When I began my psychotherapy practice, I was overwhelmed by the number of high school girls who walked into my office with intense body hatred and eating problems. As many as 15% of high school girls were identified as eating disordered during that period (Austin et al., 2008). There had been no mention of eating and body image problems in my graduate school training, and I was at a loss to address these problems. I was contacted by two young women desperately seeking help to intervene in what had become a norm of body hatred and disordered eating on their high school campus. Both of them were survivors of eating disorders and saw girls fighting similar battles all around them. As a feminist, I was concerned about the impact of negative social conditions on the girls’ healthy embodiment. I was not willing to sit in my office waiting for them to file into therapy, one by one, after years of pain and isolation; I wanted to get at the root of the problem. I was compelled to join these young activists in their cause to uncover the source of their suffering. In our first action, we spoke to all of the 9th-grade physical education classes at their school to ask questions and raise awareness about the suffering caused by critical messages about their bodies. As a result, 108 girls joined our drop-in activism group during that spring of 1995.

I reached out to the feminist therapy community to find solutions to the suffering expressed by the girls in my psychotherapy practice and in high school. At the Women’s Therapy Centre Institute in New York City, I found the leaders of the feminist psychoanalytic approach to eating disorders. Their book, Eating Problems (Bloom, Gitter, Gutwill, Kogel, & Zaphiropoulos, 1994), became my guide to understanding eating disorders from a feminist perspective. I was also inspired by the transformative model of inquiry and dialog created by Niva Piran (1995, 1996), at the University of Toronto. All of these women focused on the voices of the individuals and placed trust in women’s own knowledge and the authority of their personal experience. They used dialog to explore the symbolic meaning of body dissatisfaction and to find solutions to address the circumstances in girls’ and women’s lives that contributed to their distress.

These feminist analyses offered an explanation for the ways that cultural norms of violence and domination of women’s bodies were expressed in the suffering of body hatred that led to eating disorders. They awoke in me a desire to transform the culture that adolescent girls in my community inhabited. I was determined to help girls to resist the critical messages they internalized and to find more productive ways of resolving their distress than by endlessly attempting to perfect their bodies.

I remember one young client’s answer when I asked her, “How low do you want your weight to go?” “Beyond reproach,” she answered. “What weight is that?” I asked. “The weight at which no one can ever criticize me again.” “That weight is zero, my dear,” I responded. “It is being dead. In this world, there will always be aggression. What you need now are the skills to resist it.”

Founding the Body Positive

That same spring, I was introduced to Connie Sobczak by a colleague who recognized our common commitment to addressing the cultural contributions to eating disorders and body image problems. When I met Connie, her sister, Stephanie, had recently died from faulty breast implants and malnutrition caused by anorexia nervosa and bulimia. Connie had struggled with her own eating disorder as an adolescent but was fortunate to have recovered in her early 20 s. She was adamant about raising her daughter, Carmen, to have self-love and appreciation for her body. We shared a common passion about creating a world in which young people could focus their energy and intellect on what they wanted to do with their precious lives that could make a positive contribution to social change. In January of 1996, we brought our talents together to found our nonprofit, which we called The Body Positive (www.thebodypositive.org). Our goal was to create a lively, healing community that offered freedom from the suffocating messages that kept girls in a perpetual struggle with their bodies. We were committed to creating experiences where girls of all sizes could find what they needed to become fully embodied: to speak their own truth and to step confidently into their lives, emboldened against fear of judgment, comparison, or criticism.

It was Connie’s vision to use stories and videos to raise awareness about body hatred and to offer positive solutions to young people. We recruited eight girls to participate in a filmed discussion that we could share with potential funders in support of our fledgling nonprofit. The girls’ discussion was powerful and filled with pain, aliveness, and anger. These girls were not about to let us just walk away with their stories. They were passionate about their ownership of this new Body Positive movement. They made it clear on that first day of videotaping that the most effective way to reach young people was going to be peer-to-peer education that invited students to share their own stories and find their own solutions.

