Food and Body Shaming
By Jill Weisenberger, MS, RDN, CDCES, CHWC, FAND
Today’s Dietitian
Vol. 25 No. 6 P. 32
Counseling Strategies for RDs and Ways to Stop It
Kids on the playground bully one another about their weight or inability to swing on the monkey bars. Someone tells a friend at a restaurant, “You shouldn’t go back for seconds.” Instagram shows a person eating fruit and yogurt, and the caption chastises another for buying potato chips.
A clinician asks her patient, “Can’t you do more exercise than just walking?” These are examples of body, food, and fitness shaming. Body shaming is judging, stigmatizing, or criticizing someone about their body size or shape. Food shaming involves criticizing someone’s food choices, and fitness shaming is telling someone their fitness routine isn’t good enough. Shaming also can be less direct. The witty remark, “You can never be too rich or too thin,” exemplifies a less direct form of shaming.
According to the Media Empathy Report: Spotlight on Weight Stigma by the Media Empathy Foundation,1 portraying television characters with a higher body weight eating large quantities of food or having a disdain for exercise is a common form of shaming. This report also shows that characters in large bodies most often are portrayed as unattractive, unintelligent, less articulate, unlikable, and the target of ridicule. Furthermore, framing exercise and dieting as penance for earlier food intake is shaming and found in television, film, advertising, books, news media, social media, and other forms of media, as well as in conversations in the health care, social, and work settings.
Culture of Body Shaming
Several factors contribute to our culture of shaming, says Rebecca Puhl, PhD, a professor of human development and family sciences and deputy director of Rudd Center at the University of Connecticut. One such factor is the perception of social responsibility. “People with stronger beliefs in personal responsibility for weight are more likely to blame and stigmatize people if they have a higher weight or larger body size,” she says. The stereotype is that a person with a high body weight lacks willpower and self-discipline. A large body size becomes associated with having a character flaw.
The pervasive ideal of physical attractiveness and thinness also perpetuate food, fitness, and body shaming. Thinness symbolizes desirability, popularity, success, and discipline. “This narrative reinforces societal blame of people for their weight. As long as these sociocultural values of thinness persist, so will stigma,” Puhl says.
A third contributor to the shaming culture, Puhl says, is the media and the diet industry, both of which reinforce stigma through societal messages that promote the thin ideal and the false message that people can achieve whatever body they want if they simply work hard enough.
Jessica Broome, PhD, founder of Southpaw Insights, a quantitative and qualitative research company in Brooklyn, New York, serving the food, retail, and health care industries, surveyed consumers, fitness professionals, and dietitians on behalf of General Mills to learn about their experiences with food and fitness shaming.2 Consumers reported that social media influencers are the greatest source of shaming. Sixty percent of consumers cited influencers as a source of body shaming, and 47% reported they’re a source of food and fitness shaming. Friends and family were the next highest source of shame, followed by peer groups and work colleagues. Approximately 25% of consumers cited medical professionals as a source of shaming. Slightly more identified fitness and nutrition professionals in the news as sources of shame.
Harms of Shaming
These forms of shaming from various sources perpetuate society’s unrealistic beauty standards, says Andrea Mathis, MA, RDN, LD, a media spokesperson; recipe developer; owner of the website Beautiful Eats & Things, which focuses on realistic approaches to nutrition; and author of The Complete Book of Smoothies. Mathis says they imply right and wrong ways of eating and looking, which can lead to fear and guilt when those high standards aren’t met. The result, she says, can be depression, anxiety, an eating disorder, or other health problems. JC Lippold, MAL, RYT, an executive coach based in Minneapolis, adds that shaming hinders the ability to see and appreciate ourselves, convincing ourselves “that we are not enough and makes us desperate for the quick fix.”
Broome’s research found that 88% of people who experienced shaming report some lasting effect from it. “Shaming leads to low self-esteem, and it perpetuates isolation,” Broome says. “A lot of people who have been shamed told us that they now prefer to eat and exercise alone.” Shaming, she explains, is a cycle. Consumers hear pithy messages such as “eat clean” and “move more” that minimize their struggles, efforts, and challenges. Such simple messages reinforce that meeting their nutrition and fitness goals should be simple. However, they find it’s not simple, and they feel like failures when they don’t meet their goals. This leads to guilt and isolation, which culminates in shame and the belief that society also shames them, Broome says. Fed by societal forces, the shame cycle becomes self-inflicted as consumers continue the quest for a simple solution.
