Needing to talk about body image

[Atonement]

Lately I’ve kind of found myself in a bad place body-image wise.

Over the Christmas break, I stepped onto a scale at my parent’s house and realized that I gained 10 pounds over the last semester. Honestly, the way I’d been eating, it’s a surprising it wasn’t more.

However, that brings my grand total over the last 4 years (since I’ve last been sexual with someone) to right around 35 pounds, and putting me just below BMI defined obesity.

The thing is, I know the story. I’ve read Health At Every Size. But I’m also in a nursing program, and although I love almost every other part of it, I probably hear on average 5 times per lecture how being overweight causes all these diseases, ect. And between that and all these “healthy fitness” movements, it’s really hard to feel good about yourself/healthy/attractive/ect.

I’m almost ashamed to say that around a month ago, I put myself on calorie restrictions. I lost 5 pounds fairly easily, but after that I’ve fluctuated so much. I’ll “be good” all week and lose a couple pounds, take a day off, and go right back up.

It’s freaking exhausting. The fact that I’m a major foodie and love to bake makes it even more difficult.

A huge part of me just wants to try to embrace things as is, and try to get confidence some other way. But I’m getting so many very solid messages about health and attractiveness that it’s become very difficult. Even though I’ve read HAES, I’ve found myself having a hard time trusting it while at the same time having everything from school thrown at me.

I think a lot of the focus of this has stemmed from the fact that I’m at a point where I might, if I really liked someone and they liked me back, consider a relationship. And I’m finding it near impossible that someone I liked would be into me at this size. I know that’s not sound. Plenty of my friends are my size and heavier. They date, have boyfriends, are generally loved, ect. I’m not sure how the idea that they can but I can’t works.

The thing is, since about 11 years ago when I first became interest in guys, the Venn diagram of “boys I’ve liked” and “boys that have liked me” has had little to no overlap. And I was perfectly thin for a pretty decent percentage of this, so I know it’s not sound to blame it on my weight. In fact, I think it probably has a lot to do with how few people I like.

I can’t talk to anyone in my life about this. My mom knows she’s not allowed to talk about weight with me, but if I say something to her, she’ll just give me dieting advice, as if I haven’t been trying enough. My friends will all tell me how I’m “not fat”, then try to get me to go to the gym with them. In fact, when I’m with them all, I pretend to be perfectly confident.

I’m kind of at a point where I don’t know what to do. I mean, I know whether I lose weight or not, I have to get my confidence in check. But, I’m not even sure how. Even when I look at body positivity pictures and appreciate them, I have that nagging knowledge that most people don’t see it that way.

Help?

[Heather]

I'm just leaving for the day (but with plans to jump in with this with you tomorrow, if you'd like), but I wonder if it might be helpful, before talking about this more, to reflect on two big things that leaped out at me here:

1) A concern about "most people" and how "most people" may view your body or bodies like yours. Why do you think that's mattering so much to you? Do you feel like it would matter the same way about other things you may think -- or we even know -- a large number of people don't accept or aren't into, like say, being queer, having tattoos or piercings, people aging naturally, being vegetarian, or liking to be tickled?

2) The fact that you can clearly, intellectually, see that most of these concerns about non-acceptance, or disbelief in others being attracted to you and your body, are really about your OWN feelings about your body, and YOUR non-acceptance, which you're probably projecting unto people way more than it is or will be coming from them. What do you think YOU need that would help YOU become more accepting of your body, whatever its size? Since this has come up from you before, at a range of sizes as I recall, this is clearly less likely about what size you are than it is about just struggling with body image and self-image period.

What have you tried over the years so far to work on and help yourself with this? And no, diets or trying to change your body to look different don't count. I'm talking about true-blue efforts towards self-acceptance and body acceptance, full-stop.

[Atonement]

Thanks for responding, Heather! I look forward to hearing more from you tomorrow!

Honestly, most of my coping with the whole thing before hasn't been too successful. The biggest thing, after reading HAES, was to go with my whole conspiracy theory that the diet industry is paying off the medical and fashion industry to oppress people and keep the diet industry rich.

The last time I actually had a major issue with this was when I was in nutrition class about a year and a half ago. I'm generally pretty decent about rejecting media standards, but medical standards are much harder for me.

In a way, nutrition was almost easier for me to reject because a) their standards were just too unrealistic and b) I hated that college.

But I LOVE every other aspect of nursing, and I have to wonder if maybe they're right. After all, my BP and pulse are a little higher than they used to be, and my cholesterol, while not bad, is also not quite in the ideal range for someone my age. And the scientist in me is screaming that if you're arguing with numbers, you're probably in denial..

