by Michelle Szabo
We’ve all seen the fitness and healthy eating ads and heard the tropes among co-workers, family members, and friends: weight issues stem from a lack of will power, ignorance about nutrition and cooking, and the desire for immediate gratification at the expense of long-term wellness. The refrain is so pervasive it can get stuck on repeat in our heads: it’s up to us to get off our butts and stay active, eat well, and “take care of ourselves”. But recent research tells us that something big is missing here. We also need—perhaps desperately so—to take care of each other.
Before I go any further, I want to acknowledge that not everyone who is considered overweight or underweight by medical standards wants to change. You might have heard of the Fat Acceptance or Health at Every Size (HAES) movements, or seen “fat flash mobs” on YouTube, where self-described “fat activists” perform exuberant, celebratory dance routines in public spaces. One of the most compelling arguments from the HAES movement is that conventional weight loss treatments themselves, not to mention the significant fat shaming in our culture, may be more detrimental to physical and mental health than the weight itself.i
Although being underweight has not received the same activist attention, I have heard from more than a few slender people that “thin shaming” is also alive and well, whether or not someone feels they are at a healthy weight.
In other words, weight may be much less of a problem for the people in question than for a judgemental society, especially in modern capitalism where fault-finding is a major economic driver. Given this, let’s agree that we are talking about weight issues that are problematic to the people themselves. What I want to highlight are two of the least-discussed reasons for weight gain and loss, and perhaps some of the most important.
1. Obesity is linked to poverty, especially in women
In Canada, women with the lowest incomes have the highest rates of obesity.ii This trend is linked to the fact that a nutritious meal is now typically more expensive than a meal containing high amounts of sugar, salt and fat.iii (Think for example of a McDonald’s meal vs. a meal from a farmers’ market or health-focused restaurant.) The phenomenon of “food deserts”—neighbourhoods or regions devoid of healthy food—is also important. These are typically low-income neighbourhoods in urban centres that are dotted with fast food joints but have few, if any, grocery stores or restaurants with healthy options.iv
In Toronto’s poorer inner suburbs, for example, residents have to travel more than a kilometre to get to the nearest grocery store, and with limited access to cars and public transportation.v Some First Nations reserves, especially in the Canadian north, are also considered food deserts because of the prohibitively high cost of fresh foods flown in from elsewhere. (A colleague recently back from Iqaluit showed me photos of a two-litre jug of orange juice on sale there for $27.) The point is that people sometimes want to eat well but are not able to afford, or access, a nutritious diet.
2. Food helps people deal with trauma and pain
If you’ve ever heard the story of a survivor of abuse or neglect, or someone dealing with mental health issues such as depression or anxiety, you may have heard about how specific food behaviours can be vital allies in day-to-day survival. Although drugs and alcohol get a lot of play in pop culture as ways to blunt psychological pain, food can also ease suffering or fill a deep emotional need, at least temporarily.
A friend and self-described emotional eater confessed to me that eating junk food feels like a way to take power back from an overly critical and controlling father. Bingeing can be a way of dealing with the shame inherited during childhood traumas such as sexual, emotional or physical abuse or neglect. Survivor stories highlight that it’s not only that the sugar high provides a temporary respite from feelings of inadequacy and despair, but, as a friend with bingeing issues put it, “pummelling” yourself with food can feel like a well-deserved punishment of a seemingly “dirty” body or “unworthy” self.vi
On the other extreme, people who have experienced a significant loss of control in their life because of trauma, violence or even obsessive parents may restrict the amount or type of food they eat as a way of regaining a sense of control. For someone who was violated or controlled by others, limiting food intake can provide an essential feeling of regaining the agency that was taken away. There may also be a sense of power and satisfaction from resisting bodily signals, as in, “If I feel hunger pangs but don’t give in to them, then I know I’m a strong, competent person.”vii This temporary sense of being a “good” person may be indispensable to someone whose self-esteem is battered and precarious.
A crucial point, then, is that lack of knowledge and education is typically not the issue. A friend who deals with bingeing told me that, six of seven days of the week he eats well—he knows how to eat well, but on that seventh day when life gets overwhelming, junk food seems like the only way to cope. In other words, healing the underlying pain is essential to a different relationship with food.
