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What body positivity really means: in conversation with nutritionist Alyson Roux

Alyson Roux worked for a decade in the arts and entertainment industry, when, spurred by her own health challenges, she chose to return to her science roots to help others live as healthily as possible, reconnect with nourishment, and grow to have a positive relationship with food. I spoke with the L.A.-based nutritionist about body positivity, how insidiously diet culture can creep in even during pregnancy, and how new mothers and birthing parents can learn to feel truly comfortable in their bodies.

Everyone wants to feel good about the body they’re in, and more and more these days terms like “body positivity” are used in popular culture. But what does this term – and related terms like “body image” – really mean?

Body image is, essentially, how we view our own body, our relationship to our body, and how satisfied or dissatisfied we are with our body. And it covers body size, body shape, body composition. It can also relate to how we interpret our skin, our hair, or nails. Anything that has to do with how we view our body, and any potential ways that we view it – positively or negatively. And it’s so often influenced by culture, society, and potentially occupational pressures.

And so body positivity is multifold. Body positivity relates to embracing one’s body for exactly what it is. And trusting that our body is a size and shape that it’s meant to be – and so often influenced by genetics, environmental factors, all kinds of different factors that are often beyond our control – and making peace with that.

When it comes to the pregnant and postpartum periods – and for many people even the period of time in which they may be getting ready to become pregnant – there can obviously be a lot of major body changes taking place. One’s body could be changing in shape and size, gaining weight, losing weight, and there may even be physical issues that arise and then linger as the body shifts to accommodate a growing baby and then birth that baby. It’s a lot!

And, as you said, how we view our body can be shaped by culture. There’s certainly a lot in our culture – both more broadly in how women’s looks have traditionally been valued within society, within diet culture, and even within “new mom” culture – that contributes to the idea that new moms and parents who give birth should be unhappy with or need to “fix” their postpartum bodies and that they should focus their efforts on “bouncing back” or on “losing the baby weight.” And there’s a lucrative market for telling moms that they should maybe be unhappy with their bodies – even sometimes masquerading as self-empowerment or self-care or “taking your time back.” I’ve also seen a lot of pseudo-positive but actually shaming “What’s your excuse?” style marketing, all of which makes me livid.

So it seems to me like there is, unfortunately, a lot of opportunity to feel, well, not so satisfied about one’s body as it’s going through a lot of these changes. What do you see as being the connection between body positivity, body image, and the major bodily changes that might be occurring during these periods?

You summarized the contributions to risk really well. There’s the cultural and societal pressure, and there’s an entire industry built around profiting off of women in the perinatal period  (during pregnancy and after birth) and their shame around their body and the pressure to lose weight.

And, long term, when we’re starting a relationship with a child from a place of “I need to restrict my intake,” it actually ends up potentially impacting one’s ability to breastfeed, and when that child is a toddler or 10 years old and they’re still seeing mom dieting off and on – that’s behavior that’s easily picked up even at a young age.

So it’s something that is really worth spending some time with in the first year – to get to know “How can I be more comfortable in my body?” If someone wants to think about, “Where am I at with my body image?” it can be helpful to ask questions like, “How happy am I with my body size? How often do I think about my body size? Does it preoccupy my mind? What percentage of the time? How often am I making food choices based on my body size and how I want to change my body size?”

And there are a lot of different clinical tools to measure eating behavior. One of my favorite ones is the Intuitive Eating scale, which is accessible at the Intuitive Eating website, and that has some really beautiful questions – as well as a workbook – that can be really helpful and is actually typically safe, applicable, and accessible for someone who’s not under someone else’s clinical care to just kind of answer on their own and use as a self-reflection.

And by Intuitive Eating, I know there are a number of
principles behind this practice, but in a simple sense, I think you mean the practice of not dieting, not restricting food, not focusing on weight, not seeing certain foods or eating behaviors as inherently “good” or “bad,” and instead shifting toward eating in a way that allows one to take pleasure in eating and really listens to one’s body – and honors cues of hunger and fullness – to best support what the body needs. And as you mentioned earlier, to also accept one’s body as it is.

