Addressing Weight Bias
Recently, I had the privilege of attending the Canadian Obesity Summit — a biennial interdisciplinary conference featuring the latest research on obesity medicine. The conference included a “Weight of Living” series where individuals living with obesity courageously shared their experiences. Brenndon, one of the speakers in the series, said something that I have been contemplating since.
“I have always had to make a good second impression because my weight makes the first.”
This statement had quite the impact on me and since hearing Brenndon speak I have been thinking a lot about the phenomenon of “weight bias.” The Canadian Obesity Network defines weight bias as negative stereotyping of individuals living with obesity. Stigma can take many forms including discrimination/harassment, barriers in day-to-day life, and decreased access to health care.
I have been thinking of a patient of mine, a bright, loving and socially engaged 17 year old-young woman. Although most do not get to know her, as she is living with obesity. She has been in tears in my office exhausted from the relentless torture she feels around her weight. How must she feel, constantly judged, ridiculed and often completely ignored? Her weight makes the first impression, most do not give her a chance to make the second.
A pervading belief is that individuals living with obesity bear personal responsibility. The thought is that laziness, poor diet and lack of exercise are the cause and simply addressing these a cure. However we now know that obesity is a chronic disease and it’s causes are multi factorial.
The understanding of obesity as a chronic disease has not taken hold in public discourse. We continue to label those living with obesity as lazy or having a lack of self-control which causes further marginalization and distress. Today’s social media obsessed, selfie culture undoubtedly adds another layer of pressure to those living with excess weight. Never have we been more inundated with messaging around weight loss and advertising promoting an unrealistic body image. This coupled with the pressure to maintain a social media persona can have a significant impact on one’s mental health and sense of well-being.
A few weeks ago I attended a wedding and as the individual preforming the ceremony was getting the congregation ready, he asked us to carve out a two by two space so as to be able to focus on the ceremony. Those “who eat more” were asked to carve out a four by four space. His comment was met with scattered chuckles. The comment was offhand and not meant to offend, I’m sure, but it demonstrated clear example of weight bias. Imagine being a young male in the congregation who has struggled with weight all his life. What he heard was “it’s your fault. You’re fat because you eat too much.” Consider the perspective of someone who has worked very hard to lose weight perhaps in the anticipation of this wedding. What she heard was “you’re still big, and it’s your fault.”
So, how do we work toward changing our perceptions towards obesity? I believe we first need to look within and identify our own personal weight biases. Once they are identified, we can work to address them. Learning about the complexity of obesity can also help us change pervasive attitudes. Finally, my hope is we do not remain silent when witnessing weight bias. Respectfully addressing instances of weight bias (as I have done regarding the wedding comment) and engaging in productive conversation can go a long way to address attitudes and behaviors that need changing.
