Weight Stigma
Weight stigma is the discrimination of someone based on their weight or body size, and it has very harmful effects on folks emotionally and physically. Weight stigma appears in many places in our society, including in relationships with family and friends the workplace, social media, television and movies, retail stores, athletics, and certainly in healthcare.
Definitions
An adjective to describe someone’s body. This word has neutral meaning and can also be used in a liberating way to describe one’s own body.
Dislike, fear, or mistreatment of people because they are fat. Fatphobia can also be internalized when someone applies the biases and beliefs about fat people that they learn to themselves.
Discrimination due to someone’s size or weight.
Healthism was coined by Robert Crawford in a 1980 paper for the International Journal of Health Services. In the 1970s the U.S. had seen a wave of renewed interest in holistic health and wellness, and Crawford was wary of how that investment in health was curdling into a perceived responsibility to seem healthy to others. He defined healthism as “the preoccupation with personal health as a primary—often the primary—focus for the definition and achievement of well-being; a goal which is to be attained primarily through the modification of life styles.”
Source, and place to read further on the effects of healthism: We Have to Stop Thinking of Being ‘Healthy’ as Being Morally Better
A reductionist way of thinking about food that assumes the whole point of eating is to maintain and promote bodily health. What we know is that food is so much more than the sum of its nutrients. Food can bring people together, have emotional value, provide us comfort, and so much more – all of which are just as valuable as the nutrients that we get from food.
The idea of unconditional self-love, focusing on the goal of having a positive body image.
Accepting your body as it is and regarding it as neutral.
Check out this interesting article about body neutrality, which touches on some of the ways that body neutrality has helped folks, but also discusses where the idea lacks.
The flawed “health” measure of BMI
Body Mass Index (BMI) is a way to measure and categorize a person as underweight, “normal” weight, overweight, or obese based on their height and weight. BMI is flawed in many ways, with one of the major ways being that it was developed based only on the white, European male body, and therefore does not accurately represent any other race, ethnicity, or gender. Additionally, it does not account for muscle mass, fat distribution, or age. BMI is also often a tool used to shame folks in the medical setting, whether that be shaming them into trying to lose weight, disqualifying them from medical procedures, or causing providers to treat them different based on that number.
Commonly we will hear that BMI works well on a population-scale to categorize people and predict health outcomes and mortality; however, research suggests that cardiorespiratory fitness level is actually a much more accurate predictor of health outcomes and mortality than BMI. This analysis shows that overweight and obese fit people have similar mortality rates as those that are of a normal weight and fit.
Learn more about BMI:
- Fitness vs. Fatness on All-Cause Mortality: A Meta-Analysis
- Book: Fearing the Black Body, by Sabrian Strings
- BMI a poor metric for measuring people’s health, say experts
- WXXI Podcast: Why did the American Medical Association redefine the role of BMI (featuring one of our UHS providers, Sunshine Orta, PA-C)
- Podcast: The Maintenance Phase; Episode: The Obesity Epidemic
How to combat weight stigma
It is important that we all work to combat weight stigma, regardless of our body size. Some things that we can all do to address weight stigma include:
- Speak up when we see someone else facing weight stigma or if we hear someone using language that perpetuates this stigma.
- Use neutral language when describing bodies, as well as food. Bodies and food do not have moral value.
- Have conversations with those in your life about weight stigma, including medical providers, friends, family, etc.
- Opt out of being weighed at medical appointments. You have the autonomy to make medical decisions for yourself, and that includes being weighed at the start of your appointment. Regardless of your body size, if you feel uncomfortable being weighed, you can decide not to be. At UHS, we offer cards at check in that you can take – these cards say “please don’t weigh me”, and can be an easy way to let the provider know that you would like to opt out. There are times when being weighed is medically necessary, and your provider can have a discussion with you at that time if that is the case.
What is UHS doing to combat weight stigma?
At UHS, we strive to provide excellent care to every student. Some ways that we are combatting weight stigma include:
- Providing a variety of seating options in the waiting area to accommodate all body sizes.
- Exam tables made to accommodate weights of 400-500 pounds.
- Offering the option to take a “please don’t weigh me” card at the check in window to give to the staff member that would normally take your weight.
- In the Health Promotion Office nourishment and body image programming, we take a food neutral approach, in which there are no “good” or “bad” foods. We do not recommend things like dieting, restriction, counting calories, or anything else that insinuates that one should strive to make themselves smaller.
If you have feedback on additional things that we could be doing to combat weight stigma on our campus, we want to hear from you! With feedback about Primary Care, please visit our website to submit feedback. If you have feedback for the Health Promotion Office specifically, contact us.