1. Size Aware Care: Body Positivity and Diversity for Sustainable Health
Laura Mackie, MSW, LICSW
Networks, Inc.
~In Remembrance of Kim Winnegge,LCSW 7/30/83-12/5/18~

2. Introduction Professional Context Personal Context
Born and raised in New Hampshire
Liberal Arts undergraduate education in Elon, NC and study abroad in Perugia, Italy
Peace Corps Service in Ukraine
Master’s degree in Clinical Social Work obtained in 2012
Clinical experience working with children and families (New Haven, CT) and within university counseling systems (Western Massachusetts); joined Networks, Inc. in Burlington, VT in 2017
Mental health practitioner informed by social justice, anti-oppressive and feminist practices, narrative therapy, and EMDR trained. Generalist and also experienced in working with eating disorder recovery, body image, identity, trauma and self-esteem issues.
Social Location from “Addressing Framework” (Hays, 2008)
35 year old, “xennial”
Physical health and mental health history & living in a fat body – am I fat enough to present here?
Spiritual and non-religious, raised in a Christian family
White/Caucasian person of Irish American and Western European descent
Formerly lower-middle Class/upwardly mobile (student loan and other debt)
Pansexual
American Citizen, have lived in 5 states and 3 countries
Cisgender “femme” woman
Higher Education obtained
The personal is political is professional is political is personal

3. OVERVIEW
1. Terminology: Intersectionality and context 2. Shame based approaches to size a)US and global diet culture a) Sizeism and stigma in healthcare b) A “Radical” paradigm shift 3. Brainstorm: What can we all do? Systems thinking and “Collective Compassion”! (Taylor, 2018, p. 65)

4. Learning Objectives
1: Increase understanding, and support language development to challenge implicit bias, microaggressions and stigma associated with sizeism. 2: Increase participants’ awareness of the importance of size and body positive care, and health implications associated with sizeist care. 3: Generate conversation, recommendations and considerations to support multi-leveled interventions for incorporating size and body inclusive initiatives within healthcare systems.

5. Questions to consider:
TERMS OVERVIEW
Questions to consider:
What am I not seeing?
What may I be seeing through my own lense(s)?
Who or what is not being considered here?
Who is not being included?
*Representation, communication and collaboration are imperative components to enhancing inclusive initiatives!
1. Intersectionality (Crenshaw, 1989), Ted Talk: “The Urgency of Intersectionality” Implicit Social Cognition & Bias (Greenwald, A. G., & Banaji, M. R. (1995) 3.Microaggression (Sue et al., 2007) 4. Inclusivity (“Oxford Dictionaries, 2018)
Terminology and Polling

6. Need for a multi-axial framework of constructing experience
Terms Overview
Need for a multi-axial framework of constructing experience
“This focus on the most privileged group members marginalizes those who are multiply- burdened and obscures claims that cannot be understood as resulting from discrete sources of discrimination” (Crenshaw, K., 1989, pg. 140)
2. “Implicit attitudes are introspectively unidentified (or inaccurately identified) traces of past experience that mediate favorable or unfavorable feeling, thought, or action toward social objects.” (Greenwald, A.G, & Banaji, M.R., 1995, pg. 8)
3. “Racial microaggressions are brief and commonplace daily verbal, behavioral, or environmental indignities, whether intentional or unintentional, that communicate hostile, derogatory, or negative racial slights and insults toward people of color”. (Sue et al., 2007 p. 271)
4. “The practice or policy of including people who might otherwise be excluded or marginalized, such as those who have physical or mental disabilities and members of minority groups.” (“Oxford Dictionaries, 2018)

7. A paradigm shift from fear and shame to empowered self-love
How did we get here?
History of pathology and disease driven models of care
“Obesity Epidemic” in the US and globally
“Social evolution” (Taylor, 2018, p. 31), cultural expectations of health and aesthetics and “Body-Shame Profit Complex” (Taylor, 2018, p. 39)
Personal, anecdotal and professional experiences with sizeist care

8. Onward and upward
History of Fat Activism “A Short History of Body Positivity” (2017)
Body Positivity Movement (size as only one dimension of identity and embodied experience)
Health at Every Size,
“Poodle Science”:
Sonya Renee Taylor’s “The Body is not an Apology” (2018) and Radical Self-Love

9. Health at Every Size Linda Bacon (www.lindabacon.org)
“You can’t look at a person and tell how healthy they are
There are healthy and unhealthy people of every size
People of all sizes deserve to be treated with respect”
(Chastain, R., 2012, p. 21)

10. Radical Self-Love as Resistance and Liberation (Taylor, 2018)
“Three Peaces” (p. 57)
Four Pillars of Practice (p. 64)
Make peace with not understanding
Taking out the toxic
Mind Matters
Make peace with difference
Unapologetic Action
Make peace with our bodies
Collective Compassion
“radical self-love…requires a whole-being approach to our lives and bodies”
“Thinking, being, doing” (p )

11. Levels of Change Personal Professional Systemic Community
Micro, mezzo, macro
What can you do?
Waiting room chairs, use of language, professional development
Organizational change, governmental change, financial
Self-talk, language development
Youth development, positive role models, agency/organizational initiatives
Personal
Professional
Systemic
Community
Professional
Personal
Systemic
Community
“If you have come here to help me, you are wasting your time. But if you have come because your liberation is bound up with mine, then let us work together.”-Lilla Watson

12. References
Alptraum, L. (2017). A Short History of 'Body Positivity'. Retrieved from
Association for Size Diversity and Health (ASDAH). (2015, February 23). Poodle Science. Retrieved from
Bacon, L. (2010). Health at every size: The surprising truth about your weight. Dallas, TX: BenBella Books.
Chastain, R. (2012). Fat: The Owners Manual. Sized for Success Multimedia, LLC.
Crenshaw, Kimberle (1989) "Demarginalizing the Intersection of Race and Sex: A Black Feminist Critique of Antidiscrimination Doctrine, Feminist Theory and Antiracist Politics," University of Chicago Legal Forum: Vol. 1989: Iss. 1, Article 8.
Greenwald, A. G., & Banaji, M. R. (1995). Implicit social cognition: Attitudes, self-esteem, and stereotypes. Psychological Review, 102(1), doi: / x
Hays, P. A. (2008). Addressing cultural complexities in practice assessment, diagnosis, and therapy. Washington, DC: American Psychological Association.
Inclusivity | Definition of inclusivity in English by Oxford Dictionaries. (2018). Retrieved from
Linda Bacon, PhD. (2018). Retrieved from
Sue, D. W., Capodilupo, C. M., Torino, G. C., Bucceri, J. M., Holder, A. M., Nadal, K. L., & Esquilin, M. (2007). Racial microaggressions in everyday life: Implications for clinical practice. American Psychologist, 62(4), doi: / x m: Vol. 1989: Iss. 1, Article 8.
Taylor, S. R. (2018). The body is not an apology: The power of radical self-love. Oakland, CA: Berrett-Koehler.
TED. (2016, December 07). The urgency of intersectionality | Kimberlé Crenshaw. Retrieved from

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