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(Re)claiming our bodies using a Two-Eyed Seeing approach: Health-At-Every-Size (HAES®) and Indigenous knowledge

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Abstract

We originally proposed a study to examine changes in disparities in “obesity” between Indigenous and non-Indigenous Canadian populations, as called for in the Truth and Reconciliation Commission, Article 19 (2015), which calls for ongoing monitoring of disparities in health outcomes. Instead, we questioned the importance of reducing the prevalence of “obesity” as a health goal for Indigenous peoples. This critical commentary provides an overview of Canadian Indigenous populations’ weight, its relationship with health outcomes, and weight stigma and discrimination, using an Indigenous feminist lens. We introduce the applicability of a Two-Eyed Seeing approach utilizing a Health-At-Every-Size (HAES®) model and Indigenous ways of knowing, as a starting point, to understand weight, health, and our bodies. A new paradigm is needed to identify and close health gaps as noted in Article 19 of the Truth and Reconciliation Calls to Action (2015). We respectfully call upon health professionals and public health bodies to acknowledge the harm of weight stigma and discrimination in their practice and policies, and we encourage Indigenous peoples to (re)claim and (re)vitalize body sovereignty.

Résumé

Nous avions proposé à l’origine une étude sur l’évolution des disparités entre les populations canadiennes autochtones et non autochtones sur le plan de l’ « obésité » comme il est demandé à l’article 19 de la Commission de vérité et réconciliation (2015), qui appelle à une surveillance continue des écarts dans les résultats en matière de santé. Au lieu de cela, nous nous sommes interrogées sur l’importance de réduire la prévalence de l’ « obésité » comme objectif de santé pour les personnes autochtones. Dans notre commentaire critique, nous présentons une vue d’ensemble du poids dans les populations canadiennes autochtones, de ses liens avec les résultats en matière de santé, ainsi que de la stigmatisation et de la discrimination à l’égard du poids, le tout en utilisant un prisme autochtone féministe. Nous présentons les possibilités d’application d’une démarche de « vision à deux yeux » utilisant le modèle Health-At-Every-Size (HAES®) et les modes de savoir autochtones (pour commencer) afin de comprendre le poids, la santé et nos corps. Un nouveau paradigme est nécessaire pour cerner et combler les écarts de santé mentionnés à l’article 19 des appels à l’action de la Commission de vérité et réconciliation (2015). Nous invitons respectueusement les professionnels de la santé et les organismes de santé publique à admettre les torts causés par la stigmatisation et la discrimination à l’égard du poids dans leurs pratiques et leurs politiques, et nous encourageons les personnes autochtones à (re)prendre possession et à (re)dynamiser leur souveraineté sur leur corps.

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Notes

  1. Indigenous People in Canada are comprised of First Nations, Métis, and Inuit. Where applicable, we have used the most specific name to refer to the Indigenous group or population.

  2. We have included “obesity” in quotations to signify its medicalized and contested use (Meadows and Danielsdóttir 2016).

References

  • Alfred, T., & Corntassel, J. (2005). Politics of identity - IX: Being Indigenous: Resurgences against contemporary colonialism. Government and Opposition, 40(4), 597–614.

    Article  Google Scholar 

  • Aphramor, L. (2009). Disability and the anti-obesity offensive. Disability & Society, 24(7), 897–909.

    Article  Google Scholar 

  • Association for Size Diversity and Health (ASDAH) (n.d.). HAES® approach. https://asdah.org/health-at-every-size-haes-approach/. Accessed 19 Oct 2020.

  • Bacon, L. (2010). Health At Every Size: The surprising truth about your weight. Dallas: BenBella Books.

    Google Scholar 

  • Bacon, L., & Aphramor, L. (2011). Weight science: Evaluating the evidence for a paradigm shift. Nutrition Journal, 10(1), 9.

    Article  Google Scholar 

  • Boisvert, J. A. (2012). Native American Indian women, fat studies and feminism. Somatechnics, 2(1), 84–92.

    Article  Google Scholar 

  • Bombak, A. E. (2014). The contribution of applied social sciences to obesity stigma-related public health approaches. Journal of Obesity, 2014, I1–I9.

    Article  Google Scholar 

  • Bombak, A., Monaghan, L. F., & Rich, E. (2019). Dietary approaches to weight-loss, Health At Every Size® and beyond: rethinking the war on obesity. Social Theory and Health, 17(1), 89–108.

  • Brady, J., & Beausoleil, N. (2018). A response to “a critical analysis of obesity prevention policies and strategies”. Canadian Journal of Public Health, 108, 5–6.

