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Healthy Living

Body Image

Body Size Acceptance: Say Yes! to That Image in the Mirror

Sharon Minai, Registered Dietitian

In western countries, most people are constantly bombarded by TV shows, commercials, movies, and magazines that idealize thinness. The images of lean models and stars are identified by many with beauty, success, and value. There is intense pressure, both real and imagined, to imitate these physical ideals, a goal that most find difficult or impossible to achieve.

The dissatisfaction with one's body size that results is endemic in our society. Although body size dissatisfaction is usually associated with those who are overweight and is especially widespread among women, it is by no means limited to these groups. Nor do all overweight people have a poor body image. Anyone who does, however, may well be discouraged, unhappy, and low in self-esteem.

"Often we buy into fat phobia because it is a handy expression of more generalized low self-esteem. The situation is worsened by all the pressure to be slender and the definition that only slenderness equates to attractiveness, effectiveness, and strength," says Professor Ellen S. Parham, coordinator of Dietetics, Nutrition, and Food Systems at Northern Illinois University.

The way we react to our body when we look in the mirror can affect our mood and self-confidence so profoundly that the level at which we function throughout the day is diminished. A negative body image may also promote irrational eating patterns, some of which are dangerous. Even more commonly, it can cause us to set unrealistic goals: The resulting despair may block any efforts to achieve a healthy lifestyle. For all of these reasons, an increasing number of nutrition professionals are including body size acceptance among the tools they use in trying to achieve successful weight management.

What Is Size Acceptance?

Body size acceptance means adopting a more positive body image and learning to let go of immobilizing discontent with our body. It means discarding the "goal" of reaching supermodel weight, and sometimes even our "ideal weight" according to weight charts. It usually means learning to live with a weight that is above the cultural ideal. It means forgiving ourselves and recognizing that we deserve a chance to improve and change.

"In promoting size acceptance, it is essential to convey the concept that acceptance of body size is a different mind-set and not just a strategy to plug into a traditional fat-phobic weight loss effort," says Parham, who is a registered dietitian. "In other words, if you want to lose weight because you hate your body, you're not ready to consider size acceptance."

If, however, we can rethink our goal--describing it as becoming healthier rather than thinner--then we may gradually learn to accept our body as we develop a more active lifestyle and healthier way of eating.

Says Parham: "Body size acceptance is a part of general acceptance of oneself."

Size acceptance has traditionally been the domain of organizations such as the International Size Acceptance Association (ISAA), whose goals are to promote size acceptance, defined as "acceptance of self and others without regard to weight or body size" and to fight size discrimination. Because this view does not overtly include building a healthier lifestyle, size acceptance often gives the impression of meaning accepting the situation as it is and perhaps giving up forever on weight loss and its health benefits.

An indication that this meaning of the term is broadening, however, is evident in the fall 1999 issue of Radiance ( the Magazine for Large Women), which encourages women to live "proud, active lives" regardless of their size. The lead article is called "Health at Every Size: A Size-Acceptance Approach to Health Promotion" and includes the "Basic Tenets of Size Acceptance" (see sidebar), which were developed by dietitians and nutritionists who are advocates of size acceptance.

With the growing recognition of size acceptance as an important factor in their patients' lives, some dietitians and other nutrition experts are moving toward including size acceptance among their tools for promoting overall health rather than making weight loss a goal in and of itself.

Size Acceptance & Improved Health

The American Dietetic Association suggests a combined approach to weight management, which includes body size acceptance:

  • Maintaining a healthy diet.
  • Maintaining a moderately active lifestyle.
  • Adopting a positive body image and improving self-esteem.
  • Achieving and maintaining a steady, healthy body weight.

Adopting a positive body image can bring about a marked improvement in one's attitude toward food. With higher self-esteem, it becomes easier to rid oneself of self-destructive eating patterns and to maintain a sensible way of eating. It then, in turn, becomes easier to reach and maintain a healthy body weight, which is very important for preventing the health risks of obesity.

Research shows a clear correlation between obesity and various chronic diseases such as diabetes, hypertension, and cardiovascular disease. The good news is that even a modest weight loss of 10% of one's body weight can produce notable health benefits, such as improved blood sugar level in those with diabetes, decreased blood pressure, and reduced lipid levels. This means that even if we don't reach our ideal weight according to standardized weight charts, we can still reach a weight that will reduce the risk of the health hazards of obesity.

First Steps

When it comes to weight management, keep in mind that there is no quick solution or magic pill. It takes time and patience to develop a positive body image and achieve a healthy lifestyle, and it's important that everyone progress at his or her own pace. Here are some practical steps to get started.

  1. Try out a new way of thinking: Make health, not appearance, your weight management priority. Work toward changing to a healthier lifestyle, not toward losing weight.

  2. Focus on adopting healthy eating habits rather than "going on a diet." Diets are temporary goals, and their results are usually just as fleeting.

  3. Don't let that number on the scale affect your mood or dictate the way that you evaluate your personality and talents. Take time to remind yourself of your good qualities and to appreciate yourself as a person. You'll remember why others appreciate you, too!

  4. Take the time to focus on the good things about your body. They may include your beautiful eyes, or your strength or flexibility. Realize what your body's potential is.

  5. Make moderate physical activity part of your new healthy lifestyle. The key is to find something that's fun for you. Start small, and work up to greater challenges. As you meet new goals, you'll see that exercise can build self-confidence in ways that nothing else can. And most of all, exercise helps you know and appreciate your body for what it can do.

  6. Once you're on the way to caring about your body, you may find that you have a new appreciation for healthy eating. Enjoy picking out healthy foods and trying new recipes.

  7. Don't be concerned with what others think about you and the way you look. Aim for healthy weight management for yourself and for all it can do to improve your life.

Basic Tenets of Size Acceptance

  1. Human beings come in a variety of sizes and shapes. We celebrate this diversity as a positive characteristic of the human race.

  2. There is no ideal body size, shape, or weight that every individual should strive to achieve.

  3. Every body is a good body, whatever its size or shape.

  4. Self-esteem and body image are strongly linked. Helping people feel good about their bodies and about who they are can help motivate and maintain healthy behaviors.

  5. Appearance stereotyping is inherently unfair to the individual because it is based on superficial factors which the individual has little or no control over.

  6. We respect the bodies of others even though they might be quite different from our own.

  7. Each person is responsible for taking care of his/her own body.

  8. Good health is not defined by body size; it is a state of physical, mental, and social well-being.

  9. People of all sizes and shapes can reduce their risk of poor health by adopting a healthy lifestyle.

Source: Fact sheet developed by dietitians and nutritionists who are advocates of size acceptance; their efforts coordinated by Joanne P. Ikeda, MA, RD, Nutrition Education Specialist, Department of Nutritional Sciences, University of California, Berkeley, CA

Sharon Minai is a registered dietitian and the community administrator of

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