Fat Women’s Experiences in Therapy: “You Can’t See Beyond…Unless I Share It with You”

Akoury, Liya M.; Schafer, Kerri J.; Warren, Cortney S.

doi:10.1080/02703149.2018.1524063

Cited by 16 publications

(26 citation statements)

References 60 publications

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“…Weight bias perpetuates negative stereotypes and attitudes towards larger sized people that lead to discrimination (Carel & Latner, 2016). Weight bias is not immune in healthcare settings (Kinavey & Cool, 2019), and research suggests that providers may see patients as lazy or gluttonous leading to encouraging a treatment goal of weight loss and to overlook eating disorder symptomology (Akoury et al, 2019). The idea that weight is controllable, otherwise termed as 'obesity discourse' simply by intake and expending calories (Bombak, 2014), oversimpli es the complexities of eating and weight struggles.…”

Section: Race and Weight Biasmentioning

confidence: 99%

Is the Incidence of Eating Pathology and Intense Body Dissatisfaction in poorer communities of color comparable to national incidence?

Woodland

Lufkin

2023

Preprint

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Background: Communities of color have been under-assessed and under-diagnosed with eating disorders. Most of the previous research on BIPOC communities has focused mainly on eating pathology as it relates to food insecurity. The purpose of this study was to explore whether the incidence of eating pathology and intense body dissatisfaction in poorer communities of color was comparable to the incidence reported by the National Institute of Mental Health and National Eating Disorder Association. The data outcomes may be relevant to community based mental health clinics and their partners as it will potentially highlight gaps in research, diagnostic assessment, and treatment interventions specific to eating disorders in marginalized communities. Methods: The data was collected from 309 individuals seeking mental health treatment in a community based mental health clinic in East Harlem NYC. Two separate assessments were utilized. The first assessment was conducted at intake within the comprehensive psychosocial assessment. It was a self-reported measure that assessed frequencies of 5 types of eating pathology: 1.) restricting, 2.) restricting/binging 3.) restricting/purging, 4.) binge/purging, and 5.) binging. Body and Weight Attitude Likert assessment scale, a 14-item measure was created based on 5 sub-scales: 1.) income 2.) restricting eating and obsessive thought behavior 3.) body dissatisfaction 4.) binge-eating and compensatory behavior 5.) emotional distress. Results: This is the first study to investigate rates of eating pathology and attitudes around body image and weight in a poorer community with the majority of the community identifying as people of color. What we found was high rates of body dissatisfaction and high incidence of eating pathology which is not only comparable to the NIMH and NEDA’s data for a white population but is higher than what the current data supports for any racialized group. Our data also shows higher rates of eating disorder diagnosis, particularly for AN, AAN, and EDNOS than what is supported in either NIMH and NEDA for any racialized group We discovered the incidence of frequency of restricting food was highest in the Black and mixed-Race participants. Black participants had the highest rate of diagnosis of an eating disorder of restricting type, which is much higher than the national incidence. Body dissatisfaction is the most notable risk factor in the development of eating disorders. The mixed-race group (n=97) rated highest on intensity of body dissatisfaction. This study highlights the need for further investigation, so we don’t perpetuate the neglect of these communities in both mental and medical health care.

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Section: Race and Weight Biasmentioning

confidence: 99%

Is the Incidence of Eating Pathology and Intense Body Dissatisfaction in poorer communities of color comparable to national incidence?

Woodland

Lufkin

2023

Preprint

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“…This study examined the associations between participants’ FAS scores and their reactions to a fictional fat therapy client. Research shows that weight bias is common among psychotherapists (Puhl et al, 2014), and fat individuals report encountering sizeism in therapy (Akoury et al, 2019). If the FAS predicts meaningful differences in clinicians’ reactions to and approaches to therapy with fat clients, it could be used as part of interventions designed to improve weight-related cultural competence.…”

Section: Study 3: Incremental Validity Among Psychology Traineesmentioning

confidence: 99%

The Fat Acceptance Scale: Development and initial validation.

