This is the second part of a two post series by one of our certified health coaches, Emily Burrows. Please look at the first part here: What if Weight Loss Doesn’t Make our Clients Healthier? UNCG Health Coaching recognizes that there are a diversity of opinions about this issue, and encourages thoughtful discussion that helps us learn to be better coaches.
Coaching Beyond the Scale
So, you’ve come to the conclusion that intentional weight loss isn’t an effective or sustainable path to health. What now? How do you start to incorporate your new knowledge and interest in weight-neutral health promotion into your coaching work?
Here are some next steps to help you challenge your own weight bias and support your clients (and maybe yourself, too) in finding more peace with their bodies.
Question your language.
Words matter, and many commonly accepted body descriptors cause real harm. Terms like “overweight,” “obese,” “morbidly obese,” and even “normal weight” medically classify and pathologize body size based on BMI. Not only is BMI a terrible indicator of health, those words can unintentionally communicate to our clients that we believe their weight is abnormal and unhealthy, instead of affirming that bodies naturally come in diverse sizes and shapes.
Keep in mind that different individuals prefer different terms to describe their bodies, and while some words, fat, for example, may feel derogatory to some, others have embraced it or feel neutral about it. Respectfully follow your client’s lead, with the knowledge that you probably don’t need to use any descriptors for their body.
Explore what your clients are really saying when they use wellness words.
It helps to use the same language as our clients, or at least understand each other. That’s hard when health-related words can have multiple meanings and many of them are sub/consciously weight-centered. Explore these words with your clients and on your own, too. What do they (and you) mean when they say:
- Health: When you think of “health,” does your mind subconsciously translate the word to “weight?”
- Fitness: Do “fitness,” “exercise,” and many aspects of movement, from strength to cardiovascular endurance, mean burning calories or changing your pants size? Is “fit” used as a synonym for “thin?”
- Nutrition: Do “nutritious” and even “nourishing” primarily describe low calorie/keto/high protein/low sugar/”clean”/Whole 30/fill-in-the-blank-as-long-as-it-might-make-you-skinny food?
- Lifestyle change: When you hear “lifestyle change,” do you really hear “diet?”
- Self care: Do most “self care” behaviors point toward controlling your weight?
Broaden your referral community.
Restrictive and obsessive behaviors that would be diagnosed as an eating disorder in a thin person are often considered healthy and virtuous in someone in a larger body. Familiarize yourself with symptoms of eating disorders and get to know local fat-friendly therapists, doctors, and nutritionists so that you can refer your client toward deeper support if they need it.
Strategize about changing our culture’s fatphobia, not your client’s weight.
The benefits to being thin are very real. When you’re thin, attractive and affordable clothing in your size is consistently available. You’re less likely to be bullied or threatened on the street, online, or on a plane, because of your size. If you’re thin, you’re less likely to experience discrimination in the workplace for your appearance or be turned down for a job compared to people in larger bodies. When you go to the doctor, you are more likely to leave with a diagnosis and treatment rather than the overarching prescription to not come back until you lose weight.
For those who experience many of these challenges based on their race, religion, disability, gender identity, and sexual orientation, fatphobia can lead to additional daily stress, discrimination, and threat to their health. (Remember that oppression and other social determinants have a bigger impact on health than our individual behaviors.)
Our clients are being harmed by our culture and then blamed for being mistreated and disrespected. If we want to help our clients, we need to also take action against their oppression. If you’re in a thin body, Melissa Fabello and Melissa Toler have great advice on how to use thin privilege to fight weight discrimination and become a better ally.
As fat activist and author Virgie Tovar puts it, “Fatphobia is a form of bigotry and cultural abuse. Fatphobia is never a fat person’s fault. Fatphobia is always the abuser’s fault.”
Explore the research and ethics of dieting, fat stigma, and weight bias, and critically evaluate your role.
Even with our best intentions, the vast majority of us in the health field have participated in perpetuating diet culture. As you continue to educate yourself and hold yourself accountable, resist getting stuck in a shame spiral or getting defensive about your mistakes. You’ve been harmed by fatphobia, too. When you know better you can do better.
Support your clients in setting weight-neutral goals.
If a prospective client isn’t interested in weight-neutral goals and helping them lose weight feels unethical to you, give them space to find a different health coach (before money changes hands). Wanting to change your body is a rational response to irrational cultural expectations and it’s important to respect everyone’s body autonomy.
If, however, they are open to deeper exploration, it’s possible to validate your clients’ frustration with the present and their hopes for the future without reinforcing their desire for weight loss. Help them assess their readiness for weight-neutral, shame-free goals that get them closer to the healthier, happier future they’re envisioning for themselves.
Finally, change can be challenging. If you’ve been coaching under a weight loss paradigm for years, you might make some mistakes. That’s ok. Lean into the body acceptance world with an open heart and open mind, and keep learning.
If you’d like to continue exploring weight-inclusivity, Health at Every Size, and body acceptance, here are some leaders to follow:
Body Respect by Linda Bacon and Lucy Aphramor
Food Psych podcast with Christy Harrison
Hilary Kinavey and Dana Sturtevant
Your Fat Friend
Sonya Renee Taylor
Association for Size Diversity and Health
Emily Burrows is a self-care coach and yoga teacher in Chapel Hill. She has her MPH from UNC-Chapel Hill but stays forever loyal to UNCG, where she completed her health coaching certificate and bachelor’s degree.