In Cooke's Corner, April 2021

“Never trust a skinny chef.” One of those funny phrases touted by the classically-trained old-guard to showcase that a good chef must be overweight in order to demonstrate their love and passion for the art. Here, Charlie considers perceptions on perfection and asks whether nutrition professionals should be flaunting their flaws.

This article originally featured in In Cooke's Corner, an opinion collumn in NHD Mag, April 2021. You can read the original copy here: https://library.myebook.com/NHD/network-health-digest-april-issue-162-uk/3265/#page/38

“Never trust an unfit personal trainer” or “Never trust an overweight dietitian”? These surely must mean the opposite, i.e. no person adequately qualified and passionate about food, fitness and nutrition can be anything but the absolute personification of health perfection.

This is the question I wish to discuss in this month’s issue: do we have to hide our flaws and demonstrate a perfectly fit physique in order to be seen as reliable sources of health information in the eyes of ourselves, our peers, our patients and the public?

Now, let’s consider I was within an average range of 6.5% to 8% body fat in my time as a personal trainer and boxer, training two to four hours per day, consisting typically of two to three sessions. I had spent two years at university studying a nutrition sciences diploma and running an online health blog based around teaching the biochemistry and physiology of nutrition, alongside my studying of countless textbooks for my qualifications as a personal trainer.I then did another degree in nutrition while running a boxing fitness service, which required studying for my coaching certifications.

All of the above, I hope, showcases a person with a keen knowledge, passion and pursuit of health and fitness. Yet why do I fight the feeling to this day, that all my qualifications and experience could be entirely disregarded by my clients if they ever knew that I occasionally drink and eat too much, or can be partial to a cigarette?

I used to feel dishonest in not disclosing such behaviours, as although I truly understand my personal flaws to be completely understandable and reasonable, I would not reveal them for fear of being perceived as, “all talk without the ability to practice what he preaches”.

But, as the public perception around health begins to shift, it makes me wonder whether we can showcase our own ‘bad’ habits to our patients, both in person and especially online as, yes, we all have flaws.

HARMFUL HABITS TO HEALTH

If we are the know-it-all experts, why do we still participate in habits harmful to health? Well, according to research published back in 2008, the factors for following high-risk behaviours were listed by the Centre for Disease Control (CDC)1 as:
• innate human defiance
• need for social acceptance
• inability to truly understand the
nature of risk
• individualistic view of the world
and the ability to rationalise
unhealthy habits
• genetic predisposition to addiction

According to Dr Cindy Jardine, Assistant Professor of Rural Sociology at the University of Alberta in the US, who conducted this research: “The results showed that in fact, people have a very realistic understanding of the various risks in their lives. We, as risk communicators (scientists, academics, government agencies), have to get beyond the thought of ‘If they only understood the facts, they’d change’. They do understand the facts, but we need to look at other factors we haven’t been looking at before.”2

Here lies the balance of talking the talk and walking the walk; we know the information, but what factors have we not been looking at before? What if we struggle to follow these factors ourselves?

WHAT DO OUR PATIENTS THINK?

A fantastic piece in Today’s Dietitian asked their reader base of RDs and RNs whether they believed they can be effective nutrition counsellors if they are overweight.

The responses were, of course, mixed, though overwhelmingly in support of the idea that a person’s external appearance alone cannot be used as an accurate predictor of health or knowledge. This was a very insightful article demonstrating how we may be perceived by our peers – but what do our patients think?

Research published in The International Journal of Obesity assessed 358 participants on their likelihood to adhere to medical advice by physicians of varying weight descriptions and found: “Respondents reported more mistrust of physicians who are overweight or obese, were less inclined to follow their medical advice, and were more likely to change providers if the physician was perceived to be overweight or obese.”4

I can understand why this was the case; almost four years ago my very first article for NHD was published: a review of ‘Big Fit Girl, Embrace the Body You Have’ by Louise Green.5

At the time there were large changes happening in the ‘plus-size’ movement and Louise Green was a figurehead for the ‘This Girl Can’ campaign running at the
time.

HEALTH AT EVERY SIZE

Louise Green found popularity due to her status as a plus-size individual with a BMI of 35+ who still participated in regular exercise, proposed eating a balanced diet, and worked with a personal trainer who didn’t focus on losing weight. She went onto become a trainer herself and became popular with clients for the very reason that she was “like them”. She owned what is considered, as discussed above, to be the base of rejecting an advisor and made it her USP.

This continued rise of the plus-size movement was further demonstrated in the ‘This is Healthy’ tagline on the cover of Cosmopolitan back in January of this year, in which women of varying body shapes were featured to showcase that health is ‘not one size fits all’.6

Of course, this caused quite a media frenzy, intended or otherwise, about our considerations of bodyweight and shape in its relation to public health.

So, if patients will reject obese physicians, then why is there such a rise in plus-size and diverse voices for health? And where does this leave us in finding a conclusion to whether we need to be perfect in the eyes of our patients?

Yes, we are walking billboards, but we are also talking billboards, so although first impressions seemingly still do matter, we at least can have confidence in that as long as we are able to demonstrate control over our habits and own the fact that we are imperfect then the public are seemingly still all ears.

Maybe we need to be a little more honest about all of the meals we post on social media, the number of glasses of wine of an evening, and that being an ex-smoker doesn’t mean you are to be avoided at all costs.

We all follow incorrect behaviours. We all have vices. Everyone is aware. Perhaps it is our responsibility to own our dietary and fitness flaws in order to demonstrate to our patients and clients that health is more than how we suffer from dietary weaknesses and instead how we control and mitigate for them.

As always, honesty is the best policy, and being real is far more relatable and reliable than always being right.

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