When We Know Better, We Do Better - A Conversation About Creating Weight-Neutral Schools
Every year in Canada, Eating Disorder Awareness Week happens during the first week of February. When teachers are considering this type of awareness in their schools, they may feel unprepared due to lack of formal training in health and wellness they receive or are unsure about the best way to approach conversations about complex weight-related issues (Nocentini et al., 2019). Health promotion in a school setting must come with a considered and nuanced approach to avoid unintended harm, particularly around the topics of weight, physical activity, and nutrition (Tingle, Saunders, Nutter & Russell-Mayhew, 2023). To achieve this, there are many ways that schools and teachers can work towards avoiding unintended harm.
To shed light on how teachers and schools can work together to avoid such unintended harm, we spoke with Dr. Shelly Russell-Mayhew, director of the Body Image Research Lab, Professor of Counselling Psychology, and Associate Dean Research in the Werklund School of Education at University of Calgary, and Elizabeth Tingle, instructor at Werklund School of Education and lab coordinator for the Body Image Research Lab.
Dr. Shelly Russell-Mayhew and Elizabeth Tingle share their expertise on the benefits of weight-neutral well-being in the school setting through a comprehensive school health approach; how teachers can avoid unintended harm in health discourse around the topics of eating disorders (ED), body image, dieting, and movement; as well as ways that teachers can prioritize their own well-being. They emphasize the idea of “when we know better, we can do better”, a wonderful idea originally shared by Maya Angelou. This theme is the basis of the interview, and a great outlook for the way forward to develop healthier relationships with our bodies, physical activity, and nutrition.
(Image provided by the Body Image Research Lab)
What drew you both to this type of research?
Dr. Shelly Russell-Mayhew: About 27 years ago, when I first started my career, I was exclusively focussed on eating disorders (ED), obesity, weight bias, body image, and prevention. This then changed into, “how do we encourage and support environments that allow people to develop a healthy relationship with their body?” At first, a lot of my focus was more on programming, specifically related to these topic areas and how we might prevent them. I soon realized that if we actually want to promote healthy relationships with bodies and food in schools, we can’t just parachute in programs. We can’t just put these programs in and then leave, or have an expert come in and then leave. It’s really about creating the environment in which all the stakeholders in the school can flourish. I call myself an “accidental comprehensive school health researcher” because it was never really my intention to become an expert in school health promotion or health promotion in an educational context. These might seem really separate, but I don’t see them separate at all. In order to do comprehensive school health well, it needs to be done in a weight-neutral way. The two things (comprehensive school health and weight-neutral health promotion) are really connected in my mind and I’m a huge advocate for that framework. In order to have children develop healthy relationships with their body over time, there needs to be systemic and structural supports in place for that to happen. This type of framework is the way to do that as it creates an environment where more students can flourish.
Elizabeth Tingle: I was motivated to research weight-neutral approaches to well-being because I had an unhealthy and unhappy relationship with my body as a teenager. I now know that my experience is dismayingly common for young people. As a classroom teacher, especially when teaching health-related topics, I wanted to spare my students any of that pain I had experienced. However, I didn’t have a lot of resources or ideas on how to teach about physical health in a way that could protect my students from being preoccupied with their body’s size or appearance. When I became a mother to three children, I became even more motivated to create school environments that could support a positive relationship with our bodies.
What is the difference between a weight-centric and a weight-neutral health promotion approach?
Elizabeth: A weight-centric approach is where we use weight as a proxy or shortcut for understanding whether someone is healthy and you would manipulate food and activities to get to that “healthy weight”. When we are focusing so much on someone’s weight, it can be demotivating for people who don’t experience that change. It is a misplaced focus and is not the purpose of adding physical activity or greater nutritional variety to our lives.
A weight-neutral approach is focusing on adding healthy behaviours and what happens to body weight is not the goal. Some people’s body weight will change when you add movement or change eating patterns, but some won’t. That doesn’t mean that there aren't other impacts that are beneficial to someone’s health. We now know that weight-centric approaches aren’t health promoting and we need to shift and act towards a weight-neutral approach.
Shelly: Weight is not a behaviour. So, it should not be an outcome for behaviour modification. Moving is important for everyone. Nutritionally dense food is important for everyone. If the focus is all around weight, we are in fact then missing a whole group of people that would benefit from movement. Whether it is for their mental health, the joy of moving, or the comradery in a team sport, movement is important for all bodies for so many reasons.
In Canada, the first week of February is Eating Disorder Awareness Week. Why is eating disorder (ED) prevention so important?
Elizabeth: There are many reasons:
- Treatment is difficult. Once an ED has taken hold, it can last for a very long time.
