Weight Stigma and Eating Disorders

Turn on any major news channel reporting on obesity and you will find headless images of obese individuals eating unhealthy foods and wearing clothes too tight for their bodies. Being thin is idealized, and those who do not fit that ideal are frequently subjected to discrimination from a variety of sources including families, schools, workplaces, doctor’s offices, and the media. These messages and beliefs are believed to be contributors to shame, which may be a factor in the development of binge eating disorder. They also complicate the accurate diagnosis of eating disorders and can hinder recovery.

While weight is environmentally influenced, it is largely determined by genetics. Thus, not all bodies can or should aim to achieve the societal ideal. For more information, watch this video:

What is Weight Stigma?

Weight stigma is negative judgment based on weight, shape, and/or size. This type of negative judgment is observed in children as young as three years old. Unfortunately, as children get older these negative beliefs only worsen. Grammar school students believe their overweight peers are lazy, less happy, and less popular. College students believe overweight persons to be lazy, self-indulgent, less attractive, possessed of low self-esteem, and deserving of less attractive partners.

With our society’s focus on achieving the thin or muscular ideal, people who are overweight or obese are commonly believed to be lazy, unmotivated, or indifferent to their health. These negative stereotypes are consistently held by people of all ages, genders, ethnicities and occupations. As a result, weight stigma occurs within the home, at work, at school and within the healthcare system. The belief that obesity is a result of these negative characteristics results in a society that lacks respect for larger individuals and further drives stigmatization.

Even more problematic, obese individuals may feel stigmatized by the professionals they turn to for help. Medical professionals are frequently biased against their overweight patients and have been noted to prescribe weight loss rather than fully address their overweight patient’s true health problems. In addition to negatively affecting health, this bias may lead higher-weight patients to feel ashamed and to avoid medical appointments altogether.

Given that healthcare professionals are the persons obese individuals turn to for trust, hope, affirmation and optimism, these weight biases are extremely concerning. Stigma in the health care office may make it more difficult to seek treatment, broadening health disparities among people who are overweight or obese. Research shows that overweight clients are more likely to avoid routine preventative care and when they do seek health services they may receive compromised care.

Larger individuals may internalize this pervasive stigma and start to believe these negative opinions themselves. Furthermore, individuals who diet but fail to lose weight (or maintain weight loss) might also start to believe society’s stereotypes that their difficulty losing weight is due to internal factors like laziness or lack of willpower. This internalization of negative beliefs can reinforce poor eating habits and reduce exercise motivation.

Weight Stigma and Eating Disorders

Weight StigmaFear of weight gain can drive eating behaviors that end up actually causing weight gain. Weight stigma may also help cause overeating. One recent study demonstrated that self-perceived overweight women who read a weight-stigmatizing news article consumed more high-calorie snack foods compared to overweight women who read a neutral article. Studies also show that the more a person feels stigmatized, the more severe binge eating symptoms they experience. This cycle results in poor psychological functioning, distress, depression, anxiety, and for some individuals, further weight gain. Thus binge eating as a way of coping with stigma may further exacerbate the obese individual’s health.

Weight stigma also affects those with eating disorders. In a recent study, 67% of women with bulimia reported others making negative comments about their weight or body shape. Studies suggest that experiencing others making negative comments or perceiving weight stigma may contribute to the development and/or maintenance of disordered eating. Research also shows a high lifetime prevalence of obesity among individuals with bulimia nervosa and anorexia nervosa. Given our society’s thinness ideal, individuals with eating disorders may engage in behaviors that they perceive will protect them from becoming overweight. Similarly, weight bias or fear of weight gain may contribute to patients, their families and even practitioners not setting weight goals that are sufficient for full recovery from a restrictive eating disorder like anorexia nervosa. Additionally, restrictive eating disorders have been diagnosed in individuals who are not underweight, but these disorders are frequently misdiagnosed among overweight or obese people because of the biased assumption that weight loss in an overweight individual is a good thing and not problematic.

The Health at Every Size (HAES) movement acknowledges weight and size-based stigma, encourages acceptance of all sizes, and promotes pursuing healthy habits for the sake of health, not weight loss. Toolkits focused on standing up to weight stigma are available through the Binge Eating Disorder Association (BEDA) Weight Stigma Awareness Week and through the UCONN Rudd Center.

 

 

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About The Author:

This article was written by Liliana Almeida, a fourth year Clinical Psychology Ph.D. student focusing on eating disorders, weight stigma and obesity. You can reach Liliana through twitter.

Additional Reading:

Healthy Body Images

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Written 2015