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Karen's Blogs

Blogs are brief, to-the-point, conversational and packed with information, strategies, and tips to turn troubled eaters into “normal” eaters and to help you enjoy a happier, healthier life.Sign up by clicking "Subscribe" below and they’ll arrive in your inbox. 

What If You Didn’t Care So Much about Your Appearance?

What if you didn’t care so much about your appearance? What if you could flip to the other side of the continuum about your looks and feel a decreased sense of their importance to you? What if you could expend less time thinking about your face, body, and hair because you hate how it eats up so much effort and energy and simply don’t want to live with such a spirit-killing pre-occupation. Before you insist that this metamorphosis could never happen to you, take a deep breath and just consider “What if?” Ask yourself: What if I could care less about my appearance? What if I could change? You know how to do it: You used to adore certain friends and now don’t, were wild about particular songs and no longer listen to them, or were fiercely wedded to political or philosophical ideas and now wouldn’t be caught dead believing...
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What Higher Weight Adult Children Want Their Parents to Know About Them

Some of my most heart-breaking work is with higher weight adults and their parents, usually mothers. The pain of both child and parent is evident, as is their frustration, confusion and helplessness about how to discuss matters of weight. I write this blog to give guidance to both parties partaking in this family therapy experience. Generally parents (usually Mom) and adult children (usually Daughter) haven’t been in therapy together, but sometimes times they have a long, unhappy history of family therapy. In either case, here’s what each typically feels as therapy begins. My higher weight client feels highly vulnerable speaking directly with her mother about such a tender subject, for the first or umpteenth time, expecting to be blamed and shamed. Equally, Mom (or Dad, or Dad and Mom) come in feeling frustrated, helpless and guilty. Most often Mom is also worried about her child’s health which adds to the...
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The Destructive Power of Internalized Weight Stigma

Many higher weight people think that weight stigma may only affect their self-perception and self-esteem. Not so. It may also negatively impact their health. According to research (Himmelstein, M. S., Puhl, R. M., & Quinn, D. M. (2017, November 9). Weight Stigma and Health: The Mediating Role of Coping Responses. Health Psychology. Advance online publication. http://dx.doi.org/10.1037/hea0000575 , accessed 11/17/17), “A large and methodically diverse literature links exposure to weight stigma to a range of poor health outcomes including obesity, weight gain, metabolic syndrome, physical activity avoidance, heart disease, stress, and depression.” For this reason, “…it may be useful to address weight stigma and coping in the context of weight management and obesity treatment programs, to help protect individuals from negative health effects of experiencing weight stigma.” If you have depression, anxiety, low self-esteem or difficulty accepting your body at a higher weight, weight stigma may be having a negative impact...
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Time to Give Up the Body Shame

While reading our local paper, I came across a photo captioned “Dancing to support first responders” which really caught my eye. The photo was of a couple dancing the tango. Each was what our culture might call “overweight” or what I prefer to call on the higher end of the weight spectrum. The pose they struck showed their grace and dancing prowess. The story accompanying the photo was about why they chose to be in a charity dance competition to benefit such an important cause.   I immediately thought back to the two clients I’d seen the day before who’d complained that they were too large and embarrassed to be seen exercising. Both came from highly judgmental families, but neither was of such a high weight that she couldn’t jog, dance, or exercise. I’d seen both bound up the path to my office when they were running late for a...
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Big Can Be Beautiful – Only You Can Change Your Body Image

STRONG WOMAN KK
Image by Debbie Digioia     No matter what our weight, too many women (and men, to a lesser degree) think it’s natural to vilify fat and, if you’re of a high weight, that you need to feel badly about it. Can we all agree that we live in a fat phobic, thin-obsessed society—and it’s been that way for far too long? It’s so normalized into our society that fat is out and thin is in that you may not know that there was a time, as I do nearing age 70, when norms were otherwise, back in the days of zaftig beauties like Marilyn Monroe and Jayne Mansfield.   I discuss body image often with clients and sometimes with friends, and have come to recognize two unequal perspectives about being large in our culture. The first is to shrug and say that these are the norms and that all...
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What Are We Really Afraid of in Becoming Fat?

