Body respect and how to live well now

Dr Lucy Aphramor profile

Ahead of Dr Lucy Aphramor's 2 workshops at 11th June's #TransMCR we sat down to talk about her work on improving relationship with our bodies, the development of the Well Now programme and what 'Body respect' and 'Making peace with food' entails.

Lucy has been awarded the British Dietetic Association (BDA) Rose Simmonds Special Award and is named on the BDA Roll of Honour for her contribution to work in weight management.

Can you tell us about how the Well Now Programme came about?
When I started work as a community dietitian I realised that the ‘get thin’ message wasn’t working. The whole experience of watching calories took over people’s lives and any weight lost just went back on. I read the science to see where I was going wrong. It was shocking to find out that, despite what we get told, there’s absolutely no research proving dieting works long term. In fact, I found out that dieting is really a recipe for yo-yo dieting. I learned also it's linked with eating problems, body shame and size stigma.

What I read in the research fitted with what was happening with my clients. People were obsessed with food and told me heart-breaking stories of how ashamed they were of their bodies. I also heard outrageous examples of poor treatment because of size discrimination. It turned out encouraging a focus on weight control was just plain wrong.

In addition, I felt I was missing something by just focusing on diet and exercise. Surely there was more to health than this? For instance, I knew that social class made a difference to prevalence of heart disease, but how did this fit in with what I was saying? So I searched some more, and discovered that being treated with respect also impacts wellbeing, whatever we eat. Clearly, I needed a new approach, and this is how Well Now came about. Well Now offers a new way of thinking about how we take care of ourselves. It works by teaching respect -including body respect and health-gain for all.

Part of your work focuses on social justice, can you tell us how poverty and oppression can affect our bodies?
Health promotion often focuses on diet, smoking, drinking and exercise. We can think of these as lifestyle factors, or self-care. This is where wellbeing messages usually stop, with no mention of social justice. But there is more to health than lifestyle. What gets missed out of the lifestyle picture is that even if everyone had a great diet and kept active, health inequalities would still exist. This is because oppression would still exist and oppression impacts health. Of course we want a world where everyone has access to tasty, nutritious meals and the opportunity to enjoy being active. Above and beyond this, a healthy world is first and foremost a fair world.

There is lots of research that shows living with longstanding (i.e. chronic) stress affects the body, impacting heart health, insulin resistance and blood pressure. Living with oppression and poverty means living with chronic stress. In other words, transphobia, racism, size stigma and all other forms of oppression are a health hazard.

This means that the most effective way to improve long term population health is to tackle poverty and oppression. It’s important we remember this bigger picture. Groups experiencing oppression often get blamed for their poor health, and people can feel guilty, or confused, about being unwell. Telling the truth about oppression and health means we validate people’s reality, reduce shame and blame, and come up with answers that make sense. The Well Now way is one answer, helping people make sense of the bigger picture of health without getting overwhelmed by the challenges. It does this by linking self-care and social justice.

You’re delivering 2 workshops at June’s TransMCR, can you tell us what attendees can expect?
I’m delighted to be involved in June’s TransMCR event. One of the workshops focuses on helping people feel more in control around food. We’ll talk about hunger, taste, fullness, energy levels and so. In other words, how tuning in to body signals can make a big difference to feeling more in charge of your eating. Don’t worry if you feel out of touch with your body signals - we’ll also explore how to reconnect. This workshop includes some nutrition science too. It’s for folk interested in any aspects of eating for wellbeing.

The second workshop explores body respect. What does it mean feel at peace in our bodies? How does this relate to identity? The Well Now way teaches body acceptance - but what does body acceptance mean for someone who isn’t comfortable in their body? People may wish their body was different for any number of reasons, perhaps someone wants to be thinner, or is in pain. And of course there can be particular issues raised for trans folk.

What advice would you offer to people who are concerned about their body image?
The first thing to say is a reminder: You are and always were deserving of respect. Whatever your looks or size or identity or however much you feel at home in your body or not. You are worthy of respect.

It’s easy to lose sight of this fact when we feel bad about ourselves. And we’re more likely to struggle with self-acceptance, including body image, when we don’t feel worthy of respect. If you recognise yourself in this, please come along to the workshops if you can. You are not alone, and you may find a new way of thinking that helps you.

Every day we are surrounded by messages and images that suggest some bodies and identities are better than others and that only a narrow range of ‘perfect’ will do. This is the world we are born into. Society shames and stigmatises difference, meaning there are times when it can simply be unsafe to be ourselves. It’s no wonder so many people have issues with accepting their body and appearance. In other words, personal ‘body image problems’ thrive in world that oppresses difference. So we need an approach that helps people deal with body shame and at the same time gets real about tackling oppression and stigma. This is why Well Now is concerned with advancing body respect: the shape of a fairer future.  

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