Constructing a Model Using a Feminist Dialogical Approach

Connie and I developed our Be Body Positive Model based on Niva Piran’s (1995, 1996; Stermac, Piran, & Sheridan, 1993) feminist dialogical approach. We listened for many years, first to high school girls and later to individuals of all ages, races, and sizes in schools, community organizations, and treatment settings. We were inspired to learn from college students about the movement for more creative expressions of gender, and we joined them by expanding our work to include people of all gender identities. The more stories we heard, the more we realized how inextricable issues of body hatred were with the embodied experience of prejudice and marginalization. We worked to stay woke and engaged with the complex dynamics between intersectional identities and the experience of embodiment. We listened to anti-racist feminists, such as Becky Thompson (1994, 1996), to help us understand the divergent experiences of people with different cultures and histories. The dialogical inquiry approach underpinning our model was especially important given that U.S. mainstream culture and society teach people to look for answers outside of themselves and to distrust the authority of their own experience. We created a safe place for all people to talk about inhabiting their own bodies, and we did our best to ensure that the questions we asked were open-ended enough to allow everyone to share their suffering and find solutions that were relevant in their communities.

Buddhist Psychology and Embodiment

In addition to my psychotherapy practice and my work with Connie at The Body Positive, for the last 10 years, I have devoted myself to the study of Buddhism. In traditional Buddhist teachings, body awareness is a fundamental path to increased mindfulness (Ray, 2016). I have found a great deal of support for each of the Be Body Positive Competencies in the vibrant field of Buddhist Psychology (Albertson, Dill-Shackleford, & Neff, 2015; Germer & Siegel, 2012; Neff, 2011; Ray, 2016). Neuroscientists have validated the benefit of simple Buddhist practices, such as cultivating self-compassion, mindfully attending to the breath, and focusing on joy rather than self-criticism (Hanson, 2013). There is now ample scientific evidence that we humans can learn to create positive mental states that lead to greater resilience and joy in our lives. We can inhabit our bodies with curiosity and kindness. We can kindly embrace our fears, nourishing ourselves with qualities such as acceptance and self-love that lead to real freedom from self-criticism and preoccupation with perfecting our bodies.

Connie and I have refined the Be Body Positive Model with a fierce commitment to avoid the transmission of messages that place people in double binds because we saw how double-binding messages in advertising and the diet industry have led to confusion, frustration, despair, and feelings of failure. We define wellness not as a static end goal of perfection, but as a way of living that allows people to care for, protect, and take pleasure in their unique bodies throughout their lifespan. The Be Body Positive Model honors the fact that human beings experience suffering, sickness, aging, and eventually death. Loss and change are inevitable in a human body. Instead of beating ourselves up for not being perfectly happy with our bodies every day, we can honor the difficult days as times of learning and growth. When we do struggle, we can turn toward ourselves with kindness and forgiveness and remind ourselves that we are only human. We can reach out to people in the Body Positive community to remind us to come home to self-love and acceptance of our imperfect selves.

Connie and I combined what we learned from our community-based research with the feedback I was gathering from my clients who were recovering from eating disorders in my clinical work and what I had learned in my Buddhist studies. We carefully cataloged and organized the solutions and resources we identified into our Be Body Positive Model. This model is comprised of five core competencies: Reclaim Health, Practice Intuitive Self-Care, Cultivate Self-Love, Declare Your Own Authentic Beauty, and Build Community. I have been using this model in my clinical work for many years now and have found it to be a wonderful collection of resources to bring to clients.

Below I provide details about the Be Body Positive Model with examples of how I offer these resources to mental health providers to transform their own relationship to their bodies so that they can model self-acceptance and offer body positive tools to their clients. I also give examples of how I have used the competencies in my clinical work. All client names used are pseudonyms.

The Be Body Positive Model

Competency One: Reclaim Health

Reclaim Health calls us to embrace our ancestors and their influence on our bodies, to accept the facts about our natural size and shape, and to replace mainstream cultural myths (e.g., the thin beauty ideal) with our own stories of self-worth and celebration. Fundamental to peacefully inhabiting our own bodies is to become aware of how we internalize sizeism and to identify the ways that sizeism and size privilege intersect with other forms of oppression and privilege to create unconscious narratives that inhibit our aliveness (Scott, 2017). This competency rejects the valuing of certain body types over others and instead invites us to celebrate beauty in differences and to build more socially connected equitable communities.

