Head and shoulder photo of Franz Fanon in tie, shirt, jacket with text ‘they realize at last that change does not mean reform,change does not mean improvement. From The Wretched of the Earth.

Ten years ago I co-authored an article (with Lindo Bacon) where we unintentionally gave neoliberalism a stamp of approval. Our bad. You can read more here. It’s relevant today because it’s still being used to support a critical public health approach intent on ending oppression. But because the error remains unexamined the approach isn’t in fact anti-oppressive.

Worse, because it seems like there’s no case to answer, it stops actual anti-oppressive practice and theory gaining ground and so stabilises the medical-academic-industrial complex.

That’s worrying, right?

The article advocates an approach, HAES, that tackles fat stigma, making it very different from…


In the decade since this co-authored article (with Lindo Bacon) supporting Health At Every Size (HAES) was published it’s had over 401k hits. I wanted it open access because I wanted it to have reach. And my investment paid off — great! It’s stood the test of time as a go-to repository of all the biomedical references you need to launch an informed attack on anti-fat healthcare.

We need to upend fat stigma and pay attention to social justice in the public health system. Period.

The idea was to provide a roadmap out of oppression. But we mistakenly signposted people…


We are not born desiring or rejecting bodies according to their particular dimensions.

We are not born loathing or fearing or being comfortable with our own and other people’s thin or fat bodies. We are educated into these feelings.

In other words, our body responses, which register as sensations, affect, emotions, tacit leanings, tastes, and a whole realm of vaguely defined spidery feelings, are a social construct.

How we feel about things as adults is strongly impacted by the collective and familial circumstances, customs, and values of our upbringing.

Take food. Depending on our identities, geographical and cultural location, and…


New Pool Hollow May 2021

New Pool Hollow is a 25 minute walk away. It’s a small disused reservoir. It was reliably a quiet place for wild swimming until featured in the Sunday Times as a quiet place for wild swimming. During the lockdown summer I met my friend Liz for a weekly dip.

Liz wrote about it once on her blog “The plunge is breath-taking, awakening, vital. It confirms my body to my senses, pushes the air out of my lungs and into a shout.” …


UK news is that BMI-based healthcare has been formally recognised as harmful. Wowee. That’s great.

This questioning happened off the back of a report called Changing the perfect picture: an inquiry into body image.” Well, more accurately, it’s off the back of the courage and pain and scholarship and tenacity of all the fat folk and their allies who first spoke up. Those who had the nerve to risk the costly pushback that comes from challenging entrenched ideas and medical authority. Those who survived. Those who dared.

In Changing the Perfect Picture authors say the government’s anti-fatness strategy “is at…


A tree trunk, branches and canopy seen from the ground with sunlight coming through to the left of the photo.
Photo by Jan Huber on Unsplash

Like millions of other people, I was taught that trees compete with each other for nutrients and space and light. Rapid tree growth was a sign of success. The text book said that planting trees at some distance apart would maximise yields. The worth of a tree started when it became wood, or because it trapped carbon dioxide which benefited humans. Nowadays we can add forest bathing (shinrin yoku) — when explained only as self-care — to the list.

Imagine if we’d been taught that young trees shaded by older trees are more likely to thrive than young trees that…


or Who Says Food Isn’t Medicine?

A colourful wall mural of an elder’s face. They have long white hair and markings on their left cheek and from nose to chin in purple.
Photo by Giulia May on Unsplash

The exhortation ‘food isn’t medicine’ is doing the rounds on social media again.

It’s posted by healthcare professionals who share a concern about the impact of nutritionism, strongly allied with diet culture. Good. All food workers should raise awareness of harmful practices that masquerade as beneficial. We should all be arguing against nutritionism.

Nutritionism is a way of thinking about nutrition that turns food into a means of nutrient transfer and turns bodies into calorie-burning machines whose inner workings are fine-tuned by the calibrated delivery of nutritional substances.

Nutritionism arises from a western take…


White box with influencer crossed out, then registered dietitian centred in capitals, and nutritionist crossed out below.

The chairperson of a dietetic association said my blog post condemning weight conversion, aka dieting, was bringing the profession into disrepute and told me to remove it. Or else.

Lots of dietitians, me included, believe that it is the silence, not the speaking up, that brings the profession into disrepute. And more to the point, we put safety, integrity, and liberation before PR.

However, the legacy of poor leadership will be with us for a long while yet. This means we need to train ourselves to notice and reject the ways we have been groomed to support the status quo.


Books that I’ve read to learn about liberatory teaching and thinking

Recent coverage of racist killings by police and civilians and racialized death rates from Covid have reignited awareness of the need for ideological integrity and strategy.

If your work dismantling diet culture stopped feeling relevant as part of the call to prioritise anti-racist action then the work you are doing is not actually dismantling diet culture. Because dismantling diet culture, truly undoing the logic of the binary and replacing it with an entirely different logic, is also the work of dismantling the intellectual regimes, systems of thought and feeling, and social structures, that interact to reproduce white supremacy.

HAES might…

Lucy Aphramor

Lucy Aphramor is a poetitian — a radical dietitian and performance poet. They developed the health justice approach Well Now. www.lucyaphramor.com

Get the Medium app

A button that says 'Download on the App Store', and if clicked it will lead you to the iOS App store
A button that says 'Get it on, Google Play', and if clicked it will lead you to the Google Play store