And there’s literature showing that shifting toward using Intuitive Eating or mindful eating tools usually helps new moms get to a comfortable place – a place their body is meant to be in terms of composition – in a safer, more sustainable way, rather than restrictive dieting.

Another excellent book to read that helps unpack weight stigma within a scientific context is Health At Every Size (HAES), and it’s also available as an audiobook. Consider following HAES aligned therapists and nutrition professionals on social media who are passionate about making healthcare welcoming to all body sizes.

Related to this, a lot of “wellness” culture presents itself as being all about self-improvement and empowerment and health, but really just seems to be diet-culture masquerading as something new. It seems that certain varieties of “wellness” can so quickly move in an extreme direction – eating only “good” foods and “clean” foods while avoiding or restricting “bad” foods, rigid exercise regimens – and also contribute to increased body dissatisfaction. In your own experience, what do you see as being particularly problematic about this sort of “wellness” culture?

I think that when we have a wellness culture that continues to pathologize body fatness and focus on changing weight instead of changing behavior to become healthier and more sustainable and kinder, that’s always going to be a problem.

You know, I can’t look at my size 10 foot and say, “Be a size 6!” We can accept that we can’t just will our body to change when it comes to something like that. At a certain point, we cannot actually change our body size. The only thing we can change is our behavior and our attitudes towards our bodies and how we talk about body size diversity with our friends, family, and especially our kids.

So anytime you’re feeling pressured by a friend or another party – even if it’s well-intentioned – I think it’s so important to develop your own filters. Sometimes, for example, even well-intentioned workplace wellness endeavors, like weight loss challenges, can actually be harmful. We know these actually increase the likelihood of weight gain later on and also significantly increase the risk of developing an eating disorder or a relapse. So filtering out harmful pressure – this even includes filtering your Instagram feed! – is so important.

With all of these potentially harmful influences that might contribute to making individuals not feel good about their bodies – how else can new moms and birthing parents move in a kinder direction and toward body positivity, both during pregnancy and then postpartum?

Again, Intuitive Eating is a great tool – and there is a great Intuitive Eating workbook that can be used as a tool for self-reflection.

And I think to find the potential root causes of why someone may struggle particularly with body image, as well as to reconnect with nourishing oneself after delivering a child, we have to go back to the care that they’re receiving before then – and potentially even before conception when they might have been working on enhancing their fertility. So often there’s a lot of talk about body size during that time.

For example, if someone is diagnosed with a condition that’s often associated with living in a larger body size, like polycystic ovarian syndrome (PCOS), there can often be a lot of stigma there. With PCOS there may be insulin resistance or pre-diabetes, so individuals may be asked to monitor their blood pressure and blood sugar. And these things may be medically necessary, but they can potentially create hypervigilance. So if something like that is already starting to feel triggering, there are resources out there – like “Eat What You Love with Diabetes,” a lovely book and part of the “Am I Hungry?” series by Dr. Michelle May, while it’s not directly about PCOS, would be a helpful book to continue to have a healthy relationship with food while managing a condition that may be influenced by food.

And weight-stigma for those pregnant in larger bodies impacts an individual’s experience as a patient during pregnancy, impacts quality of care, and may also increase the risk of feeling less supported by one’s care team, so there’s the risk of missing opportunities for providing more adequate care.

The other piece of this is if there’s any history of chronic dieting, eating disorder, or struggling with body image already, and you’re entering into the fertility process, or if you are pregnant, or during the perinatal period, you’re going to want to develop really healthy boundaries with your providers. Decide what you’re comfortable disclosing – because that is up to you – but it’s really important that you decide how you want to handle what is potentially going to be a lot of triggering information.

So for women in larger bodies or those in recovery from an eating disorder, learning how to be your own advocate, being honest about your history, and establishing boundaries can be really meaningful. You can even recruit a partner or friends as advocates. And if this feels tough, a therapist can really help.


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