Putting body weight at the center of thinking and talking about health is referred to as the weight-centered health paradigm (WCHP). This has resulted in arguments for a paradigm shift away from focusing on weight and focusing instead on health and well-being. We reviewed the literature to identify the main components of the WCHP. From the results, we created a framework, named the WCHP 3C Framework. The 3C Framework describes the people and industries contributing to the WCHP and the central claims of the paradigm. It also identifies the three major types of critique of the WCHP: ideological, empirical, and technical. Finally, the 3C Framework highlights that the WCHP is contributing to weight stigma and fat phobia, reduced health and well-being, and poorer quality of life. We hope the 3C Framework will contribute to a paradigm shift in weight science.
There is a need for a system of values and principles consistent with modern health promotion that enables practitioners to purposefully integrate these values and principles into their understanding of health, as well as their needs assessment, planning, implementation and evaluation practice.
The Red Lotus Health Promotion Model enables practitioners to proactively and purposefully put into action a connected system of values and principles across the phases of a health promotion process.
The weight-centred health paradigm is an important contributor to the broader cultural paradigm in which corpulence is eschewed in favour of leanness. The desirability to reduce body fat or weight or to prevent gaining 'excess' fat is driven by both aesthetic and health ideals. The 'war on obesity' is a broad health-based set of policies and programs designed to problematise 'excess' body fat and create solutions to the 'problem'. There is a substantial body of literature that claims to demonstrate the harmful effects of 'excess' body fat. Recent critiques of 'obesity prevention' programs have highlighted the importance of focusing on environmental changes rather than individuals due in part to the risk of harmful consequences associated with individualistic, victim-blaming approaches. Beyond this, there are suggestions that framing body weight as the source of health problems - known as the weight-centred health paradigm - is in itself a harmful approach. The range of harms includes body dissatisfaction, dieting, disordered eating, discrimination and death. Health promotion policies and programs that operate within the weight-centred paradigm have the potential to have a negative impact on the health and well-being of individuals and communities.
Critical reflection is a core competency for health promotion practitioners to address the ethical imperative to move towards critical practice. There is a need to explore the application of a critical reflection model in health promotion to determine how it may support critical and ethical practice. So what? If health promotion is to meet its ethical responsibilities, then critical reflection needs to be articulated as a core health promotion competency and a model for its application in health promotion developed.
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