What You Need To Know About Weight Stigma
Written by Isabel Vasquez, RD, LDN
It’s no secret that our society has an issue with people in larger bodies. The idea that thinner is better is a key tenet of diet culture–a belief system that promotes thinness and certain food choices as morally superior.
As a result, people in larger bodies face systemic oppression, and those in straight-sized bodies have a certain level of privilege (often called “thin privilege”). This weight-based oppression is often called weight stigma, anti-fat bias, or fatphobia. Not only is it morally depleting, research shows it has real consequences on health.
In this article, I’ll explain what weight stigma is, address what the research says about its harms on health, and offer suggestions for shifting the focus away from weight.
What is weight stigma?
According to the National Eating Disorders Association (NEDA), weight stigma is, “discrimination or stereotyping based on a person’s weight”. It can also be called weight bias, anti-fat bias, or fatphobia, and it is comparable to bias based on race, gender, disability, or religion.
Intersectionality and weight
Intersectionality is a term that was coined by Kimberlé Crenshaw in 1989 to address the ways our different identities intersect. If you’ve heard of intersectionality before, maybe you’ve thought of race, gender identity, sexuality, disability, or socioeconomic status as identities worth considering, but have you thought of weight?
Because of the prevalence of weight-based discrimination, we must consider weight as another common cause of oppression. In fact, in most states, weight-based discrimination is still legal (unlike discrimination based on race, religion, sex, or gender identity).
The more marginalized identities someone holds, the less privilege they probably experience in their lives and the more oppression they face.
What does weight stigma look like in daily life?
Weight stigma is perpetuated by a variety of sources including healthcare professionals, family, friends, and the media. Many times, people may think they’re being “helpful” or “considerate” or “just looking out for your health” but what they’re really doing is perpetuating weight stigma.
Weight stigma in healthcare
In interactions with healthcare professionals, weight stigma might take place at an appointment where the conversation centers around weight instead of health-promoting behaviors or other health markers like lab results.
Someone may come in for something totally unrelated to weight (like strep throat or a stubbed toe) and the healthcare provider may either attribute their issue to weight or bring up weight loss before they leave.
They may have totally normal lab work and still be advised to lose weight.
In fact, studies have shown that healthcare providers are some of the worst perpetrators of weight stigma.
For example, one study including 122 physicians found that the physicians were more likely to prescribe more tests to, spend less time with, and have negative views about heavier patients.
Another study found that among dietetic students and professionals, negative attitudes about higher weight patients were extremely prevalent.
Even using the terms “overweight” and “obese” can be very problematic because of the way it pathologizes certain people’s bodies. These are terms based on the flawed BMI system, and they have become highly stigmatized.
This stigma is largely because of the ways weight has become inextricably tied to health in our society and the false idea that our weight is within our control.
Weight stigma from family and friends
When it comes to family and friends, weight stigma often presents as comments centered around food and weight. If you lose weight, maybe you’re met with, “Wow! Did you lose weight? You look great!”, implying that you didn’t look great when you were at a higher weight. *eye roll*
In our Latino families, comments like “Mija, estas gorda” are too often used as a greeting. That can definitely be a form of weight stigma, even if our families think they’re just being playful. Usually these kinds of comments come with pressure to lose weight so you won’t be labeled “gorda” anymore.
Even if you are not the target of these comments, they can still be harmful.
Let’s say your tía speaks negatively about your prima’s weight gain. Listening to that may cause you to fear gaining weight. If your prima is viewed poorly for gaining weight, why wouldn’t you be viewed poorly if you gain weight? The sentiment gets internalized.
Weight stigma in the media
When it comes to weight stigma in the media, the list goes on and on. Weight stigma is everywhere!
In movies and TV, people in larger bodies are rarely cast as the lead, and if they are, their weight is typically an issue they are working to correct.
They are often stereotyped. Their weight is often joked about or portrayed as a big hurdle they need to overcome. (Shows like Shrill and Lizzo's Watch Out for the Big Grrrls are doing an amazing job of changing this narrative.)
From comments demonizing eating certain foods to the word “fat” being used with clear negative undertones to characters being on diets, the media is a hub for weight stigma.
What are the harms of weight stigma?
When discussing the harms of weight stigma, we have to address that the origins of weight stigma are rooted in oppression.
As Sabrina Strings details in her book, Fearing the Black Body, fatphobia originated from white people's racism and disgust with black folks who they observed tended to have larger bodies. They associated fatness with blackness and wanted to separate themselves from this racial group.
People of all sizes and shapes deserve to be treated with respect. Period.
Stigmatizing people based on weight and perpetuating the idea that weight equals health furthers this oppression and discounts all the other factors backed by research that impact someone’s health.
It places blame on the individual instead of acknowledging the systemic causes of poor health, more specifically, the social determinants of health. Systemic issues like poverty, lack of access to health care, lack of access to quality education, and racism demonstrate that health is not simply an individual responsibility.
Weight stigma harms physical health
Furthermore, weight stigma is an independent predictor of poor health. Why?
For one, it decreases people’s desire to seek out healthcare and the quality of healthcare they receive if they do seek it out. It makes sense that if you’re afraid of being stigmatized for your weight at an appointment, you’re less likely to go to that appointment!
Weight stigma has also been shown to cause chronic stress, harming our immune function, increasing rates of depression and poor body image, and triggering poor metabolic health.
Weight stigma harms mental health
In addition to harming physical health, weight stigma harms mental health. As explained by NEDA, “Weight stigma is dangerous and can increase the risk for adverse psychological and behavioral issues, including depression, poor body image and binge eating.”
It makes us feel bad about our bodies, harming us mentally!
Weight stigma obviously affects those in larger bodies the most; however, it also harms those who are in straight-sized bodies. It causes people who aren’t in larger bodies to intensely fear gaining weight because they do not want to be subjected to the blatant weight stigma we constantly see directed at those in larger bodies.
Shifting the Focus Away from Weight
Weight and health have become inextricably linked despite research showing that although the two are associated, the relationship is not necessarily causational.
Other factors are increasingly being revealed as the causes of this association, weight stigma being one of them! The weight stigma directed at people in larger bodies has health consequences (explained above).
Shifting the focus away from weight and instead towards health-promoting behaviors like getting in physical activity, eating a variety of food groups, getting good sleep, and managing stress is key to decreasing weight stigma and has been shown to be more beneficial to health.
While tackling weight stigma is a big task that will require commitment stemming from a national policy level, shifting the focus away from weight is something we can all do on an individual level in our daily lives.
Addressing weight stigma in your life
For one, reflect on how weight stigma impacts you. What biases have you internalized regarding weight? These implicit bias tests are free and there is one specifically about weight if you are interested in learning if you hold implicit weight bias. (Chances are, you do. We’ve been surrounded by it our whole lives!)
As you reflect on how weight bias has impacted you, be sure to validate your own experiences with weight stigma before being too hard on yourself. You can realize you hold weight bias while also working to dismantle it.
Reflect on if you’ve had experiences like the examples of weight bias I gave above. If you have, reflect on how they have affected you. Acknowledge that this is a societal issue, not an issue with your body. Remember that health-promoting behaviors are more important than manipulating your weight. Remember your body has value regardless of what society says.
If you’re ready to take action, remember that when it comes to health, it’s usually best to focus on behaviors. Live this out in your own life. Move joyfully instead of exercising to lose weight, eat intuitively instead of dieting, engage in stress-reducing behaviors and adopt a sleep routine that works for you.
If possible, work with weight-inclusive healthcare providers!
For more support, we offer a 3-part masterclass on intuitive eating to help you improve your relationship with food, your body, and movement.
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