Weight Bias, Weight Stigma and Weight Discrimination

Let’s talk about weight bias, weight, stigma, and weight discrimination. This is a topic that often comes up with my clients and I don’t think it’s something that many of us truly understand, and I believe that we really need to address this issue because it surrounds us daily in our environments (home, school, work) and within our health care system!

FIRST, LET’S REVIEW A FEW DEFINITIONS…

It’s important to understand what these terms mean before we move on for you to get a better understanding of how and why certain behaviours are harmful to all people, especially people in larger bodies.

Weight Bias:

1. A bias is when someone has a disproportionate belief for or against an idea or a thing. For example, a parent can be biased by saying that their child is the best soccer player on their team.
2. Weight bias, it is a set of negative views and attitudes in regard to someone’s body weight, most often in relation to someone living in a larger body.

Weight Stigma:

1. A social stigma is a disapproval against a person based on perceivable social characteristics that can distinguish them from other people in our society. For example, a student may learn at a slower pace than the other members of their class, therefor they are labelled as being “less intelligent” than the majority of the class, which results in society believing that anyone who learns at a slower pace is less intelligent.
2. Weight stigma is when we make assumptions for a whole group of people who are in larger bodies based on our biases. It’s the sum of stereotypes and misconceptions about obesity and people living in larger bodies. These stereotypes can include beliefs that people living in larger bodies are “lazy” or “lack self-discipline/self-control”, are “sloppy”, “stupid”, etc. All of these are negative attributes towards someone based on their weight, which can be extremely damaging and are stigmatising them.

Weight Discrimination:

1. Discrimination is a consequence of someone’s biases and stigma. This is when someone chooses to act on their negative beliefs in a manner that is unfair towards a particular group of individuals.

I perceive it like this:

Bias → Stigma  → Discrimination

2. Weight discrimination is when we actively act in a negative and unjust way towards people of certain body sizes, specifically people in larger bodies. Weight discrimination can be verbal (ex: making fun of someone for being in a larger body) and/or physical (ex: someone in a larger body can’t access certain equipment or attend certain events because they are not suitable for their body size). It’s important to note that weight discrimination does not need to be overt, such as calling someone “fat” out loud to their face. It goes beyond the “in your face” actions, because most marginalised groups face discrimination in a more subtle and indirect manner, such as not being able to find a seat on the airplane. These are known as microaggressions and it ALL counts as discrimination.

Self-Stigma:

Last one I promise!

This is when people who do not live in larger bodies, accept the social stigma that people in larger bodies are less worthy or less respectable. These beliefs are internalised and often times, it leads to a person in a smaller body devaluing themselves because of the prominent stigma around people in larger bodies and the discrimination they face in our society. We may also refer to this as internalised fatphobia. They take everything that society tells them, and they internalise it towards themselves.

WEIGHT BASED DISCRIMINATION CONTINUES TO INCREASE

Some may think that weight-based discrimination is a relatively new concept, however it has been going on for MANY years. We are only starting to shed light on this matter in recent years.

In the United States, weight discrimination is the third most prevalent cause of discrimination in women, after gender and age and the fourth most common form of discrimination in men. In fact, weight-based discrimination is three times higher in women than in men and is found to be the highest amongst racial minorities, specifically black women. The prevalence of weight discrimination increased from 7% in the 1995-1996, to 12% in 2004-2006. This represents a 66% increase in weight-based discrimination, so the rate and the extent to which people are discriminated against for their body weight actually gets worse the larger your body gets. So, you don’t need to weigh a certain number to be discriminated against, however this shows how a society’s bias translates into unjust actions towards people in marginalised groups.

WEIGHT BIAS IS PRESENT EVERYWHERE

At Work:

60% of people who have experienced weight discrimination say that it has happened in their work place or while trying to get a job! This means that either they were not hired, they got fired or they were not able to get promoted because of their body weight.

