Oliver-Pyatt Centers Founder Wendy Oliver-Pyatt, MD, FAED, CEDS matches both her comprehensive training and personal victory over food and body issues with an unwavering belief in compassionate and scientifically sound treatment. She shares some of her expertise in this week’s blog post by discussing the stigma surrounding weight and body size in our culture.
Weight stigma, also known as weightism, weight bias, and weight-based discrimination, is discrimination or stereotyping based on one’s weight, especially larger or thinner people. Weight stigma reflects internalized attitudes towards body size that affects how those who are the targets of bias are treated.
A person who is stigmatized possesses a weight that leads to a devalued social identity, and is often ascribed stereotypes or other labels denoting a perceived deviance which can lead to prejudice and discrimination. Some common “weight-based” stereotypes are that obese persons are lazy, lack self-discipline, and have poor willpower, but also possess defects of intelligence and character. Pervasive social portrayals of people of larger body size create and reinforce biased attitudes.
Research has documented that physicians are the #2 source of weight stigma. Weight stigma has also been demonstrated in nurses and medical students, psychologists, dietitians, and fitness professionals.
Rebecca Puhl of the Yale Rudd Center for Food Policy and Obesity illustrates in the Cycle of Bias and Obesity the pursuit of help followed by the avoidance of help, likely caused by the stinging, invasive weight bias experienced by the patient. The patient may not know they were subject to weightism, and may even believe that the shaming, unhelpful remarks are warranted, deserved and appropriate, and that they are even less valuable a person and therefore avoid the doctor and pursuit of health care altogether.
The person experiencing weight stigma is in a bind. They may seek assistance from healthcare or other providers, but the “help” can in fact reinforce and intensify shameful feelings the person experiences on a day to day, moment to moment basis. This leads to avoidance of health care, and even turning to food and bingeing to dissociate from this painful experiences.
When well-intentioned providers “prescribe” simplistic, behavioral weight loss plans (the typical eat less, exercise more mantra,) the individual with Binge Eating Disorder feels even more powerless. Not only is their shame exacerbated, their illness is being mismanaged, and they enter into a hopeless-helpless paradigm.
The truth is Binge Eating Disorder is a mental illness, and requires treatment that addresses the bio-psycho-social issues that contribute to the development of an eating disorder.
A patient told me that a physician once told her “You’re fat everyday so you should exercise everyday.” This statement is grounded in ignorance. It was not helpful. Worse yet, it was harmful and might have contributed to further avoidance of healthcare, shame, and ultimately, bingeing. Thankfully, this patient knew better. She found another healthcare provider rather than blame herself or avoiding the help she desperately needed.
Weight Stigma is perhaps the most recent, socially acceptable form of discrimination. I am thrilled that Binge Eating Disorder Association (BEDA) and National Eating Disorders Association (NEDA) are spreading the word on the insidious, destructive reality of weight stigmatization, a current reality of modern society and modern medicine. I hope we will be able to look back one day and realize how far off medicine once was, and recognize instead that attitudes and approaches founded on compassion, love and science are how we heal our patients.
© Wendy Oliver-Pyatt, MD, FAED, CEDS
Oliver-Pyatt Centers Primary Therapist Carmen Bolivar, MSW, LCSW gives a glimpse into the work she does at Casa Rosada Comprehensive Adult Program in this week’s Meet Our Team. She shares about her journey to joining the OPC team and the passion she puts into every day spent supporting women on the journey to full recovery. Learn more about Carmen and OPC by reading her blog post…
What is your name and what are your credentials?
Carmen Bolívar, MSW, LCSW. I am a Primary Therapist at Casa Rosada Comprehensive Adult Program.
Please give us a brief description of your background.
