Like many of her high school peers, Donna Robinson has long had a complicated relationship with food and her body. She didn’t look like the woman who walked red carpets or shared lifestyle tips on social media.

So, like many of her peers, Donna tried to force her body to conform.

She never ate around classmates, fearing they’d watch and judge or, worse, comment on how much and what she was eating. She measured the merit of foods based on calorie count, trying to take in less than 1,000 calories per day, half of what NIH says a “somewhat active” girl ages 14 to 18 needs. She was happiest when she successfully deprived herself the most, existing for weeks on celery, cucumbers, smoothies and maybe half a hard-boiled egg.

“People at school, that would be their main conversation topic: How much weight they’d lost,” says Robinson, now 18 and a senior at William L. Sayre High School. “And I hadn’t been losing at all, and I knew I looked different from a lot of people online.”

Improving or changing someone’s self perceptions can’t happen overnight. But the Body Empowerment Project, which Robinson first took part in more than a year ago, was a good place for her to begin.

Body Positive

Launched as a two-school pilot project in 2020 as Body Positive Philly, the Body Empowerment Project wants to help young people redefine their relationships with their bodies, teaching ways to accept and appreciate themselves in whatever form they take, and thus stopping eating disorders before they happen. Project participants attend weekly meetings led by near peer facilitators who introduce body acceptance ideas, point out the problems in traditionally accepted health measures like BMI, and listen and willingly address any other topics of concern.

“We don’t say, This is what anorexia is. Here are the behaviors. We save that for the adults working with these students,” says Clara Pritchett, who now leads the non-profit organization. “We focus more on the protective factors that we know build against eating disorders: Self esteem, self confidence, self compassion.”

While the concept of the program was initially difficult for some to digest, it’s now in demand. This year, Body Empowerment Project has worked with 17 Philadelphia schools. Of those, 13 offered twice-yearly 10-week programs. The four others had shorter programs. An additional 15 schools have expressed interest in the program. Since the project began, they’ve worked with an estimated 1,000 students.

“Nurses and teachers reach out to me and tell me about the disordered eating patterns of their students. They say, I need something, anything, to help them,” Prichett says.

At the end of each 10-week cycle, the organization asks participants to report how they’ve changed because of it. In a fall 2023 survey of participating students, 85 percent reported improved body image and 92 percent said their worth was less dependent on their body size.

The project, Robinson says, “has helped me come up with different coping mechanisms to help me be more accepting of my body and feel OK with myself. There’s been a huge jump from where I started to where I am now.”

“It’s important to think not just: Why don’t I love my body? But also: Why is the world telling me not to love my body?”  — Clara Pritchett, Body Empowerment Project Executive Director

Founded by Penn students

The American Academy of Eating Disorders estimates that 9 percent of Americans will develop an eating disorder during their lifetime. For 95 percent of those roughly 29 million people, the problems start between ages 12 and 25.

All students are welcome at Body Empowerment Project, but it does seek out lower-income, racially marginalized students. Large-scale studies “have found that rates of all eating disorders are the same or higher in all racial and ethnic groups as compared to White individuals. Despite the lack of differences in rates, individuals with minoritized, marginalized and other intersectional identities are less likely to receive care and services,” according to the National Eating Disorders Association.

But TV shows and movies with eating disorder plot lines more often focus on cis-gendered White girls, many of them teenaged and privileged. Troian Bellisario wrote, directed and starred in 2017’s Feed, which was inspired by her struggle with anorexia. Lily Collins, who plays the lead in Netflix’s 2017 To the Bone, opened up about her eating issues in her memoir Unfiltered. On the British series Skins, which ran from 2007 to 2013, fair-haired Cassie (Hannah Murray) observes that, “I didn’t eat for three days so I could be lovely.”

Media accounts also rarely present disordered eating as a problem for boys. Of all 1,000 students who’ve gone through at least one 10-week Body Empowerment Project program, the demographic break-down has been similar, Pritchett says: 65 percent girls, 30 percent boys, and 5 percent gender non-comforming. About 60 percent of participants identify as African American, 25 percent Latino, 11 percent White, 10 percent multi-racial, 8 percent Asian and 6 percent Native/Indigenous.

Body Empowerment Project co-founders Christina Miranda and Amanda Moreno launched the program while students at the University of Pennsylvania. In her own teen years, Miranda began restricting her food intake and obsessively exercising. One physician told Miranda’s mother that it was probably “just a phase.” A few months later, a school nurse became concerned about Miranda’s low heart rate and called an ambulance. Only then did she get the treatment that she believes saved her life.