Stand with our Ancestors

Our weight, our shape, and the ways our bodies change as we age are all attributes inherited from the long line of ancestors that stretch behind each of us to our original African ancestors. Each of our ancestors survived with fierce resourcefulness that outlasted many dangers (e.g., hunger, wild animals, war, oppression, time). Every one of them made it to adulthood and produced a child to continue the lineage of our families, all the way to this moment. Our bodies represent this remarkable achievement. Of course, there are variables beyond genetics that influence the shape of our bodies, and some are related to our life circumstances and the choices we make. However, in large part, we are what we are, and our bodies represent an amazing ancestral saga. What we have found at The Body Positive is that the logic behind sizeism (i.e., that size is in our control and determines our social ranking) denies this ancestral truth and prevents many people from accepting their genetically pre-determined size, shape, and weight.

Address Sizeism

Sizeism is bias based on the shape of our bodies; it is closely tied to fat phobia. Both are tangled in the intersecting identities that place us in privileged or silenced positions in society. How closely we resemble the thin, White, cis-gendered, beauty ideal determines privileges (e.g., freedom, approval, acknowledgment, inclusion). Size privilege is closely tied to White privilege. The links between size privilege, White privilege, and sexism are easy to see: women and people of color tend to carry more body fat, and it is they who become victims of the powerful myths promoted by the diet industry. These myths, which speak of our ability and moral responsibility to slenderize our bodies to be “healthy,” are veiled attacks on all women and on Black and Brown bodies (Brooks, Clayton, & Kornstein, 2014; DuMonthier, Childers, & Milli, 2017).

As we come to see the suffering imposed by sizeism, the effects of size privilege, and their intersections with other forms of oppression and privilege, we are in a better position to understand the conflicts people experience in inhabiting their bodies. My client, Claire, was keenly sensitive to and concerned about world suffering caused by poverty and racism, despite having been raised in an affluent, white family. She felt mortified by the way her parents spoke to the Latin American people who worked in their home, and she felt closer to those workers than to her family members. To compensate for her parents’ excesses, and to atone for her sense of helplessness in the face of others’ suffering, Claire starved herself. Self-deprivation was her form of penance; in her mind, it righted the wrong of unearned privileges. By starving, however, Claire became smaller, more dependent, and less socially defiant. Moreover, as she lost weight, Claire was applauded by her family and other students at her Ivy League college for attaining the ideal of White femininity. People constantly commented on Claire’s discipline, selflessness, and beauty. Their praise led to additional internal conflict about her unearned White privilege and made Claire feel like an imposter as well as an unworthy inheritor of her fortune.

In therapy, Claire was able to bring these conflicts to light and find more constructive ways to align her behaviors with her core values of social justice. For Claire, this meant supporting herself and living simply. She left her Ivy League school, took a job making sandwiches at the local market, attended a community college, and started teaching adult immigrants to read at a local nonprofit. Feeling engaged and connected, getting close to people she could serve, Claire found a sense of purpose and meaning. As a result, she could eat again. She could allow her body to fill out again. She was able to eat in support of achieving her goals and a more positive identity.

In the United States, we receive strong cultural messages that a woman’s body is more pleasing and more acceptable when it is White, small, and delicate when her desires are not too big, and her demands are not too loud. The rarified feminine ideal in this society cherishes purity and values women who are free of appetites and demands. It ignores real life and the needs that we mere mortals experience in our diverse bodies. The association of women’s flesh with greed, filth, and worthlessness is not new, and the current obsession with purifying our bodies through starving and cleansing is a powerful expression of these messages and begs the following questions: What feelings do we need to address to embrace our ancestors as they show up in our flesh and bones and to come to terms with our race, size, and shape? What do we need to grieve and let go so that we can accept our bodies as they are right now? What lifestyle shifts must we make to in order to nourish our bodies with increased joy and purpose?

Adopt the New Paradigm of Health that Acknowledges Genetic Differences

The Be Body Positive Model promotes Health at Every Size (HAES), a health-centered paradigm that has been adopted by a growing number of medical and mental health professionals (Bacon, 2008). Activists and lay-people globally have joined forces to shift the current weight-centered paradigm to one that honors genetic diversity and promotes healthy lifestyles (van Amsterdam, 2013).

