weight stigma

I want to talk about something that’s been bothering me…a lot. Namely, the idea that anyone needs to change their body to meet someone else’s ideals. That someone could be a spouse/partner, a friend, a stranger, or society at large.

I belong to a number of professional Facebook groups related to Intuitive Eating and Health At Every Size® (HAES). The other day, someone mentioned working with a patient who was struggling with disordered eating and body image issues. This person had reached a weight that was too low to be healthy for them, even though it was a “culturally acceptable” weight. They lamented that they were treated so much better by other people at that weight. Houston, we have a problem. That problem is our culture’s “thin ideal” and the accompanying stigma directed at people who don’t meet that ideal.

The destructiveness of weight stigma

Weight stigma is a very real issue, and it’s one that’s affecting people’s health. Those chronic health problems that are “associated” with being at a higher body weight? The bias, stigma and discrimination inflicted against people at higher weights is responsible for at least some of that. That’s especially if people internalize that stigma. (When you internalize weight stigma, you believe you are less worthy because you weigh “too much.” Or, you believe you don’t deserve to do or have certain things because you weigh “too much.”)

Tragically, weight stigma drives far too many people to take drastic steps to reduce their body weight in an attempt to comply with the thin ideal. This includes everything from highly restrictive diets to having part of their stomach and/or intestines removed. Unfortunately, weight loss surgery can have serious complications. As for dieting? Attempts to diet below the body’s defended set point range is a recipe for rebound weight gain. In fact, many dieters ending up at a higher weight than if they had never dieted. (For more on this, I highly recommend dietitian Rebecca Scritchfield’s podcast interview with Sandra Aamodt, author of “Why Diets Make Us Fat.”)

weight stigma

Who needs to change?

Everything I’ve mentioned so far had been bothering me so much that I wrote a lengthy article on weight stigma for the January issue of Today’s Dietitian magazine. But what really got a bee in my bonnet recently was a disturbing comparison that popped into my head:

Someone changing their body weight or appearance to gain acceptance and avoid stigma and discrimination is a little like an abused spouse trying to change their behavior to reduce the amount of abuse they suffer.

Whether we’re talking about stigma or abuse, the onus should never be on the victim to change. It’s the perpetrator (whether it be an individual, a culture or a society) that needs to change.

Each of us is inherently valuable and worthy of the same respect that might be given to any other human being. Our weight-centric and health-centric (read: health is a moral virtue, and if you weigh “too much” you can’t possibly be healthy) society is not making us happier and healthier. It’s making us less healthy and miserable. It needs to stop.

Previews from my soapbox

I do my part every day with my one-on-one patients to help them develop balanced relationships with food and body while improving health in meaningful, sustainable ways. HAES and Intuitive Eating are the frameworks I use, because those are the sane counterpoint to dieting insanity. I also have written about these topics on the blog and elsewhere. I plan to take an even deeper dive into those topics on the blog in 2018. You’ll also see posts on related issues like body image, body acceptance and weight stigma, . Taking it further, I also have a handful of related articles in progress for various publications on those same topics.

A reminder that I post my latest Seattle Times and Washington Post articles on the home page and here, and you can find links to other articles here.


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