I'm sure we've all heard it before; the commenting on people's weight as though a weight gain automatically means someone became "less healthy," and weight loss means someone became "healthier." This is an example of weight stigma and weight bias, and dietitians have the opportunity to advocate against them in a very meaningful way.
Weight stigma refers to the stereotypes and misconceptions about overweight and obesity present in our society. Weight bias refers to viewing overweight and obesity in a negative light. These can mean viewing individuals with overweight or obesity as "lazy," "unmotivated," or "lacking self-control." When so much of society collectively believes these ideas, it has very damaging effects on the individuals facing this prejudice.
According to World Obesity, weight stigma has been shown to:
Reduce students' acceptance to higher education programs and reduce the financial support received;
Hinder employees' access to career counseling, interviews/hiring, salary promotions, and subject them to harsher disciplinary actions and contract termination rates;
Generate the most harmful stigmatisations in personal relationships with spouses/partners, parents, siblings, friends;
Hinder relationships with medical professionals;
Underrepresent overweight and obesity in the media and overwhelmingly target individuals for weight loss products.
To further touch on the impact of weight stigma/bias in the media, I want to share a recent observation of mine. In completing some personal projects, I have been searching for inclusive photos of individuals of all shapes and sizes. However, what I've frequently found is pictures of individuals gorging on junk food, having a shameful look on their faces, or intensely exercising, as if that's all that individuals with overweight or obesity know how to do or should be doing.
To further this point, in this infographic, Obesity Canada reports various effects of weight discrimination specific to Canadian population. They found that elementary school children with obesity have a 63% higher chance of being bullied; that 54% of adults with obesity report stigmatization from coworkers; and 64% experience weight bias from healthcare professionals.
As an example in dietetic practice in particular, what comes immediately to my mind is the need for assessing of sarcopenic obesity in older adults. In this article examining the Canadian Longitudinal Study of Aging, Purcell et al. (2021) suspect the prevalence of sarcopenic obesity ranges up to 85% in males and up to 80% in females depending on the measure of body composition. This makes it incredibly important to always complete nutrition-focused physical exams, for example.
Moreover, in this article, Tomiyama et al. (2018) conclude that weight stigma is more likely to drive weight gain in our society, so we must bring awareness to the prevalence of the negative ideologies associated with overweight and obesity. With this, they propose that the most effective approaches for ending weight discrimination is to change the behaviours of those who participate in it, such as healthcare teams. If we have open discussions with healthcare providers about the harm in propelling weight discrimination through "anti-fat" bias, we can provide better care for those with overweight and obesity.
To conclude, you may have seen the body positivity movement that is gaining traction in the media, especially related to Intuitive Eating and the Healthy At Every Size approach. This is an incredible start to ending the prejudice, but I'm sure you can see why dietitians have an incredibly important role to play in preventing the continuous spread of the misconceptions related to overweight and obesity. We need to be active participants in the healthcare and public health sectors (as well as in our personal lives) to address the negative effects of weight discrimination and halt the misinformation being spread about overweight and obesity.
-Justine Chriqui, McGill Dietetics Graduate Student
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