HAES functions on both scientific and political platforms. Its model focuses on how we view weight as it relates to health, and it addresses social justice issues that accompany weight-based discrimination. HAES practitioners worldwide work in medical and mental health settings, conduct education and activism to transform people’s views about fat, and fight for human rights legislation at the policy level. Many professional organizations, including the Association for Size Diversity and Health (ASDAH) and the National Association to Advance Fat Acceptance (NAAFA), work to advance the HAES principles. Once people are educated about genetics, set-point theory, and other crucial factors that contribute to appearance and body size, they can begin to embrace the natural size and shape of their bodies and care for them with love and appreciation for their functions.

Bacon, Keim, Stern, and Van Loan (2005) conducted a 2-year study of health outcomes of a HAES treatment versus a traditional dieting treatment in a group of women classified as “obese” by BMI standards. The women who followed a HAES approach were taught to recognize and follow internal hunger and satiety cues, encouraged to exercise moderately on a regular basis, and provided social support to feel better about their size and shape, regardless of whether or not they lost weight. Results revealed that the overall health of HAES participants (measured by cholesterol, blood pressure, physical activity, and self-esteem levels) not only improved, but was maintained. Some members of the dieting group experienced short-term weight loss and health enhancements, but no sustainable improvements were achieved. Not only did all of the dieters’ health indicators return to their initial measurements, but their self-esteem levels were even lower than they had been at the beginning of the study. The dieting group also had a difficult time staying with the program, as shown by the high dropout rate. This finding is noteworthy in that it reflects a similar dropout pattern among people who pay for diet programs or join gyms to help them lose weight. When the focus of a program is on weight loss, there is a much greater chance of failure—right from the start (Ahlstrom, Tomiyama, & Mann, 2013).

Each body has its own natural or “set-point weight.” A genetically determined weight-regulating mechanism works hard to keep one’s body weight within a certain range. A healthy weight is achieved by creating a balanced relationship with food, exercise, and rest. This means eating when hungry, stopping when full, eating a wide variety of foods, exercising regularly and moderately, and resting when tired or ill, as best as one can. A person’s natural weight might be fat or thin or in-between depending on many inherited traits.

As mental health practitioners concerned with the improved self-care of our clients, it makes sense to promote a weight-neutral approach to health that focuses on improving how our clients take care of themselves, instead of supporting unsustainable attempts to manipulate weight and shape. Shame and blame do nothing to improve a person’s health (Brown, 2006). This is why in clinical work with people of all sizes we focus on improving health and quality of life with an approach to self-care that is life-enhancing and sustainable.

With the Reclaim Health Competency, we each rewrite our body story from a generous and kind perspective that considers the context of our life circumstances. Our bodies may have suffered criticism and violence, but we have survived to take stock and find meaning for ourselves. Rather than endlessly working to perfect our bodies, we can focus on our experiences, our goals and purposes in life, and the beauty of who we are. When we accept the authority to narrate our own story, our identification shifts from victim to hero.

Competency Two: Practice Intuitive Self-care

This competency offers a way of relating to food, exercise, rest, and life in general that encourages us to learn what is right for our unique bodies and to find more pleasure in the pursuit of health. It is a feminist position that rejects hierarchical structures of knowledge and instead focuses on the lived experience of the individual. Living intuitively heightens our physical senses and puts us in touch with the innate wisdom with which we were born, the best guide for how we need to eat, exercise, and rest to provide nourishment, fitness, and pleasure.

To practice intuitive self-care is to learn to trust the authority of our bodies and develop sustainable, positive self-care behaviors. Intuitive self-care is not something that we perfect and then never struggle with again. Making decisions through deep listening involves trial and error, which means making “mistakes.” Instead of getting discouraged, we should recognize that these experiences of discomfort give us crucial information that allows us to learn and grow as human beings. From each experience, we fine-tune a process of feedback that expands our knowledge of our unique body’s ever-changing needs and desires; this process leads to the creation of sustainable, long-term habits.

If we can embrace our body’s natural size and shape, we can focus on nourishing ourselves in an attuned, intuitive way and get away from external rules and diets. Responding to signals of hunger and satiety, we can learn to eat when we are hungry, eat what our body is hungry for, and stop when we are satisfied (Tribole & Resch, 1995). People who restrict their eating fall out of touch with two of the most primitive signals in their bodies: hunger and satiety. The deadening of this connection to the body impedes our awareness of important internal cues that are needed in relationships and life choices.

