Stigmatising language around body weight is one way in which weight stigma shows up in the world. In schools, during interactions with medical and health professionals, at family gatherings and when we are consuming media, to name a few.
Labels such as obese, morbidly obese[1] and weight problem[2] are frequently raised in both research and community circles as phrases that are highly stigmatising and feel like blame statements.[1] There are legitimate reasons for this. Research has shown us that doctors and other health professionals often associate ‘obesity’ with personal attributes such as poor hygiene, reduced will power, dishonesty and reduced intelligence.[3]
Why does the experience of stigma matter? Weight stigma is not just a feeling that exists in isolation. It has real and damaging consequences that can impact one’s experience and access to health.
The literature and experiences of individuals tells us that being a recipient of weight stigma can lead to:
- Disordered eating behaviours[4]
- Psychological distress, including Anxiety and Depression[4]
- Reduced engagement with medical services and health care providers[4]
- Social isolation
- Avoidance of physical activity[4]
- Reduced participation in education amongst children[2]
- Increased mortality risk (early death)[5]
Hold on…aren’t these the sorts of health and wellbeing concerns we want to help liberate individuals from?
By pathologising certain body sizes using stigmatising labels, we are making a lot of assumptions. We are assuming disease where disease may not be present. We are assuming that certain bodies are a problem, often without regard for physical, mental and emotional markers of health. We are assuming that body diversity is not acceptable. We are assuming that living in a larger body is a barrier to enjoying health and longevity when we know that this is largely determined by practicing healthy habits, independent of body weight[6].
This of course can be incredibly hurtful and can understandably bring up feelings of anger. It can also lead to what is known as internalised weight stigma, the process of absorbing and believing negative medical and cultural stereotypes associated with labels such as ‘obesity’ and believing those stereotypes to be true of oneself[4].
So how can we step away from contributing to such suffering?
The research suggests descriptors such as weight, higher BMI and fat have been observed to be received as more neutral and less stigmatising in the research. [1][7] However, we should always consider the individual in front of us when we are in a position where we may be asked to describe their body. We need to be considerate of the lived experience and preferences of the individual and appreciate the reasons for which they may find certain weight/shape-related labels stigmatising.
At the end of the day this conversation is ultimately about respect. Individuals in all bodies deserve the right to be described using language that does not feel like it is loaded with a host of assumptions and judgements.
Although this will certainly not eliminate weight stigma, being mindful and reflective about the language we use and share is an important step forward.
References
[1] Puhl R, Peterson JL, Luedicke J. Motivating or stigmatizing? Public perceptions of weight-related language used by health providers. International journal of obesity. 2013 Apr;37(4):612.
[2] Pont SJ, Puhl R, Cook SR, Slusser W. Stigma experienced by children and adolescents with obesity. Pediatrics. 2017 Dec 1;140(6):e20173034
[3] Puhl RM, Heuer CA. The stigma of Obesity: A Review and Update, Obesity. Rudd Center for Food Policy and Obesity, Yale University. 2009.
[4] World Health Organization. Weight bias and obesity stigma: considerations for the WHO European Region.
[5] Sutin AR, Stephan Y, Terracciano A. Weight discrimination and risk of mortality. Psychological Science. 2015 Nov;26(11):1803-11.
[6] Matheson EM, King DE, Everett CJ. Healthy lifestyle habits and mortality in overweight and obese individuals. The Journal of the American Board of Family Medicine. 2012 Jan 1;25(1):9-15.
[7] Thomas SL, Hyde J, Karunaratne A, Herbert D, Komesaroff PA. Being ‘fat’in today’s world: a qualitative study of the lived experiences of people with obesity in Australia. Health expectations. 2008 Dec;11(4):321-30.