While at Penn, Miranda tutored in public high schools and noticed that when students struggled with material, it wasn’t because they weren’t intelligent enough to grasp the concepts. It was the lack of self-confidence.

Lack of confidence in one’s body can lead to disordered eating. The pandemic worsened that problem. One study found that the number of patients in eating disorder treatment programs grew by less than 1 percent per month in the two years before the pandemic closures. In 2020, these programs grew by more than 7 percent each month. The number of intakes began to decline only in April 2021.

One big problem, Miranda noted, was that eating disorders were developing unchecked. Only hospitalization triggers intervention. She wanted to find a way to prevent the cases from getting to that point.

She asked Moreno, a close friend, to help her find a solution. During the pilot programs at Paul Robeson High School and Kensington Health and Science Academy, they relied upon a curriculum and facilitator training developed by The Body Positive, a nearly 30-year-old national non-profit that helps people overcome negative body image. (Body Empowerment Project has since developed its own curriculum and protocols and offers two facilitator trainings each year.)

The data they collected from their first participants found students were “really struggling” with food issues, Miranda says. But there was some hope: Student surveys done before the program and at its midpoint showed more than 90 percent of students felt their body image and self esteem had improved. School staff also noticed an improvement in student behavior and interactions.

A major step forward for the Body Empowerment Project came in 2021 when it was awarded one of three $100,000 President’s Engagement prizes, given annually to students who create and implement post-graduation projects with the potential to make positive, lasting impact.

Before winning the prize, Miranda and Moreno had had trouble convincing potential funders the project was needed. Some people wondered how students living with food instability could have eating problems or weight issues. (Multiple studies have found that childhood food insecurity can lead to binge eating disorder.)

One potential backer asked how much weight participants could lose by taking part in the program. Still another would-be support organization asked how the program was “going to stop a fat Black kid eating a bag of Doritos.”

“That was not a funder we wanted to partner with,” Miranda recalls.

Age matters

Body Empowerment Project’s facilitators range in age from 18 to 25. That’s why they’re called “near peers.” Some are college students or recent graduates. Others have chosen paths that don’t involve higher education. Groups range in size from 8 to 25 and have a facilitator : participant ratio of 1 : 6.

Age matters, says facilitator Malini Correa, a Penn senior who has been part of the project since her freshman year. “We’re close enough to them in age that they can relate to us, but they can also look up to us as trusted figures and big brothers and sisters,” she says.

When Body Empowerment Project organizers go into a school to get students interested in being part of the program, they talk to students during lunch or when they’re visiting nurses or guidance counselors. Participants tend to “self select,” Correa says, but “we’re targeting a group left behind by body positivity.”

Asha Ketia, 18, a senior at the Philadelphia High School for Creative and Performing Arts, remembers when, as a sophomore, she met the women who would be facilitating the Body Empowerment Project at her school. She was wary about the program in general, she says, as it was still being tested and “we were like guinea pigs.”

“I said, How are three skinny White women going to teach us something about this topic? How can they relate?” Asha laughs. “All of my concerns were debunked. … They were very understanding, they knew what they were talking about, and they taught me things about having a healthy relationship with my body that I never knew before.”

She remembers one session focused on BMI, the Body Mass Index scale still widely used by medical professionals to determine if an individual is at a healthy weight. The facilitators, Asha says, “taught us its history and how it was based off of White men. It doesn’t make sense to measure a Black woman like myself based on information from White men. It’s like trying to measure degrees with a ruler.”

Diet culture was a popular topic, too. Most people see diets as restrictive and limiting. Health professionals talk up “healthy” foods and what people should eat. That shouldn’t be the case, Asha says.

“Diets are restorative. They’re about listening to your body and what makes your body feel good,” says Asha, who participated in three 10-week Body Empowerment Project programs and is now a facilitator. “I’ve learned so much about health and what it actually is. It’s not about being a certain size. It’s feeling good and being free of disease so you can live life to the fullest.”

Correa was one of the “skinny White women” who led Asha’s initial 10-week course. She remembers being impressed by Asha’s insight that privileged groups in society have often co-opted programs aimed at helping minorities. Correa is thrilled that Asha loved the course so much that she became a facilitator, but she doesn’t take credit for Asha’s choices.

