Hey folks. Board-Certified Health Coach — and Primal Health Coach Institute’s Coaching Director — Erin Power is here to answer your questions about weight loss, diet culture, and health at different sizes. If you’re wondering how these fit into a Primal approach to eating and lifestyle, read on! Have a question you’d like to ask our health coaches? Leave it below in the comments or over in the Mark’s Daily Apple Facebook group. 

Tamara asked:
“Can you settle a debate between my sister and me? I am so sick of diet culture and fat shaming. Yes, I’m a large-sized woman by some standards, but I feel fine and am otherwise healthy. My sister insists that can’t be the case and keeps telling me to lose weight or go to the doctor. This infuriates me and makes me feel like crap about myself. Please weigh in: Can you be overweight and still be healthy?”

I have immense empathy for anyone struggling with fat shaming or the painful, harmful effects of mainstream diet culture. I’m so sorry you’ve experiencing this, Tamara. Shaming, stigmatizing, or stereotyping someone about their body size or other aspects of physical appearance is never okay. It’s also the exact opposite of what usually encourages a meaningful and productive approach to achieving health and wellness.

Having this come from a sister or other family member is especially rough. Family dynamics tend to be long practiced, deeply triggering, and difficult to shift. Plus, it’s just not as easy to walk away from a relationship when it’s with a family member. It’s never comfortable to be in relationship with someone who oversteps boundaries and comments on or criticizes your body or weight. Many people unfortunately experience such treatment from family members, partners, friends, colleagues, or even strangers on the Internet.

Again, this is never okay. Good for you for recognizing that and seeking backup.

Before we get to your question, I do want to encourage you to let your sister know how her words are affecting you. Rather than point out what she’s “doing wrong,” you might calmly and honestly explain that while she may mean well, her commentary is painful, leaves you feeling bad about yourself… or whatever wording rings most true to you. Approach this as setting a boundary, rather than as lodging a complaint, which could cause her to become defensive and shut down.

It’s incredibly important for you to speak what it was that bothered you, why, and how you wish to communicate about this topic moving forward (if at all). Let her know that if you want her advice in the future, you will specifically ask. Otherwise, request that she kindly refrain from bringing up your body weight.

Now onto your question…

Health at Any Size?

It’s really important for me to disclose that while there are many experts on this topic (and while the anti-diet approach is one that is growing increasingly interesting to me as a coach), I am not a leading expert in the Health At Every Size (HAES), body neutrality, fat acceptance, intuitive eating, or anti-diet space. For that, I would direct you to someone like Stephanie Dodier, who we hosted on our podcast, Health Coach Radio. She studied under Evelyn Tribole who is considered the leader in this space.

I also want to mention that this topic is highly polarizing, and emotions run high. If you’re feeling bothered, triggered, or upset by anything in this article, I invite you to take a few deeps breaths and explore what specifically is troubling you about this topic before you head into the comments section. Sometimes the language around this topic becomes needlessly hurtful to the people around us, as evidenced by Tamara’s question here. Let’s practice compassion and kindness, and have a good, productive conversation about it. This is the coach approach.

So, can you be healthy at any size? And, is there a correlation between body weight and health?

Sometimes, yes. Specifically, excess body fat (as opposed to muscle) and obesity are often correlated with widespread modern diseases such as cardiovascular disease, high blood pressure, high cholesterol, type II diabetes, non-alcoholic fatty liver (even in kids), obstructive sleep apnea, and most cancers. These usually go hand-in-hand with chronic inflammation  and a weakened immune system.

In other words, excess body fat and obesity does seem to factor into our state of health and wellness, at least from a correlative perspective. There is some question in the Health At Every Size space as to whether this correlation is strong or important enough to make widespread judgements about the health of fat people. I’m here to say: making widespread judgements about the health of anyone whose health status you don’t know is generally a terrible idea. So let’s all agree to stop doing that.