When clients talk about not wanting to be “fat” or become “fat,” I ask them what exactly that means to them. What images do they conjure up, what do those images say about them and the society we live in, and what is having a “fat” body all about for them, whatever their current weight? Does “fat” mean the same thing to men and women, young and old, all races and ethnicities? Fat used to mean having accumulated enough money to eat well and was a sign of wealth and status. Just as lawns were a (status) symbol of having excess land beyond what a person needed to farm and grow food or raise livestock, fat was a way of indicating that you had plenty, in fact, more than you needed. In a world of food scarcity, it was a way of flaunting excess and success. In my middle-class childhood,...
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How to Talk with Young Girls about Weight

You may think that, because of your own eating struggles, you know how to talk with your daughters (or nieces or granddaughters) about weight. Or, never having had eating or weight concerns, you may not pay much attention to what you say about their bodies or their eating. Either way, here’s the latest research on the subject. You Can't Talk to Girls About Their Weight by Carleen Wild (LifeZette, retrieved 6/17/16, http://www.lifezette.com/healthzette/you-cant-talk-to-girls-about-weight/ ) is based on research by Brian Wansink, PhD, who was inspired to study this subject because he has three daughters. His take home message is that parents need to be extremely careful about what they say to their female progeny about their bodies. “His team found that women who recall comments from their parents about their weight are more prone to being overweight as adults and less satisfied with their weight than other people.” Of course, this...
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5 Ways to Help Stop Fat Shaming

No matter what your size, gender, or age, you can play a part in stopping fat shaming—whether it’s done privately by someone you know or publicly by someone like Donald Trump shaming a former Miss Universe contestant’s weight gain and opining that a recent hacking of the Democratic National Committee could have been done by “somebody sitting on their bed that weighs 400 pounds.” (“The shame of fat shaming,” by Gina Kolata,10/1/16, http://www.nytimes.com/2016/10/02/sunday-review/the-shame-of-fat-shaming.html?_r=0 ) Science writer Gina Kolata describes studies on the impact of weight stigma on children and adults. The effects are real, harmful, and they’re lasting. Finally, fighting discrimination against higher weight people is becoming a major issue in this country and the movement behind it is growing stronger. It’s taking its rightful place next to movements to end prejudice against people of color, women, gays, lesbians, transgendered people, and the physically challenged. What are you—yes, you in...
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Body Image and Fear of Rejection

One of the most debilitating issues about having a high weight is the stigma attached to it by this culture. The debilitation comes in great part from fear of social rejection. My hunch is that how you feel about rejection in general is a major factor in how you perceive negative reactions to your weight or body size in social situations. In “Unpacking the psychological weight of weight stigma: a rejection-expectation pathway” (Journal of Experimental Social Psychology, vol. 63, 3/16, pp. 69-76), authors Blodorn, Major, Hunger and Miller studied expectations of social rejection in women and men who had various body weights and BMIs. No surprise that “Men’s responses were largely unaffected by body-weight” in the dating context of the experiment. However, the study concluded that, “As predicted, high body-weight women reported increased expectations of social rejection…which in turn predicted decreased self-esteem, increased self-conscious emotions, and increased stress.” Of course,...
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Fat Shaming Is Down, But...

I’d love to tell you that fat shaming is well on its way to being eradicated forever, but isn’t. According to 2015 ObesityWeek study, “Data from research with more than 70,000 US adults beginning in 2014 suggests that ‘the public increasingly understands that obesity is more complicated than simplistic notions of personal responsibility or blame.’” (ConscienHealth, “Fat shaming is down, but weight bias persists, retrieved 11/13/15). It’s fantastic news the public is finally recognizing how complicated the subjects of eating and weight are and that fewer folks are buying into the shame-and-blame model of weight stigma. I hope you’re one of the enlightened, both when you view higher weight individuals and if you have a higher weight yourself. As eating disorder therapists and researchers have been insisting for decades, gaining weight, not losing it, or not keeping it off is not about a simple eat-less-exercise-more formula. Far from it. Science...
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Using People-first Language to Avoid Obesity Stigma

