Overcoming anti-fat bias: Myths, facts, and tips for better overall health

Unfortunately, if you are in treatment for breast cancer, and you’ve put on some extra weight, you may experience anti-fat bias (even in medicine) or fat shaming. “We live in a fat phobic society,” says Suzanne Dixon, MPH, MS, RDN. We also know that body shaming is “counterproductive and creates stress,” Suzanne adds, which can be especially harmful at a time when a person’s focus should be on recovery.

Weight gain and risk of reoccurrence

Suzanne, a registered dietitian and epidemiologist, dispels some of the myths associated with weight gain and overall health with regard to risk for breast cancer recurrence (cancer coming back), and offers tips for people who have gained some weight during treatment:

• Being overweight does not cause breast cancer to come back. While there is a relationship between being overweight or obese and cancer recurrence, it is not proven to be a cause/effect relationship, Suzanne says. That’s because “weight can be a biomarker for a host of other markers,” (conditions that increase risk) like drinking too much alcohol or having an unhealthy diet.
• Exercise is more important than weight. If you are active regularly, your chance for breast cancer recurrence decreases, regardless of your weight.

The American Cancer Society offers activity guidelines for people affected by cancer. They include:

• Avoid being inactive and keep up with your daily routine after diagnosis and treatment.
• Start slowly; aim to build up to 150-300 minutes (about 5 hours) of moderate activity each week.
• Try to exercise several times a week for 15 minutes at a clip. Include stretching and resistance training in your practice.

Avoid “all or nothing” thinking, says Suzanne. “The evidence is clear” that any exercise–even a 15-minute walk–is better than none at all.

If you’re looking for a place to start or some inspiration, you may want to try LBBC’s BeACTive exercise series, designed specifically for people being treated for breast cancer.

The same is true for having a healthy diet. “If you’re making healthy choices, the weight is less of an issue,” says Suzanne. Strive to eat more vegetables and fruits, nuts, seeds, whole grains, and beans. Limit processed and sugary foods.

Healthy moves to make

• “Focus on deposits, not withdrawals.” Suzanne advises applying a banking mentality to eating: Maximize what you put into your body – the deposits – and steer clear of withholding or restricting foods you think are “bad.”
• Consider eating to reduce risk for other health concerns, like heart disease. For example, The DASH – Dietary Approaches to Stop Hypertension – eating plan has been shown to lower risk for hypertension (high blood pressure) and heart disease in breast cancer survivors. “This is really important,” Suzanne explains, “because some breast cancer treatments increase risk for heart disease, and anything a person can do to reduce that risk is positive for overall health.”
• It is a myth that soy is off-limits for people concerned with breast cancer recurrence. In fact, eating whole soy foods, like tofu, tempeh, and edamame, may actually lower risk of recurrence. “If these are foods you enjoy,” says Suzanne, “there is no reason to stop eating them.”
• If you’re trying to lose weight, and the pounds won’t budge, talk to your doctor or a dietitian. “There are all kinds of things, like hormonal changes, that can cause extra weight to come on,” says Suzanne. A professional may be able to help you address those things.
• Seek out weight-neutral care. If your primary care doctor focuses solely on weight, it might be time to seek out a new physician, says Suzanne. “Ask if they offer weight-neutral care to find someone who can support your healthy lifestyle goals without a big focus on shedding pounds.”

Anti-fat bias can be hard to tune out – and it can negatively affect your body image. Remember, urges Suzanne, to let how you feel, not the number on the scale, be your guide to health. If you’re eating well and being active, while you may feel discouraged that you can’t seem to shed unwanted extra pounds, what you do is more important than what you weigh. “This is what we have to come back to,” she says, “behavior and making choices day by day to nourish your body and find joy in movement.”