Weight shaming is literally sickening
Stigma against size harms people’s health — both mentally and physically
Lindo Bacon gives a lot of school talks. But one has always stuck with them. Bacon is a writer, speaker and scientist in California. They also are the author of the book Health at Every Size. Most of their school talks are about how to reduce weight stigma — stereotypes or discrimination based on a how much someone weighs.
But after one particular talk, “there was a girl that came and approached me,” Bacon says. “She was a large girl, and she was just in tears.” When Bacon took the girl aside and asked what was wrong, the girl told them that Bacon was at her school because it was National Childhood Obesity Month.
Everywhere the girl walked in school, posters showed large and small bodies side by side, stating that only the smaller body was healthy. “How can they think that it’s promoting good health to tell people, ‘We don’t want anyone to look like you?’” the girl asked. At lunch, the girl’s smaller friends criticized what she ate — even though they were all sitting down to eat the very same lunch.
The result, the girl told Bacon, was that she got bullied for her size even more than usual. Concludes Bacon, “It’s like the adults are giving the kids permission to view fatness as wrong and something that you need to change.” Declaring a National Childhood Obesity Month is intended to make parents and kids aware of the consequences of obesity. But weight is not, by itself, a measure of health. Instead, some kids may end up bullied and teased for their body size as a result of this campaign. In an effort to make students aware, the campaign had made one girl’s problem far worse.
Scientists have shown over and over that bias against larger-bodied people can be harmful. This stigma can cause people to feel depressed. It can also stress their bodies.
This bias can be hard to avoid, despite its known harms. Parents urge larger kids to lose weight or put them on strict diets. Smaller kids bully larger kids. Doctors tell larger-bodied people that their health problems may be due to their size — whether or not it’s true. Government entities may urge people to lose weight. And social media feeds everyone a steady visual stream of beautiful small bodies. The underlying message is that this supposed “ideal” body type is obtainable if you just work out enough and eat the right foods. Yet that may not be true.
In the end, weight stigma is something that people are taught — by their parents, teachers, friends and culture. But it doesn’t have to be this way. We could learn something else instead — that weight is just another physical trait, not something bad or wrong.
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The hate of weight
Doctors and scientists like to put people into categories. They categorize body size based on a body mass index — or BMI. This is a mathematical formula — a person’s weight (or mass) in kilograms, divided by the square of their height in meters. In kids and teens, the math also accounts for their age. People use BMI to categorize individuals as “underweight,” “normal,” “overweight” and “obese.”
Weight and height, however, are not actually measures of health, notes Bacon. “There’s a lot of research that shows that people who are heavier are more likely to have diseases like diabetes and heart disease,” Bacon says. “And if you believe that fat is bad, then you look at the data and you immediately say, ‘Oh, it’s the fat causing it.’” The solution, then, must be for the person to lose weight.
Can I use the word “fat”?
For people with larger bodies, whether that applies to height or weight, “larger body” is often a preferred term. Some people identify as “fat” and have no problem with being called fat. Others view that word (or use it) as an insult. Mary Himmelstein of Kent State University surveyed teens and found there’s no one right answer. Some prefer “curvy,” others “overweight.”
What term should you use? When describing yourself, use whatever word feels more comfortable to you. If you’re describing someone else, ask them what they would prefer — after all, it’s their body. No matter what, no one’s size should ever be used as an insult.
But plenty of larger people are healthy. And just because someone is larger and ill doesn’t mean their size caused their illness. “What we don’t realize is that there could be a lot of explanations for why people who are heavier are more likely to get certain diseases.” What’s more, losing weight isn’t a cure-all.
Though BMI isn’t a good measure of health, more and more people in the United States are classified as “overweight” or “obese.” In 2018, 73.6 percent of adults were categorized as overweight or obese. So were 41.5 percent of children.
With more people weighing more, it might seem like larger bodies should become more acceptable. “There’s this idea that the more exposure we have to people who are different from us, the better our attitudes should become,” says Tessa Charlesworth. When it comes to weight, though, that has not proven true, Charlesworth finds.