Connecting to the truth of our own experience and acting in accordance with this wisdom is a fundamentally feminist idea that locates the source of wisdom and power within the individual. A fifth-grade client of mine expressed this complex feminist idea in a straightforward way when she told me, “Us girls who know how to eat intuitively, well, we start to know a whole lot about what we know about a whole lot!” This was a simple and direct expression of the connection between listening to ourselves in this basic arena of hunger and satiety and coming to trust the authority of our experience in other areas of life. She went on to describe how the girls she had trained to eat intuitively in her Body Positive group stopped apologizing so much and started sharing their own ideas more directly. They started to know what they knew about a whole lot!

Bridget had starved, binged, purged, and over-exercised through 4 years of college. Her conflicts about her size and shape kept her focused on changing her body instead of addressing the problems in her life. When I taught her about intuitive eating, she recognized that, during her entire college experience, she had been completely out of touch with her own needs and desires. As she reconnected to her body, she realized that she had completed her degree in an area of study she had no interest in pursuing. She had wasted 4 years listening to what others wanted her to do with her life. Once Bridget started listening to her gut, she was able to identify her true love and passion: to become a lawyer and fight for environmental rights. As she learned to respond to the primitive signals of hunger and satiety, she became attuned to subtler signals about what brought meaning and purpose to her life.

Intuitive self-care is guided by a deep connection to pleasure. It involves listening over time to discover what feels good and what enlivens us and then moving toward our discoveries. To do this, we must redefine our relationship to pleasure; we must let go of shame about our appetites and desires and trust what we know is right for our bodies.

As they connect to the wisdom of their own bodies, I help my clients figure out what is important to them and how they can bravely pursue their dreams and desires. I point out how perfectionism gets in the way of learning. I teach them to react to failure with self-love so they can take risks and try new things. As self-compassion strengthens, my clients begin to inhabit their relationships with more clarity and courage. They develop a sense of what they need from friends and partners, and they gain the confidence to protect themselves when necessary.

Competency Three: Cultivate Self-love

Self-love is the practice of developing a compassionate, gentle, and forgiving heart to guide and protect ourselves. We can learn to transform our critical voices that perpetuate insecurity and fear into sources of information that help us grow. If we turn toward our critical voices rather than try to run from them, we can learn how those inner voices try to protect us (misguided as they may be) and how to work with them to understand our true needs. In this way, we transform our fears into allies (Allione, 2008).

Kristin Neff’s extensive research confirms that self-compassion (called “self-love” in the Be Body Positive Model) is a powerful resource. People who practice self-compassion have a healthier body image; are less perfectionistic, anxious, depressed, and suicidal; and have more optimism, happiness, and gratitude than those who do not (Neff, 2011; Warren, Smeets, & Neff 2016). These qualities are all crucial resources for resisting body dissatisfaction and accepting our natural size and shape.

Nancy, one of our first Body Positive leaders, came to understand this competency in an exchange with her father. She shared the following epiphany with her group: “I got it! I got that thing you are always talking about when you ask, ‘If this distress were not about your body, what might it be about?’ Just this morning my dad was yelling at me about a grade I got on a test, and I looked down at my thighs and thought, ‘Wow, they are huge!’ Then I remembered your question, and I realized my thighs are not too big—they are fine! The problem is, my dad is a bully and he has to stop yelling at me!” Before she became involved with The Body Positive, Nancy had believed that if she could just perfect the size and shape of her body, she would be immune from aggression. What she learned was that distress about her thighs symbolized a real problem in her life that she needed help to address: her father’s anger.

Buddhist teacher Lama Rod Owens has written, “When I define healing as freedom, I mean to interrogate how I am a slave to my own self-deprecation fueled by internalized oppression” (Williams, Owens, & Syedullah, 2016, p. 63). Self-love is a practice of nonviolence on the most intimate level: our relationship with ourselves. As we cultivate a quality of deep self-love, we become more confident and willing to protect ourselves. I have learned from my clients that this practice can produce a fierce determination to defend oneself from danger. Those who practice self-love are not preoccupied with what others think; thus, they are able to identify aggression and take action without second-guessing their “gut instincts.” They create more equality in their relationships because they respect and value themselves and are willing to stand up and speak truth to power.

