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Some biases around weight have become so deeply ingrained in society that they’ve almost become invisible—that is, for anyone who doesn’t experience them.
The rise of diet culture has made issues like weight stigma, and the fat shaming that results from it, all too common. In fact, these ideas have been so prevalent for so long, many people may not even realize they’re expressing anti-fat attitudes. But the behavior can have real—and harmful—effects on those it’s directed toward.
Before people can work on embracing change, they first have to understand what needs to change. Luckily, awareness around weight discrimination, anti-fat bias, and fat shaming are increasing, along with strategies for recognizing and changing these harmful behaviors and attitudes.
Fat shaming, anti-fat bias, and weight bias are closely related issues that revolve around people’s negative attitudes and actions toward body shape, size, and weight. They can manifest as negative thoughts about or attitudes toward other people or present as internalized self-criticism over one’s own weight or body shape.1
Technically, the terms are defined as:
Fat shaming: The act or practice of subjecting someone to mockery or criticism, based on their weight or size.10
Anti-fat bias: Discrimination against someone based on their weight or the perception of them being "fat."11
Weight bias: Different treatment of someone based on their body weight.5
In reality, of course, these situations can look many different ways.
Fat shaming can come even from trusted sources, like doctors, who may rely on the faulty body mass index (BMI) measurement to judge someone's overall health and pressure them into losing weight.
Medical professionals may also perpetuate anti-fat bias or weight bias. A patient may visit a clinic presenting genuine symptoms of an unrelated condition, but these may be ignored or minimized, with a doctor insisting weight loss is the best or only solution, even if this isn't the case.
But sadly, these attitudes can—and do—come from everywhere, especially in the age of social media, where entire "brands" and platforms are built around these unhelpful ideas.
How prevalent is fat shaming?
Due to the widespread adoption of diet culture, many people have experienced weight-related discrimination, bias, or shaming.
One study, conducted in Europe, found that anywhere from 18.7% to 38% of overweight or obese people (as considered by the study) have experienced weight stigma. These attitudes reportedly came from a multitude of sources, including employers, educators, the media, health professionals, and even family members and friends.1
Weight stigma can come from employers, educators, friends and family, and even health professionals.
Sadly, even school-aged children can not escape these issues. Another study found children who were, by the study, considered "obese" were up to 63% more likely to experience bullying.1
And, in America, those attitudes may be further perpetuated by media consumption, with research indicating that 72% of media images and 77% of videos in the country stigmatize people who are considered fat.1
Fat shaming and obesity
It’s difficult to untangle the idea of fat shaming and obesity. To many, including many researchers, "obesity" is considered a clinical term, due to its use in the body mass index, a tool frequently used in the healthcare world.
BMI is based on the ratio of a person's height to weight, with the resulting calculation used to define someone as "underweight," "normal weight," or "obese," compared to a chart of averages.
At Within, we don't believe BMI is an accurate indicator of health. Learn why.
While long used to dictate everything from public health to personal recommendations, this tool is increasingly being thought of as faulty, as it merely represents one aspect of someone's overall health. BMI also does little if nothing to indicate the amount of body fat in different areas of the body, which makes a bigger difference in overall health and medical recommendations than what the ratio calculates.2
Still, the BMI and its weight classifications are regularly used, despite the word “obesity” having a stigmatizing and pathologizing effect. The frequent use of this term exemplifies how entrenched and pervasive anti-fat bias has become and, when expressed on a wide enough scale, can even contribute to the types of attitudes that lead to “obesity” stigma.1
Consequences of fat shaming
Fat shaming doesn't just feel unpleasant to experience. Studies show that this type of treatment can have very real, and devastating, impacts on mental and physical health.
One recent look at the effects of being fat shamed found that experiencing this type of behavior can have a detrimental impact on psychological health, with fat shaming linked to depression, anxiety, and low self-esteem.5
Those dangers increased once someone internalized the stigma and attitudes, with those who expressed self-criticism related to fat shaming being three times more likely to develop metabolic syndrome, a group of symptoms that raise the odds of experiencing heart disease, stroke, diabetes, and other serious medical complications.5 Other studies have connected internalized weight bias with an increased risk of cardiovascular disease.6
And overall, those who experienced fat shaming were found to be more likely to have poor metabolic health and experience weight gain. The weight gain effect was noted in patients of every size, including those considered "normal weight" or "thin."5
Depression, anxiety, and low self-esteem aren't just detrimental on their own, but often work to underpin eating disorders. And, in fact, research has started to connect weight discrimination, fat shaming, and these unhelpful conditions.3
Largely at play is the stress hormone cortisol, and its corrosive effects on the body and mind. But drops in self-esteem can also lead to drops in self-control, which can play a big role in someone engaging in disordered eating behavior.5,6
Bullying, like the kind experienced by many school-aged children who are perceived to be "obese," has also been connected to the development of eating disorders, including anorexia nervosa (AN) and bulimia nervosa (BN).8
And the pressures of diet culture also likely play a role. Dieting and the pressures to lose weight or achieve a certain body type has long been linked to the development of disordered eating behaviors, specifically those involved in binge eating disorder (BED).12
Assuming someone is unhealthy solely based on their weight is an example of anti-fat bias.1 Weight is not an indicator of overall health, but simply one of many factors that should be considered, alongside genetics, income, living conditions, working conditions, discrimination, oppression, and more.4
And while greater awareness around these ideas and the concept of holistic health are increasing in the healthcare community, many professionals still experience anti-fat bias, whether consciously or otherwise.
