Fat Shaming

Ever heard that anecdote about ‘that friend’ who was constantly bullied about being fat in high school but eventually pulled it together, started hitting the gym and now is in great shape, has a supremely attractive partner, and is winning at life all around? It’s a great story, where an underdog undergoes hard times and comes out on top. If you talk to the now-successful high school loser, you might hear them say that the bullying is what drove them over the edge. It’s all those taunts that gave them the drive to lose weight and prove everyone wrong. In that way, the bullies may be similar to the abusive personal trainer — harsh, but effective. But how effective is fat shaming — really?

In reality, fat shaming appears to have a negative impact on people. A recent study in the UK found an association between weight discrimination and the likelihood of gaining weight. People who had experienced discrimination were more likely to be heavier, more likely to have larger waist sizes, and more likely to be obese at a 4 year follow up (1). This may be because discrimination is more likely to induce negative attitudes toward exercise and healthy eating than producing the cathartic ‘prove them wrong’ mentality. Qualitative studies suggest that the stigma around being overweight creates a barrier toward participation in healthy activities (2). It’s difficult to go to the gym when most of the people there are healthier, fitter and thinner than you because they constantly remind you of how unhealthy, unfit and fat you are. Overweight people are therefore more likely to turn to easier, less effective ways of losing weight, such as crash diets or homeopathic medicine.

Since obesity is becoming a problem for developing countries as well as high income countries, attitudes toward obesity are very relevant to improving global health. These attitudes differ among countries and socioeconomic groups. For example, in various cultures larger body sizes are traditionally viewed as attractive. However, a study in Samoa found that while adolescents of low socioeconomic status were more likely to regard overweight people as attractive, they were still more likely to rate thinner body types as more attractive on average (3). This suggests that the Western idea of the ideal thin body type may be influencing other countries’ perceptions toward weight.

Because of the rising global prevalence of obesity, these changing attitudes toward weight, and weight discrimination are especially relevant to policies and initiatives targeted at reducing the burden of chronic diseases associated with weight. In South Africa, being overweight is regarded as normal among black women (4). This normalisation presents a particular challenge to encouraging exercise and healthy eating among this group, as they may view their increased body weight as an inevitable part of life.

Fat shaming is currently a problem that is exclusively studied in high income countries. However with changing rates of obesity and overweight in low income countries, attitudes toward obesity may change as well. These attitudes are therefore important in reducing the global burden of weight-related illnesses. Positive approaches rather than negative approaches to improving health outcomes related to obesity are the way to go.

Sky News Interview with Dancer Whitney Thore

References:

1. Jackson SE, Beeken RJ, Wardle J. Perceived weight discrimination and changes in weight, waist circumference, and weight status. Obesity. 2014 Dec 1;22(12):2485–8.
2. Lewis S, Thomas SL, Blood RW, Castle DJ, Hyde J, Komesaroff PA. How do obese individuals perceive and respond to the different types of obesity stigma that they encounter in their daily lives? A qualitative study. Social Science & Medicine. 2011 Nov 30;73(9):1349–56.
3. Swami V, Knight D, Tovée MJ, Davies P, Furnham A. Preferences for female body size in Britain and the South Pacific. Body Image. 2007 Jun 30;4(2):219–23.
4. Okop KJ, Mukumbang FC, Mathole T, Levitt N, Puoane T. Perceptions of body size, obesity threat and the willingness to lose weight among black South African adults: a qualitative study. BMC public health. 2016 Apr 29;16(1):365.