends bemoaning the Christmas pounds they’ve ‘piled on’ and determinately resolving to shun the biscuit tin.

The pressure to diet and lose weight is a year-round phenomenon, particularly if you are female it would seem, but in January it is especially unavoidable.

This January we’ve also seen renewed panic in the tabloids over the ‘Obesity Crisis’ and a plastic surgery app aimed at teenage girls.

And so the Body Respect event I attended in Coventry last week came as a breath of fresh air and its timing could not have been better.

The event was hosted by Coventry Women’s Voicesand Coventry Feminists, and was led by Lucy Aphramor, who established the Well Founded organisation.

I found the evening hugely inspiring, thought provoking, and at times very moving.

Lucy led an interactive workshop which challenged the widely accepted premise that ‘overweight equals unhealthy’, introduced the idea of size as equality issue and spoke about the Health at Every Size (HAES) approach to health care which she advocates.

At the start of the evening we were asked to discuss in small groups what Body Respect meant to us, and two clear concepts emerged; that of respect towards our own bodies and respect towards, or from, others.

In these conversations, and those which we subsequently had about dieting, people spoke honestly about their own relationships with their bodies; the ease with which some of us can tell others to ‘love their bodies’, but the difficulty we have applying that message to ourselves; the diets we’ve tried that haven’t worked; and the pressure from all sides to be a certain body type – namely the thin, perfectly proportioned ideal constantly shoved in our faces by the media.

Despite an overwhelming response that ‘diets don’t work’, when asked to raise our hands if we still go on them, the majority of the women in the room acknowledged they did. Lucy linked this show of hands to the need to value our own embodied experiences and hold dominant narratives, including medical ones, up to scrutiny.

I am always humbled by the openness and honesty with which people share at events like this, and the wonderful effect that telling our stories can have.

After setting the stage with these discussions Lucy continued to dismantle some commonly held preconceptions about size and health, with some often surprising facts.

She started by reminding us that the most consistent effect of dieting (weight loss) over two years is in fact weight gain and that you can tell more about a person’s health by their post-code than by their BMI.

If we could promote one thing to improve the health of people in Coventry, she asked, what would it be? Reduce smoking? Increase exercise? Eat healthier food? Finally we got round to it: equality.

This was one of the core messages I took away from the event; that social justice is the route to health.

Lucy quoted the work of Sir Michael Marmot, which has shown that only 5-25 per cent of health inequalities can be counted for by the ‘big four’: eating, smoking, alcohol and excercise, and that it is living with stigma, oppression and discrimination that causes health inequalities.

This led to talking about the stigma, oppression and discrimination which ‘overweight’ people face daily, and the sizeism which has become a very accepted part of our society.

From the NHS to tabloid papers the message rings loud and clear; that ‘fat is bad’; and that everybody can, and should be, thin. Today, with the panic over ‘the obesity crisis’, thin people are given the moral high ground and a sense of superiority over those deemed overweight; and increasingly the motivation to lose weight is built on a foundation of shame.

In the UK today these messages start early; one mother present talked about the advice given to her 8 year-old daughter at school about eating low fat yoghurts, and the ‘anti-obesity weeks’ held in primary schools across the country.

All this flies in the face of actual evidence, which would challenge the direct, simplistic correlation between weight and health, and sustain the assertion that shame and blame only ever increases health inequality.

It is interesting to note, as several people highlighted on the night, that whereas things like sexuality, age and race are now protected characteristics, size is not, and attacking people for their size is currently much more culturally acceptable. Size has not been politicised in the same way as these other characteristics, and people who suffer from sizeist abuse or discrimination find they have nowhere to turn.

Through her work with the NHS as a dietician, Lucy has seen first hand how this ‘weight first’ approach is broadly applied to all number of ailments as a cure-all.

She has also seen how this approach inevitably fails, and is even harmful, which is why her work with patients now is based from a starting point of acceptance and teaches compassion towards oneself as opposed to shame.

There was so much more included in the evening than I could hope to capture here and I can’t over-emphasise the impact of hearing a message which so flies in the face of what we are typically told to feel about our bodies.

At the end of the evening Lucy asked us to discuss in our groups what a society that embraced body respect would look like.

We imagined a world with changed media images, no diet foods or diet ads, a greater range of clothes sizes readily available, kinder and happier people, of an existence free from objectifying comments and body shaming.

We’ve got a long way to go, but I feel that the 3o or so people that left the room that night carried with them seeds of body respect that will be sown into their own lives and the lives of those around them.

Lucy Aphramor will be doing further Body Respect talks for Coventry Actively Influencing Mental Health Services (AIMHS) in the coming months. For more details see the Well Foundedwebsite.