Weight Stigma Awareness
What is Weight Stigma?
Most people have experienced some form of weight stigma in their life. We experience internalized weight stigma when we apply negative stereotypes or judgements about weight to ourselves or externalized weight stigma if we've been a victim of weight-based judgment or mistreatment. Recently, Weight Stigma Awareness Week aimed to bring awareness to the harms of weight stigma and what we can do about it. The hosts created an incredible lineup of events and speakers throughout the week. If you missed it, you can check it out here where you can watch past and present video recordings, access book lists, get podcast recommendations and more. Below, I'll share a bit more about what weight stigma is and some ideas for advocating for the care you need. As always, please reach out for support or just to say hi!
"Weight stigma, also known as weight bias or weight-based discrimination, refers to the negative attitudes, beliefs, stereotypes, and discriminatory behaviors directed towards individuals based on their body weight or size. This form of discrimination is prevalent everywhere and manifests in various settings and in social interactions.
Weight stigma often targets individuals who are deemed to be in higher weight bodies, but it can affect people of all body sizes. Weight bias can increase body dissatisfaction, a leading risk factor in the development of eating disorders. In fact, the best-known environmental contributor to the development of eating disorders is the sociocultural idealization of thinness." (Paula Edwards-Gayfield, MA, LCMHCS, LPC, NCC, CEDS-C for NEDA)
Weight stigma may show up in a variety of ways. Here are some examples:
assumptions about someone's food intake and activity based purely on physical appearance.
being told to lose weight in order to be granted medical treatment.
when a medical condition is blamed on weight.
Weight stigma negatively affects healthcare and health outcomes because it...
...is stigmatizing and leads to the avoidance of routine healthcare for fear of the anxiety and judgment it will bring.
...can lead providers to miss important diagnoses because they are so focused on weight rather than the whole human.
...is a chronic stressor that may increase cardiometabolic risk (Pearl et al. 2017). The associated stress response can lead to elevated blood pressure and cortisol (Himmelstein, Belsky, and Tomiyama 2014).
...is strongly associated with poor outcomes in people with Type 2 Diabetes (Potter et al. 2015).
...is linked to high blood pressure, disordered weight control practices, binge eating, poor body image, clinical eating disorders, low self-esteem, and depression among all age groups (Tylka et al. 2014).
Regrettably, experiences of medical weight bias and anti-fat sentiment seem to be commonplace. Negative health care experiences often lead to health care avoidance. Studies show that higher-weight women are less likely than thinner women to seek health care (Mensinger, Tylka, and Calamari 2018). A 2014 study found that 53% of women and 38% of men reported being shamed by a physician, with weight as one of the top reasons for the experience (Darby, Henniger, and Harris 2014).
Here's a real life example of weight stigma and its' subsequent harm that I highlighted in my book:
Rebecca Hiles, who shared her experience of weight stigma–fueled medical neglect on Good Morning America and in Cosmopolitan magazine in 2019, was told over and over to simply lose weight when she reported breathing problems to her clinicians (Dusenbery 2018). For six years she was told that her troubled breathing was due to her weight, but when a new doctor finally did a thorough evaluation, it was determined that she actually had lung cancer. This delayed diagnosis of her life-threatening condition led to the eventual removal of her entire left lung.
If you or a loved one has been subject to weight stigmatizing care, perhaps some of the ideas below will help:
Get comfortable with self-advocacy
Say "no thanks" to the routine weigh-in at medical visits
Lead the conversation by stating what you'd like to cover in your visit today
Share research on the harms of care that focuses on weight (see above)
Use the letter provided as a resource in my book
If possible, switch to a provider that is more inclusive. Check out https://barehealth.co for a list.
Want to work with a weight-inclusive Registered Dietitian? Schedule a complimentary Q&A call to see how working with an RD may benefit you.