Lived Experience: Part 2 —
Trigger warning: Discussion of weight, eating disorders, health and weight loss.
Yesterday, we heard from seven women who shared their experiences with the social determinants of health (SDH) and how it has affected their self-care. For the final three questions, I ask them to describe their relationship to Health at Every Size® (HAES) and for their suggestions on how we, as a community, can address the social determinants of health. What’s awesome is that their answers sound a lot like the suggestions made by Dr. Dennis Raphael and Dr. Stephen Bezruchka, the two SDH experts with decades of research in this field.
Question 4: Do you consider yourself to be “practicing HAES”? If so, what does that look like in your life? If not, how has HAES been insufficient at meeting your needs?
I used to think I was practicing HAES, but I am not so sure anymore. I find that I am not necessarily at my healthiest. I know that my weight is taking a toll on my body. I am still curvy, but I am finding that when my own weight goes down my joints and polycystic ovary syndrome (PCOS) symptoms go down. So I am really conflicted.
I consider myself to be practicing HAES. I find that with me, balance is key — everything in moderation. I don’t drive, so I walk and take public transportation everywhere. Still, I wish I had more enjoyable movement in my life. I used to go clubbing a lot, but at over 40 I feel like it’s time for something new.
I do my best to practice HAES. There are times when I have to let go of it, though. I’m gluten free to help with joint pain/inflammation, and when I get really broke, I end up eating cheap, processed wheat products to get by. And when I get really busy with work, or I have to travel long distances for art fairs, my activity level plummets.
I think that doing the best you can with the resources available to you at any given time is part of HAES. Seeing health and healthy choices as a continuum, rather than a right or wrong situation, is what differentiates HAES from the weight-loss paradigm. I’m reminding myself of that a lot lately, like when I seek out healthy behaviors and treatment for health conditions that my body weight might change as a side effect. I’m currently examining ways to control my PCOS better, and it’s looking like all of the options that I haven’t tried yet typically lead to weight loss, often significant weight loss. I’m struggling to integrate that with my HAES mindset.
Yes, I have been practicing HAES since 2010. I’m not saying it has been easy or that I got it perfectly. I’ve been working on different aspects of myself ever since.
Since I have struggled with eating disorders before. It’s been a long way. So far I have manged my self-image and understood my hunger signals. Still, I struggle with diet mentality and with joyful movement mainly because exercise was my way of purging.
I do, however, enjoy exercise. I don’t have a problem with motivation, but with obsession on performance. I tend to overdo stuff and I burn out. It has been more difficult ever since I got Hodgkins last year. I’ve lost a good deal of physical fitness since then. I can’t seem to take it easy and I overdo my routines. I’m giving myself a break on that. Also, I’m focusing on learning how to nurture myself without concerning to excess about the “perfect” meal. Which rationally I know its bullshit, but from time to time I tend to get engage in a diet mentality, I know I eventually will get it, but I think I need professional support to achieve it. And that is where money gets in the way.
I would say yes. I have made an effort to eat food that makes me feel good, to add in more fruits and vegetables, to try new things. I can’t exercise like I used to due to a knee injury, but I do the best I can. I think that HAES should incorporate doing the best you can with what you have while trying to enjoy yourself. I’m not going to participate in movement that I don’t like and I’m not going to eat food that I don’t like for the sake of “health.”
For me, it’s a mixed bag. Oftentimes, I’ll eat plenty of good fruits and vegetables and other food that makes me feel good, and I’ll be fairly active and get a good amount of exercise, but other times, not so much. When my depression flares up, though, I don’t do as well, and I’m less active and less mindful about the foods that I eat.
Question Five: The SDH have both social and economic origins. If you could direct a group of activists to fight the SDH in a way that would have a positive impact on yourself and/or others you know who struggle with the SDH, what would you recommend? If you have multiple suggestions, please give some indication as to priority or “bang for the buck” in your view.
The most important thing for me is something many activists are already focusing on: being treated fairly, by medical and fitness professionals, would really make a huge difference.
My answer would take too long. The short version would be to make healthy habits more affordable and sustainable. I budget myself well enough to get by, but I work like a dog to do it and forego certain things like owning a vehicle, etc. Things I want to partake in either aren’t available in my area or are too expensive to maintain long term. Plus, who has time?
Here in Massachusetts, the Governor installed a program that allows doctors to write a prescription that would give obese patients at high risk a considerable discount to use the local bike share program, called New Balance Hubway, to get around. However, the Hubway bikes are only rated to 260 pounds and you must sign a legal contract that you won’t put more weight than that on the bikes — anything happens to you on that bike and you’re on your own. My current focus of ire are the carnival barkers who talk over fat people and oversimplify the issues while stealthily being backed by industries set to profit off public fears.
I agree with Lisa, the first thing would be to pressure the healthcare system to educate about weight prejudice. Second, I would urge them to pressure the government to stop the new legislation in my country that will penalize the patient for their illness.
To add to what the others have said, I’d encourage more work toward changing the way our food production system is currently incentivized. The agricultural subsidies are just a start (to be clear, I don’t want to take those subsidies away from farmers completely, just shift the focus and perhaps make those subsidies only available to individual farmers and not corporations). At a more local level, I love the programs that allow SNAP recipients to purchase produce at farmer’s markets. Let’s use those agriculture subsidy dollars to pay farmers to set up markets in food deserts. Let’s make fresh foods and whole foods cheaper than processed foods. I’d love to see more options for quick meals for people who spend a lot of time working or using public transit or in school or whatever. Let’s put home economics back in schools so that people have the opportunity to learn the skills they need to cook from scratch. I could go on and on, but there’s a start. Oh, and finally, involve the people you’re trying to help in the planning and implementation of the solutions. Not in a patronizing, “you’re here as the token poor person on the committee” way, either.
Final question: If you were Benevolent Dictator of your nation for an hour, what changes would you make to improve the SDH situation for yourself and others?
Education! And pay equality. lol
I agree, if I had an army on my side I would dismantle the corruption in the Mexican government, confiscate their assets gained with dirty money, and see that those assets covered some of the main financial problems in Mexico, so we can have better social and economic conditions that would make it easier to achieve a better health.
- Better social and economic conditions for Mexicans
- A food and agricultural policy that provides support to local farmers, and better exportation and importation policies
- A truly universal public health system that provided people full health coverage.
- Involvement of the private sector, but not just as “promoters of health”; rigorous regulations on toxic wastes, and true ecological engagement, along with better working conditions for employees
Public transit. It benefits people’s economic situation in that they can get to and from their jobs without the expense of a car. It reduces stress from commuting, it helps the environment, and when using public transit people typically are more active by walking/wheeling to the transit stop. What we did for roads with the interstate system in the US we now need to do with public transit. And by making public transit cleaner, more efficient, and more accessible, we reduce the stigma of utilizing that service. When it’s not just a service for the poor but a service for everyone, we’re doing something right.
More time. We spend so much time working and commuting. I really don’t blame anyone who doesn’t want to leave work to start chopping vegetables for cooking or to go to the gym for two hours.
I would also say pay a parent to stay at home for at least the first four to five years of a child’s life. And three to four weeks of paid vacation per year.
I can’t think of anything that hasn’t already been said in these comments. I definitely second improving public transit, and less time working. I know Europeans think the American work week is barbaric.