IS BODY-SHAMING A REAL CONTRIBUTOR TO UNHEALTHY, MORE THAN FAT ITSELF?
There is racism, sexism….and then there is weightism. Also known as weight-stigma, weight-bias, body-shaming or fat-shaming, this is the discrimination or stereotyping based on someone’s weight or body size. Our culture fosters prejudice against body weights and sizes and this is becoming a bigger problem. Why do we still think it’s okay to ‘put down’ the over or under weight or treat someone differently because of their physical appearance? Furthermore, is stigmatising someone’s weight going to motivate them to be any healthier? Do we justify it by the ‘link’ overweight has with health issues?
The wise J.K. Rowling once said ~ “Is ‘fat’ really the worst thing a human being can be? Is ‘fat’ worse than ‘vindictive’, ‘jealous’, ‘shallow’, ‘vain’, ‘boring’ or ‘cruel’? Not to me” ~
Weight stigma is pervasive. It occurs in workplaces, schools, on trains, in doctor’s offices, even at home. It happens behind peoples backs and also to their faces. It happens with vindictive and cruel connotations even sometimes with no harm intended. However, it always results in harm done.
“She’s too skinny, she needs to eat more”
“She’d be pretty if she was thinner”
“What a fatty. I bet he’s lazy.”
“Oh you look great, you’ve lost weight” (this is well intended, but insulting none the less. It suggests they didn’t look great before they lost weight, and also suggests thinner is better)
“You’ve put on a little bit of weight around your middle. Best if you lose that so you don’t have a heart attack” (the complex manifestations of this comment may have just increased the person’s risk of a heart attack more than being at a higher weight)
“You might feel better if you lose a few kgs” (they might feel better if you don’t comment on their weight!)
“You need to start watching your weight if you want to find a partner”
“You are too fat to adopt a baby” or “too fat for IVF treatment”
“She has fatty arms”
“I heard this 5:2 diet is good for losing weight, you should try it”
We have a cultural obsession with the scrutiny of others and for some reason, this fat-phobia and this discrimination is considered okay in our distorted society. As Jennifer Anniston recently said “I’m fed up with the sport-like scrutiny and body shaming that occurs every day” “it reflects the warped way we calculate a women’s worth”.
The constant messages and suggestions that people are undesirable and less worthy in a bigger body, is damaging. The fat jokes are often intended as harmless fun, and the larger people ridiculed for eating a burger is not even blinked at, but it’s damaging. The unsolicited, well intended diet advice given to those who are supposedly not good enough just as they are, is damaging.
I believe shaming someone’s weight, size or appearance is a judgment which says a lot more about the person making the comment than it does about the person on the receiving end. “What Susan says of Sally, says more of Susan, than of Sally.”
Is the vilification of fatness justified by the supposed link with disease and early mortality? Not at all.
You cannot shame someone into losing weight or becoming healthier. It does not work. Full stop. There is a rapidly growing body of research which shows the detrimental effects it has on someone’s physical and mental health. (1)
Thin shaming can be as equally hurtful and detrimental to someone’s health as fat shaming. Any form of body shaming is mean and needs to stop.
WE HAVE A FEAR OF FAT
We are bombarded with anti-obesity talk, warnings that fat is bad and misinformed messages that weight loss is the answer to this ‘problem’ and will always lead to improved health. These tales which perpetuate the thin ideal have spread so far and are so embedded in our culture and our psyches that we are blind to what really constitutes health. It has led to a fear of fat and a hateful bias towards fat people.
The ‘obesity epidemic’ talk suggests that obesity is a direct cause of diseases and people dying prematurely. This stems from the knowledge that there is an association between being over-weight and many diseases….but this is not necessarily a causal relationship in which one causes the other.
As an example: We know more firemen sent to a fire is associated with more damage done. So, do we say more firemen cause more damage, or could there be another factor causing both? Yes, the factor of a more ferocious fire increases the damage done at the same time as increasing the need for more firefighters.
So, we know that being overweight is associated with chronic disease, but we don’t know that being overweight is the sole cause of disease. It is likely other factors such as fitness, activity, diet and socio-economic status increase disease risk at the same time as increasing the risk of weight gain. Fat itself probably doesn’t cause disease, behaviours that can lead to overweight can also lead to the associated diseases.