- EDs are very resource-intensive to treat and may require multiple attempts.
- EDs can significantly compromise someone's quality of life and physical health so prevention is always better.
- Disordered eating and body dissatisfaction, which contribute to the development of EDs and compromise well-being, are also very widespread.
While not many children and youth have acute eating disorders, there are a lot of subthreshold behaviors on the eating disorder spectrum that compromise well-being, such as disordered eating, compulsive exercise, and making frequent body comparisons. There needs to be a public health response because body dissatisfaction is so widespread and poses a real threat to health and well-being. We don’t have enough mental health practitioners to support the number of students that are struggling with these issues. This is why a comprehensive school health framework really needs to be part of the solution to helping children and youth have a healthier relationship with their bodies.
How can PHE teachers bring ED awareness into their classroom(s) in a way that avoids unintended harm?
Shelly: Here is the thing, “when we know better, we do better”. I am someone myself who struggled with a troubled relationship with my body. I have explored the weight spectrum and most weight related issues in my lifetime. In the past, I have been guilty of telling my story at schools when I was much, much younger, and much closer in age to the students that I was talking to. At that time, I thought sharing my story would prevent someone else from suffering. However, research does not back up that type of approach for EDs. No one is immune to the cultural discourses that we have around ideals such as “thinness” for women, “muscularity” for men, or what a “healthy body” looks like. These cultural beauty “ideals” are rampant. We all live in this type of culture (i.e., weight-centric, diet-culture). No one is immune to it and there is no blame on the teacher.
Instead, there are lots of other things you can talk about in the classroom that have way more upside to them (click the drop-down button to learn more):
1. Teachers should ask themselves and think about, "How do we want our students to best spend their time?":
Shelly: Especially prior to high school, we have a limited amount of time to address health related topics in schools. We need to think about and ask ourselves how we best utilize this time. I am not sure how helpful it is for students to be able to define disorders versus the potential upside of talking about diet culture, how to develop a healthy body image, a healthy relationship with food and exercise.
2. Model to students how to develop a healthy relationship with their body:
Elizabeth: Dr. Niva Piran, a Canadian Researcher and Co-Founder of National Eating Disorders Association, talks about how teachers can model a healthy relationship with our bodies way more than just a lesson on eating disorder prevention. The way we (teachers) talk about ourselves, food and movement, can be preventative of eating disorders. Her research found that even just one adult figure in someone’s life that has a more, I would say, counter-cultural approach to their body can be protective.
Shelly: Another short version of Dr. Niva Piran’s work is “teachers as being versus teachers as doing eating disorder prevention”. Sometimes, doing less is more effective.
3. Conversations entry points should be about connection, not appearance:
Shelly: There are all sorts of unhealthy messages underneath a comment that can come from one little exchange. This could be as seemingly innocent as overhearing two teachers talking in the hallway and one teacher says to the other, “You look great! Have you lost weight?” This is something that is often said in our larger culture, but the messages that this sends to students are:
- Losing weight is good;
- If I want to look good, then I have to lose weight or be smaller; and,
- Adults are trying to change their bodies.
If you are coming into a conversation with the intention of making a connection, there are many alternatives to focusing on weight or appearance and therefore, less chance of unintended harm.
4. Establish classroom norm - if it can't change in 5 seconds, don't comment on it:
Elizabeth: As teachers, I think we can coach and model that for students. When you set up classroom agreements you can say:
- It’s really important to me that everyone feels safe and welcome. One of my guidelines is: We don’t talk about other people’s bodies.
- I consider it rude to talk about people’s body’s because you never know how even what you might think is a compliment is going to land.
A BEd student of mine made a suggestion that if a comment is about anything that can be changed in 5 seconds, it’s most likely fine. These can be comments more about choices like, “cool glasses” or “nice shirt”.
In my research, comments about height were the beginning stages of some people feeling different about the body. I think comments about height can land differently depending on gender, but it does lead to self-consciousness. Especially in a period in a kid's life when there are height spurts, weight spurts, growth spurts. Anything that is talking about their bodies is not advisable, so let's refrain from making comments about their genetics.
5. Model healthy movement behaviours:
Elizabeth: There is a risk for compulsive movement and compulsive exercise. We are seeing an increased risk of this, particularly in males. We want to make sure that we (as teachers) are not advocating for extreme approaches to movement and exercise, such as “no rest days” or “no pain, is no gain”. Those kinds of messaging are negative and feed into the eating disorder mindset as well.
6. All foods fit:
Elizabeth: Helping students realize that there are other ways to relate to our bodies than the default, diet-culture setting is important. In small comments, we can say and model this. How you respond and how you talk about these small things are important, especially because of the underlying messages that follow. You never know who is listening and who needs to hear that different take.