And yeah, I've definitely felt insecure before. The only times I really didn't were maybe ages 18-21 and a period around a year ago when I really didn't want anyone to be attracted to me.

I also thought about those other examples you gave me. And the thing is, I can be totally understanding of those things. The main difference: none of those apply to me.

Honestly, I don't know what would make me feel more accepting. I kind of don't even think validation from others would help.

I'm not really sure what I can do to work on this. All the thing's I've ever done that have made me feel good about myself have to do with self improvement of one kind or another.For example, when I was feeling down about my grades at my old school feeling well, I don't feel better until I got accepted to my new school and started doing well. So, maybe that's sort of a pattern for me.

[Heather]

So, it sounds like "acceptance" is just something, period, you're not at yet. Improvement, after all, is about change. Acceptance is about being okay with how we are just as we are.

I want to do a little unpacking about weight, health concerns, and some of what you're hearing in your nursing program. You know, from reading things like HAES, that a lot of this is biased research and people not looking at good research properly. You also know a lot of this is just old information (as someone who trains medical students and clinicians sometimes, I know all too well that educational programs about medicine often do not teach current information).

But by all means, there are some things that can be -- but may not always be -- related to weight, or more to the point, eating well and getting the right amount of activity, that are health issues. So, if you are concerned about your health, then having a conversation with a sound doctor about this is a fine idea. But I don't hear you voicing concerns about your health here. And becoming more healthy (which is unlikely to be about calories, and more likely to be about just staying active and not eating crap) may not wind up changing the shape or size of your body, nor how you feel about it.

When it comes to improving body image, the common ticket is figuring out what you can do that makes you feel good in your body, at home in your own skin, and more focused on who you are as a whole person, and what your body does as a vehicle for living your life, than just what you look like.

So, is there anything you've found that when you're doing it, you do feel at home in and happy with your body? That you find gets you focused more on using your body for life experiences that really enrich you, rather than seeing it as something that's about its appeal to others? Same goes with social situations: have you found people or groups where you tend to feel more comfortable in your skin, and everyone else seems to as well?

[Keda]

I'm gonna share some links here, which might be tough reading for you, because they're stories of people who are very, very frustrated and pissed off with doctors and nurses. I'm not trying to make you feel bad, I swear

I haven't read HAES, but it sounds like it covers a lot of the issues these links discuss from a big-picture perspective. The links are some personal stories from people who've had medics misdiagnose them, not treat them, or be very unprofessional with them because they're fat. I'm hoping that the personal anecdotes will make it easier to see this problem not just as an abstract one related to medical journals, but as one of a bunch of people who really, truly are good people trying to help their patients, actually making things worse because of their unconscious biases.

http://bakafox.tumblr.com/post/89783142 ... e-atlantic - the big long comment here is by my lovely friend, who used to be very active (and fit, and fat), but has had mental health problems nobble her ability to engage in her exercisey hobbies; and has spent lots of time failing to convince psychiatrists that if she was mentally healthy on a drug which is known to cause weight gain, she would still lose weight overall due to being able to cope with leaving her house and being active.
http://seananmcguire.tumblr.com/post/10 ... n-the-past - This one is pretty self-explanatory, but one thing that doesn't come across as well in this version as it does in other retellings is that she'd checked with her doc before embarking on both exercise regimes, and both times the doc felt that Seanan losing weight was more important than the risks (but didn't tell Seanan that or allow her to make a decision on the risks).
A couple more:
https://fathealth.wordpress.com/2013/01 ... o-end-now/
https://fathealth.wordpress.com/2013/05 ... g-a-flare/

I'm not posting these to accuse the medics involved of being bad people! But they are all stories of a medic allowing assumptions about a patient's weight to severely cloud their medical judgment. This isn't something that all medics do at all, but the number of such stories which are being shared suggests that it is a common problem, and there are also various proper scientific studies which suggest that these issues are significant (which you may have read about in HAES; if not, here are a couple, there are more and these aren't carefully selected: 1, 2). The fact that medical knowledge and practise is influenced by these biases means it is not 100% fact. It is a partial version of the truth, and it is challengeable; by not fully subscribing to it, you're not rejecting the evidence or being in denial, you're taking an intelligent, critical and valid approach to medical information. Now the challenge is to do that with all the potential flaws in medical knowledge-generation, not just the ones related to weight.

[Atonement]

The healthy eating thing is something I need to consider more.