Kase¹,

Mohr²

2022

Journal of Counseling Psychology

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The fat acceptance movement arose to combat the widespread stigmatization of fatness and fat people through personal liberation and political activism. Support for the movement and its underlying ideology has grown rapidly over the past three decades; however, a self-report measure of fat acceptance with strong psychometric properties has not yet been developed. The current studies aimed to develop the Fat Acceptance Scale (FAS), a measure of fat-accepting beliefs, attitudes, and behaviors that was designed to be appropriate for use with people of all sizes. In Study 1, exploratory factor analysis (n = 266) and confirmatory factor analysis (n = 267) supported a three-factor solution assessing fat activism, health beliefs related to weight, and interpersonal respect for fat individuals. In Study 2 (N = 291), FAS scores predicted reactions to fictitious fat women after controlling for an established measure of antifat attitudes. Data from a subsample of 47 participants indicated moderate-to-high stability of the FAS over 4 weeks. In Study 3 (N = 156), health service psychology doctoral students' FAS scores predicted their reactions to a fictional fat psychotherapy client after controlling for antifat attitudes. Taken together, results provided preliminary evidence for the validity and reliability of FAS scores and suggest that the FAS may be a valuable tool for researchers, clinicians, and advocates interested in fat acceptance. Public Significance StatementThe fat-acceptance movement arose to combat the significant discrimination that fat individuals encounter in a variety of contexts. This article describes the development of a new scale measuring fat-accepting beliefs, attitudes, and behaviors (the Fat-Acceptance scale; FAS). The results of this study suggest that the FAS may be a reliable and valid tool for researchers, clinicians, and advocates interested in fat acceptance.

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“…With the recent push for body positivity, fat people are finding themselves within a dichotomous pull, between body acceptance/positivity and the need to feel shameful about being the size one is. Effects include mental health challenges (Rath & Behura, 2015), the denial of fat oppression (Akoury, Schafer, & Warren, 2019), as well as internalized stigma and disordered eating (Major, Viljoen, & Nel, 2019) Fat studies literature also emphasizes the fat body's constant state of surveillance and (self)regulation in relation to "biomedical constructions of appropriate body size and its relationship to 'good health'" (Wills et al, 2006, p. 396). Mik-Meyer (2010) notes that those whose bodies do not fit the mould are seen as "lack[ing in] self-discipline, control, and willpower" (p. 388), and therefore must be regulated.…”

Section: )mentioning

confidence: 99%

Whiteout and the reproduction of (fat) white normativity :a critical discourse analysis of the presence of whiteness in fat studies literature

Zerafa¹

2021

Preprint

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This Major Research Paper consists of a critical discourse analysis of the operation of whiteness in the field of fat studies, focusing on how it becomes invisible and consequently manifests in emergent theorizing, especially at its establishment as an academic discipline. Two fat studies readers were selected, one published then and one written more recently, with six chapters selected from each. Using a dialectical-relational approach, these texts were analyzed both individually and intertextually to look at the origin stories of the field, the use of language to obscure whiteness, and the need for critical race/intersectional approaches. Findings show that fat studies has, and predominantly continues to, find itself in a self-imposed state of ‘whiteout’, through which Black, Indigenous, and Racialized people, voices, and experiences are sanitized, marginalized, or erased altogether. To challenge this, fat studies must take up whiteness and white supremacy toward its goal of fat liberation for all.

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Fat Women’s Experiences in Therapy: “You Can’t See Beyond…Unless I Share It with You”

Cited by 16 publications

References 60 publications

Is the Incidence of Eating Pathology and Intense Body Dissatisfaction in poorer communities of color comparable to national incidence?

Is the Incidence of Eating Pathology and Intense Body Dissatisfaction in poorer communities of color comparable to national incidence?

The Fat Acceptance Scale: Development and initial validation.

Whiteout and the reproduction of (fat) white normativity :a critical discourse analysis of the presence of whiteness in fat studies literature

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