Example 1: A student is talking about how they had a chocolate bar for lunch and that maybe they shouldn’t have. Instead of responding, “Yes, you shouldn’t have. That isn’t very healthy,” you could say, “I think all foods can be a part of a healthy diet”.
Example 2: When children hear adults make comments like, “Oh. I can’t have that donut. I didn’t do my workout this morning.” The underlying messages are:
- I have to earn my food through exercise;
- I am only allowed treats if I burn calories;
- If I eat that then I am unhealthy; and,
- That type of food will change my body in negative ways.
7. Avoid talking about the signs and symptoms of eating disorders with children and youth:
Shelly: Evidence shows that when talking about the causes and consequences of EDs it can actually increase the risk of those kinds of behaviours. At best, talking about the signs, symptoms, causes, and consequences of EDs does nothing; at worst, it can increase the risk for disordered eating behaviours. Focusing on disorders and diseases is really not that helpful. I would argue that didactic delivery of information about an ED is not the best use of our time.
Elizabeth: The reason why it’s problematic is because teachers don’t know how many, or who, have weight loss goals already. When you are talking about eating disorders, some students may already be in the mindset of “the number one goal in my life is to change my body in some way”. That’s how students will then filter that type of information. The other reason why it’s tricky to raise that content in class is because there’s already so much pro-ED content online. Students then are at risk of going to search about them and stumbling onto some pretty unhappy and unhealthy places on the internet. This is why you don’t want to bring EDs up in the classroom in a didactic “let’s talk about this as a lesson or a research assignment” type of way.
Elizabeth: We live in a disordered culture. You have to be intentionally counter-cultural to change that default setting that the adults, and the students themselves, are immersed in and bring those values into the school setting.
Shelly: As we learn, we can do things differently. Some of the best intended activities are actually just perpetuating diet-culture and what I would call “ED thinking” or “disordered eating kind of thinking”. It has become so normalized in our society. With that, I think we need to be easy on teachers. Teachers are no different than anyone else. We are a part of this larger culture that has this obsession with weight. Those discourses then end up playing out in schools in, potentially, really harmful ways. That’s why, “when we know better, we do better”.
If a student asks about a type of ED in class, what would you recommend teachers do when navigating that type of conversation?
Shelly: Do that conversation one-on-one. If a student asked me about an ED I would say to them something like, “That’s a really interesting question. I would like to chat with you about that after class”. I wouldn’t answer that question in the large classroom because you don’t know who is in the room. Often, students who are interested in knowing that are either themselves potentially at risk of an ED, they have someone in their life at risk; or both. If a student is showing a particular interest in that type of question I would be trying to do those conversations one-on-one. I would then be very aware of anything else I am noticing about that student.
Elizabeth: If you feel that a student is at risk for an eating disorder, reach out to a parent, document observed behaviours, and utilize the referral pathways in your school to get them the help they need.
What are some other ways to flip the conversation around to focus on making a connection so we can avoid underlying, harmful messages?
Shelly: Our culture is obsessed with appearance so it’s pretty common for someone to comment on how you look as an entry point into conversation. If that’s the first thing we end up saying to each other then the message really is, “the most important thing about you is how you look”. I worry that if that’s the value we are all holding in the highest regard, we’re in trouble as a culture. When you think about the teacher that had the most influence in your life, that made the most difference to you in a positive way, it was not about how they looked. Yet, in our day-to-day conversations we are often focussing on appearance. Entry points to conversations should move away from the body, and be around making connections rather than prioritizing the value of appearance. Try saying things like:
- “You have lots of energy today”
- “It’s great to see you”
- “I missed you”
- “I am so happy we are in the same room”
- “I get to see you in 3D today I am so excited”
- “I really like that colour on you”
- “I could tell you had fun playing that”
- “Tell me about what is new in your life”
- “You look really happy today”
It’s important to think about the comment and if it is coming from a place of connection. Although we want to refrain from commenting on someone’s appearance, if someone is wearing a dog shirt you could say, “Oh, I love dogs!”. The difference here is you are noticing what someone is wearing, but you are making it less about what they are wearing, and more on how you can connect around that comment.
What should a teacher or school be mindful of when starting a health related movement initiative to avoid unintended harm?
Shelly: When we look at some of the literature from 15-20 years ago, students were often picked out to participate for being in a large body. These students were typically picked out of class and had to go to a mandatory, after school, “move your body” or “exercise program”. There are a lot of problems with this type of approach. What we know from studies like that is a large percentage of those children ended up in hospital with an eating disorder. Even when we have the best intentions, we have to think about that and be diligent about counter-culture. To create a truly safe space in schools for all bodies we have to be anti-diet culture and weight-neutral with how we are communicating to people.