I’m originally from New Jersey and relocated to Miami, FL a little over a year ago. I received my BA in Sociology from Rutgers the State University and my Masters in Social Work with a concentration on International and Community Development from Monmouth University. I am also Trauma Focused-Cognitive Behaviorally Trained and have over five years of experience in residential settings. In addition to adult residential, acute in-patient and out-patient experience, I have also worked within different aspects of the Children’s System of Care of NJ. I have worked to provide wrap around services to children and adolescents with complex behavioral and/or emotional needs and their families. In the summer of 2015, I moved to the Sunshine State to pursue never ending summers and say good-bye to blizzards for good. I found OPC on my pursuit of happiness and am grateful to be part of such an amazing and dedicated group of professionals.
What does a typical day look like for you at OPC?
One day never looks like the next! In my role of Primary Therapist at Casa Rosada, I wear many different hats. I facilitate Body Image and Shame and Resilience groups, share meals with the milieu and collaborate with my colleagues. A few times a week, I put on my war paint (lipstick) and enter the battlefield (my office) and wage war (humbly request) for insurance coverage for my caseload. In the afternoons, I see clients individually, conduct family sessions and complete documentation.
In your own words, please describe the philosophy of OPC.
OPC has many strengths and the one that speaks to me the most is the ability to deliver quality individualized care to clients with unique needs. I believe the multidisciplinary approach provides the most comprehensive and effective care to our clients, giving them the opportunity to achieve sustainable recovery from their eating disorders. No two eating disorders are alike and therefore OPC treatment thrives because we approach each client’s treatment uniquely.
How does your team work together? How do your roles overlap and differ?
I feel truly blessed to part of the team at Rosada. We collaborate and work together to support each other when we are facing challenges, needing encouragement and especially, problem-solving. Our roles overlap in that we consistently collaborate and share our expertise to provide comprehensive and individualized care for our clients.
What is your favorite thing about OPC?
My favorite thing about OPC being able to work alongside my colleagues who share the same passion I do about the work we do. We are able to connect, learn and grow from each other. I am inspired by my colleagues and they motivate daily.
What are three facts about you that people do not know?
That I once completed a Tough Mudder and will probably never do that again.
I have performed with a Salsa team in NJ at Salsa Congresses.
I used to be very afraid of clowns…now I’m only moderately uncomfortable.
Oliver-Pyatt Centers Clinical Director of Intensive Outpatient and Transitional Living Programs Giulia Suro, PhD will present at OPC’s First Wednesdays Series for Clinical Professionals on Wednesday, February 1st. Dr. Suro will share her expertise on “Using Acceptance and Commitment Therapy to Drop the Rope in the Context of Challenging Therapy Cases”.
Acceptance and Commitment Therapy (ACT) challenges conventional wisdom and overturns the ground rules of most of Western psychology. Within the framework of ACT, quality of life is dependent on mindful, values-guided action, regardless of how many symptoms you have. Applying an ACT approach in the context of complex pathology (e.g. personality disorders, trauma, eating disorders) provides an opportunity to address the numerous and multifaceted factors that maintain the symptom presentation. ACT encourages clients to examine the function of their symptomatology from an objective and compassionate stance. Additionally, ACT techniques teach clients and clinicians alike how to live a meaningful and valued life in the presence of the most painful and unrelenting thoughts and feelings. For our February edition of First Wednesdays at OPC, Dr. Giulia Suro will provide a general overview of the theoretical underpinnings of ACT as well as specific clinical techniques to use in challenging cases.
Through this presentation, participants will be able to identify and define the six core components of the ACT hexaflex. Participants will learn techniques to illustrate the skills of diffusion and experiential acceptance in the context of thoughts and feelings associated with the eating disorder and to define the difference between a value and a goal in the framework of working with clients toward behavioral change.
Lunch begins at 12:00pm and the presentation will be from 12:30-1:30pm. One CE hour will be offered for PhD, PsyD, LMFT, LMHC, LCSW, LPCC and RD. If you would like to join Oliver-Pyatt Center’s First Wednesdays on February 1st, please RSVP to Florida Outreach Manager Callie Chavoustie at CChavoustie@www.oliverpyattcenters.com or RSVP here by Montday, January 30th.