“As facilitators, we’re really just there to prompt discussion and introduce activities. It’s the students who share the responsibility of leading them. They learn the most from each other, not us,” she says.

“We give students a place to talk about things they feel passionate about. We want to help them find their voices so they can see themselves as activists and leaders.” — Clara Pritchett, Body Empowerment Project Executive Director

“My body is good.”

One way Body Empower Project builds community early on is by asking participants to share the messages they’ve received about weight, their bodies and exercise. When the messages are listed for all to see, participants are often surprised, and comforted, by the fact that many of the negative messages are the same. That was true for Robinson.

“I had felt alone for a good portion of my life because of my horrible relationship with food and my body,” she says.

While some activities are repeated across the program, facilitators are trained to allow students to drive the discussions.

“Giving students a voice is a huge part of our program,” Pritchett says. “We give them a place to talk about things they feel passionate about. We want … to help them find their voices so they can see themselves as activists and leaders.”

Correa has seen this happen. One transgender student who joined the project with his sister said he often felt shut out socially. “We made it clear our space was open to absolutely everyone and he was able to share things that were difficult,” she says.

Another group activity asks participants to write something complimentary about the others in the room without referencing appearance. Then they’re tasked with writing five affirmations they can repeat to themselves when negative thoughts arise. One student who earlier said she didn’t “feel right” in her body changed the message to “My body is good. It does the things I need it to do, and I appreciate it.”

“Responding to hurtful comments or situations can be difficult, but we hope we give them the tools to dissect the information they’re getting about their bodies, and we let them know that it’s OK to question things they’ve heard about weight for their entire lives,” Correa says.

Learning to address and redirect negative thoughts also removes their power. When these bad feelings surface, students are urged to think, “I have this thought. I’m going to acknowledge this thought. And I’m going to try to move on from this thought.”

Amy Watson, a counselor at J.S. Jenks School, was eager to bringthe program to Jenks’ sixth and eighth graders. “These are good kids and they don’t realize what they say can have a strong impact and make them feel badly,” Watson says.“There’s a lot of We were just playing.”

During one meeting, a sixth-grade girl who was struggling with weight issues talked about how badly she felt when people made cracks about her appearance. Others in the group, including some who in the past may have teased her, rallied round.

“They said, You don’t need to worry about what people think about you. You should love your body. If you’re happy, don’t let other people tell you you’re not good enough,” Watson says.

The students’ work within the program has changed how they behave outside of it, Watson says. She saw more compassion in the sixth graders, and more confidence among eighth graders.

“It’s definitely improved communications skills,” she says. “They’re better able to articulate what’s bothering them and to talk about themselves and relationships with other people.”

“I’ve learned so much about health and what it actually is. It’s not about being a certain size. It’s feeling good and being free of disease so you can live life to the fullest.” — Asha Keita

“I’m not going to do this anymore”

Pritchett is the first person to lead the organization since its founders stepped away to attend medical schools out-of-state. All three women agree the job seems tailor-made for Pritchett. The Philadelphia native attended public school, and struggled with body image and disordered eating. That didn’t change until Covid shut down her in-person classes at Brown University.

“I had a lot of time to think and I realized I didn’t want to spend the rest of my life at war with my body,” she says.

She immersed herself in the anti-diet world, including sociologist Sabrina Springs’ Fearing the Black Body: The Racial Origins of Fat Phobia. “I didn’t know any of it, and it really made me think about how the notions I had about my body were rooted in racism. I said, I’m not going to do this anymore,” she says.

When schools reopened, Pritchett developed a course at Brown focused on diet culture and fat phobia in the U.S. Her senior thesis looked at the racial roots of fat phobia and how that affected modern anti-obesity campaigns.

Body empowerment, she says, “is not about loving yourself in a superficial way … It’s important to think not just: Why don’t I love my body? But also: Why is the world telling me not to love my body?”

Pritchett recently ran into a high school friend who she knew had also suffered with body image issues. Pritchett was excited to talk about the Body Empowerment Project.

“I said, ‘My job is to tell 12-year-olds their worth is not based on how they look or how much they weigh,’” Pritchett recalls. “We looked at each other and realized how different our lives would have been if someone had said that to us.”

This piece is part of a year-long editorial series looking at innovations to address inequities in women’s healthcare, sponsored by Independence Blue Cross.

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