Eating disorder Recovery: When Intuitive Eating Gets Anti-fat

April 16, 2021

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CW: This post discusses content related to weight loss, disordered eating, the medical industry, diet culture and anti-fatness.

Recently I was browsing the internet and came across some casual fatphobia while perusing the Instagram account of one of my favorite celebs – Demi Lovato. I’ve felt a connection to Demi ever since 2009 when she debuted on Disney Channel. My best friend and I were convinced that Demi was queer. She was relatable. I’ve followed her story ever since and she’s been through a lot. Demi has struggled with addiction, self harm, and eating disorders, but seems to be on top of the world lately. She talks about her sobriety and eating disorder recovery in her latest YouTube series Dancing with the Devil. This is no doubt a positive thing for her, and it’s also great for her 102M+ followers to see.

It recently became clear to me that Demi still has some untangling to do from her commitment to thinness. On her social media, Demi expressed that she had unintentionally lost weight from giving up disordered eating and being more intuitive with her body. She did this while pulling her pants out from her belly and stretching them to show how big they were on her, glowing with pride.

anti-fatness from trusted recovery sources

I’m not here to shame anyone for wherever they’re at in their personal self love journey. I do think Demi seems to be on a track that is bringing her much more happiness than before. But I want to talk about this because I’ve noticed it come up in various spaces. There is an underlying tone of anti-fatness within the anti-diet, HAES aligned, intuitive eating world. It feels insidious and clever. You can feel this tone when “anti-diet” folks address body changes. They tend to say things like, “and if you end up losing weight as a result, that’s great! but its not the goal.” Have you ever heard a friend or ally say something like that? It hurts. It’s also especially harmful when it comes from a medical professional.

What does it mean when someone in a position of authority, like a medical professional, uses this kind of language? While wearing an anti-diet mask, it still celebrates thinness. It gives the illusion of ally-ship. It makes the source feel trustworthy. They are picking up pieces from the body liberation movement and melding them with their own definitions of health. They haven’t quite removed their anti-fat blinders just yet, but they’re using language that sounds encouraging to the fat patient seeking holistic care.

A commitment to thinness in disguise

In the moment, it sounds like they value our fat bodies just as much as their thin patients. But how can that be if they are holding out hope that our bodies will get smaller? What does that say to the fat patient about the medical professional’s intentions when giving advice? While the discourse is moving away from talking about intentional weight loss in anti-diet spaces, we’re still seeking a celebration of unintentional weight loss.

Celebrating weight loss, even when it is a result of intuitive eating and having more compassion for your body, is still a commitment to thinness and still perpetuates fatphobia and diet culture. 

The thing is, I don’t believe its my place to control what anyone else does with their body. Everyone is on their own journey and I think people like Demi are doing things that are bringing them closer to peace. But these “work-in-progress” narratives can be harmful when shared on large platforms of young impressionable people. They can also be harmful when an expert relays these messages to vulnerable fat folks seeking support.¬†This does nothing for building trust between marginalized communities and healthcare.

Distrust of the Medical Industry

Distrust of the medical industry is understandable in the US. We have a system that routinely fails people of marginalized communities. Black and Brown people are statistically receiving less quality health care than white people. Transgender youth are being denied access to gender-affirming healthcare. People with disabilities and/or fat folks on the higher end of fat spectrum routinely have to navigate a healthcare system that bases their science on bodies unlike anything like ours.

Language barriers, inaccessible and unaffordable health insurance, and even medical health care deserts, these barriers make it hard for people to get in the door to be looked at in the first place. Further, we have evidence that even implicit bias results in inadequate healthcare results for marginalized communities, like the Black community. It shows that due to implicit bias, Black people are sicker than their white counterparts in the US. Black people are routinely dismissed, misdiagnosed, and denied access to medications at a higher rate than white people. So even if they can access a medical professional, the quality of care they are receiving is not up to standard.

Implicit Bias and Fat Patients

It’s not hard to imagine that implicit bias could hinder fat folks from feeling safe within the medical world. Evidence shows that fat folks are more likely to avoid cancer screenings, due to feeling embarrassed about their bodies with their doctor. This begs the question, how might healthcare look for fat people if we weren’t afraid of how our medical professionals feel about our fat bodies? What might eating disorder recovery look like without a commitment to thinness?

Medical professionals have influence: positive and negative. When you are credentialed as a knowledgeable professional and seen as a trusted source, you have impact. The responsibility is not on that of the oppressed to compromise our care nor our values. The onus is on dieticians, health care providers, and therapists to think critically about their language when working with people. You must be intentional about treating vulnerable communities with care. You must be willing to unlearn implicit bias in order to stop doing harm in spaces meant for healing.

1 Comment

  • Ryan June 12, 2021 at 7:59 pm

    Thank you so much for addressing this. I agree with you totally. I love the intuitive eating approach but have noticed a strange focus on weight loss with it even in anti-diet circles. Just like you said, everyone’s journey is their own and adopting intuitive eating may or may not change people’s weight, but there is a trend to focus on and celebrate occasions where it results in weight loss. This unfortunate bias is even present in the movement’s eponymous book – at least the second most recent edition. I picked it up during my ED recovery as my program (correctly) used its ten principles as part of recovery guidance, but the book has many stories with a very specific formula I found disconcerting. It tended to go something like this: someone wants to lose weight and has tried conventional diets only to fall into the restricting/bingeing pendulum of disordered eating, they seek out an intuitive eating dietitian who tells them not to focus on weight loss (all good so far), and then presto! by not worrying anout it and restricting, they end up losing weight anyway. I have to assume this written in an attempt to appeal to people disillusioned with the wright loss industry, but it still reinforces the idea that like all other forms of eating, the goal is still weight loss. Needless to say, I did not need that in my recovery and put it down after one too many iterations of the formula. My personal journey in recovery, and in adopting intuitive eating, involved weight restoration, which is difficult enough by itself without antifat sentiment in my recovery materials. Thanks again for speaking up about this!

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