Competency Four: Declare Your Own Authentic Beauty

This competency invites us into a community of people who believe that beauty lies in the authentic, open-hearted, and vulnerable expression of one’s life. It addresses popular culture’s failure of imagination related to beauty and rejects the narrow standard of “perfection” offered by marketing industries. It teaches us to live our lives as artists and to see our ever-changing beauty through the lenses of self-love, imagination, and our lived experience.

When we find the essence of beauty in ourselves as living, breathing, conscious beings, we are able to see more beauty in others; we remove ourselves from the beauty hierarchy in which so many people are caught. We have a true opportunity to care for our bodies because we do not confuse physical self-care with a desire to transform our bodies to fit someone else’s definition of beauty.

If we can reject suffocating social rules (enforced by practices such as calling confident people “conceited”—or worse), we can adopt an expanded esthetic of beauty that grows from within and includes our imperfections. We connect to our cultural heritage in a deep way by recognizing that our ancestors, whether known to us or not, lived and thrived to make it possible for us to be alive. We develop an appreciation and love for our bodies, seeing them—including their perceived flaws—as an amalgamation of all the people who gave us this precious gift of life.

My client, Rachel, learned about this concept of claiming her own beauty, and she realized she had fought her entire life against the body type she had inherited from her Eastern European Jewish grandmother. Her mother, who was embarrassed by her daughter’s curvy, “Jewish-looking” body, had wanted her to change it so she could “fit in.” This led Rachel to decades of self-punishment, including extreme diets and exercise regimens, in a rejection of her Jewish heritage. Ironically, her grandmother was the only person in the family who had loved Rachel unconditionally, whose abundant body had been a loving, comforting place where Rachel found relief from cold and critical parents. When Rachel truly embraced her curvy body as an adult, she realized that her mother had fed her terribly conflicting messages about her genetic inheritance. She committed to giving up those fundamentally anti-Semitic messages and, on her 60th birthday, reclaimed her round and comforting grandmother in her own body. Rachel quit dieting, gave herself the gift of loving her body, and stepped into her beauty with imagination and creativity, celebrating her curves with colorful fabrics and artistic fashions. It was deeply moving to see Rachel’s aliveness and joy as she gave up fighting with her body and, instead, celebrated it. As Ruth Gendler (2007) wrote, “In beauty’s presence there is a dignity that is not interior or exterior, but coherent. All the way through.” (p. 80).

Competency Five: Build Community

The Body Positive builds communities wherein we support one another in choosing to love and respect our unique bodies. We honor the human need for authentic connection. Body Positive communities are places where self-criticism and dieting tips are not topics of conversation and bodies are not blamed for our problems. Instead, conversations focus on what is actually happening in our lives. We support each other in finding our place in the world, moving toward what gives our lives meaning, and expressing our genuine needs and desires.

In order to embody the first four competencies fully, it is essential to build a Body Positive community that champions these values. Without this support, it is easy to succumb to messages that promote inadequacy and insecurity. The likelihood of blaming our bodies for other problems in our lives (especially if we have done this in the past) is greater if we are not connected with others doing the same work to make peace with their bodies. Each Body Positive community loves and celebrates its members just as they are in the moment, struggles and “imperfections” included.

A psychotherapist who attended a recent Be Body Positive professional training shared that in her hometown of Lagos, her friends were getting cosmetic surgery and living on 500-calorie a day diets. She commented that the ideal of beauty had changed radically in her lifetime and that the need to build a positive community is as important in Nigeria as in her current home in Canada. The proliferation of the Western thin ideal has spread worldwide. She commented, “My hope is that more and more people become aware of the [Be Body Positive] Competencies, that they recognize that they don’t have to live this life of body shaming forever. That they can actually come to a place of love and acceptance for their bodies. I’m telling you, I wanted to just scream yesterday, [in the training] ‘Yes, yes, yes, yes.’ It just resonated. Yes! It’s freeing because you don’t have to fight anymore. You can just accept your body. This is what it is. This is who I am. I don’t have to do anything different, and it’s okay. It’s beautiful. We’re all beautiful” (F. Ayeni, personal communication, May 13, 2017).

