The weighty consequence of fat-phobia
Fact or Fiction: Is obesity actually an epidemic? Part 2
What is weight stigma?
For this instalment of this series, I want to talk about weight stigma and the consequences that it can have on health. The World Obesity Federation defines weight stigma as “the discriminatory acts and ideologies targeted towards individuals because of their weight and size…[weight biases] can include laziness, lack of willpower, lack of moral hygiene, etc.”
Bias and stigma are often veiled behind concerns for health. However, new research has been able to show that fat-shaming actually has a contradictory effect on health.
Personal effects of weight bias
Weight bias causes feelings of shame, which can lead to unhealthy coping mechanisms such as increased caloric consumption (1), disordered eating (2), substance abuse (3), and self-isolation (3). Not surprisingly, there is a dose-dependent, negative association between weight stigma and mental health – meaning that the more weight stigma you experience, the poorer your mental health tends to be (2). If that wasn’t bad enough, the negative health outcomes of fat-phobia also extend beyond personal behaviours and into healthcare and professional settings.
Weight bias in health care
Observational studies have found that physicians spend less time in appointments with their obese patients and provide less education to obese patients, leading to poorer patient outcomes (3). People who experience bias in the healthcare system, or shaming from their doctor, are also less likely to go back for care – which means missing follow up appointments or delaying regular cancer screening tests (3). As a result, preventable diseases such as cervical or breast cancer are not caught as early, and can have worse consequences (3).
Weight bias in the workplace
In the workplace obese individuals statistically receive lower starting salaries, are ranked as less qualified, and work longer hours compared to thin employees (3). Weight stigma is higher among women vs men, which only compounds with the already too-high gender and race pay gaps (3).
Why is weight stigma so hard for people to quit?
If making comments about someone’s weight doesn’t actually help their health, then why do so many people do it? Fat-phobia is pervasive in our society for a number of reasons, but the one that I want to focus on is the $4.4 trillion global wellness economy. Stakeholders in this industry (including everyone from the head of supplement companies to individual personal trainers), have something to gain from people who are unhappy or shameful about their bodies. This industry thrives on and perpetuates the moralization of weight and food, misinformation about health and ultimately fat-phobia. My hope with this series is to address that misinformation – if we know better, we can do better.
Stay tuned for the next instalment of this series, where I’ll be using the latest research to address how much weight actually affects health. And if you haven’t read the first part of the series, what are you waiting for? (linked in the footer)
Sources:
1. Major B, Hunger JM, Bunyan DP, Miller CT. The ironic effects of weight stigma. J Exp Soc Psychol. 2014 Mar;51:74–80.
2. Emmer C, Bosnjak M, Mata J. The association between weight stigma and mental health: A meta‐analysis. Obes Rev [Internet]. 2020 Jan [cited 2021 Feb 2];21(1). Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/obr.12935
3. Rubino F, Puhl RM, Cummings DE, Eckel RH, Ryan DH, Mechanick JI, et al. Joint international consensus statement for ending stigma of obesity. Nat Med. 2020 Apr;26(4):485–97.