I see the complexity of weight and shape as being like what we might see through a kaleidoscope: it has many different facets, which interact and connect, and these facets in their entirety form a picture that cannot be understood by looking at just one part on its own.
Yet conversations in wider society about weight often seem to reduce this complexity to something straightforward. A person is encouraged to lose weight, told to put weight on, or offered advice that assumes making changes to behaviour will result in the body responding directly to behavioural changes. Eat less, exercise more. Eat more. What can become lost is the person themselves, and the many influences on the body they inhabit.
Losing weight, gaining weight or remaining at a constant weight is not necessarily straightforward. Nor can someone’s personal health, eating or emotional context be understood from looking at their shape and size. And yet, judgements are made based on shape and size. What gives anyone the right to judge someone else’s body?
Much more than a matter of changing behaviour
Genetics, biology, metabolism, medical conditions and prescribed medication can all influence weight. Hormonal changes, including those associated with menopause, may affect body composition and how weight is distributed. Thyroid conditions can also affect the metabolism and weight, although their effects differ between underactive and overactive thyroid conditions and between individuals. Neurodiversity can have a significant impact on eating and weight – for example, more is being understood about the connections between autism and eating and how sensory experiences of food can influence what and how someone eats. Some disabilities can also impact our abilities to eat, digest and metabolise food.
For some people, losing weight may be difficult because of factors such as health conditions or reduced mobility. For others, gaining or maintaining weight can be an ongoing challenge. An overactive thyroid, for example, can contribute to being underweight. Illnesses that affect appetite, digestion or nutrient absorption may affect weight. Conditions associated with muscle loss, or with pain and reduced mobility, can also affect someone’s physical circumstances. These are different and very individual experiences and understanding the complex connections between food, eating and our weight reiterates that there is no single explanation for someone’s weight or straightforward approach to changing it. This means that our bodies do not all respond in the same way, and that changes in weight cannot simply be read as evidence of effort or motivation.
“Eat less and exercise more” is advice people in larger bodies may hear, including in healthcare settings. Whatever its intention, this kind of statement can feel dismissive and shaming when it does not consider the person holistically or consider someone’s health, circumstances, lifestyle or experience. For many people, it overlooks the person as a whole and does not begin to address what makes their situation difficult.
Our relationship with food matters too
Alongside our consideration of the physical influences is the psychology of eating. Food provides nourishment and is essential for survival, but our relationship with food and eating can carry many other meanings.
Eating may offer comfort, evoke memories, express care or bring people together. It may also be associated with fear, guilt, shame, anger, conflict, loneliness or loss. Our relationships with food begin early in life and develop within our histories, families, cultures and our relationships with others. What feels ordinary or pleasurable to one person may be very painful or distressing for another.
How we feel can influence how and what we eat, and experiences of eating are connected to how we feel. For some people, food becomes a way of managing feelings that are difficult to bear. For others, psychological distress and an inability to connect with emotions may make eating difficult or diminish their appetite. There is no single psychological explanation for body shape and size, and assumptions based on someone’s body and their appearance are unacceptable.
Being thin does not necessarily mean that eating is easy, that someone feels comfortable in their body, or that they are free from judgement. The relationship with food, eating and the body can be conflicting and confusing. Putting on weight can be extremely challenging, depending on someone’s physical health, relationship with food and level of psychological distress. Similarly, living in a fuller body tells us little about what that person eats, the person holistically or what they have experienced.
When bodies become open to comment
We live in an environment in which bodies are frequently displayed, compared and critiqued. Technology and social media can bring this scrutiny frequently into everyday life, although it is also present in families, workplaces, social encounters and healthcare. Our society has a view on what body shape and size is acceptable.
I often find myself asking the question, why is it that people feel entitled to comment on another person’s body, shape or size? To me, this is unacceptable. It is very personal, can feel exposing and evoke pain or shame.
Advice, criticism and even apparent praise may communicate that a body is under scrutiny and create a sense of not being accepted. Someone may feel that they are acceptable only if they become smaller, larger or seen differently in some way. This can add to existing experiences of weight stigma and shame, rather than helping them feel accepted and recognised in the body they live in.
People across the size spectrum can experience painful prejudice and judgement. Every experience is different: people in larger and thinner bodies may also encounter weight-based discrimination and barriers to receiving appropriate support and care. The forms and extent of stigma and discrimination are varied across body sizes.
Belonging without having to change shape
As human beings, we need to feel that we belong. Yet judgement about shape and weight can leave people feeling alienated and isolated because of the body they inhabit. They may feel noticed for their appearance but unseen in their individuality, their relationships, their abilities or their pain.
For those of us working with clients around eating, body and weight, recognising this complexity matters. It invites us to remain curious rather than assume: what is happening physically? What does food mean to this person? What experiences of judgement, prejudice and weight have they encountered? How does my own relationship with food, eating and the body impact my work with my client, and how might my own beliefs about weight influence my clinical work?
The kaleidoscope reminds me of the complexity of this area and that there is always more to consider and for us to wonder about. Compassion and curiosity about the client sitting in front of me are where I begin.
Perhaps we can hold in mind a more fundamental question: Why are we defined by our body shape and weight?
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