Being overweight can also, for many people, place extra strain on joints and internal organs, limit mobility, and contribute to feelings of low energy or fatigue. Some, all, or none of this may be true for you: an individual with a unique, lived experience inside a unique body. You, more than anyone, know how YOU feel in your body, both physically and mentally. If you truly feel your most vital, healthiest self, that’s a fantastic sign. We are quick to dismiss the subjective, lived experience of being in a body, instead rushing to judge it against the cultural norm, or against the hastily-formed health and medical opinions of acquaintances, loved ones, and internet strangers. If you feel good, that’s good. 

If you don’t feel good, or if you suspect there might be room to feel a little better, that’s a really strong and powerful “come from” to consider implementing some changes to your food, movement, or lifestyle.

A checkup with a medical professional can provide extra information, too. Gather the objective data from a health care professional that you can match up to the subjective experience of living in your body. If going this route and if accessible, I recommend searching for a functional medicine doctor trained in metabolic health and using a range of treatment modalities, including lifestyle and dietary guidance (not just pharmaceuticals).

Health Beyond Size

You didn’t mention your eating or lifestyle habits, but as a coach, I ask about those first and foremost. They are the biggest health and vibrancy dial-movers, after all. Regardless of body size, folks who do not eat a nourishing, nutrient-dense diet or follow the other 10 Primal Rules often tend to struggle with lack of vitality, unmanageable energy, brain fog, low moods, and other symptoms that just don’t feel good.

And this goes way beyond body size. I’ve had overweight, underweight, and “healthy weight” clients who’ve expressed this lack of vibrancy.

Almost anytime a client moves toward eating a Primal diet made up of high-quality animal protein and dairy, healthy fats and oils, veggies, fruits, and moderate amounts of nuts, seeds, and dark chocolate, they feel better, seem to slow or reverse their accumulation of body fat, and eventually step into the energetic vitality that has always been their birthright.

If they’re eating Primal and still struggling with excess body fat or other unfavorable health markers, I look to the other Primal Rules:

1) Eat Plants and Animals
2) Avoid Poisonous Things
3) Move Frequently
4) Lift Heavy Things
5) Sprint Once in a While
6) Get Plenty of Sleep
7) Play
8) Get Plenty of Sunlight
9) Avoid Stupid Mistakes
10) Use Your Brain

(Even after 15 years of Primal living, I’m always struck about how these rules just make sense. They reflect how our bodies and minds have evolved to live and thrive.)

To be clear, none of this is about blaming, shaming, or stigmatizing. It’s simply pointing to the evidence and part of my role and responsibility as a coach. Clients hire me to do exactly this (a much different scenario than someone giving unsolicited “advice” or commentary on another person’s body or health).

When working with a skilled, thoughtful, compassionate coach, the focus is on helping you figure out what’s going on and what you most need to feel your best. This requires connection to the objective (data and facts) and subjective (how does it feel) aspects of having a body of any size.

This enables us to slowly extract ourselves from diet culture by aligning with our mind, emotions, and biology to support wellness, longevity, and feeling really good.

Back to You

Body size, food, and health are extremely personal, multilayered issues that go way beyond what’s on our plate or what size pants we wear. It takes an entire lifetime to get where we are with food, eating, and body image, and there are many factors at play.

In the end, you are your number 1 caretaker and know best how you feel. As individuals, we each have a responsibility to get really honest with ourselves, make supportive choices, and live in ways that allow us to be as healthy as possible within our personal set of circumstances. That, plus checking in with a medical professional when needed and accessible, is a far more accurate predictor of health than unsolicited commentary.

By the way: it’s not always easy. Part of taking individual responsibility is knowing when to ask for skilled, caring support. This sort of support does NOT come from “fat shaming” or “diet culture.” It does come from meaningful conversations about your goals, the experience of living in your body, and your vision of health and happiness.

Having external perspective and accountability will help you know whether you’re on track with health at any size. Working with a coach can help you put solid strategies in place for dealing with well-meaning but unhelpful family and friends. Visit myprimalcoach.com to learn more and get started.

Do you struggle with mainstream diet culture? Or have someone in your life who offers unsolicited health “advice”? Let it out and drop other questions for me in the comments!

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