    Google Scholar 

  • Brady, J., Gingras, J., & Aphramor, L. (2013). Theorizing Health At Every Size as a relational-cultural endeavour. Critical Public Health, 23(3), 345–355.

    Article  Google Scholar 

  • Chateau-Degat, M.-L., Dannenbaum, D. A., Egeland, G. M., Nieboer, E., Laouan Sidi, E. A., Abdous, B., & Dewailly, É. (2011). A comparison of the metabolic response to abdominal obesity in two Canadian Inuit and First Nations population. Obesity, 19, 2254–2260.

    Article  CAS  Google Scholar 

  • Clark, N. (2016). Red intersectionality and violence-informed witnessing praxis with Indigenous girls. Girlhood Studies, 9(2), 46–64.

    Article  Google Scholar 

  • Combahee River Collective. (n.d.) The Combahee River Collective statement. https://combaheerivercollectiveweeblycom/the-combahee-river-collective-statementhtml. Accessed 18 September 2020.

  • Crawford, R. (1980). Healthism and the medicalization of everyday life. International Journal of Health Services, 10(3), 365–388.

    Article  CAS  Google Scholar 

  • Crenshaw, K. (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, 14, 538–554.

    Google Scholar 

  • Cyr, M., Slater, J. (2016). The meaning of bannock in Winnipeg’s North End. In F. Deer, T. Falkenberg (Eds.) Indigenous Perspectives on Education for Well-Being in Canada. Winnipeg, MB: ESWB Press.

  • Czyzewski, K. (2011). Colonialism as a broader social determinant of health. The International Indigenous Policy Journal, 2(1). https://doi.org/10.18584/iipj.2011.2.1.5.

  • Dyck, R., Osgood, N., Lin, T. H., Gao, A., & Stang, M. R. (2010). Epidemiology of diabetes mellitus among First Nations and non-First Nations. Canadian Medical Association Journal, 182(3), 249–256.

    Article  Google Scholar 

  • Ellison, J., McPhail, D., & Mitchinson, W. (2016). Obesity in Canada: Critical perspectives. Toronto: University of Toronto Press.

    Book  Google Scholar 

  • Genest, J., McPherson, R., Frohlich, J., Anderson, T., Campbell, N., Carpentier, A., et al. (2009). 2009 Canadian Cardiovascular Society/Canadian guidelines for the diagnosis and treatment of dyslipidemia and prevention of cardiovascular disease in the adult – 2009 recommendations. The Canadian Journal of Cardiology, 25, 567–579.

    Article  CAS  Google Scholar 

  • Government of Canada (2010). Eating well with Canada’s Food Guide – First Nations, Inuit and Métis. https://www.canada.ca/en/health-canada/services/food-nutrition/reports-publications/eating-well-canada-food-guide-first-nations-inuit-metis.html. Accessed 18 Sept 2020.

  • Green, J. A. (2017). Making space for Indigenous feminism (2nd ed.). Black Point: Fernwood Publishing.

    Google Scholar 

  • Hatcher, A., Bartlett, C., Marshall, A., & Marshall, M. (2009). Two-Eyed Seeing in the classroom environment: Concepts, approaches, and challenges. Canadian Journal of Science, Mathematics, and Technology Education, 9(3), 141–153.

    Article  Google Scholar 

  • Hegele, R. A., Cao, H., Harris, S. B., Hanley, A. J., & Zinman, B. (1999). The hepatic nuclear factor-1α G319S variant is associated with early-onset type 2 diabetes in Canadian Oji-Cree. The Journal of Clinical Endocrinology & Metabolism, 84(3), 1077–1082.

    CAS  Google Scholar 

  • Kolahdooz, F., Sadeghirad, B., Corriveau, A., & Sharma, S. (2017). Prevalence of overweight and obesity among Indigenous populations in Canada: A systematic review and meta-analysis. Critical Reviews in Food Science and Nutrition, 57(7), 1316–1327.

    Article  Google Scholar 

  • Lear, S. A., Humphries, K. H., Kohli, S., & Birmingham, C. L. (2007). The use of BMI and waist circumference as surrogates of body fat differs by ethnicity. Obesity (Silver Spring), 15, 2817–2824.

    Article  Google Scholar 

  • Martin, D. H. (2012). Two-Eyed Seeing: A framework for understanding Indigenous and non-Indigenous approaches to Indigenous health research. Canadian Journal of Nursing Research Archive, 44(2), 20.

  • Meadows, A., & Danielsdóttir, S. (2016). What’s in a word? On weight stigma and terminology. Frontiers in Psychology, 7(Oct), 1527.

