When kids grow up in larger bodies

Killam graduate scholar explores how young people experience weight bias

Robert B. Desjardins - 16 October 2019

Most people know that discriminating against individuals because of their weight is wrong. What few realize, says Killam graduate scholar Alexa Ferdinands, is that body shaming may also harm the health of those it targets.

"If a girl goes to the gym and is teased for her body type, she may avoid physical activity in public for the rest of the year," says Ferdinands, a PhD candidate in the Health Promotion and Socio-behavioural Sciences program in the School of Public Health.

"And if a boy is mocked because of his weight, he might cope with his feelings by binge-eating. This has been called the vicious cycle of weight bias, and it carries a whole range of physical, mental and social health consequences."

Recent research, in fact, shows that weight bias -- a term often used to refer to weight-related discrimination, prejudice and stereotypes -- can produce some of the same effects as obesity itself, from heart disease to type 2 diabetes.

That startling fact, she says, is sometimes overlooked in the health care world, where studies tend to examine the effects of obesity alone. And when researchers do develop educational programs targeting the stigma associated with overweight, they often focus specifically on individuals -- striving to change personal attitudes about body types.

That's important work, says Ferdinands. But it doesn't always address the ways that institutions, and society as a whole, condition us to talk and think about weight.

Her PhD project seeks to fill this gap by examining how people's everyday actions and attitudes are shaped by public policies, by the media, and by school curricula. "How," she says, "do these broader forces make us look in the mirror and think negatively about our bodies? How do they lead us to treat someone differently because of the way they look?"

Focusing on the context

To explore these questions, Ferdinands has been interviewing young people between the ages of 15 and 21. Following a method called "institutional ethnography," she investigates how individuals' experiences are shaped by the ways that people in society think and talk about weight -- ideas we often take for granted because they're embedded in institutions and everyday interactions.

"One of the surprising findings so far is that kids' interactions [about weight] with their parents were often more negative than with their peers," Ferdinands says. "While they got teased in school, the thing that had the greatest impact on them was their relationships at home."

This may help to explain why even younger respondents were familiar with the clinical and medical language that adults commonly invoke when discussing body size. "Already at age 15," she notes, "they used terms like 'Body Mass Index' without feeling they had to explain them, because they're just things that everybody knows these days."

These preliminary findings provide a jumping-off point for deeper analysis of the social issues that were important to her respondents. Having completed her interviews, Ferdinands is now leading working groups to gain new insights into the data.

"We hope to develop recommendations for health care providers, educators and parents. We want to explain how young people prefer ideas about weight and body size to be communicated - how to avoid doing it in derogatory ways."

An organic process

Ferdinands' method - a slow, thoughtful, and sometimes unpredictable process - mirrors the path she took to arrive at her research questions.

It began with a sense of dissatisfaction. In her earlier role as a dietitian, she sometimes felt that merely telling people how to eat better didn't fully address their needs in a society where the food environment wasn't supporting healthy choices.

That interest in bigger-picture analysis brought her to study at the University of Alberta's School of Public Health. Working with Dr. Kim Raine, who leads the development of Alberta's annual Nutrition Report Card on Food Environments for Children and Youth, she opted to examine the key indicator of weight bias - and soon became fascinated with the subject.

"I really like the fact that people can understand it, and that it's relevant to everyday life," she says. "That's so important to me, making sure that something tangible comes out of it."

With that in mind, Ferdinands is grateful to the Edmonton Community Foundation, which provided a grant to support her working groups. And she is especially excited about winning a Killam award - an honor that is not just prestigious, but also curiously comforting.

"I think all graduate students have impostor syndrome," she laughs. "And winning the Killam kind of gives you the reassurance that you're doing OK."

Alexa is one of three winners of the 2019 Dorothy J. Killam Memorial Graduate Prize, awarded annually to the most outstanding Killam Memorial Scholarship recipients at the U of A. It was made possible by the Killam Trusts, which are among Canada's largest and most prestigious endowments for scholarly activities. For more on the important role of the Killam bequest at the University of Alberta, see this page.

Alexa's research has also received generous support from the Stollery Children's Hospital Foundation, through the Women's and Children's Health Research Institute (WCHRI). She is, in addition, the recipient of a Vanier Canada Graduate Scholarship.