Is Shame Often Deliberate?
According to Felicia Stoler, DCN, MS, RDN, FACSM, FAND, DiplACLM, “Shame is not only an internalized feeling, but it has been used as an interpersonal weapon.” Whether it’s a scarlet letter or unkind words, shame is used to punish, ostracize, or embarrass people for some perceived misdeed, Stoler says.
Many people purposefully use shame as a misguided motivational tool. “Before I mended my relationship with food,” Mathis says, “I would constantly shame myself for ‘overeating’ (which usually included a normal eating pattern of three meals per day), and talk negatively about my body. Like most people, I thought shaming would provide me with a sense of motivation to change and find the magic solution for rapid weight loss. But it actually left me feeling worthless and alone.”
The incorrect notion that shaming—both from others or oneself—boosts an individual’s motivation to change is widespread, says Rachel Goldsmith Turow, PhD, adjunct faculty at Seattle University and the Icahn School of Medicine at Mount Sinai, and the author of The Self-Talk Workout. But it’s counterproductive. Turow cites a meta-analysis of 26 studies involving nearly 8,000 individuals that found self-kindness—not self-criticism—was associated with increased motivation. “Self-criticism,” she adds, is linked to decreased motivation, more procrastination, and less achievement.
Broome’s research uncovered fitness professionals as common sources of shaming to motivate. Seventy-four percent of surveyed fitness professionals agreed that it’s OK to give people diet advice even if it makes them feel guilty. And 42% of consumers agreed that it’s OK for fitness professionals to make them feel guilty. More than one-half of fitness professionals said they make their clients feel guilty if the clients don’t meet their exercise goals.
Consumers also may feel guilt and shame when working with dietitians. When asked to imagine discussing their eating habits, 22% expected to feel judged. Fifty-four percent expected to feel at least one negative emotion.
Shaming Language
The language of shaming ranges from subtle to obvious. Statements such as “I can’t believe you ate that much pizza,” and “If that’s all the effort you can give your workout, you’ll never get in shape,” fall into the obvious category. Some comments are indirect and slight yet readily internalized and cause long-term harm, especially when experienced frequently. For example, a client likely feels shamed if a dietitian questions a food record with, “Didn’t you eat any vegetables yesterday?” or “Did you really eat two pieces of birthday cake?”
“Shame is built into our systems,” Lippold says. “If we can’t stop it, we can at least see it, acknowledge it, and move forward with it.”
In Broome’s research on food and fitness shaming, a single mom who had recently gone back to school explained why she hadn’t gone to the gym lately. “I’ve been really lazy these last few months, since school started. I’ve been so busy. I should really get back on a new plan,” she said. In this explanation, she shamed herself by calling herself lazy while advancing her education, financially supporting her family, and raising her children.
Other examples of understated shaming or self-shaming are the following: “I’m just a walker,” “I wasn’t successful this week because I ate less than two pieces of fruit over three days,” “You’ll have to run an extra mile for each one of those you eat,” and “You should eat this instead of that.”
Considerations for RDs
Negative self-talk aside, no one is immune to having biases about their own bodies in this society, so addressing the problem starts with awareness, Puhl says. She suggests dietitians examine their own biases by asking the following questions:
• What assumptions do I make about people based on their body size?
• Where do these assumptions come from?
• How do I feel when I interact with people of different body sizes?
• What evidence do I see in the world around me of people who challenge these stereotypes?
Mathis says dietitians can reduce shame and bias by recognizing their own privileges, “which can include food accessibility, financial stability, and able-bodied privilege, and understand that everyone doesn’t have the same background and experiences.” She further says that RDs must listen, accept, and educate themselves on those differences and keep them in mind when communicating with clients.
