Articles and Blog Posts
Articles are written by Lucy unless otherwise indicated.
Creating Knowledge for Transformation: Understanding Healthism
A beginner’s guide to healthism and how an understanding of the concept helps practitioners advance a socially- aware nutrition practise.
Preventing fat stigma and repairing harm: A practical, pragmatic, radical response for advancing weight justice through public health policy and everyday conversation
Here’s the edited slides from a key note presentation I gave at the 2018 Weight Stigma Conference in Leeds, UK.
Why We Need to Talk About Trauma in Public Health
An accessible read for people unfamiliar with the issues.
Terms of Belonging: Words, Weight and Ethical Autonomy
In this article, I explore how the language we use to describe body size impacts our practise and shape people’s lives. I introduce the term obgobbing and highlight the pseudo-science of BMI-based healthcare. I unpick some of the assumptions behind the terms we use, and finish with a vision of difference.
Validity of claims made in weight management research: a narrative review of dietetic articles
In this article, I investigate how researchers published in the British Dietetic Associations’ journal report weight science. I chose a number of common claims around weight correction and health, such as any impact on diabetes, and the effectiveness of dieting for weight loss. I highlight discrepancies between what the evidence shows and what the researchers say it shows. I finish by recommending another approach called HAES. However, since writing the article I have developed my thinking and I think my conclusion, somewhat ironically, misrepresents the science. Instead, of recommending HAES I now recommend the approach I developed, called Well Now.
Weight Science: Evaluating the Evidence for a Paradigm Shift. L. Bacon and L. Aphramor
This co-authored article makes the case for dropping a weight-centred approach to health and using a weight-neutral approach called HAES instead. The article is really useful as a go-to source of references. It highlights flaws in some of the core assumptions that drive a focus on weight correction and offers alternative ways to think through taken-for-granted views. However, it many ways it is also a normative statement for neoliberalism and a compelling illustration of doublethink. For example, we state that “The primary intent of HAES is to support improved health behaviors for people of all sizes without using weight as a mediator” (my emphasis). We also say that the philosophy recognizes the structural basis of health inequities. However, an ethos that prioritises behaviour change is incompatible with one grounded in social justice. As of December 2016, the article has been viewed more than 211500 times and it is surprising and, perhaps also alarming, that there has been no critique of its internal contradictions. The article was a stepping stone on a path in which I find, endorse and then move away from HAES. I now advocate, and continue to develop, a weight-equitable approach called Well Now. Well Now teaches body respect and health-gain for all and is grounded in compassion, connection and criticality.
How Compassion Supports Innovation and Effectiveness in Addressing Weight Concerns: A Critical Review of Compassion Theory and Weight Science
Aphramor, L. The Journal of Psychological Therapies in Primary Care, Vol. 5, July 2016: pp. 26–46.
For copyright reasons I am unable to share this article on my website. You can access it by signing up to www.academia.edu.
Compassion focused therapy (CFT) and Acceptance Commitment Therapy (ACT) are increasingly being used in work with people with eating and weight concerns. This ‘compassionate mind approach’ is used to promote weight-correction rather than weight-equity. I wrote this article because I want to challenge this development as danger and error. I demonstrate that weight-correction approaches misrepresent the biomedical evidence and completely eclipse the social justice evidence. Approaches that claim to deploy compassion to meet end goals of weight correction are theoretically incoherent and provide a compelling example of doublethink. I show how compassion can be used congruently to support people with eating and weight concerns by outlining some of the theory relied on in Well Now. Well Now is a weight-equitable approach teaching health-gain and body respect.
Mindfulness in healthy weight and diabetes
Aphramor, L. Mindfulness in healthy weight and diabetes. Journal of Diabetes Nursing, 19: 401–7.
You can also access this by signing up to www.academia.edu
This article is written for practitioners. It gives an overview of how Well Now principles translate into practice. I was asked to write about mindfulness in diabetes. I try to keep weaving this in, which will be obvious if you read it, and slightly skews the flow. Nevertheless, it seemed a good opportunity for raising awareness of the dangers of weight-correction by piggybacking on practitioners’ interest in the relevant topic of mindfulness.
Body Respect disrupts business as usual to advance nutritional wellbeing for all
Disruptive women blog – Click here to read article
This blog explains why I use the term ‘body respect’. I outline three ways in which body respect supports, and makes links between, an individual’s ability to nourish themselves and enhanced overall population wellbeing and equity. The theory is Well Now theory. This isn’t mentioned as it was not permitted to publicise ‘own brands’. I have seen the blog promoted as describing HAES theory. However, this is a misattribution.
A Stages-of-Change Perspective to Diet, Non-diet and Health-gain Approaches for Weight Concerns
Dietitians are taught models designed to make them effective in supporting health behaviour change in clients. A go-to health behaviour change model is known as the stages of change, or transtheoretical, model. I find the whole narrative of health behaviour change extremely problematic and think that the models used are dangerous because they embed mechanistic thinking and promote a neoliberal ideology. In this article I use the assumptions of the stages of change model to encourage dietitians to think critically about how they view body weight, and to interrogate the assumptions that shape their practise. I hope this draws attention to the deep flaws of a behaviour change approach, and of weight-correction, and starts conversations that incite progressive thinking and action.
Effecting Change in Public Health
“The current focus on lifestyle change as a route to improved public health ignores the influence of toxic stress on metabolism and does not address the social determinants of health”. I think we need a radical change of direction in how we talk about health. In this article I explore the scientific shortcomings of current theories and outline theory and data to support the shift I propose. There’s also a CPD activity provided.
Body Respect: What Conventional Health Books Leave Out, Get Wrong, or Just Plain Fail to Understand about Weight L. Bacon and L. Aphramor, Benbella: USA 2014.
I co-authored a book called Body Respect that was published in 2014. Since writing it, I changed my mind about a central point we make in the book. I think we outline a useful, if incomplete, theory, but I don’t think this theory can be described as HAES. One reason I say this is that the theory we outline is explicitly weight-equitable, and HAES is by definition weight-neutral.
Meanwhile, I am working on several books –watch this space!
Well Now Think Papers and Handouts
- Think Paper Body Respect – the book
- Think Paper Well Now Theory and HAES Theory
- Think Paper What is a Think Paper?
- Think Paper Untangling Health Behaviours, Respect, Weight, Wellbeing and Social Factors
- Worksheet Untangling Health Behaviours, Respect, Weight, Wellbeing and Social Factors
- Think Paper Myths About Well Now and Non-Diet Approaches
- Worksheet Strengthening the compassion muscle.
- Worksheet Hunger-o-meter
- Takeaway The Well Now Cycle