Creating a Platform to Build a Body Positive Movement

In a feminist approach to therapy, I believe it is essential to bring our work out of the office to build community and make positive changes in the world that will end the suffering of our clients. Activism work that amplifies the voices of the most marginalized members of the community to build their power and agency in society has a real impact on sizeism and body dissatisfaction. The community-based work I do with The Body Positive has helped me to stay positive and hopeful and has reduced my clinical burnout over the years. Whenever I have grown tired of the day-to-day stressors inherent in organizing and funding a nonprofit, I remember how much hope and joy I receive by seeing the confidence and self-love of the Body Positive leaders who work to address sizeism in their families and communities. Their joy helps me to last another day on the front lines of treatment, responding to the intense distress of my clients.

Over the years, Connie and I have developed materials and training to support a growing movement to promote size acceptance. To teach our model, we created videos and curricula for K-12 teachers to use in their classrooms. We wrote a guidebook for educators and therapists to develop youth-led eating disorders prevention programs in schools and community-based organizations (Scott & Sobczak, 2002). We wrote group curricula for student leaders to teach the Be Body Positive Model to their peers in middle schools, high schools, and colleges and developed an intensive 2-day training to develop them as leaders. We also created a curriculum that professionals can use to teach our model. These facilitators are encouraged to listen to their group members’ experiences and adapt the lessons to make them relevant to the specific populations they serve. More recently, Connie (Sobczak, 2014) wrote a book to share our model through the telling of her own story and those of Body Positive community members. Her book helped us expand our Body Positive movement to people across the country and the world.

Researching the Be Body Positive Model

In 2014, The Body Positive partnered with Kristen Lohse to conduct a pilot study to evaluate the preliminary efficacy, feasibility, and acceptability of the Be Body Positive leadership program for college students. The study was designed to assess the ability of The Body Positive’s peer education program to train student leaders to use the Be Body Positive curriculum to promote acceptance for diverse size bodies and reduce body dissatisfaction and other risk factors such as eating disorders among their peers. The quantitative results of this pilot study demonstrated significant improvements on measures associated with increased resilience against eating and body image problems. Students who participated in peer-led groups reported a reduction in their shape and weight control beliefs, body preoccupation, and internalization of the thin ideal; we found fewer social determinants of poor body image and an increase in body satisfaction from baseline to the end of eight group sessions. Further improvements on all measures were shown 8 months after the training ended (Lohse, 2014).

Building a Movement to End Body Hatred and Eating Disorders

The Body Positive has reached more people than we ever believed possible when we held our first focus group in 1997. We have trained thousands of individuals to bring our work to their schools and community settings, reached thousands more through our multi-media school-based curricula, and Connie’s book (Sobczak, 2014) has been positively reviewed (e.g., Chrisler, 2015) and read by people all over the world. In the fall of 2016, Cornell University implemented Body Positive Cornell, a comprehensive Body Positive program that established student-led groups in multiple university locations over three semesters. Laura Barre is currently conducting quantitative and qualitative research on the feasibility and acceptability of the program, as well as the impact of the curriculum on the participants. Preliminary results were presented at the March 2018 conference of the International Association of Eating Disorders Professionals, and an article will be published in 2019.

In the past year, to support the expansion of the Body Positive movement, we developed our first online training for the public and also for professionals in mental health, nutrition, medicine, education, and community organizing. Feedback from the mental health professionals who attend the online institute indicates that the competencies we teach are highly practical in their work with clients with eating and body image problems. After 20 years of helping people create joyful and peaceful relationships with their bodies, we are delighted to share these resources with the world.

Conclusion

It is my lifelong mission to free people to inhabit their bodies with kindness and curiosity. I hope that readers will find the ideas in this article useful for themselves as well as for their clients. We therapists must heal ourselves in order to be of service to the world. As beloved Zen teacher angel, Kyodo Williams (2017) has said, “Love and justice are not two. Without inner change, there can be no outer change. Without collective change, no change matters.” Niva Piran (2017) has written that just one “empowering relationship” can provide protection from adverse social conditions that promote disruptions in a healthy embodiment. In this article, I hope I have provided many ways as therapists we can supply that pivotal, empowering relationship to our clients.

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