These barriers are likely also present for men, non-binary or gender non-conforming individuals, but the evidence has tended to focus on women. The physical discomfort, shame and fear all interfere with students’ ability to focus on class content and participate fully in class activities. For students with current or former disordered eating, the stakes can be even higher.

“As someone who has struggled with restrictive eating since I was a child and compulsive exercise since college, my experience in the MPH program only added fuel to the fire of body preoccupation, disordered behaviors, and a heavy veil of orthorexia. My “clean eating,” various diets, and multiple hours of exercise every day were applauded by classmates, family, and friends. The moralizing of “health” and thinness that I had internalized much earlier in life was amplified through reading articles and completing assignments in the MPH program. This was definitely not healthy for me.” ~School of public health faculty

In general, public health is committed to social justice and using an equity lens in our work. However, body size is often not included in this perspective. (See, Body Liberation Fits in Public Health, Reason #3.) Not only is this harmful for students in larger bodies, it harms our credibility with our students.

“As a person in recovery from an eating disorder, I found being a student in a public health program to be destabilizing. I encountered an academic environment that spoke of innovation, systemic change, and equity but was unwavering in its belief that health meant having a particular body size. The curriculum and faculty reinforced and legitimized fatphobic norms which often made school feel like a direct threat to my recovery. I was drowning in the message that success in Public Health meant making sure bodies did not look like mine.” ~State health authority employee.

After earning their MPH degrees, all of the students quoted in this article went on to engage in a period of “unlearning” and re-learning how to approach public health work in a weight-inclusive way. They accomplished this through reading, workshops, continuing education, networking and reframing their personal experiences. Instead of seeing their bodies (or anyone’s body) as problematic, they see clearly that the problem lies squarely in society and the institutions that help to maintain the status quo. Like so much of public health work, it is the social determinants (discrimination, anti-fat bias, weight stigma, oppression) that must be changed, not individuals.

“As a person in and out of a fat body, it’s taken a long time since my MPH to realize some of the harm that was caused by the fat-phobia (specifically the obsession with BMI and o*esity) in the MPH curriculum. In a search of my archived MPH folders, I found 194 documents (articles, assignments, etc,) mentioning the o-word. While I feel saddened about the psychological impacts of anti-fatness in public health (for folks in and out of the profession), I choose to feel hopeful about how we can advocate for our profession to change and for adding body-size to our overall social justice work in public health.” ~Public health faculty

“Fortunately, during and after I finished the MPH program, I was able to find resources to help me recover and re-stabilize my own health, and to continue my learning about body liberation and fat justice.  The unlearning from the program is an ongoing process, but I am proud to say that I now practice in a weight-inclusive way in my work.” ~Therapist

Our students should not have to go elsewhere to learn how to practice effective, compassionate and inclusive public health. We can be innovative leaders in making public health inclusive and effective for all bodies.

Many thanks to Christina Jäderholm and Hannah Cory for their edits and expert insights. So much gratitude for those willing to revisit and write about their graduate school experiences in the hope that it will lead to change.