WHAT ABOUT THE OBESITY PARADOX?
There is a pattern of overweight and obesity being associated with longer survival in many diseases. Obese people with diabetes, hypertension, heart disease or chronic kidney disease actually live longer than thinner people with the same condition. (2)
Body size, except for absolute extremes, does not strongly predict longevity. In fact, it has been shown that overweight people live as long as or even longer than ‘normal’ weight people. In other words, weight itself is not an accurate predictor of living longer or dying from disease! (2)
Evidence shows the idea ‘fat is bad’ is archaic. (2) The old argument of fat is bad for one’s health no longer justifies any weight stigmatising or fat-phobic rubbish.
There is definitely a problem with people eating unhealthily and moving too little which can increase risks of many chronic diseases, however this applies to all body types.
A healthy diet and regular exercise can influence a person’s health more than their level of ‘fatness’. Overweight, but cardiovascular fit individuals have a lower risk of mortality (dying) compared to normal-weight, unfit individuals. (3)
A growing body of research suggests most indicators of health can be improved by changing health behaviours, regardless of whether weight is lost or body shape changes. For example, behaviours such as diet and exercise can reduce blood pressure and blood lipids and improve insulin sensitivity even if there is no change in body weight. (2)
Body size is NOT an accurate indication of health. Health is much more complex than that. It encompasses many physiological factors, emotional state and social connection. All of which cannot be measured simply by looking at someone, and all of which are influenced by many, many factors! Health should not be oversimplified and portrayed to be about only physical appearance or fatness.
People can have a small body, a medium body, even a large body and still be healthy. Being ‘overweight’ does not equal unhealthy. Being thin most definitely does not automatically equate to optimal health!
No one is qualified to be able to simply look at someone and know their risk of disease!
Next time you’re about to judge someone’s health based on their weight, think again. Health comes in all sizes!
Our focus should be off weight and on the promotion of healthy behaviours regardless of the amount of body fat somebody has.
And let’s be honest here, if someone is happy to be of a bigger size, even if they’re unhealthy, and don’t want to pursue healthier behaviours, then who are we to judge and criticise. Their body, their business!
WEIGHT STIGMA ITSELF DAMAGES HEALTH
The fear of fat and the pursuit of weight loss has not made the population thinner or healthier. Our cultures obsession with thinness, the associated weight stigma, and constant suggestions for people to lose weight leads to feelings of shame and body hate and doesn’t do any good.
Weight shaming does not encourage people, but demotivates behaviour changes to improve health. It disheartens people, it disempowers them and most definitely does not support them. It is paralytic. It’s causing more harm than good. These people are less likely to respect and care for their body and take steps to improve their health which leads to a long, downward spiral of physical, mental and social implications; poor body image, low self-esteem, stress, anxiety, depression, weight cycling/fluctuations, dieting, binge eating, less physical activity and avoiding medical care. Additionally, each of these also have their own health consequences and ultimately leads to poorer health. People’s wellbeing is compromised and they suffer these side effects as a result of feeling pressured to conform to the unrealistic and unjustified body ‘ideal’.
It causes stress
The stress of social stigma causes the chronic release of stress hormones which can initiate or aggravate conditions such as heart disease, high blood pressure and cholesterol, diabetes, stroke, anxiety and depression. (4-5) These physiological effects of stress, rather than ‘fatness’, may be part of the explanation for overweight people experiencing these health issues.
The overproduction of these stress hormones can also lead to over eating and increased weight gain, perpetuating a viscous cycle.
It leads to disordered eating and dieting
Discrimination and the pressure to lose weight often leads to dieting and disordered eating. This can include binge eating, skipping meals, self-induced vomiting, obsessive calorie counting, poor self-worth, misuse of laxatives and diuretics, fasting or chronic restrictive eating. These abnormal eating behaviours lead to fatigue, malnutrition/nutrient deficiencies, poor concentration, affected social life and anxiety and depression. (6)
Dieting is the biggest risk factor for developing an eating disorder. Girls who diet are 5-18 times more likely to develop an eating disorder compared to those who do not diet. (6) for more information regarding eating disorders and how to help someone, visit The Butterfly Foundation.