    PubMed  PubMed Central  Google Scholar 

  • Monaghan, L. F., Bombak, A. E., & Rich, E. (2018). Obesity, neoliberalism and epidemic psychology: Critical commentary and alternative approaches to public health. Critical Public Health, 28(5), 498–508.

    Article  Google Scholar 

  • Mosby, I., & Galloway, T. (2017). “Hunger was never absent”: How residential school diets shaped current patterns of diabetes among Indigenous peoples in Canada. Canadian Medical Association Journal, 189(32), E1043–E1045.

    Article  Google Scholar 

  • MMIWG. (2019). Final Report of the National Inquiry into Missing and Murdered Indigenous Women and Girls. https://www.mmiwg-ffada.ca/final-report/. Accessed 19 Oct 2020.

  • O’Hara, L., & Taylor, J. (2018). What’s wrong with the ‘war on obesity?’ A narrative review of the weight-centered health paradigm and development of the 3C framework to build critical competency for a paradigm shift. SAGE Open, 8(2).

  • Oster, R. T., & Toth, E. L. (2009). Differences in the prevalence of diabetes risk-factors among First Nation, Metis and non-Aboriginal adults attending screening clinics in rural Alberta, Canada. Rural and Remote Health, 9, 1170.

    PubMed  Google Scholar 

  • Oster, R. T., Johnson, J. A., Hemmelgarn, B. R., King, M., Balko, S. U., Svenson, L. W., et al. (2011). Recent epidemiologic trends of diabetes mellitus among status Aboriginal adults. Canadian Medical Association Journal, 183(12), E803–E808.

    Article  Google Scholar 

  • Riediger, N.D., Clark, K., Lukianchuk, V., Roulette, J., Bruce, S. (2017a). Fasting triglycerides as a predictor of incident diabetes, insulin resistance and B-cell function in a Canadian First Nation. International Journal of Circumpolar Health, 76, 1310444.

  • Riediger, N.D., Lukianchuk,V., Roulette, J., Lix, L.M., Elliott, L., Bruce, S.G. (2017b). Diabetes-related weight change in a Canadian First Nation cohort. International Journal of Circumpolar Health, 76, 1340548.

  • Sellers, E. A., Triggs-Raine, B., Rockman-Greenberg, C., & Dean, H. J. (2002). The prevalence of the HNF-1α G319S mutation in Canadian Aboriginal youth with type 2 diabetes. Diabetes Care, 25(12), 2202–2206.

    Article  CAS  Google Scholar 

  • Suzack, C. (2010). Indigenous women and feminism: Politics, activism, culture. Vancouver: UBC Press.

    Google Scholar 

  • Tomiyama, A. (2014). Weight stigma is stressful. A review of evidence for the cyclic obesity/weight-based stigma model. Appetite, 82, 8–15.

    Article  Google Scholar 

  • Truth and Reconciliation Commission of Canada. (2015). Truth and Reconciliation Commission of Canada: Calls to Action. Truth and Reconciliation Commission of Canada.

  • Warbrick, I., Came, H., & Dickson, A. (2018). The shame of fat shaming in public health: Moving past racism to embrace indigenous solutions. Public Health, 176, 128.

    Article  Google Scholar 

  • Wharton, S., Lau, D. C. W., Vallis, M., Sharma, A. M., Biertho, L., Campbell-Scherer, D., et al. (2020). Obesity in adults: A clinical practice guideline. CMAJ, 192(31), E875–E891.

    Article  Google Scholar 

  • Yellowhead Institute (2019). Land back: A Yellowhead Institute Red Paper. October 2019. https://redpaper.yellowheadinstitute.org/wp-content/uploads/2019/10/red-paper-report-final.pdf. Accessed 18 Sept 2020.

Download references

Acknowledgements

We would like to acknowledge the partnership, support, and guidance for this work by Jeff LaPlante, Executive Director of the National Indigenous Diabetes Association.

Funding

This work has been funded by the Canadian Institutes of Health Research (CIHR), Canadian Community Health Survey Nutrition Analysis (Grant #151546). NDR is the recipient of a CIHR Early Career Investigator Award (2018-2022; grant #155435).

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Correspondence to Monica Cyr.

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Cyr, M., Riediger, N. (Re)claiming our bodies using a Two-Eyed Seeing approach: Health-At-Every-Size (HAES®) and Indigenous knowledge. Can J Public Health 112, 493–497 (2021). https://doi.org/10.17269/s41997-020-00445-9

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