Are you guilty of weight bias?

Quick — what’s the first thing that goes through your mind when you see a person suffering with the disease of obesity?

If you’re like many people you may assume they eat too much, that they don’t exercise enough or that they don’t have any willpower.

These are some of the common stereotypes ingrained in society about those with a larger body size. People often think that those living with obesity have no one but themselves to blame. But the truth is, obesity is a complex medical condition that is caused by key factors that go beyond diet and exercise — including genetics, metabolism and other non-behavioural issues.

A recent international study reported in the International Journal of Obesity found that 58% of the study’s 14,000 participants who were actively trying to manage their weight had encountered weight stigma,  mostly from family members, followed by classmates and physicians. Their experiences were most common and upsetting during childhood and adolescence.

Almost 30% of Canadians suffer from obesity (the figure is 40% in the U.S.) and while public attitudes toward other traditionally stigmatized groups have become less prejudiced, weight bias still persists due to the fact that thinness continues to be celebrated in North American culture, as evidenced by the multi-billion dollar diet industry and negative portrayals of people with larger bodies.

Weight stigma only makes people who are overweight and obese feel worse about themselves (known as “weight bias internalization”), and this can lead to depression, anxiety, low self-esteem lower physical activity, disordered eating and avoiding health care appointments. 

For the first time in 2020, the Canadian Clinical Practical Guidelines for adult obesity management addressed weight bias and stigma. Recommendations to health care practitioners included: asking permission to discuss weight with patients, assessing the patient’s history to understand the root causes of obesity, discussion of treatment options, agreement on a long-term action plan with realistic expectations and assisting with barriers and drivers of weight gain (these can include lack of access to health care providers with expertise in obesity, lack of coverage of obesity medications by drug plans and long wait times for bariatric surgery, for example). Another recommendation is for health care workers to assess their own attitudes and beliefs about weight.

While weight stigma is still extremely prevalent, there are hopeful signs that societal attitudes are shifting. For example, the body positivity movement which has become popular over the past few years focuses on ending the culture of “fat-shaming” and challenges unrealistic body standards, particularly when it comes to female beauty. 

Photo by Kevin Wolf on Unsplash