She’s a psychologist — someone who studies the mind — at Harvard University in Cambridge, Mass. Charlesworth studies ways in which we might automatically judge someone without thinking about it. Scientists call this implicit bias. To see how people’s biases change over time, Charlesworth uses a set of online tests called an Implicit Association Test. The more people interact with other people of different ages or races, she found, the less bias they have. From 2010 to 2016, she showed, people’s implicit bias against race, skin tone and sexuality fell.
But not for weight. Over that time, people actually showed more bias toward larger-bodied people. Charlesworth and her colleague, Mahzarin Banaji, published their findings in a 2019 issue of Psychological Science.
This bias against size might be fueled by people thinking that weight is something a person can control. But for most people, Charlesworth explains, that just isn’t true. The vast majority of people who diet to lose weight gain it back within a few years. Also, she notes, many people interpret a larger body as “bad and unhealthy.” These people may conclude, she says, that “if you’re fat, you’re sick.”
The weight of stigma
Shaming people for their weight is obviously hurtful. Still, some might try to argue that shame will motivate people to lose weight. In fact, says Janet Tomiyama, it doesn’t. Stigma tends to have the opposite effect, this health psychologist says. Working at the University of California, Los Angeles, she studies how emotions affect physical health.
In one study, Tomiyama worked with her UCLA colleague, Jeffrey M. Hunger, to analyze data on 2,400 teen girls. If by age 14 the girls had been labeled as “too fat”, they were more likely to have a BMI in the “obese” range by the time they reached 19. They also were unhappier with their bodies than girls who had not been labeled “too fat,” the researchers found. Girls labeled “too fat” were more likely to show evidence of eating disorders, too.
Girls in this study suffered from the effects of this weight stigma even if they weren’t larger-bodied at the start of the study. “Regardless of what you actually weigh, if someone stigmatizes you, your risk for [becoming obese] is higher,” Tomiyama says. She and Hunger published their findings in JAMA Pediatrics.
Stigma over one’s weight can also cause stress. It’s something Tomiyama and her colleagues reported in a 2014 study in the journal Obesity. The team invited college-aged women into a room and informed them they had been enrolled for a study on shopping. Then, they told half of these women that they would not fit into the clothing in this study — dishing out weight stigma for science.
Afterward, Tomiyama’s team collected saliva from these women. A stress hormone called cortisol was higher in those who saw themselves as fat — and who had been told they would not fit into the clothing. The rude comments had an effect on both the recruits’ mood — and on the chemistry of their bodies.
“Cortisol has many jobs,” Tomiyama notes. One is “to signal to your body to deposit fat.” And that might be one way that weight stigma could foster weight gain. “You could see this vicious cycle that happens where a person experiences weight stigma [and] that triggers a stress response,” she explains. That stress could then promote weight gain.
Weight stigma does not only affect women and girls. People of every gender can experience it, notes Mary Himmelstein. A social health psychologist at Kent State University in Ohio, she has worked with Tomiyama.
For instance, one 2019 study recruited 1,500 larger bodied men. Himmelstein found that roughly four in every 10 of them had experienced weight stigma. That means men are experiencing weight stigma at the same rate as other genders. She and her colleagues shared their findings in the journal Obesity.
A life in stigma
“People start to learn that fat equals bad between the ages of three and five,” says Virginia Sole-Smith. She’s a journalist and author of a 2018 book, The Eating Instinct. Currently, she is at work on a book called Fat Kid Phobia. Weight stigma, she notes, even shows up in children’s shows such as Peppa Pig. “They talk about daddy pig’s big tummy. And they make fun of him all the time for how much he eats,” she says. “And when he jumps in the pool, there’s a big splash and everyone laughs. It’s horrible.”
When kids go online, she says, it gets worse. “Social media gives kids a constant drip feed of weight stigma,” Sole-Smith says. There are what-I-eat-in-a-day posts, before-and-after-weight-loss posts and so many tips and guidelines for dieting. All of these — whether they are on Instagram, Snapchat or TikTok — suggest that larger bodies are bad. They also suggest and that the right products, diets and routines can forever change people for the better.
Yet not everyone gets the same firehose of fat-shaming, says Charlotte Markey. A psychologist, she works at Rutgers University in Camden, N.J. Her work has focused on middle-school girls and their social-media lives. That research is still underway. But her early data show that what seems to matter is not whether girls have social-media accounts, but how they use them.
