THE NOURISHED LIFE:

F I N D I N G H E A L T H A T

E V E R Y S I Z E

Sage Nutr it ion, LLC

Emily Estes , MS, RD, LMNT

Presenter

Emily Estes, MS, RD, LMNT

Objectives

• Define Health at Every Size [HAES]

• Describe the principles of HAES

• Identify bias within the healthcare

community

• Identify personal biases around food,

weight, and body image

Health at Every Size Assumptions

Health at Every Size Principles

• Weight Inclusivity

• Health Enhancement

• Respectful Care

• Eating for Well-being

• Life-Enhancing Movement

Weight Inclusivity

Accept and respect the inherent diversity of body shapes and

sizes and reject the idealizing or pathologizing of specific weights

Health Enhancement

• Support health policies that

improve and equalize:

• Access to information and

services

• Human well-being

• Socio-economic status• Race• Gender

Respectful Care

• Acknowledge our biases• Work to end:• Weight discrimination, stigma and

bias• Provide information and services from

an understanding what impacts weight stigma• Socio-economic status• Race• Gender

Eating for Well-Being

Promote flexible, individualized eating based on • Hunger and satiety• Nutritional needs• Pleasure

Life-Enhancing Movement

Support physical activities that allow people of all:• Sizes• Abilities• InterestsEngage in enjoyable movement

Weight Bias in Healthcare

Identify the biases that exist in the

healthcare community.

Presence of Weight Stigma:Patient Perspective

• “others making negative assumptions”• “nasty comments from children”• “physical barriers and obstacles”• “inappropriate comments from doctors”

*more than half of the sample (nearly 3000 people in the sample)

Presence of Weight Stigma:Patient Perspective

• 69% of sample, cite doctors as second most common source of weight stigma (preceded only by family members)

• Women cited doctors as the most common source of weight bias• Men named classmates as the most common source of weight

bias

Coping With Weight Stigma:Patient Perspective

• 79% report using food to cope• Using food to cope was reported to be the most frequently

employed coping strategy by both sexes• 75% reported “refusing to diet” as a means of coping

Consequences of Weight Stigma:Patient Perspective

• More vulnerable to:• Depression• Anxiety• Body Image Disturbance• Binge Eating• Decreased Self-Esteem• Suicidality

Presence of Weight Stigma:Health Care Professionals

• Medical students have reported they believe patients who are obese:• Lack self-control• Less likely to adhere to treatment• More “sloppy,” “unsuccessful,” “and “unpleasant”

…than thinner patients

Presence of Weight Stigma:Health Care Professionals

• 24% of nurses reported they felt “repulsed” by patients who were obese

• 12% reported they did not want to touch obese patients• 31-42% indicated they would prefer not to treat patients

who are obese

Presence of Weight Stigma:Health Care Facilities

• 91% of health care professionals reported their facility did not have scales readily available for patients over 350 pounds

• 79% of facilities did not have gowns sized for larger patients• More than half did not have armless chairs• 40% did not have exam tables that could accommodate

larger patients

Perceptions | Thin Privilege

HOW FAT PEOPLE ARE PERCEIVED HOW THIN PEOPLE ARE PERCEIVED

Lazy Active

Sedentary Hardworking

Gluttonous Self-Control

Unhealthy Healthy

Bad Good

Less Competent Successful

Sloppy Attractive

Socially Awkward Popular

Emotionally Unstable Happy

Identifying

Personal Biases on

Food, Weight, and

Body Image

• I count calories, points, or macros.

• I measure or weigh my food.

• I cut out carbs.

• I avoid sugar.

• I avoid fat.

• I avoid eating processed foods.

• I don’t allow myself to drink caloric beverages.

• I choose the lowest caloric meal at restaurants.

• I eat carefully during the weekdays so I can eat

whatever I want on the weekends.

• If I do “good” with my diet, I will allow myself

“cheat days” to eat whatever I want, regardless.

• I use exercise to compensate for what I’ve eaten.

• I believe I must lose weight to be healthy.

• I view foods as “good” or “bad.”

• I weigh myself frequently.

Source: The Cultivated Self

Quiet the Diet

“Normalized” in Culture

• Restriction• Avoiding “unhealthy”/”bad” foods• Counting calories/macros• Dieting to lose weight and be “healthy”• Associating health to BMI• Weighing self frequently

Source: https://www.ellynsatterinstitute.org/wp-content/uploads/2019/07/Normal-Eating-1-up-with-EC-secure.pdf

https://www.ellynsatterinstitute.org/wp-content/uploads/2019/07/Normal-Eating-1-up-with-EC-secure.pdf

What is Normal Eating?

• Going to the table hungry and eating until you’re satisfied.• Trusting your body to make up for going over or under your

caloric needs.• Taking up some of your time/attention but keeps its place as only

one important area of your life.• Flexible in response to your hunger, schedule, food, and feelings.

Source: https://www.ellynsatterinstitute.org/wp-content/uploads/2019/07/Normal-Eating-1-up-with-EC-secure.pdf

https://www.ellynsatterinstitute.org/wp-content/uploads/2019/07/Normal-Eating-1-up-with-EC-secure.pdf

How to identify harmful trends:

• Promote and/or lead to rapid weight loss.• Claim no need for physical activity.• Promises a “magic” food or supplement will lead to easy weight loss.• Claims a single hormone causes weight gain.• Claims it will result in “dropping ‘x’ pant sizes in ‘x’ days.”• Promises weight loss will be permanent.• Claims you can “eat as much as you want and still lose weight!”

Physical, Mental, & Emotional Implications of Fad DietsPhysical Implications

• Weight Cycling

• Slowed Metabolism

• Cannibalizing Muscles

• Fat Overshooting

Mental & Emotional Implications

• Poor Self-Efficacy

• Body Dissatisfaction

• Poor Self-Esteem

• Diet Mentality

• Financial Strain

Short-Term Implications of Fad Diets:

• Dehydration• Acne• Depression• Irregular Bowel Movements• Fatigue• Blood Sugar Fluctuations• Increase Cholesterol• Increase in Blood Pressure

Long-Term Implications of Fad Diets:

• Slowed Metabolism• Nutritional Deficiencies• Weight Gain

Assess Personal Weight Bias

• Understanding Implicit Bias• https://implicit.harvard.edu/implicit/takeatest.html

• Perceptions that drive diet mentality

Effective Interventions

Strategies to combat negative associations with food, weight, and

body image.

MINDFULEATING

Meeting Emotional Needs

emotional

wellness

move

connect

purpose

nourish

Questions?

THANK YOU!

Emily Estes, MS, RD, LMNTSage Nutrition, LLC

emily@sagenutrition.org