Another friend struggling with her relationship with food put it this way: “It’s not that ‘I will feel good when I achieve my ideal weight’ but that ‘I will achieve my ideal weight when I feel good.’” And feeling good often means meeting unmet emotional needs—easing the suffering that motivated someone to turn to food for solace in the first place.
Paradoxically, this suffering tends to be exacerbated by the body-shaming words and behaviours of peers and family members.viii Recent research by Rebecca Puhl and colleagues at the University of Connecticut confirms what many emotional eaters already know: attempting to shame a person into changing their weight is likely to backfire.ix
A Call for Compassion
So what can we do about these issues—the fact that there are significant physical and economic barriers to a nutritious diet and that food can be a lifeline for those healing from trauma and mental health challenges?
There are no straightforward solutions to such complex problems, but we could begin with a different way of thinking about weight issues. What if, instead of giving diet and exercise advice, we offered empathy and non-judgemental support? What if, instead of judging fast-food eaters, we supported initiatives that bring affordable, nutritious food to food deserts and low-income households (e.g., community gardens, food co-ops and mobile markets)?
Behind the weight, there is always a unique human story. What richness might we find in these stories if we’re ready to listen?
With acknowledgements to Kim Holt and Barb Janicek for their insightful comments.
Michelle Szabo is a Professor of Environmental Studies and Sociology in the Faculty of Humanities and Social Sciences at Sheridan College.
i Burgard, D. (2009). What is health at every size? In Solovay, S. and Rothblum, E. D. (eds.) The Fat Studies Reader (pp.42-53). New York : New York University Press; Wann, M. (1998). Fat? So! Berkeley, CA.: Ten Speed Press.↩↩
ii Public Health Agency of Canada (2011). Obesity in Canada. Retrieved from http://www.phac-aspc.gc.ca/hp-ps/hl-mvs/oic-oac/determ-eng.php↩
iii Drewnowski, A & Specter, SE. (2004). Poverty and obesity: the role of energy density and energy costs. American Journal of Clinical Nutrition, 79, 6-16.↩
iv Martin Prosperity Institute, University of Toronto (n.d.). Food deserts and Priority Neighbourhoods in Toronto. Retrieved from http://martinprosperity.org/images/stories/jmc/cache/mpi-food-deserts-and-priority-neighbourhoods-in-toronto.pdf↩
v Canadian Environmental Health Atlas (n.d.). Food deserts. Built Environments. Retrieved fro http://www.ehatlas.ca/built-environments/food-deserts; Pedersen, S. (2013). Food Security Evidence Review. B.C. Ministry of Health. Retrieved from http://www2.gov.bc.ca/assets/gov/health/about-bc-s-health-care-system/public-health/healthy-living-and-healthy-communities/food-security-evidence-review.pdf↩
vi Cohen, Mary Anne (1995). French Toast for Breakfast: Declaring Peace with Emotional Eating. Carlsbad CA, Gurze Books; Beitchman, J. H., Zucker, K. J., Hood, J. E., DaCosta, G. A., Akman, D., & Cassavia, E. (1992). A review of the long-term effects of child sexual abuse. Child Abuse & Neglect, 16, 101-118↩
vii Brown, C. (1990). The Control Paradox: Understanding and Working with Anorexia and Bulimia. National Eating Disorder Information Centre. http://nedic.ca/sites/default/files/control-paradox-understanding-and-working-anorexia-and-bulimia.pdf↩
viii Puhl, R. et al. (2017). Experiences of weight teasing in adolescence and weight-related outcomes in adulthood. Preventive Medicine, 100 (2017) 173–179. Available at http://uconnruddcenter.org/files/Pdfs/Experiences-of-weight-teasing-in-adolescence-and-weight-related-outcomes-in-adulthood-A-15-year-longitudinal-study_2017_Preventive-Medicine.pdf↩
ix Puhl, R. et al. (2017). The Role of Stigma in Weight Loss Maintenance Among U.S. Adults. Annals of Behavioral Medicine. http://uconnruddcenter.org/files/Pdfs/art%253A10_1007%252Fs12160-017-9898-9. pdf http://foodshare.net/program/mobile/↩