Weight Bias

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October 14, 2019

If you are living with overweight or obesity, then you may have already experienced a host of weight-related consequences. No, I am not referring to the standard medical warnings you’ve heard over the years, like monitoring your blood pressure or being tested for diabetes. Instead, I am referring to the pervasive weight-related bias that affects people living with obesity in harmful and unhealthy ways. At work or school, at home, and in medical offices, hospitals, and therapists’ offices, weight bias is alive and well, and if you are a person living with obesity, chances are it is harming your health.

Weight bias is sometimes subtle, like a waiting room, restaurant or concert venue that does not have chairs that are comfortable for your body. Other times, the bias is obvious, like when a physician disregards your presenting medical complaint in favor of advice to lose weight.

Research on the effect of weight bias on health has been accumulating over the years. We know with near certainty that those who experience weight bias are more prone to: disordered eating, weight gain, less physical activity, depression and anxiety symptoms, lower self-esteem, avoidance of routine medical care, and overall lower quality of life. Still, just last month in early September 2019, Bill Maher used his highly public platform on HBO to encourage weight bias and fat-shaming saying “fat shaming needs to make a comeback.” Clearly, we have a long way to go.

Societal myths that people living with obesity are lazy, lacking willpower, or are ignoring their condition persist despite the science. Perhaps these myths are fueled by the interweaving of weight with our cultural beauty standards, class issues, and an ingrained North American value system of self-determinism (e.g., you make your own destiny). The truth is that obesity is a disease—plain and simple. It was formally recognized as such back in 2013 when the American Medical Association (AMA) released a statement identifying obesity as “a complex, chronic disease that requires medical attention”—the culmination of over three decades of scientific efforts to understand the condition.  

If you or someone you love has lived with obesity and has been the victim of diet-mentality marketing and quick-fix promises, perhaps you know the truth. Perhaps you know that obesity really is a complex and chronic condition that has contributing factors far beyond personal responsibility. If you look at your family tree, perhaps you will start to understand that genetics are a real and consistent factor in who develops obesity and who does not. And perhaps it won’t surprise you that a multi-disciplinary approach to the treatment of obesity is best if it includes medical care, psychological or behavioral health care, nutrition and exercise support over the long run, just like any other complex, chronic medical condition. But maybe you, too, have been shamed for living in a body that doesn’t conform to societal norms, or you have learned to beat yourself up with negative self-talk every time you “fall off the diet wagon.” If so, let this moment be a call to action. You can do something about it today.

First, educate yourself about obesity as a disease. Read about it in the scientific literature and you will be surprised to learn just how far the science has come at understanding the complexity of the condition. Next, educate yourself on weight bias. Organizations like the Obesity Action Coalition and the Rudd Center for Food Policy and Obesity are two great spots to read the science behind how weight stigma harms health and also to learn tools for combating bias you experience in your doctor’s office, at home or at work. Finally, start today by using people first language, as I have done throughout this article. Instead of saying “obese woman” say “woman with obesity” or, if more comfortable to you, “woman living in a larger body.” If you wouldn’t say it about cancer, don’t say it about obesity. Would you refer to a friend or patient as a “cancerous woman?” Probably not. Would you say about yourself “I am a cancerous man?” Again, not likely. Instead, say “I have obesity” or something similar that feels right to you. Doing so helps to emphasize, remind, and reinforce the truth. Obesity is a disease that real, good, everyday people have and not something to be shamed, stigmatized, or scorned. We all have a part to play in reducing weight bias, whether you wear a white coat to work or not.