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Friday, December 11, 2015

Stigma And ‘Fat Shaming’ Can Fuel Depression And Increase Obesity

While it might seem like stigma could motivate someone to lose weight, studies have found it can actually trigger more overeating. (Pixabay)

While it might seem like stigma could motivate someone to lose weight, studies have found it can actually trigger more overeating. (Pixabay)

Two-thirds of American adults are considered overweight or obese, but despite their majority, bias against those with excess weight is common in places like school, the workplace and in the media.

The stigma of obesity, researchers have found, has major implications for mental health, sometimes leading to stress, anxiety and depression. And while some believe stigma may act as a motivation tool for those trying to lose weight, studies have linked it to the increased likelihood of behaviors like binge eating.

In the fifth and final installment of Here & Now‘s series “America on the Scale,” host Jeremy Hobson speaks with Rebecca Puhl, who studies perceptions of obesity and the psychological affects of weight bias. She’s deputy director of the Rudd Center for Food Policy & Obesity at the University of Connecticut.

Interview Highlights

How much of a stigma is there for overweight people?

“We live in a society where there are very negative societal attitudes when it comes to individuals who have obesity, and we’ve been studying this for over 15 years now and we see substantial stigma and discrimination. This is a problem that occurs in many different domains of living, it occurs in the context of employment, in medical facilities, educational institutions, in interpersonal relationships with family members and friends and certainly also in the media.”

On weight discrimination in the employment context

“When we look at employment, we see that weight discrimination happens at virtually every stage of the employment cycle, from getting hired to getting fired. We see inequities in hiring practices where employees who are obese or overweight are much less likely of getting hired even if they have identical or even better qualifications of thinner individuals. And we also see that employees who have obesity are more likely to be fired or terminated from positions because of their weight.”

Why do we have those stereotypes?

“There are a number of reasons why we have this pervasive bias. One is that we live in a culture that has very stringent socio-cultural ideals of thinness. But we also live in a society that tends to oversimplify the causes of obesity. We believe mistakenly that obesity is simply an issue of laziness or willpower. We do not talk about the much more complex contributors to obesity, many of which are beyond personal control. Because the emphasis is often on personal responsibility, this often perpetuates blame and stigma of individuals. We also see very negative media portrayals being communicated about both children and adults who have obesity, so it’s not surprising we see such negative societal attitudes. The other reason why this remains pervasive is that it remains legal to discriminate on the basis of weight. Currently there are no federal laws that prohibit weight based discrimination in the U.S…There’s one state, Michigan enacted a law back in the 1970s, there are also a handful of local jurisdictions across the country that have passed laws, but for the vast majority of people who experience weight discrimination there is no legal recourse.”

What effect does this have on people who are overweight?

“We know from multiple studies that children and adults who experience stigma or bullying or discrimination because of their weight, are vulnerable to a range of negative psychological and physical health consequences. These include things like higher rates of depression and anxiety, low self-esteem, poor body image, even increased suicidal thoughts and behaviors. When it comes to physical health consequences we see that individuals who experience weight discriminations or stigma engage in unhealthy eating behaviors like binge eating or increased food consumption, avoidance of physical activity. One reason it’s important to identify and emphasize this is that there tends to be this societal perception that maybe stigma’s not such a bad thing when it comes to obesity, maybe stigma will somehow motivate people to lose weight or provide them with incentive to lose weight. But when we look at the research on this issue, we see the exact opposite is true, that in fact experiences of weight discrimination or stigma is actually reinforcing obesity and risk of weight gain so it’s actually contributing to this issue.”

Does the language we use contribute to this issue?

“When it comes to language about obesity, there are a lot of different personal preferences that people have. It’s important to identify that there is increasing movement in the field of medicine and public health to be using people-first language with obesity, which involves putting people first rather than labeling them by their disease or disability. This has become common standard for addressing people with different diseases or illnesses. Essentially it involves referring to people who have obesity or are affected by obesity, rather than an obese person.”

What should we say if we want to address someone’s health based on their weight?

“This can be a difficult conversation, and I think it’s helpful to remember that people often already feel shame about body weight and we need to be sensitive and thoughtful if this is a topic you decide to bring up with a family member or friend. We certainly recommend trying to keep the conversation focused on overall health instead of bodyweight, so instead of saying things like ‘I’ve noticed you keep gaining weight’ or ‘you don’t fit into your clothes’ instead indicate that you care about them and are worried about their health. It’s also important to think about how you would want someone to talk about a sensitive topic. Would you appreciate a friend’s advice, or would you find it offensive or uncomfortable? So all of these factors need to be considered.”

What is the solution as a society?

“I think multiple solutions are needed. Certainly we need to have an increased public understanding that obesity is a very complex issue with multiple contributors, many of which are outside personal control, but we also need to shift the conversation more on overall health rather than just the number on the scale. When we look at stigma though, really broad remedies will be needed to shift societal attitude. Some of this will require policy-level remedies, such as laws to prohibit weight discrimination, or strengthening policies in schools and states to protect students from weight-based bullying. We also need to look at the way the media portrays people with obesity and make sure those portrayals are respectful. So there really are a number of remedies that are required in order to effectively address this problem.”

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Robin Young and Jeremy Hobson host Here & Now, a live two-hour production of NPR and WBUR Boston.

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