What is weight bias and why we need to end it

Research has shown that experiencing weight bias and stigma increases risk of disease and death at a population level.

Photo credit: Canadian Obesity Network

Nearly six million Canadians could be living with obesity. This means that about one in four adults and one in 10 children have experienced, or are experiencing, weight bias or stigma at school, at work or in their own homes.

Ximena Ramos Salas, (PhD '18) and managing director of the Canadian Obesity Network, breaks down what weight bias and stigma is, why addressing it is important and what you can do to help.

How weight bias develops

Weight bias starts young. In 2014, a study was conducted to assess anti-fat views with 85 pre-school aged children. The children were asked to select their preferred playmate from figures of children with different body sizes, disabilities, and conditions. The children were also asked to give positive and negative characteristics to figures that varied in size-thin, average, large-after having short stories read to them.

The majority of children, gave negative attributes to figures of larger bodies and the positive characteristics to thin and average sized figures. When selecting a playmate, only 5.9% of children chose to play with the child in a larger body size, the rest opted for average or thin playmates.

Children are always listening and learn from their own personal environments. Ramos Salas says if you think about children's movies, cartoons or even story books, the majority of evil, goofy, unattractive or unlikeable characters, are usually overweight. These stereotypes and biased attitudes lead to discrimination against people who live in larger bodies or who have obesity.

A key driver of weight bias is the belief that obesity is controllable through individual behaviours. However, we know that obesity is caused by a variety of biological, psycho-social, and environmental factors that are beyond an individuals' behaviours. Simplifying obesity as an issue of "unhealthy diet and lack of exercise" is a key driver of weight bias attitudes and beliefs.

"We live in a society where we don't question this discrimination," explains Ramos Salas. "Fat jokes or fat shaming happens everywhere-even with family and friends. In many cases, we know it's wrong to make jokes about someone's sexuality, race and gender, so why is it okay to make fun of someone about their weight?"

Why addressing weight bias important

"This is a social justice issue," explains Ramos Salas. "If we don't address weight bias we are driving discrimination against people with obesity. This not only impacts that person's individual health, but also population health outcomes by increasing health disparities."

The Canadian Obesity Network has been researching and bringing attention to weight bias and stigma for the last 10 years. Research has shown that experiencing weight bias and stigma increases morbidity and mortality at a population level. But Ramos Salas says that although there is more awareness about weight bias in Canada, there is still a long way to go.

"Weight stigma is a social determinant of health. It's a key issue in public health - we need to start addressing it on a larger scale."

What can you do to help

1. Be aware of it.

"We live in a society that is highly biased against body size being larger and against people living with obesity. The first step is being aware of the issue and understanding it," says Ramos Salas.

Ramos Salas notes that this does not mean pointing fingers at people and accusing them of being bias or stigmatizing. It is simply recognizing that weight bias is pervasive in our society and that we are not immune to it. Weight bias attitudes and stigmatizing behaviours are bad for people's well-being. Weight bias and stigma affects everybody.

2. Shame is not the name of the game.
"There is a pervasive belief in society that if you shame someone they will change their eating and physical activity behaviours," explains Ramos Salas. "This couldn't be further from the truth."

Ramos Salas says that research shows it's the opposite. Shaming does not change behaviour; in fact, it causes worse health outcomes and causes people to avoid health promotion behaviour.

"If someone feels shamed at the gym, they aren't going to go to the gym," says Ramos Salas. "These behaviours are not helpful and it makes the issues worse."

3. When you see it happening, question it and challenge it.
We have all been there. A joke or comment is made that doesn't feel right. Instead of staying quiet, question it and kindly bring it to that person's attention.

"Sometimes all it takes is asking that person if they would make that joke if it was about someone with a disability or the colour of someone's skin," says Ramos Salas. "It provides people with a new perspective and hopefully they realize that jokes like that aren't okay."

Another example? If you are using images in your workplace of people living with obesity consider pulling from the Canadian Obesity Network's open image bank.

"Most times, the media uses images of people living with obesity eating fast food or sitting on a couch," explains Ramos Salas. "This just perpetuates the problem and reinforces the messaging that obesity is a matter of lifestyle."

4. Don't assume you know where the person is at.
Be critical about your assumptions when you see someone who-in your opinion-is carrying excess weight. Stop and think about the assumptions you are making about that person and about their behaviour.

"The person in front of you could be managing their weight and may have just lost 100 pounds" says Ramos Salas. "Or, they could just be living in a larger body size. They could be a marathon runner, for all that matters. You do not know that person, and you cannot assume they need to lose weight or offer advice on how to do so."

Know the terms

Weight bias: an individual's attitudes or beliefs about a person because of their weight.
e.g. That person is so fat. They are clearly lazy, unmotivated and lack willpower.

Weight stigma: the social stereotypes we have about people with obesity and about obesity.
e.g. People with obesity eat unhealthy foods and do not exercise; hence they don't care about their own health.

Weight discrimination: when people act on their own individual biases and the social stereotypes of people with obesity and treat people differently because of their weight.
e.g. Less promotions in the workplace, lower salaries, lower expectations by teachers for children with obesity in school.

Obesity: abnormal or excess fat accumulation that impairs health (WHO definition).
e.g. May contribute to arthritis, diabetes, heart disease, cancer, sleep apnea, high blood pressure, depression, body dissatisfaction, etc.

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