National Eating Disorders Association (NEDA) has deemed the week of September 25-29 as Weight Stigma Awareness week. Weight stigma and discrimination impacts all of us, whether you have a larger or smaller body. This especially impacts the eating disorder community.
Weight Stigma defined
According to NEDA weight stigma, or discrimination is stereotyping a person’s size. It may come up as the dislike or fear of being fat or getting fat. You may not be aware of how ubiquitous it is. It shows up in healthcare, media, with your friends and family, fitness centers, workplace, and public settings.
The mission of weight stigma awareness week is, “To eliminate anti-fat bias, which is rooted in racism, to end the resulting stigma, shame, trauma and discrimination around body shape and size.”
Weight stigma can be implicit or explicit. Our implicit views take place outside of our awareness and happen automatically. Our explicit views are those expressed verbally. In relation to weight stigma they may be expressed through humor or sarcasm. Obese people are portrayed as fat, lazy and have no will power.
Impact of weight stigma on health care
Weight stigma can prevent people from getting help for their eating disorder due to shame. They also might not get the medical help they need. Those with eating disorders may be normal weight, thus their eating disorder diagnosis may be missed.
Research has been conducted on higher weight individuals and how it impacts healthcare. A common view amongst health care providers is that overweight people will less likely adhere to medical treatment. In addition the research shows that the providers spend 28% less time with these patients. They may make assumptions about the reason for the individuals condition. They may assume their issue is due to their weight, thus misdiagnosing them. Also, the viewpoints of the provider may make the person feel less welcome, thus impacting the willingness of the individual to return.
In addition, higher weight individuals experience stress based on 3 processes. They include identity threat, stereotyping and stigma. Identity threat is when the person feels less valued because of the stigma. This can impact their self-esteem. Because of the stigma of obesity, the person may be ready for a sense of rejection in the health care setting. This takes away their sense of empowerment. Stereotype threat happens when the person is aware that they are a member of the stigmatized group and monitor their behavior so as not to conform to the stereotype. The felt stigma is when the person expects that they will get subpar treatment based on past experience.
Decrease in communication with health care provider
These things together can make communication between patient and provider less effective. Thus the level of care will decrease. This adds to the stress of the patient, which can further exacerbate problems with physical and mental health. In addition if the person feels stigmatized their shame or discomfort may make them reluctant to reach out for medical help. This avoidance may lead them to seek help only for more advanced disease processes, which makes outcomes even worse.
Something the average person might not recognize with regards to weight stigma is the pain, shame and impact on mental health on these individuals. They tend to have more struggles with body image, anxiety and depression. The stress of the stigma makes them more vulnerable to substance use disorders. They also may cope in other unhealthy ways, such as restricting food, or bingeing. Many people who restrict also binge, as the body wants to maintain homeostasis. In addition, trying to watch their weight leads to further food preoccupation.
How to challenge weight stigma
This is such a huge social issue. It is important to look at larger people with compassion and curiosity. It is much easier to criticize them than to wonder what may have occurred in their life that is impacting their weight such as trauma. Perhaps think of the pain and humiliation that larger individuals struggle with. It is important to work towards accepting people of all sizes.
Raising awareness is the first step to change. Pay attention on how you speak about yourself or others and their weight. How do you speak about weight with your friends and family members? Do you beat yourself up about your own weight? If you do this in front of your children, what message do you think it sends to them? Working on acceptance of our own bodies and focusing on what the body does for us, vs. what it looks like is a healthy goal. In addition, just because you are obese does not mean you are unhealthy. Just because you are a normal weight doesn’t mean that you are healthy.
If weight, or weight stigma is something you struggle with, therapy can help. Give me a call at 713-304-6554 and we can work on tools to help you get to where you want to be.
Take care,
Debbie
