BEDA promotes cultural acceptance of, and respect for, the natural diversity of sizes, as well as promoting a goal of improved health, which may or may not include weight change. The views expressed by our featured bloggers are their own.
Lisa Kantor, a Los Angeles lawyer and partner in Kantor & Kantor, LLP, represents people denied health benefits for treatment of both physical and mental illnesses. Most recently, Ms. Kantor has focused her efforts litigating insurance company denials of coverage for residential treatment of eating disorders. Kantor & Kantor is the only law firm in the country with a distinct eating disorder practice staffed with lawyers and other professionals experienced in the specific needs of people who have been denied benefits for eating disorder treatment.
Ms. Kantor sues health plans that refuse coverage, or agree to pay for treatment for a short period of time, forcing patients to be discharged before their health is restored. In 2007, she won the first published eating disorder decision in California in which the court applied the state’s mental health parity law to beneficiaries who sought treatment outside California. In August 2012, she won the first federal court ruling that determined health plans must pay for all medically necessary treatment for mental illnesses, including residential treatment.
For her achievements, Ms. Kantor was named a Top Woman Lawyer by the Los Angeles Daily Journal and an Attorney of the Year by the San Francisco Recorder. She received a “Special Recognition” award from the International Association of Eating Disorders Professionals Foundation and a California Women Lawyers’ Woman of Distinction Award.
Resistance to Change – Combating Weight Stigma
By Lisa S. Kantor, Esq. and Rachel Teicher
As an advocate for those with eating disorders, a question I often ponder is, “how long must we wait before the truths that dieting does not work, all body types can be healthy, and weight is not a predictor of overall health, become assimilated into our culture?” Recently, Sue Thomason, the anti-dieter, helped me answer my question, through her blog on the six necessary stages of paradigm shifts:
- The existing paradigm encounters an anomaly – an inexplicable observation;
- Initially the anomaly is ignored or rejected;
- People try to explain the anomaly within the existing paradigm;
- A new paradigm is proposed in which the anomaly is resolved;
- The establishment rejects the new model, often ridiculing its proponents;
- The new paradigm is accepted and it accounts for new observations.
I think that paradigm shifts help to explain the “cognitive dissonance” that often surrounds weight, dieting, and weight stigma. Cognitive dissonance describes the uncomfortable tension that results from having two conflicting thoughts at the same time, or from engaging in behavior that conflicts with one’s beliefs. Perhaps over time, the uncomfortable dissonance between what we think to be true about weight and dieting, and what is actually true, will push us into acceptance.
As many of you know, in the past several years, the “obesity epidemic” has generated a great deal of panic around weight and body image across the world, and has further perpetuated the toxic illusions that thin is healthy, fat is bad, and external appearances imply either success or failure as a person. The dieting industry (or the “Weight-Cycling Industry”) has undeniably made the most out of this “obesity panic,” as millions of Americans buy into dieting and desperately try to avoid being labeled as “obese” or “fat.” We hear about obesity on the news, it’s talked about in our places of employment, we are confronted with our BMI in our doctor’s office, we are bombarded with the topic of obesity through the media, we are programmed to teach our children about the scary monster called “obesity” – and as a result, we now live in a society where weight stigma is everywhere. As a result, those of a larger body type have experienced greater shame and stigma, as myths about what it means to be healthy, as well as the legitimacy and power of dieting, fester.
What astounds me is that, amidst all the “obesity epidemic” hype, research about dieting, especially dieting in response to “obesity,” has been blatantly shoved aside. Research has long proved that diets do not work in the long-term, and in fact, diets can actually make people gain weight. Scientific evidence (you know, the stuff that the scientists – ones who aren’t funded by drug companies seeking to solve obesity with a pill- have proved) tells us that restricting calories can alter your metabolism and brain, causing your body to store fat and your mind to be consumed with food cravings or food obsession, often leading to food-binges.
Diets encourage us with a temporary solution to a (perceived) problem. Diets label food as “good” or “bad,” oftentimes dictating how people feel about themselves after they eat. Diets control when and what you eat, rather than encouraging you to listen to your body’s intuitive hunger-cues. Diets can restrict or eliminate food groups; when we all need a variety of foods from all food groups, including fat, in order to get the right balance of vitamins, minerals, and other nutrients necessary to help our bodies function efficiently. Diets can also often lead to eating disorders and disordered eating.
Devoted dieters tend to stay fixed to the long dis-proved idea that fat causes disease. The irony is that evidence tells us that repeatedly losing and gaining weight is linked to cardiovascular disease, stroke, diabetes and altered immune function. According to professor of Psychology and UCLA researcher Traci Mann, “We found that the majority of people regained all the weight, plus more. Sustained weight loss was found only in a small minority of participants, while complete weight regain was found in the majority. Diets do not lead to sustained weight loss or health benefits for the majority of people.” If we have the evidence that dieting doesn’t work, then why do people continue to suggest (and believe) that dieting is the answer to the “obesity epidemic?” As the six-stages of paradigm shifting demonstrates, it is incredibly difficult to change people’s beliefs…even in the face of explicit evidence. As the founder of the six stages of paradigm shift says, “Every truth passes through three stages before it is recognized. First, it is ridiculed. Second, it is opposed. Third, it is regarded as self-evident.”
Weight bias has even seeped into the hands of insurers, who oftentimes provide coverage for things like bariatric surgery and diets (like Weight watchers, Jenny Craig, Lindora, etc.) yet consistently deny access to life-saving treatment for eating disorders. Dr. Edward H. Livingston wrote that “bariatric surgery does not provide an overall societal benefit.” Though acknowledging that such surgery has “dramatic short-term results,” he added that “its longer-term effects — including on longevity — have been disappointing.” Although weight loss surgeries and diets can be very costly (and not very effective in the long run), weight loss continues to be greatly valued and highly encouraged within the medical community.
My hope is that evidence about the ineffectiveness of dieting rampantly infiltrates those in our world who are in charge of our healthcare, especially penetrating through to our own thinking, choices and behaviors in response to the “obesity epidemic.” I also hope that as more and more people begin to truly see that diets do not work, they will come to have body acceptance, positive body image, and pledge to enjoy life using the tenets promoted by “Health at Every Size” (HAES). Lastly, my hope is that someday soon, children will not be discriminated against because of their weight or body type, doctors will better understand the correlations between weight and health, the amount food and body preoccupation, as well as self-hatred, will lessen throughout our world, and that our culture as a whole will come to believe that being thin will not make us healthier or happier.
I will continue to urgently advocate for positive body image, access to medical and mental health treatment for every body type, and for a healthy wellbeing as a priority… until we begin to make change.
For more information on the six stages of paradigm shifts, please visit: http://www.peterrussell.com/pete.php
If weight stigma or bias has adversely impacted your ability to receive treatment for an eating disorder, do not hesitate to contact Kantor & Kantor for advice. We understand, and we can help.
www.kantorlaw.net (800) 446-7529