We’ve long known that the language used to describe people can strongly impact how they’re viewed and how they view themselves. In social work school, I was taught to describe clients as people “with” or who “have” a condition—people with addictions rather than addicts or people with schizophrenia rather than schizophrenics. This is called people-first language. The editors of the journal Obesity recently developed a statement about the language to use in describing people who have high weights. Here are some excepts from it: “Describing individuals as obese as opposed to having obesity could have a negative impact on how people view them. People-first language has been widely adopted for most chronic diseases and disabilities, but not obesity.” For example, persons with diabetes, rather than diabetics or persons with disabilities, rather than the disabled. “Labeling individuals as obese creates negative feelings toward individuals with obesity, perpetuates weight bias, and must...
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Virtuous Aging and Body Image

I heard someone in her 40s say that, being middle-age, she was worried about her aging body. For some people, aging automatically brings about a shedding of body image concerns, while for others, it amplifies them. Did you know that there’s an increase in eating disorders among aging women? Forget culture and the media, we have it in our power to decide how we want to view the inevitable changes in our bodies, so, for goodness sake, let’s choose a viewpoint that is positive and healthy. According to Joann M. Montepare, director of the RoseMary B. Fuss Center for Research on Aging and Intergenerational Studies at Lasell College in Massachusetts, the view of “researchers may be part of the problem—that focusing on how to mediate and mitigate the ravages of growing old can fuel negative self-perceptions among those of us engaged in graying…Ultimately, we need to figure out how to...
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View on Fat and Obesity Changing

For those of you who fear being stigmatized for your larger-than-average size, finally, some good news. The article, “Fat stigma fading? Fewer see obesity as problem of bad personal choices, survey says” (11/6/14, WBUR’s CommonHealth), tells us that new research indicates that “the general public and health care providers are starting to view obesity as a ‘community problem of shared risks’ as opposed to a personal problem stemming from ‘bad choices.’” Quotes from the Obesity Society News suggest a “significant shift in perceptions of obesity in 2014,” and that “data also show differences among various demographic groups. In 2014, younger and higher income respondents more likely view obesity as a community problem. Older respondents more likely view it as a medical problem. Male and rural respondents more likely view obesity as a personal problem of bad choices.” Says Rebecca Puhl, PhD, Deputy Director at Yale University’s Rudd Center for Food...
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How Control Issues Morph Into Body and Weight Concerns

Control is a major issue for us all. We want to control our environment and people’s behaviors to help us survive and thrive. Although we have little control over either when we are children, we become more empowered as we mature. But, fact is, we will never have complete power over our lives, even as adults, and this is a crucial fact to remember so that we don’t keep questing after something that is unattainable. We cannot control the forces of nature or the actions of others. Accidents, life upheavals, and catastrophes occur no matter how hard we try to keep them at bay. The best we can do in these situations is whatever is possible to empower ourselves and accept our fate. Knowing that we are neither totally powerless nor all powerful is a platform for effective life management. For disregulated eaters, it may mean the difference between obsessing...
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Why People Shame Fat People

It seems to me that there are two kinds of fat shaming: about what and how much a person eats and about their size. Why does fat shaming happen? The simple answer is because we all let it happen. We need to call this abuse by its name and stop it in its tracks—make it taboo—or it will continue. You can start by not shaming yourself. Shaming someone about what or how much they eat is common place: Are you going to eat all that? Do you really think you should eat so much? Why don’t you eat something more low fat or low calorie? You know you shouldn’t eat that! Let’s assume that some people who say these things love you and care about your health and well-being. If you don’t tell them that their words are hurtful—and totally unhelpful—how will they know in their ignorance that they’re making...
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More on Fat Shaming

If you are going to get past fat shaming—letting others do it to you and doing it to yourself—you will have to understand the dynamics of why and how it happens. If you are still allowing (yes, allowing!) fat shaming to happen, then you are part of the problem. Remember, it takes two not only to tango, but for shaming to take place. An article in The Guardian online, “Fat-shaming: how the slim and sanctimonious help to cause our obesity crisis” by Gaby Hinsliff (9/11/14), provides an excellent discussion of the topic as it is experienced in the UK. Hinsliff explains why “sitting in judgment of fat people” has become so official and public: “Doctors are told not to be afraid of the word ‘fat,’ to stop muttering about body mass index and starting telling it like it is” and in tough economic times she reckons that employers think, “Why...
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Weight Stigma Can Make You Fat