While I probably SHOULD keep the exercise in my life, I really don’t eat badly. I dislike most fast food, and I very rarely eat fried stuff. In fact, other than the fact that I tend to go overboard on desserts, I’d really consider myself a healthier eater than the average person.

Honestly, there’s not really a whole lot of “physical stuff” that I enjoy. I’m trying to get more active, but it’s honestly not something I enjoy or get any real pleasure out of. Most of my life is internal and intellectual. Even most of my social life is just talking/ect. So, I guess you could say I’m not very in tune with my body and probably never have been.

Honestly, I think most of my friends are pretty “safe”. With the exception of one girl (who made a comment the other day about not wanting to go to the beach because she was “fat” despite being unquestionably the thinnest person in our group), no one seems to be very fixated on their bodies. I usually feel totally comfortable with them, until the pictures go up the next day and I start mentally critiquing how I look in them.

So yeah, I think it’s safe to say that self-acceptance in general is something that’s a difficult thing for me. Weight has been particularly difficult for me.

I was about 10 or 11 when my mother first put me on calorie restrictions. I don't lose any weight, and all I remember is feeling bad about myself. Another time at around the same age, I have a distinct memory of my dad telling me that I was thinner than my best friend last time I saw her, and I didn't want to switch spots. The sad thing is, I don't think I would have even realized I was chubby if it hadn't been pointed out to me.

Even now, my mom knows she's "not allowed" to comment on my weight, but I know her well enough to know what's going on in her head. That I would be "better" if I lost 30 pounds and became more conventionally attractive. That one day I'm going to wake up, realize fat=bad, magically stop loving baked goods and ride off into the sunset with some guy. I love her, but she's one of those ladies who can't watch an awards ceremony without evaluating every single woman's body, assessing their gains and losses, ect.

[Atonement]

Also, those were a really interesting read, Keda.

The thing is, though, one of the main things they teach in nursing school is how to prioritize.

Even with the model that fat=bad, all of those cases were very poorly prioritized by any halfway decent doctor/nurse, even with bias.

But you are right. There's a lot of weight bias. And I've even pretty much had a teacher show us how to calculate BMI and say "It's a very flawed assessment tool, but you need to know it for the NCLEX exam"

[Heather]

I grew up with similar stuff, so I certainly understand the impact it can have.

I think for me, the big AHA! with that, though, was realizing that much of that kind of talk comes from someone with their own big problems with body image and self-acceptance. In other words, that kind of talk and approach really tells you more about THAT person's feelings about their own body than it tells you about your body. And frankly, someone who is still so far behind with their own positive body image that they need to try and control the bodies of others, and judge the bodies of others, is someone we can know is about the least credible person when it comes to giving us sound information and feedback about ANY body at all.

When we have a positive body image, and we also want others to, we just don't behave or relate that way. Know what I mean?

It does sound like one thing that's missing here is finding ways to use your body, physical ways, that you do find you enjoy. Perhaps for you the ticket might be finding things to do where physical movement is also linked with emotional and intellectual activity, or creative pursuits? For instance, some kinds of yoga are very reflective by design. Hiking out of doors gives us all kinds of sensory input and has a range of opportunities for thinking throughout.

[Heather]

Btw, if you have never seen this, this is something I pulled together with some cool people in my life a while back, and I remain in love with their suggestions: http://www.scarleteen.com/blog/heather_ ... body_image

[Atonement]

Yeah' I've tried Yoga a few times, but I don't tend to have the patience for it. The poses tend to be kind of awkward and uncomfortable for me, and I never stick with it. I also always have a hard time keeping my mind there.

I actually do enjoy going on walks, and have taken few in my neighborhood. Unfortunately, though, I like in in area where the weather is very frequently awful, something I'm pretty sensitive too. Not to mention, most weekends I'm confined to studying.

I know it sounds like I'm making excuses, and who knows, maybe I am...

I'm at a point where I know that I need to do something. It's just so hard for me to have something that society perceives as a "flaw" and not try to change it.

[Sam W]

Just jumping on a thought about the walks (since they sound like something you enjoy). They might be something that you could build into your study/other commitments schedule, like say " I'm going to study for x amount of time, then go for a walk, then study some more." That way, they might be able to serve double duty as exercise and as something that centers or de-stresses you.

[Keda]

Another option might be performance; acting, dance, giving speeches or presentations at student events, reciting if you like creative writing. They're not particularly exercisey, with the exception of dance, but they are ways of consciously using your body and the way it moves and works to achieve a desired effect. As a way of working with your body rather than against it, and of getting to be proud of what your body can do, performance can be great if it's something you'd like to get into.