“Girls who are using Instagram to follow influencers, celebrities and to watch beauty tutorials … are less satisfied with their own bodies.” Those girls also are more rigid in their ideas of who is beautiful and what people should look like, Markey says.
Who you follow on social media is bound to affect you. It’s called a social comparison — how we measure ourselves against others we see. “It’s also an almost automatic process, like you don’t decide to do it,” Markey says. “You look at this ideal, which is basically completely unattainable,” she says.
In fact, she says, it’s likely that “what you’re looking at is fake because it’s been photoshopped and edited and filtered and everything else. You look at it, and you feel bad. Because you’re not that.”
The internet isn’t the only place that can make people feel bad about their bodies. A lot of weight-teasing starts at home, notes Leah Lessard. At the University of Connecticut in Hartford, she studies how body weight affects the way teens are treated.
Lessard asked more than 2,500 teens whether they were teased at home about their weight. Roughly one in every four (24 percent) said they were. Those teens were more stressed and had lower self-esteem. They also were more likely to use drugs and alcohol as they got older. Lessard shared her findings in the July 2021 Journal of Adolescent Health.
Still, most bullying over weight takes place in school. “From personal experience, that’s where I experienced a lot of weight stigma,” says Sarah Nutter. She studies weight bias and stigma at the University of Victoria in British Columbia, Canada. She also identifies as someone with a larger body.
“We see higher-weight people are attaining lower levels of education,” Nutter says. Some teachers might view teens with larger bodies as poor students. However, she notes, “It’s not that at higher weight, people are less intelligent.” Instead, with bullying, teasing and teachers that see them as lazy, “school perhaps hasn’t been the most welcoming environment.”
A prescription for acceptance
Lessard is now studying how schools might stop weight-based bullying. “In some schools,” she says, “kids with higher weight aren’t getting picked on as much.” She’s trying to learn what is different about these schools.
Diversity appears to help. When students don’t look alike, “it’s harder to stand out,” she says. And where schools are more diverse, she finds there’s less weight-based teasing. Along with Jaana Juvonen of the University of California, Los Angeles, Lessard reported these findings in the July 2020 Journal of School Health.
When it comes to how kids treat each other in the classroom, she says, “teachers set the role and tone.” When teens felt their teachers would help prevent weight-based bullying, larger-bodied kids got better grades, her team reported in the January 2021 School Psychology Quarterly.
And keep in mind that social media doesn’t have to be a negative place, Markey says. It depends on what posts people view. When scientists showed adult women images of larger bodies, the women’s idea of what’s an “ideal body” also got slightly larger, a March 2021 study found. “If people are seeing larger-sized people, then what they think is attractive and what they think they would like to look like changes,” she says. Filling social-media feeds with all types of bodies may help reduce the stigma over larger bodies.
In fact, social media can become a place of acceptance. “Lots of fat kids and fat adults tell me that social media has saved them,” says Sole-Smith. Why? “Because they’ve been able to find support in fat-acceptance communities that wouldn’t be accessible to them in real life.” She notes that activists, journalists and celebrities often use social media now to “call out weight stigma and critique diet culture.”
Parents and teachers should also extend kids a little more trust. Photos of models and celebrities that kids see may be highly edited — and most kids are better than adults at spotting these changes. “They know how to [photo] edit,” Markey notes. “They know probably what’s been edited, or they appreciate that everything’s been edited.”
One promising trend: Charlesworth has found that a bias against weight is already diminishing. In one study, her team looked at people’s implicit bias between 2010 and 2016. More recently, she reviewed implicit bias about weight between 2017 to 2020. “In just those four years, the bias has actually started to decrease by about six percent,” she says. Charlesworth presented her new data in May at the Annual Meeting of the Association for Psychological Science.
People are showing less stigma against others due to race, gender and many other things, notes Nutter. It’s now time for weight stigma to go. After all, she says, if even one stigma is socially acceptable, “we haven’t finished our work yet.”
Correction: The work by Janet Tomiyama and Jeffrey M. Hunger was published in JAMA Pediatrics, not the Journal of Adolescent Health, as originally stated.