Unfortunately, diets do not work. If they did, would we still have this so called ‘obesity crisis’? Has dieting contributed to the increased prevalence of overweight? It is very well established that only a very small percentage of dieters maintain their weight loss for more than a couple of years. Weight is often regained even if dieting and exercise is continued, and most regain more weight than they lost! This leads to further restriction/dieting and consequently further weight gain. There are biological systems humans have which resist long-term weight loss. (The physiological, psychological and emotional reasons diets don’t work, and the associated health implications is a very significant and complex issue which I will unravel in a future post). This weight-cycling, losing and regaining weight, has been shown to cause increased risk of some of the very health conditions we associate with obesity; heart disease and diabetes. In many cases being overweight but a stable weight is more healthy than losing and regaining weight. (2)
It fuels body dissatisfaction
People are hating their bodies more and more and at younger and younger ages.
It dampens motivation for physical activity
It is well established that weight shaming demotivates people to engage in healthy behaviours. If you want to make someone less active, just call them a derogatory, fat bias name, or simply tell them their body isn’t good enough and that they need to lose weight. That will probably do the trick! Some research has shown that a lot of people who perceive weight discrimination or stigma are more likely to avoid physical activity and this is true whether the person is overweight or not. (7) It may even contribute to the cycle of weight gain and further stigma.
It leads to avoiding medical care
Patients in bigger bodies often experience prejudice, derogatory comments and poor treatment when visiting a doctor. Often the finger is wagged at them and they are told to lose weight even when the reason for visiting is 100% unrelated. “Doctor, I have a sore throat” “Well, you really need to lose weight”. “Doctor I slipped and broke my arm” “Okay then, you need to get this weight under control” “Doctor, I’m on fire!” “Hmm we really should do something about this excess weight, that will make you feel better”.
No research has shown that losing weight improves health in the long term, mainly due to the fact it is rare for people to maintain the weight loss for more than a few years. Furthermore, there is collateral damage that comes with the pursuit of weight loss; there are many unhealthy consequences. So, these ‘weight loss’ focussed recommendations are not evidence based at best and unethical at worst. Remember, healthy behaviours do improve someone’s health regardless of weight changes!
Patients who are made to feel ashamed of their body, no matter what size they actually are, are more likely to miss general check-ups and health screens which of course has poorer outcomes.
Every person in every body size and shape deserves the same respect, compassion and equal opportunities to health and a happy life.
Some researchers have suggested that the consequences of a person experiencing weight bias may be more harmful to them than simply having a large body and that perhaps the health problems we see in bigger people may be largely the result of weight bias and discrimination. (8)
Furthermore, people of ‘normal-weight’ can also be sent in this downward health spiral when they feel the pressure to be thin and adopt restrictive dieting behaviours.
Researchers have concluded that due to the significant social, psychological and physiological consequences of being victim of weight stigma, it in itself is a public health concern. (9)
WHAT WE CAN DO
As a dietitian I help guide clients in the direction of eating well and support them in making behaviour changes which will help to optimise all facets of health, and I will measure their success in much more meaningful ways than a number on the scales. My instinct is to be compassionate first and my professional expectation is to do no harm.
‘Follow your instincts. That’s where true wisdom manifests itself.” Oprah Winfrey
Weight stigma does harm. Diets do harm. On the contrary, encouraging respect for bodies, no matter the amount of space they take up in the world, leads to more healthful nourishment and exercise along with other self-care behaviours and ultimately, happier and healthier people! Compassion does no harm.
My beautiful Nan always said to me “If you cannot say anything nice, then don’t say anything at all”. Very wise words, and it proves to be a very good idea in this case of body size.
So, If you can’t be kind, be quiet.
Let’s accept and respect all body shapes and sizes and minimise the unintended consequences of weight stigma. After all, there is no wrong way to have a body!
Let’s take the emphasis off our obsession with thinness and weight loss and encourage healthy behaviours, well-being and happiness for all people regardless of body size. Let’s focus on what is really important. Oh, and let’s be compassionate.
Ponder this for a while. Think about it as you go on with your everyday lives in this weight obsessed world. Be mindful when you find yourself judging. Pull yourself up and be quiet if you find yourself shaming or suggesting weight loss. Remember it when you see or hear someone else criticising someone, simply because of their body size. Remember the harm it does.