Weight Bias and Stigma

This post was supposed to go out last Thursday, but Wednesday I got the call that I was getting a niece a bit early (her due date was today) SO all other things went on the back burner including proofreading, editing and sharing this post. She's adorable and happy and big sister likes her most of the time and I'm glad I dedicated my time to being there for my sister... But now I must get back to the last piece of my HAES series (just kidding, I will forever and always post about HAES but this is the last one I intentionally have planned in the foreseeable future).

So to embark on our HAES journey we have to acknowledge that those who are living in a larger body live with a stigma due weight bias. To fully understand, let's define these terms:

Weight Bias: Like any other bias is a judgement particularly made due to their size. This can be an assumption about their lifestyle and habits, their current health, their knowledge or education level, their relationship status, their happiness, their satisfaction with their life or body... This bias can and has infiltrated every inch of our society from our health care, to our schools, to our families, to our own minds. 

Weight Stigma: The result of weight bias leads to unfair treatment, inadequate care, discrimination, and harassment that one might face due to being in a larger body. The bias that results in this stigma can be both external and internal. 

The effects of bias and stigma in multiple subgroups has been linked to poor health outcomes (POC, LGBTQ, Low SES, Mental Illness, etc). Sometimes it can be an internalization of this stigma that prevents someone to get treatment to begin with, however, we must ask what is happening to make them not want to seek proper care? 

Of course, there are some individuals who literally live in a space without access to adequate care or do not have the means to see a health care provider. And that's a problem I hope is fixed in my lifetime (sooner would be great). 

In this instance though, I'm talking about people who choose not to go to the doctors (or perhaps elsewhere) because fear of biased care and treatment based on their or others experienced stigma. 

Then there are the ones who do but their problems are ignored because of this bias:

We're talking about the patient who went in for an earache to be told that they needed to diet.

The prospective gym goer who was immediately told prior to any assessment that they could help them lose the fat.

The new mom who was approached during a target trip to receive unsolicited weight loss advice. (Pro-tip: Stranger or not, just don't give weight loss advice. Weight loss attempts fail 95% of the time, so just don't.)

The one who's experienced some variation of all of the above and just doesn't leave the house anymore.

You may think that these scenarios aren't real. Or that they rarely happen. But they do happen and in my opinion that is enough to want to make a change. 

The fact that these people are human beings,  and in my opinion every human being deserves care, respect, and to be able to live day to day without being ridiculed for something they have no control over, and this should be enough but it isn't and there is even more at stake.

When weight bias infiltrates our healthcare system we misdiagnose. With weight bias we don't see the whole person. We don't listen. We miss important symptoms that in any other individual would be cause for concern.

With this comes high demands and impossible standards. We withhold treatment until weight loss is made or we suggest risky treatment that results are questionable.

We won't do a knee surgery that could improve one's quality of life but we would not hesitate to amputate healthy organs that will certainly have terrifying side effects, including the risk of death.


All of this for the sake of a number that means next to nothing. All of this in hopes of achieving the (is it so glorious?) thin ideal. All of this because our society has a problem, a dangerous fatphobia. 

So how can you challenge weight (and other) bias?

Weight bias is not going to go away over night. It will likely be around for a very long time. It's ingrained in us and our society, but we can take steps to challenge it and make efforts to contribute to a shift.

  • Start with your own bias
    • Notice when initial thoughts about someone pops up and question where they come from. If it's an assumption-it was probably learned.
    • We may never be able to completely irradicate these thoughts but we can acknowledge that they are untrue, that they don't match our values, and move forward with compassion for everyone.
    • Start shifting your language. Being fat, POC, disabled, LGBTQ or any other group is not a bad thing. Because it is how someone identifies it's important not use any of these labels as a put down or used negatively in any way. Apply this to chat with others and our own self talk.
    • Vary what you see. If you use social media make sure who and what you're following provides a diverse representation. Our world is not one size, color, or gender. Our feeds should better represent that.
    • If you have children do your best to show them role models and heroes come varied too.
  • Take note if places you go are accessible to all bodies (why stop at larger bodies?)
    • Do they offer seating without arm rests that would be comfortable and supportive for all bodies
    • Is it handicapped accessible
    • Is it inviting to all persons
    • Do they use appropriate languages
  • Shop at places that offer a variety of sizes 
    • If you have a favorite shop that doesn't you can always try to reach out and see if they'll offer a variety of sizes
    • In Southern Indiana I love Skirt and Satchel and The Lemon Seed Boutique - the first offers all of their clothes in XS to 3X and the latter has a Plus Size Section
  • Use language that is preferred by the person
    • Some people may enjoy people first language (Person with X)
    • Others may find that their size, disability, or race is a core part of their identity. Let them define it for you. 
    • If you say something wrong, apologize and use it as a learning moment.
  • If you have the energy and passion, share your experiences and what you learn with others. Call people in. Stand up for others who you feel are being treated unfairly.

If you want to practice Health at Every Size definitely look up Linda Bacon and her work, as well as the Association for Size Diversity and Health. If you have any questions or want to discuss this more please feel free to reach out!