Puhl adds that health professionals need to step up and call out instances of shaming. “If we say nothing, we contribute to the problem,” she says. “We also need to look for opportunities to educate others about the harms of body shaming and model and express support and acceptance of people of all body sizes.”
Broome recommends fighting shame on social media. When surveying consumers, she found that 95% of consumers use social media and that one-third are motivated by nutrition professionals in their social media feeds.
Counseling Strategies
When counseling clients, Puhl asks dietitians to explain the complex etiology of body weight, which includes many factors outside of personal control and to choose their words about body size and weight carefully, thinking about how others may interpret those words. “Our studies on client preferences for weight-based terminology show that neutral words such as ‘weight’ are much more preferred over words like ‘fat’ or ‘obese,’ which typically are disliked and perceived to be stigmatizing,” Puhl says. “But, it’s important to note that there’s variability in people’s preferences, so we recommend asking each patient what words they feel most comfortable with to describe their body weight and using their preferred terminology in conversations about weight-related health.” Similarly, Broome advises RDs to avoid oversimplified messages that are “easy to say, but hard to do,” such as “eat more vegetables” or “move daily,” as these soundbites may lead to disempowerment once clients fail to meet their goals.
Turow suggests dietitians help clients envision themselves as their own cheerleaders by giving themselves praise whenever they do something well. Often, clients chastise themselves for not meeting a food or exercise goal and rarely praise themselves when they do meet their goals. “The habit of self-criticism is” as detrimental to mental health as cigarette smoking is to physical health. “[Self-criticism] can start in different ways, but it then becomes a default mental habit,” she says. To handle critical inner voices, Turow suggests an exercise from her book called Spot the Success. She asks readers and clients to write down 10 behaviors they did that day that helped themselves, others, or the world. She insists that nothing is too small. Then she asks individuals to view the list with appreciation, not evaluation. “It might feel strange at first,” she says, “to view ordinary tasks as successes, but people then report they begin to feel more accomplished and grateful towards themselves, and even feel more energy and momentum.” If clients worry that such a list will lower their standards and encourage complacency, dietitians can remind them that regular self-encouragement is beneficial because self-kindness leads to empowerment, increased motivation, and greater success.
Turow also encourages dietitians to suggest meditation to clients who struggle with shame. Research shows that five to 10 minutes of meditation several times per week for about eight weeks can improve how people relate to themselves. A good place to start is with free guided meditations available online, she says.
Lippold suggests dietitians help clients connect health and wellness to their happiness by reexamining why they engage in healthful behaviors. For example, encourage clients to run in the morning or eat a balanced breakfast because of the way they feel, not because these behaviors make them faster or thinner.
When it comes to shaming oneself, Turow recommends dietitians tell clients they’re not alone in their struggles. They can tell clients, “I hear this from lots of people.” Broome found that half of the dietitians interviewed had food shamed themselves. She suggests RDs convey empathy by sharing their own stories of struggling with shame.
When Stoler works with clients who shame themselves, she engages in conversation to explore how that internal dialogue began. She asks clients to consider the validity of the shaming statement. Clients can help themselves by looking for both the proof that the statement is true and that it’s false. Finally, Mathis suggests clients start by acknowledging the shame instead of hiding it and remind them that self-compassion is key. Mathis adds, “Know your worth. Identify your strengths, embrace your differences, and recognize your value.”
— Jill Weisenberger, MS, RDN, CDCES, CHWC, FAND, is the author of several books, including Prediabetes: A Complete Guide, Second Edition. She’s a freelance writer, nutrition and diabetes consultant to the food industry, and the creator of online courses for people with prediabetes and others.
Resources
• The Self-Talk Workout: Six Science-Backed Strategies to Dissolve Self-Criticism and Transform the Voice in Your Head by Rachel Goldsmith Turow, PhD
• Self-Compassion: The Proven Power of Being Kind to Yourself by Kristin Neff, PhD
• Media Empathy Report: Spotlight on Weight Stigma by the Media Empathy Foundation
• Free online guided meditations from the University of California, Los Angeles’ Mindful Awareness Research Center (https://www.uclahealth.org/programs/marc/free-guided-meditations)