In one recent study, 69% of adults considered, by the study, to be "obese" reported experiencing stigmatization from a healthcare professional.1 Alarmingly, another study found that physicians viewed overweight patients as “less self-disciplined,” and “more annoying,” while reporting they felt less desire to help them.7
Aside from feeling more uncomfortable with everything from their overall health to their physical appearance, this type of treatment may also make patients feel less compelled to follow medical advice or return for follow-up appointments.
This can be particularly dangerous for people struggling with an eating disorder, who may feel proper care is inaccessible to them due to the stigma they’ve experienced and may delay treatment. And this, in turn, can lead to life-threatening complications if an eating disorder progresses.
How to combat fat shaming
Thankfully, awareness around the dangers of fat shaming is growing, both in the medical community and beyond.
Clearing out social media feeds
Social media is a big perpetuator of anti-fat attitudes and ideas, along with the idealized body types promoted by diet culture.
While removing anti-fat shaming or stigma from the world at large may be difficult, you can start by clearing out your personalized world—your social media feeds—from harmful content. Any person who regularly uses anti-fat words or imagery or who has bullied you or others in the past is probably best removed or blocked from your feed.
Block or remove anyone from your feed who uses anti-fat words or imagery.
For public accounts, this can be more tricky, as many "brands" and influencers claim they are promoting positive body image while they are actually parroting the beliefs of diet culture. Be wary of those who still only focus on "perfect" looking photos, exclusively show thin or fit bodies, or promote dieting or exercising to achieve a certain body type.
Rather than focusing on positivity, it may be more helpful to look for accounts that promote inclusivity. These social media users will preach ideals of self-love, equality, and the concept that weight is not the sole determinant of health.
Seeking out treatment
It can be extremely difficult for anyone to lay down and stand by boundaries or express their true feelings, especially if they're feeling hurt or struggling with low self-esteem. But there are some types of therapy that focus on helping patients promote their own self-interest and gain confidence in themselves.
Interpersonal psychotherapy (IPT) is used by many people to help them address current interpersonal problems that may be harmful to their mental health, using methods to help bolster life goals and build self-esteem, among other personal improvements.13
But there are many other types of therapy that can help people with these aspects, including acceptance and commitment therapy (ACT), dialectical behavioral therapy (DBT), and cognitive behavioral therapy (CBT).
Learn about remote eating disorder treatment at Within
The Health at Every Size™ (HAES) movement has been gaining momentum among some healthcare providers and in the mainstream. HAES advocates for people of all sizes to have access to high-quality, informed care without being judged or discriminated against.
Instead, the group proposes health as a continuum that varies over time and is influenced by many factors, aside from weight. Other HAES principles include:9
Weight inclusivity
Health enhancement
Eating for well-being
Respectful care
Life-enhancing movement
These principals encourage followers to:9
Accept and respect that bodies come in many shapes and sizes
Reject idealizing or pathologizing specific weights and body shapes
Acknowledge biases and work to end weight discrimination, weight stigma, and weight bias
Practice flexible, individualized eating based on hunger, satiety, nutritional needs, and pleasure
Support health policies that improve and equalize access to information and services
Engage in personal practices that enhance overall well-being and strive to meet individual physical, economic, social, spiritual and emotional needs
Support physical activities that allow people of all sizes, abilities, and interests to engage in enjoyable movement
Help is within reach
At Within, we embrace the idea that every body is worthy of quality, compassionate care, and we understand the devastating effects fat shaming can have on higher weight individuals. If you suspect you or a loved one may be struggling with an eating disorder, please reach out to us today.
Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.
Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.
Fat shaming is defined as the act or practice of subjecting someone to mockery or criticism, based on their weight or size.10 It can have many forms, including outright bullying or more subtle suggestions from friends, family members, or even doctors.
How do I know who's a fat shamer?
In many cases, people who fat shame are very frank about their intentions and opinions. After all, the idea in many cases is to humiliate someone for their body shape or size.
But fat shaming can also be much more subtle.
Doctors who use measurements like BMI or weight alone to insist on a weight loss program or other similar remedies may be fat shaming. And online "brands" or influencers may also be fat shaming if they regularly promote the attainment of a thin or fit body as the ultimate life goal or ideal.
What do I do if I'm being fat shamed?
If you're experiencing fat shaming, you're not alone. Though these behaviors and attitudes may feel hurtful and devastating, there are several ways you can deal with them.
You may want to confront someone who's fat shaming you with information. The Health at Every Size movement has many useful facts and resources you can use to help someone understand why weight isn't the sole marker of someone's health or worth.
Still, changing other peoples' minds is not easy, nor necessarily the best way to spend your energy. The most important thing you can do in the face of this nastiness is to cultivate even more self-love, self-esteem, and self-respect.
Various types of therapy can help in this regard, as well as suggestions from the HEAS movement. But looking in the mirror and truly loving yourself and what you see is the best victory of all over hateful attitudes.
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