The alarming rates of obesity have brought widespread attention to the medical consequences of this public health problem. Often ignored, however, are the social and personal obstacles overweight and obese individuals face.
People who are obese may immediately understand that weight stigma does exist. A clothes shop salesgirl telling you “Sorry, we don’t have big sizes” is enough to feel labelled.
Weight stigma refers to negative attitudes towards a person because they are overweight or obese, such as the stereotype that obese people are “lazy or don’t have willpower”. This can be manifested in various ways, such as verbal comments like name calling, physical bullying, or through aggression such as kicking and pushing.
Many also suffer from relationship victimisation, such as being ignored or avoided, or even sometimes overt discrimination such as not being accepted for a job or promotion.
Experimental studies have found that when a CV is accompanied by a picture of an overweight person (compared to an average weight person), the overweight applicant is rated more negatively and is less likely to be offered the job. There are also physical barriers due to weight, such as medical equipment that is too small for obese patients or seats in public venues and airplanes that do not accommodate obese people. Children who are overweight or obese are especially vulnerable. Simply look at movies and it becomes clear that obese kids are usually the bullied ones. Evidence shows that negative attitudes toward obese children begin as early as three to five years of age. As children grow through school, the attitudes can become worse.
Unfortunately, weight stigma has adverse health effects on people. It is known that adults who experience weight stigmatisation have higher rates of depression and anxiety and may experience social isolation and poorer psychological adjustment. The reaction of people to weight stigma varies. Some react by internalising and accepting negative attitudes against them, which may in turn increase their vulnerability to low self-esteem.
Obesity is not just a lack of willpower but a condition that merits medical attention
Many times obesity is considered by society as a consequence of failure of willpower, putting the onus on the individual person. This, in turn, will perpetuate the belief of failure and has further negative consequences on eating behaviours by interfering with weight loss attempts and leading adults to eat more food in response to stigmatising encounters.
This is further exemplified in cases where people who are overweight due to a medical condition, for example hypothyroidism, are less stigmatised than those who are obese due to more non-medical ‘controllable factors’. Stigma also has implications on physical health, whereby people may avoid attending healthcare services due to bias in medical settings.
Bias and stigma affect the emotional well-being of children. They often internalise negative attitudes and engage in self-blame for the negative social experiences they confront. Adolescents, who are exposed to weight-based teasing, usually have low self-esteem and depression, and overweight teens are more likely to be socially isolated.
Many experts classify obesity as a disease in itself. Looking at it from this point of view will help eliminate the stigma of regarding obesity as the result of a lack of willpower rather than a medical condition.
We are living in an obesogenic environment which supports enhanced eating and a lack of physical activity. To tackle obesity, we need to change our mentality and to make the healthy choice the easier option for everyone. By classifying obesity as a disease, we are admitting that these people need help as much as diabetics or other people with chronic diseases do. Realising this will help reduce the stigma, as obesity is not just a lack of willpower but a condition that merits medical attention.
There are various strategies to deal with weight stigma that need to be adapted to particular situations.
• Become educated on the effects of obesity stigma to help challenge negative attitudes.
• Seek support from people who overcame weight problems and from supportive friends and family members.
• Practise positive self-talk strategies that emphasise self-acceptance and positive self-esteem which will motivate you to act on your weight and change eating practices.
• Be vocal about individual needs and ask people to support you in your needs
• Communicate with people who are perpetuating the weight stigma on you. Make your feelings clear that such remarks are unkind and hurtful. Most people will understand.
• Seek professional support to help you identify effective coping skills to deal with stigma and to replace self-defeating thoughts or self-blame with healthier ways of coping.
One has to remember that a person’s weight says nothing about their intelligence, character or contribution to society. We need to fight obesity, not obese people.
Dr Charmaine Gauci is superintendent of public health.