In our society today we are flooded with the thought that thinness equals health. Either spoken out loud or through more subtle ways. The idea that weight is synonymous with health can lead to bias and stigmatization that is incredibly harmful. It’s called weight stigma and it’s real and pervasive.
what is weight stigma?
Weight stigma, also known as weight bias or weight-based discrimination, is discrimination or stereotyping based on a person’s weight and size. This can look like shaming, blaming, “concern trolling” online and even participating in physical abuse towards someone based on their size (1). It can occur to individuals on the spectrum of body shape and size.
Weight stigma happens all around us at work, school, in the media, in the home and even at the doctor’s office. Weight stigma has been shown to increase body dissatisfaction, a leading risk factor in the development of eating disorders.
where is weight stigma prevalent?
Weight stigma is, unfortunately, very prevalent in our society today. It can be found in a variety of very common settings and contributes to the cemented beliefs of the victims that their bodies are “wrong” and must be changed.
- In the classroom: Studies show that prevalence of weight stigma perpetrates classroom settings (from both fellow classmates and teachers) and leads to increased incidences of bullying, impairment of student’s educational experience and decreased percentage of students pursuing a higher level of education (3).
- In the media: Weight bias is thought to be perpetuated by the media through idealization of thin bodies and under-representation and stereotyping of larger bodies. When characters in larger bodies are portrayed they are commonly the targets of fat humor and stigmatization (4).
- In the workplace: The workplace is a common setting where weight bias and discrimination occur. Employees who have a higher body weight face weight-based inequities in employment including unfair hiring practices, lower wages, fewer promotions, harassment from co-workers, and unfair job termination (5).
- In the home: Sometimes weight stigma can be happening in the very place we want to feel safe: our homes. Comments surrounding weight in the home are very common and equally dangerous with the potential of leading to disordered coping mechanisms in order to achieve a specific body type.
- In healthcare: Weight stigma spans pretty much all of healthcare and can occur on the spectrum of body sizes. Doctors, therapists and dietitians alike making comments or suggestions based on a client’s weight can be extremely harmful. Many clients report that their care suffers because all their providers can see is their weight. This leads to patients feeling uncomfortable and unwelcome in the healthcare sphere and potentially avoiding necessary visits and check ins due to fear of shaming. Some examples of weight stigma in healthcare include:
- Continually recommending diet and exercise interventions without asking the patient’s current routine or interest. This can stem from lack of report building and assuming lifestyle choices based on their body size.
- Recommending weight loss as the sole treatment when the patient has come in for an unrelated problem.
- Comments made about body shape or size.
This is poor patient care and is significantly impacting the mental and physical health of people.
what causes weight stigma?
Weight stigma at its core comes from weight bias - or the negative ideologies associated with individuals who are categorized as “overweight” or “obese” by BMI scale. Which, by the way, is an inappropriate and inaccurate measure for health.
The drivers of stigma are primarily based in our society’s belief that thinness equates with health and that health itself is a moral issue. In other words - those who are considered “healthy” (likely represented by thin individuals) are typically considered “good”. On the contrary, those who are considered “unhealthy” (typically represented by those who live in larger bodies) are considered “bad”.
Many people also attribute weight gain to personal responsibility, and fail to grasp the complex mix of genetics, environment, socioeconomic and biological factors that drive it. The focus on personal responsibility results in blaming individuals for weight gain and enables stereotyping them as “lazy” and “lacking in willpower”.
It is argued by some that making comments about a person’s body size will incentivize them to lose weight “in the name of health”. However, evidence shows that this is a counterintuitive approach (and also just plain wrong). Therefore, in addition to crossing moral boundaries, bias and stigma contribute considerably towards negative physical and mental health of individuals (2).
what are the negative effects of weight stigma?
Despite its unfortunate prevalence, weight stigma is dangerous and can increase the risk for adverse psychological and behavioral issues.
Studies have linked the prevalence of weight stigma with an increase in:
- Risk of chronic disease development (specifically diabetes)
- Stress levels (measured through cortisol, C-reactive protein levels and overall oxidative stress in our bodies)
- Eating disorders and disordered eating behaviors
- Body image dissatisfaction
- Poor self-esteem (2).
If comments about weight and size are really in the “name of health” then this list above clearly disproves that alone and shows that, in reality, many aspects of health are seriously damaged with the presence of weight stigma.
how you can challenge weight stigma
Weight stigma is present all around us. But, very similar to diet culture, we do have the choice to participate in it or not. If you have experienced it in your life or not - there are ways to challenge weight stigma in our society.
Call it out. If you see weight stigma happening, recognize that and call it out. Change cannot happen if these issues are not brought to light and people recognize the damage it is causing. Especially if you have not experienced weight stigma in your life, recognizing that it is harmful and speaking out can significantly benefit another person’s well-being.
Work on your own beliefs around weight and its impacts on health. This is a great conversation to have in a session with your dietitian, therapist or maybe a like-minded community. Invest in some reading and learn more about how a weight-neutral approach can benefit your health in more ways than one.
Diversify your social media feed: Follow accounts that promote size diversity and fill your feed with people of all sizes doing things they love!
Start the conversation in the workplace: Does your employer have anti-harassment regulations? Is the workplace inclusive in terms of access for employees of all sizes (i.e desk chairs, access to the building, etc)? Do they have any sort of anti-bias training that includes weight bias? Starting the conversation can be hard and totally worth it.
Advocate for yourself in healthcare: Remember your doctor works for you. It is within your right to decline getting weighed at their office and setting the tone that weight is not something you would like to address. If they are unable to honor your requests, maybe it’s time to find a new provider.
Join a like-minded community: Combating weight stigma and diet culture alone is hard work. Having a community where you can have these conversations can feel like a breath of fresh air. It helps you recognize that there are other people who have experienced very similar things and are working hard to challenge them and develop a healthier relationship with food and body, just like you.
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- Wu Y-K, Berry DC. Impact of weight stigma on physiological and psychological health outcomes for overweight and obese adults: A systematic review. J Adv Nurs. 2017;00:1–13. https://doi.org/10.1111/jan.13511
- Nutter S, Ireland A, Alberga AS, Brun I, Lefebvre D, Hayden KA, Russell-Mayhew S. Weight Bias in Educational Settings: a Systematic Review. Curr Obes Rep. 2019 Jun;8(2):185-200. doi: 10.1007/s13679-019-00330-8. PMID: 30820842.
- Ata RN, Thompson JK. Weight bias in the media: a review of recent research. Obes Facts. 2010;3(1):41-46. doi:10.1159/000276547