The most important component of the new paradigm approach is self and size acceptance. Self-acceptance is not a denial of the importance of self-care but is rather an affirmation that, just as human worth is not based on race, color, or creed, it also is not dependent on body weight, shape, or size. Our obsession with thinness has spawned what may be the last acceptable prejudice against individuals who do not live up to our unrealistic cultural standards. Like racism, sexism, antisemitism, and homophobia, this weightism:

"is based on visible cues, i.e., the fat person is discriminated against primarily because of the way she looks . . . defines an entire group of people numbering in the millions within a narrow range of negative characteristics and behaviors . . . elevates the status of one group of people at the expense of another . . . and serves as a vehicle for the bigot's own anxieties, frustrations and resentment."¹

    The result of this prejudice is rampant social, economic, and educational discrimination against larger individuals.^1-4 As with all forms of prejudice, however, it is not only the persecuted group that suffers. Women of all sizes suffer from an intense fear of fat that plays havoc with their body image and self-esteem and promotes disordered eating and exercise behavior. Men suffer as well, "by participating in a culture that defines the worth of more than one-half the population in terms of physical appearance, rather than by the recognition of truly meaningful qualities such as honesty, compassion and love."⁵

    As we strive to honor diversity in other areas, size-acceptance must also be encouraged by honoring the natural diversity in the human form and by more effectively challenging cultural weight prejudice. Health professionals from all disciplines must begin by confronting their own prejudices and must learn strategies to empower their clients to do the same.

    Materials, including a behavioral assessment, have been developed to assist health professionals with the process of understanding and combating their own weight prejudice.^6,7  In addition, a number of excellent books, written by larger women health professionals who have struggled with the pain of growing up in a thin-obsessed culture are available to help clients begin the long and difficult journey toward self-acceptance.^8-12

......Kratina, King, and Hayes discuss the importance of self-acceptance in their book Moving Away from Diets: New Ways to Heal Eating Problems and Eating Resistance.¹³ Trusting internal signals and feeling good about one's body is important for four main reasons:

1. With self-acceptance the mind and body can really connect, which is a critical component of overall health.
2. It is difficult for clients with body dissatisfaction/body hatred to take good care of themselves.
3. People need to care about themselves to want what is best for their health, and self-care is necessary for health and well-being.
4. Without a sense of peace, for example when people are constantly degrading themselves for their size/habits, making healthy choices is extremely difficult.

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© Fall 2001