I totally agree that all the stories I linked show a lot more failure of medical judgment than just the person having a bias, yeah. It was the last paragraph that was what I really wanted to say, the stories were necessary to put it in context.

[Heather]

You know, I think it's interesting that you didn't have an issue controlling calories and dieting, but you clearly are very resistant to activity. If you're truly concerned about your health, simply moving in our bodies is something we know is the most important thing, and inactivity tends to have poor health impacts on people no matter what they weigh. If you're interested in improving body image, finding ways to be in your body, using it, and enjoying doing so is truly one of the big tickets.

I have generally observed that people -- especially women -- tend to have an easier time doing things that are about depriving themselves (like restricting eating) than things that give them things (like being active in some way in your body). Given sexism and the way a lot of women are socialized in general, that's hardly surprising, but I do think it warrants attention.

How about we do some more brainstorming with this, rather than just giving up, especially since this really is the stuff that is most likely to protect your health and make you feel better in your body? Patience, after all, is something we can learn and often need to work to learn, so the fact that you have, thus far, had a hard time with activity because of a lack of patience need not be a barrier. Again: you clearly found the patience to diet, so.

How do you get around? I ask because walking, skating, biking -- ways of being physical that also provide transportation -- are often some of the easiest ways to get a little more active and to experience your body as something that helps you live your life, rather than as something that is just a billboard for sexual appeal or interest.

Too, it also is sound to talk about ways to enjoy your body that are restful, as well as active, and that also are often positives for people. For instance, how do you feel about massage (often that's financially restrictive, but in major cities, you can often find massage students on the cheap)? Acupuncture? Some kind of spa experience (those that are clothing-optional can be particularly beneficial)?

[Atonement]

Sorry it’s been so long! I had 2 tests and a clinical last week, so I got kind of distracted. But I haven’t forgotten our discussion!

I officially stopped restricting my diet the day I posted. I almost feel like a part of the issue was that after all those anti-fat lectures, I just needed to get permission to like my body as it is. Of course, the issue isn’t over, but just hearing “It’s ok” from people that I trust in this area helped a lot. Yesterday I went to a lunch party at a friend’s house, ate as much as I wanted, and didn’t feel the slightest bit guilty.

I do need to think of some way to be more active. And I think part of it will be finding something I can do indoors. I’ve never been outdoorsy- I didn’t even like to play outside as a child very much. I think it’s also hard for me because I’ve NEVER been very physically active, so even a little bit feels like a lot of work. I’m really looking forward to starting work again once my program is over. I’m not sure constantly having to be studying is helping.

I’m thinking that maybe yoga deserves another chance, just that maybe I need to go slower. I like the way the stretching feels, ect, but I never really feel like I’ doing the poses correctly. I think maybe the stuff I’ve tried might be too advanced, even if it was labeled “beginner.”

There are a few places locally that I like to walk. There’s a nice mall not far from my house, and when I go there I prefer to walk. There’s also a Whole Foods walking distance that I like to go to sometimes, but I can’t really afford to get all my groceries there, so I end up driving to a further, less expensive store most of the time. This all contained to the cooler months though- once it gets above 80 or so, I can’t bear to be outside. And here, that’s pretty much April to November. My school is too far to get to by any method but driving, unfortunately.

I haven’t tried massage or any of those things, mainly due to cost. I didn’t know about the schools thing though, so maybe I will do a search and see if there’s anything nearby. The closest I come is giving myself a pedicure every couple weeks.

I wouldn’t necessarily say I found the patience to diet, though. I kind of built myself up into starting for a month or so, and it only lasted about 3 weeks. Even then, I went over a lot, to the point where I was just gaining and losing the same 3 pounds by the end of it.

[Heather]

But you DID do it for that time period, which says to me that you have the ability to do something similar with other things. And the good news is that when you do that with things much more likely to benefit you physically and emotionally than food restriction, chances are awfully good it'll be a lot easier to start habits you stick to.

You mention that stretching feels really good, and you tend to feel more comfortable indoors: so, why not just start with stretching? In terms of a yoga practice that works with that, should you be interested (don't mean to push that, it's just that yoga, skating, boxing, biking, hiking and hula-hooping are my personal areas of exercise knowledge), you might want to check out restorative yoga. That type is mostly about rest, relaxation, emotional support and stretching. Nothing in that type is challenging: it's effectively made to be doable and restful by design.