Doctors, Researchers Address Obesity, Body Image Differently

Few medical conditions are so frequently “diagnosed” by lay people as obesity. Because obesity is associated primarily with a visual manifestation of body weight, even those who are not medical professionals feel that it is easy to recognize an obese person who needs help.

“I’ve had significant others tell me I was too heavy in an effort to ‘help’ me,” says Katie Little, an Athens paralegal who has long struggled with weight and body image.  “My ex would tell me I needed to work out more or how disgusting it was to see me eat.”

But these efforts at ‘help’ are often the opposite of helpful. Even doctors may not handle the topic of weight in a way that patients find supportive or tactful.

“I found a nutritionist who was very positive and made recommendations that weren’t just ‘cut and paste’ ideas,” says Little. “But my general care doctor has always been more negative in his approach, generally implying that I needed to lose weight or face death.”

This is a delicate conversation for doctors and patients to have. Obesity can and often is associated with diabetes, heart diseases, and even certain cancers. Except….when it’s not. Many individuals are technically overweight but consider themselves physically active and generally healthy.

“Size doesn’t affect longevity and I ran a marathon last week,” says Coretta Shade, an Athens, Georgia­­­­­­­­pathologist who identifies as “plus sized.” “You can’t judge someone by what size pants they wear.”

Shade’s frustration illustrates one of the primary lines of contention in the study of obesity today: the line between the robust, but healthy body and the overweight or obese (and thus unhealthy) body is a thin one. More than that, it is one that is constantly changing.

“What we as a society consider to be a healthy or desirable body today has not always been the ideal,” says Shade. “Heavier women used to be that ideal.”

Physical markers of health, such as a healthy blood pressure or the ability to exercise for extended periods, are more reliable markers of true wellness.

These are the markers of health targeted by most weight-loss intervention programs. Rachelle Acitelli, a UGA Ph.D. candidate studying kinesiology, has been involved with two such programs.

“UGA DIVAS was a study examining healthy interventions for women older than 65,” says Acitelli.

“We weren’t just looking for weight loss,” she continues, “but rather for decreased feelings of fatigue and increased endurance, with the hope that this will help women keep their independence longer.”

There are documented biases associated with such programs, however. Like many other researchers, Acitelli noted that it is extremely difficult to reach participants of color.

“Our samples are predominantly white,” she says. “This was true both in DIVAS and in Girl TALK, a summer activity camp for rising middle school girls I designed as part of my dissertation research.”

Acitelli suggests that technology may be a powerful tool in reaching out to underrepresented groups.

“Many people of color live in poverty, and may not have the means to come to a lab or gym a few times a week,” she says. “But most people have access to the internet, and health apps and online support may help keep them involved.”

Health awareness is not only physical, however. Programs such as the UGA Body Project encourage participants to examine in groups how physical ideals promoted in society may not be realistic for every body.

“We’re not out to encourage students to not eat right or that you shouldn’t exercise,” says Leah Spigelman, a moderator for the program. “But we are trying to help them realize that your ‘best shape’ may not be the same as someone else’s ‘best shape.’”

“I’m technically ‘overweight,’” she continues. “But I try to eat healthy. I try to exercise. I also sometimes sit in bed, eat a donut, and watch Netflix. And that’s OK too. I still like myself. I don’t think body positivity and health are mutually exclusive. There’s room for us all to be healthier but also accept ourselves more.”

By Shelby F. Jarrett

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