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Weight stigma, also known as weight-based discrimination and weight bias, can have harmful consequences on a person’s social, mental, emotional, and physical health. It is pervasive and systemic, present in healthcare, school, social, and work settings, as well as showing up on transportation, TV and movies, and more.
Weight stigma is a form of oppression; however, body liberation is freedom from this weight–and size-based oppression. Achieving body liberation requires a relational and intersectional approach, including acknowledgment of various forms of discrimination that may prevent body liberation, such as racism, transphobia, ableism, homophobia, sexism, and beyond.
The University of Vermont’s Center for Health and Wellbeing defines body liberation as “the freedom from social and political systems of oppression that designate certain bodies as more worthy, healthy, and desirable than others.”1
Essentially, body liberation asserts that all bodies are worthy of respect and care.
Body liberation is necessary because of systemic and structural weight discrimination and weight stigma, which influence host of other issues like
Weight stigma is also an important example of a determinant of health as well as a form of oppression.
The context of a person’s life determines their health. Determinants of health are the economic, social, physical, emotional, mental, and behavioral factors that influence a person’s health. Common examples include:
Because health is so complex and multi-faceted, we know that blaming people for their bad health is not only inaccurate, but it’s also detrimental. And on the other hand, it’s inappropriate to credit people for their good health, considering so many different influences, many of which are out of their control, affect health status.
Weight stigma is a major determinant of health, given that it can can cause a lower quality of health, mental health issues, stress, disordered eating, and more.And intersectionality matters as well—someone sitting at the intersectional of two or more marginalized identities, such as a Black trans woman, is more likely to experience systemic oppression, which can negatively impact health.
Weight stigma is a form of oppression because it is systemic mistreatment of higher-weight individuals. It’s not an isolated incident that affects various individuals—they are the norm in society and in healthcare settings. They are also perpetuated by complex systems of power, placing the blame for body size and weight on the individual and treating people in larger bodies with bias, discrimination, and stigma. These systems of power create poorer overall health and fewer opportunities for healthcare, housing, and employment of people inhabiting fatness.
Healthism is a societal belief that personal health is the responsibility of the individual and the most important pursuit in life, beyond mental health and well-being. Healthism ignores the many determinants of health a person experiences—such as systematic issues like oppression and biopsychosocial factors like genetics and pollution. Healthism situates the problem of health and disease at the level of the individual, which is incredibly stigmatizing. This cultural attitude is directly connected to:
Weight stigma can present in many different ways, in a variety of settings. Weight bias in medical settings could look like:
In childhood, weight stigma often presents as persistent teasing and bullying. And peers aren’t the only ones perpetuating weight bias—teachers, especially physical education teachers, are guilty, too.
Weight stigma often shows up in occupational settings, as well. People living in larger bodies may experience fewer promotions, harsher disciplinary actions, and lower salaries than their thin peers.
Interpersonal relationships are also some of the most prevalent sources of weight bias, with family members, spouses, and close friends frequently making harmful and stigmatizing comments, such as how much weight someone has gained, how someone looks on TV, comments about what someone is choosing to eat, and suggestions that perpetuate diet culture, healthism, and disordered eating.
The one unifying facet of weight discrimination is that it is ongoing for life, across many different settings and situations.
Weight bias and weight-based discrimination can cause a host of harmful effects, including:2,3,4,5
Many people living in larger bodies report using food to cope with the weight stigma they experience, while others report refusing to diet as a a response to weight bias they experience in medical settings.2
The profound stress caused by weight stigma can lead to physiological reactivity, such as elevating blood pressure, increased cortisol levels, and C-reactive proteins.5
This stress can also affect physical activity and eating behaviors, such as:5
Weight discrimination can also lead to various healthcare consequences, such as:5
Weight stigma is a type of oppression, which means it is chronic and ongoing, causing significant psychological stress. Every day, people living in larger bodies are exposed to micro aggressions, fatphobia, shame, bullying, exclusion, and lack of mental and physical healthcare. This chronic form of discrimination is an example of trauma, which can lead to post-traumatic stress disorder (PTSD), specifically complex PTSD.6
While many people may think of trauma as a one-time terrifying event, such as sexual assault, witnessing death, or experiencing a life-threatening accident, many types of trauma are ongoing. Weight stigma causes chronic shame that undermines a person’s sense of self, especially when important people like caretakers, loved ones, and healthcare professionals partake in weight discrimination.
Intaking an intersectional approach, it’s important to note that the more co-occurring stigma and discrimination a person experiences, the more trauma is entrenched. So, someone who experiences weight stigma as well as other forms of discrimination, such as racism, homophobia, and ableism, may experience more cumulative trauma.
When trying to move toward body liberation for all, it’s vital that we shift our approach from weight-normative to weight-inclusive. Weight-normative emphasizes weight loss as a main form of healthcare. Someone living in a larger body may go to the doctor for the flu and leave with a diet recommendation. It’s not only unhelpful, but it’s stigmatizing and demotivates people to go to the doctor. Research shows that a weight-normative approach is not effective for most people due to:7
Meanwhile, a weight-inclusive approach emphasizes viewing wellness as multi-faceted, while also aiming to improve healthcare access and decrease weight stigma.
In understanding the oppression, stigma, and trauma of weight discrimination, treatment providers can help work toward body liberation while treating their patients. Here are some ways to fight weight stigma and take a weight-inclusive approach:
Systemic change doesn’t happen overnight—instead, we have to do the small things in our daily lives that can wind up making a difference and contributing to body liberation.