At School:

There is a lot of weight bias, weight stigma and weight discrimination rooted in the school system’s messaging. In post-secondary health science programs, such as nutrition, nursing, med school etc. we are taught information from a weight centric lens. I know when I was in university studying nutrition, weight inclusivity was not a topic of discussion.

In our Health Care System:

More than 60% of adults living in a larger body have reported experiences of weight bias from a healthcare professional. Remember, this only counts for what has been reported, I would not be surprised if it were to be more than that.

AND MANY MORE, such as at home, at extracurricular activities, in clothing stores etc.

OUR WEIGHT CENTRIC HEALTH CARE SYSTEM

Many health care facilities do not have equipment to treat and assess individuals in larger bodies, such as hospital gowns and blood pressure cuffs. This means that basic health care is often not accessible for these individuals, and that’s a problem.

How is this problematic you might ask?

If you are someone in a smaller body, do you ever worry about whether you will be able to sit in the chairs in the waiting room? Do you ever stress over how your doctor may recommend you start a diet, even though the reason you went to see them was for an infection? Probably not, because doctors do not have a personal bias towards someone in a smaller body by assuming that they are unhealthy.

Many studies have shown that someone’s weight will affect how their doctor will view and treat them, and many health care providers tend to see patients living in larger bodies as less compliant, lazier and not wanting to be healthy, so they treat them with less respect and due to their internalised weight bias. If you were faced with this type of discrimination, would you feel comfortable going back to the doctor’s office? Probably not.

A lot of people in larger bodies avoid seeking medical care because they do not want to face  discrimination, however the long-term effects of not seeking medical care can lead to developing chronic conditions. Because of these stigmas and biases, there is the assumption that people in larger bodies don’t care about their health, when in reality, it is the opposite. They do care about their health just as much as people in smaller bodies, however they avoid medical attention because they do not feel like they are being treated equally.

Bottom Line:

The weight related stereotypes we have are rooted in diet culture. These ideations have been around for many years and provide an overly simplistic understanding of health by basing it on weight. We know that we cannot assess someone’s health based on how they look. This is a fact! So, when we have these biases and internalised fatphobia, we also become part of the problem. Whether you are a healthcare provider or not, it’s so important for us to start noticing our own biases.

NEXT STEPS: WHAT CAN I DO TO CHANGE?

3. Acknowledge your own personal biases: we need to recognise our own biases and privileges, to have a deeper understanding of how we treat and speak to others and ourselves!
   1. Check out the Weight Bias Implicit test created by Harvard University to assess your own biases: https://implicit.harvard.edu/implicit/canada/takeatest.html
4. Educate yourself: take the time to acknowledge your biases and learn more about how/why weight stigma can lead to weight discrimination and why this is harmful.
5. Speak up: This is hard. It can feel awkward to speak up for yourself or someone else who is facing weight discrimination, by being the one to call out ignorance. However, you can still do this in a way that will create a window of opportunity to educate others on how and why their words/actions are harmful.
6. Change your environment: Surround yourself and your environment by content and resources that are more weight inclusive. For example, do your posters in your office promote body diversity? Are the chairs in your waiting room only suitable for people in smaller bodies? Is your social media feed filled with diet culture messages?

CONCLUSION

Everyone deserves to be treated with respect and dignity at every size. All body shapes and sizes deserve to have equal access to health care, to jobs, to respect, etc.

I know this was A LOT and you are so awesome for sticking until the end!! Truthfully, there is SO MUCH more I could have covered, but this blog post would have been WAY too long. If you want a more in-depth explanation, you can listen to my full podcast episode!

Need support?👇

The Balanced Practice is a team of professionals specialized in eating disorder outpatient treatment, disordered eating. Our mission is to help as many folks heal their relationship with food and their bodies so they can live happily outside of diet culture!

We strive to provide evidence based nutrition counselling to support you, or your loved one, in achieving full recovery. Schedule a connection call now.

Marie-Pier Pitre-D’Iorio, RD, B.Sc.Psychology
Lead Registered Dietitian and Founder of  The Balanced Practice