The #BoPo hashtag is trending, diversity is desirable, and marginalised bodies are being welcomed into spaces previously denied to them. The social movement that is body positivity advocates for the acceptance and love of all body types, shapes, sizes, of all skin colours and textures, gender identity, physical ability, and neurodiversity. Social media and the planet at large may slowly be coming around to welcome and love all body types, but what about the medical world?
We are often told that BMI (body mass index) and the ‘ideal weight range’ are accurate indicators of good health. That the sun spots on our face absolutely need to go away for us to have ‘healthy skin’. That it is surprising that our facial hair is natural, and not a result of thyroid or PCOS. Perhaps unwittingly, we are made to feel ashamed about our bodies, as if they’re ‘unhealthy’, purely on the basis of what we look like and certain stereotypical global markers. How much of this should we take seriously?
Dr Yejushree Reddy, a general practitioner, believes that the body positivity movement is great, but the concern is that it shouldn’t become an excuse to neglect one’s overall health. “We are at a point in time when lifestyle diseases in India are at an all-time high and the largest killer. More than half the deaths in the country are linked to lifestyle diseases like heart health, diabetes, and cancer. One of the root causes of this is obesity, which happens to be more prevalent in women than men. Childhood obesity in young girls can also cause complications later in life. The main cause of obesity are factors such as no exercise, poor food choices, lack of adequate and quality sleep, and stress.
“However, there may be other causes such as genetics, the environment, and underlying medical issues, as well. As healthcare providers, the idea is not to tell everybody to be thin or emulate what they see on social media or in the movies. Rather it is to get to the root cause of their health issues. Some people can work towards health and self-care without actively attempting to lose weight. However, if obesity is causing them to lead a less fulfilling or healthy life, we need to point that out and provide solutions to lose weight. Does this mean you have to deprive yourself or force yourself to change anything just for others? Absolutely not. No one should be made to feel apologetic about their bodies, especially with a healthcare provider. Our job is to provide a safe, non-judgemental space – it is up to our patients to decide whether and how to implement our suggestions for treatment.”
A large part of the body positivity movement is the quest to change perceptions in society, among peers, and within ourselves. But a more significant part also involves access, equity, and inclusion.
Dr Reddy admits that obesity forms a large part of the body positivity conversation, but those who are differently-abled, trans, and chronically ill have a more challenging time navigating healthcare spaces and practitioners.
“There are some spaces that provide appropriate healthcare across the country for transwomen, women with disabilities or chronic ailments, but these are few and far between. Often, these women encounter bias from the very healthcare providers that are meant to make them feel cared for. The answer lies in sensitising our medical workforce towards treating different bodies and people. For this, proper policies need to be implemented at hospitals, clinics, and healthcare centres, and this often needs to come from the top echelons of the organisation,” she says.
Skin colour, type, and pigmentation are other key concerns. In 2020, The New York Times published an article stating ‘Dermatology Has a Problem With Skin Color’, going on to say that globally, dermatologists were wired to treat women with lighter skin better than those with brown or black skin, due to unconscious biases. In India, dermatologists tell you that your life will magically improve with ‘skin-brightening’ treatments (a somewhat shady substitute for skin lightening), or a chemical peel to remove skin pigmentation or acne scars – both of which have been routinely acquired through the course of life and won’t kill you. The ancient Indian medical science of Ayurveda prescribes remedies as well; expectant mothers can make sure they have ‘fair’ babies by eating oranges and drinking saffron-infused cow’s milk.
“Although I am in my early 20s, I still have rather painful, chronic acne,” says Charita Jagan, a post-graduate student of history and political science. “When I visited a dermatologist for help, I expected to get a topical cream that would help me get rid of it. Imagine my shock when I received a prescription for heavy steroids, and the suggestion to undergo invasive and chemical procedures because my ‘acne pits’ would look ugly. I understand that there are women who benefit from some of these treatments, but I categorically told her that I was only interested in treating the current acne.
“She constantly told me how my skin tone and complexion would improve, how perfect skin would help me bag the ideal career and husband, and so on. I may have considered taking the steroids, but after the whole unwanted ordeal, I just walked out of there. I’m not dissing all doctors. In fact, I found a wonderful dermatologist soon after, who understood what I needed and worked with me.”
Whatever the medical world says, being body positive has one key health benefit -- better mental health. Those who embrace their bodies completely, or adopt a policy of body neutrality, actually feel better, less stressed, and are not prone to depression or eating disorders. Work towards what makes your own body and mind happy. Surround yourself with positive people. Practice self-compassion. Yes, the doctor’s office can and must tell you how to get healthy, but they can’t tell you that health has an ideal ‘look’.