A question to ask yourself when wanting to avoid a weight-centric approach can be, “Are we planning on doing behaviour modification on something that is not a behaviour?” Again, weight is not a behaviour and it shouldn’t be used as the outcome.
In your research, you mentioned how “teachers responsible for delivering health education are themselves often members of a high-risk population for increased body dissatisfaction, dieting and eating disorders”. What would you recommend to PHE teachers when it comes to focussing on their own well-being?
Elizabeth: PHE teachers do tend to have higher rates of internalized weight stigma and EDs, and in the name of “good intentions”, they may have done some of these unintended harms, and we don’t want teachers to feel bad or ashamed about that. If we’ve implemented health promoting activities that may have fallen into the category of a weight-centric approach to health, we need to have self-compassion for ourselves. We want teachers to have self-compassion for themselves. This is also a really protective factor in ED mitigation. The more self-compassion we have for ourselves, then the healthier our relationship with our body can be. Teachers not only need to talk about that, and model it for their students, but they need to have compassion for themselves, as educators, in the choices they’ve made. Teachers have only done what they thought was best. We don’t want people, and teachers, to feel shame and guilt over trying to do what they thought was best and doing what many people were asking teachers to do in the name of health and health promotion.
Everyone deserves to feel at home in their body, teachers included. If they don’t, we recommend they reach out to a mental health professional. People shouldn’t feel that they need to meet the diagnostic criteria of an ED to talk to someone about how they feel. When they do get support and talk about this, there can be a big improvement with someone’s physical and mental well-being. They can then begin to potentially reframe how they talk to themselves, about their body, about food, and movement.
Shelly: Oftentimes, my assumption is that the PHE specialist teachers come from a history of being involved in a sport of some kind or, at least, have an interest in that area. That may be why they are specializing in PHE. The reason why PHE teachers may be more at risk then is because they’ve been in subcultures that are even more weight-centric. They may have even been in an at-risk sport where the aesthetics are really important like figure skating, gymnastics, or in a sport where there are actual weight categories and are doing all sorts of disordered eating to reach the weight on your weigh-in day. Even just sport in general tends to have subcultures of weight-centric ideas that are not questioned. Not all, but some PHE teachers may bring this with them. We are people outside of being a teacher. We aren’t immune to the diet or weight-centric cultures that we’ve been around. We bring all of ourselves into our teaching interactions. It’s important for teachers to trouble that and take care of yourself.
What can schools/administrators/school boards do to promote and support health promotion in schools to avoid any unintended harm?
Elizabeth: Bullying policies should mention body shape and size. Often, these policies state how schools will not tolerate racism, homophobia, transphobia, amongst others, but there is nothing about weight-based bullying. Weight-based bullying is one of the most common forms of discrimination in school settings and is often coded for other forms too. Students know that they will get in trouble for saying something explicitly racist, but they may not get in trouble for saying something negative about someone’s body. Interestingly to note, students that are a part of the 2SLGBTQIA+ community experience more weight-based bullying across the entire size spectrum. That then says to me that this is a coded way that people are discriminating against that group. The students and parents aren’t reporting that type of bullying as much too because of the shame around weight. This makes weight-based bullying not seen as something as serious, when it actually does perpetuate a lot of harm.
To expand your learning, check out the following additional resources and podcasts:
- Body Image Research Lab
- School is for Every Body - Weight-Neutral Wellbeing in the School Setting
- Taking Weight Out of the Equation: Unintended Harms of Weight-Focused Health Discourse in Schools
- Comprehensive School Health: weight-neutral-example-case-study.pdf
- National Eating Disorder Information Centre
- Eating Disorder Awareness Week
- Weight-Neutral Health Promotion in Schools with Dr. Shelly Russell-Mayhew
- Positive Nutrition Messaging in School with Anna Lutz and Katherine Zavodni
- Weight-Neutral Approaches to Physical Activity with Natalie Costa and Sarah Balla
- on The Podclass: Conversations on School Health. Werklund School of Education, University of Calgary, & Ever Active Schools.
References:
Elizabeth Tingle, Jessica F. Saunders, Sarah Nutter & Shelly Russell-Mayhew (2023) Taking Weight Out of the Equation: Unintended Harms of Weight-Focused Health Discourse in Schools, Journal of Physical Education, Recreation & Dance, 94:2, 49-58, DOI: 10.1080/07303084.2022.2146818
Nocentini, A., De Luca, L., & Menesini, E. (2019). The teacher’s role in preventing bullying. Frontiers in Psychology, 10, 1830. https://doi.org/10.3389/fpsyg.2019.01830
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