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Kenzie Brenna, a full-time social media influencer who promotes self-love and body positivity, has used her online posts to discuss everything from her stretch marks to how people of every size deserve respect.

Melissa Renwick/The Globe and Mail

Kenzie Brenna lived an active lifestyle prior to the pandemic, filling her weeks with dance, yoga and spin classes. But when gyms closed and the stress of the pandemic became inescapable, things changed.

“I slowed down a lot. I ate more food than probably I ever have,” the 31-year-old said from her Calgary home. “I absolutely, 100 per cent gained weight.”

Ms. Brenna, a full-time social media influencer who promotes self-love and body positivity, has used her online posts to discuss everything from her stretch marks to how people of every size deserve respect. But in May, as she was trying to drop a few pounds to help her deal with foot pain and varicose veins, she posed a question to her nearly 400,000 Instagram followers that tapped into just how polarizing the conversation about body size has become: “Are fat influencers/actors/musicians allowed to lose weight?”

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Hundreds of responses came flooding in. “In my opinion, intentional weight loss is always fatphobic,” one commenter said. “I don’t really agree with this [because] intentional weight loss will always negatively affect the fat community,” wrote another. “If you want to eat better and exercise and stuff because you love your body and you want to feel better in it, amazing! And if you then happen to lose weight, that’s no one’s business but yours. But if your intention is to lose weight, that’s fatphobic,” said another.

Canadians had been steadily getting bigger long before COVID-19. Sixty-three per cent were classified as either overweight or obese in 2018, up from 61.9 per cent in 2015, according to the most recent data available from Statistics Canada.

While physicians have been urging people to lose weight for decades, citing an increased risk of Type 2 diabetes, stroke and depression, among other conditions, the notion of going on a diet to adhere to social norms is increasingly seeing the kind of pushback that Ms. Brenna unleashed in her post. When American singer Lizzo posted videos on social media of her doing a smoothie cleanse last year, for instance, some fans took it as a betrayal, accusing the singer of promoting “diet culture.”

Now, with so many Canadians having gained unwanted weight during the pandemic, medical experts and advocates say there’s an opportunity to develop a more nuanced understanding of weight.

But the question remains: how do you recognize the health benefits of weight loss without participating in the cycle of body shaming and stigma?

A new medical understanding of obesity might be the first step. Updated clinical practice guidelines for obesity in adults, published in the Canadian Medical Association Journal last August, make clear that people living in larger bodies aren’t necessarily unhealthy.

The guidelines advise doctors to stop relying solely on Body Mass Index – the measure traditionally used to determine obesity – when diagnosing patients. Obesity, according to the new guidelines, needs to be understood as a chronic disease “characterized by abnormal or excessive body fat (adiposity), that impairs health.” In other words, if a person has fat that isn’t impairing their health, they’re not obese.

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“If we can help people decouple body size and health, that’s going to help everybody,” said Lisa Schaffer, chair of the public engagement committee at Obesity Canada, an advocacy group that works to reduce weight-related social stigma and discrimination.

With this in mind, the guidelines also attempt to steer medical practitioners away from the view that weight is a failure of willpower. Instead, physicians are asked to address obesity as a complex condition with multiple causes.

The pandemic has increased the potential constituency for a social understanding of weight that is not mired in stigma and bias.

A survey of nearly 10,000 Canadians, conducted by researchers at Dalhousie University and released in April, found that 42.3 per cent of Canadians had gained weight during the pandemic. Of those, most gained between six and 10 pounds.

Stress played a significant role in people’s eating habits, with a total of 51.4 per cent of survey respondents saying they tended to eat when feeling worried about the pandemic. According to Sylvain Charlebois, the study’s lead author, the survey’s results are more proof that mental health and lifestyle are key drivers of weight.

“The focus is and should be more about lifestyle than any number on a scale,” Dr. Charlebois said in an interview. “The number on a scale is just an indicator. It’s just one metric.”

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Yet it is the metric that has often dominated conversation about weight during the pandemic, most conspicuously in discussion of the so-called “Quarantine 15.”

Ms. Brenna said the recent conversations about weight gain during the pandemic have the potential to change our thinking.

Melissa Renwick/The Globe and Mail

When researchers identified obesity as a condition that could increase the risk of severe illness from COVID-19, there followed a raft of news articles encouraging people to lose weight. While those articles may have been well intentioned, they were potentially damaging to many people living in larger bodies, said Sarah Nutter, an assistant professor at the University of Victoria whose research focuses on weight stigma and body image.

“It was really harmful and absolutely has the potential to have increased weight stigma in our society,” she said.

And the news isn’t the only vector for potentially harmful ideas about body size. Complaining about not fitting into our pre-pandemic pants or fretting about re-entering the world a few belt sizes bigger can add to the bias against people with larger bodies, said Jennifer Mills, a psychologist at York University in Toronto.

“The more we talk about that, and the more we glorify weight loss, the more stigmatizing it is for people who live in larger bodies,” she said.

That stigma can have a wide range of negative effects. “It absolutely has physical health and mental health consequences,” said Sara Kirk, a professor of health promotion at Dalhousie University.

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A study published in the journal BMC Medicine in 2018 found that people who perceive that they have been discriminated against because of weight are about 2.5 times as likely to experience mood or anxiety disorders, compared to those who do not feel they have faced weight discrimination. In another study, published in May in the International Journal of Obesity, researchers found that weight stigma was associated with greater disordered eating, sleep disturbance and alcohol use.

And while some people believe weight shaming might help those living in larger bodies to slim down, research suggests that the opposite is true.

A 2014 study published in the journal Obesity found that weight discrimination was linked to a 6.67-times greater risk of becoming obese.

So how do we best address conversations around weight with those who want to come out of the pandemic healthier? The answer, experts say, is to focus on our lifestyles – eating better and moving more – rather than a number on a scale.

“Weight is not a behaviour. That’s the critical thing we try to get across to people,” Dr. Kirk said.

Ms. Brenna, the influencer, said the recent conversations about weight gain during the pandemic have the potential to change our thinking.

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“There is a sense of solidarity there, which leads to things being less stigmatizing, which is great,” she said.

“The goal is not weight loss. The goal is health.”

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