Generally we think of weight stigma as a result of being overweight, but what if it is also a trigger to putting on pounds? We already know that stigma stresses the body and produces more of the chemicals that harm optimal well being. Now we are discovering how this process takes a psychological toll as well. In “Stigma and the perpetuation of obesity, Alexandra A. Brewis (Social Science and Medicine, vol. 118, pages 152-128) tells us that “social stigmatization of obesity seems to be strengthening and globalizing” and describes “four mechanisms by which a pervasive environment of fat sigma could reinforce high body weights or promote weight gain, ultimately driving population-level obesity.” Stop and think about what this means. I mean really reconsider, because disregulated eaters generally view fat as an individual problem, a la “I did this to myself.” This study is saying the opposite, and it’s an enlightening...
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Science Weighs in on Body Size Stigma

It’s Weight Stigma Awareness Week! Because size stigma is a cultural problem, that is, large people have difficulty due to the negative meanings society ascribes to fat, they fare better when they understand the physical effects that stigma has on their nervous systems and can resist internalizing such arbitrary prejudices. *STUDY: “Associations of weight stigma with cortisol and oxidative stress independent of adiposity, “Tomiyama, A. Janet; Epel, Elissa S.; McClatchey, Trissa M.; Poelke, Gina; Kemeny, Margaret E.; McCoy, Shannon K.; Daubenmier, Jennifer, Health Psychology, Vol 33(8), Aug 2014, 862-867. doi: 10.1037/hea0000107. Result: “Independent of abdominal fat, weight stigma was significantly related to measures of cortisol…as well as high oxidative stress. Perceived stress mediated the relationship between weight stigma consciousness and the cortisol awakening process. Conclusion: “…Weight stigma is associated with greater biochemical stress, independent of level of adiposity. It is possible that weight stigma may contribute to poor health underlying...
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Proof—Fat Phobia Is a Cultural Phenomenon

No matter how much I insist that fat phobia is nothing more than a cultural phenomenon, disregulated eaters are unwilling to believe this fact. Well, here’s a great illustration of the truth from an article entitled “Much too fat: the doctor says it’s time to slim down.” (The Economist, 6/14/14, page 44). The article comes out of Johannesburg, South Africa and describes how that country’s people are now considered the fattest in Africa. It reports that high weight “is evidence, to many South Africans, of the good life: fast food, a fast car, an urban lifestyle. Moreover, a chubby woman traditionally betokened health and beauty, whereas thinness smacked of disease. Among men, a big belly is often thought to spell maturity, wealth, and success. South Africa’s latest government is a portly crew, with many a ministerial suit bursting at the seams.” The article goes on to observe that “Most South...
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Body Dissatisfaction

Our view of our bodies is not fixed as you might think. The way people think about their overweight bodies may be due to the size and weight of people around them. Or so says a new-1.3 million person study from the University of California-Boulder. According to a Journal of Health and Social Behavior study analyzing the three-way relationship among obesity, life satisfaction and where you live (Sarasota Herald-Tribune, 6/10/14, 29E), “obese men and women who live in U.S. counties with high levels of obesity are much happier than obese men and women who live in slender areas. Nor do people of ‘normal weight’ enjoy much advantage in neighborhoods with more flesh per capita.” The study’s conclusion: what is important to us is that in order to feel satisfied, we need to “look like the people around us.” The study was done by asking people to rate their satisfaction and...
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This website is owned and operated by Karen R. Koenig, M.Ed., LCSW. It contains material intended for informational and educational purposes only, and reasonable effort is made to keep its contents updated. Any material contained herein is not to be construed as the practice of clinical social work or of psychotherapy, although adherence to applicable Florida States, Rules, and Code of Ethics is observed. Material on this website is not intended as a substitute for medical or psychological advice, diagnosis, or treatment for mental health issues or eating disorder problems, which should be done only through individualized therapeutic consultation. Karen R. Koenig, LCSW disclaims any and all liability arising directly or indirectly from the use of any information contained on this website. This website contains links to other sites. The inclusion of such links does not necessarily constitute endorsement by Karen R. Koenig, LCSW who disclaims any and all liability arising directly or indirectly from the use of any information contained in this website. Further, Karen R. Koenig, LCSW, does not and cannot guarantee the accuracy or current usefulness of the material contained in the linked sites. Users of any website must be aware of the limitation to confidentiality and privacy, and website usage does not carry any guarantee or privacy of any information contained therein.  Privacy Policy