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Weight stigma is a pervasive and challenging issue that may be just as dangerous as it is misunderstood. That’s why Dr. Wendy Oliver-Pyatt and Chevese Turner founded Weight Stigma Awareness Week.
An activist and advocate with more than 20 years of experience in eating disorder research, Turner has worked tirelessly over the years to change the way these conditions are viewed and treated.
Through her work with the Binge Eating Disorder Association (BEDA), which she founded in 2008, and the National Eating Disorders Association (NEDA), which merged with BEDA in 2018, she’s brought positive change and awareness around the interlocking issues of eating disorders, discrimination, weight stigma, racism, and more.
Oliver-Pyatt has more than 25 years on the clinical side of eating disorder treatment. Throughout that time, she’s developed five different treatment programs for the conditions, incorporating the vital psychotherapeutic, behavioral, and medical needs unique to eating disorder patients. She is also a co-founder of Within Health, a pioneering virtual treatment program for eating disorders.
Together, the women hope to raise even more awareness around the truth of eating disorders, including how weight stigma works to power these harmful conditions.
Weight stigma is an often invisible phenomenon involving people's preconceived ideas about people in larger bodies. Among other damaging perceptions, weight stigma often manifests as ideas that these people are:
These notions can be overt or subconscious, but in either case, they impact how people think about those in larger bodies and how they treat them.
Turner mentions that weight stigma also has racist roots, used as a way for European women to hold themselves as “morally superior” to enslaved Africans, who tended to have larger bodies.
Weight stigma can be difficult to identify because, as Oliver-Pyatt explains, it’s socially sanctioned. People in larger bodies are often encouraged to lose weight regardless of their current health status, even though health and weight are not directly related.
Often, this encouragement comes from trusted or authoritative sources, including:
Aside from unnecessary calls to lose weight or change one’s body size or shape, weight stigma can also manifest as bullying and discrimination, even from healthcare professionals or treatment providers.
Weight stigma can be extremely damaging, having a negative impact in a number of areas.
Through her work with BEDA, Turner noticed how weight stigma particularly impacted people with binge eating disorder (BED). The issue, she says, took much longer to be understood as a “full-blown” eating disorder, as researchers thought that designation would be equivalent to “glorifying obesity and pathologizing gluttony.”
She says researchers couldn’t understand the idea that people in larger bodies could also participate in restrictive eating patterns, as many people with BED do. (It’s often the restriction that leads to the binges.) Rather than research real ways to address the issue, doctors simply recommended patients with BED lose weight, which has been found to be physically, mentally, and emotionally harmful in its own way.
“It’s hard to get researchers to understand that prescribing weight loss for an eating disorder is like prescribing an eating disorder to treat an eating disorder,” she says.
Oliver-Pyatt adds that insurance companies still don’t take BED “that seriously,” thanks to internalized anti-fat bias and views influenced by weight stigma.
Unfortunately, one of the most prevalent settings for weight stigma is the healthcare community. Facing discrimination and anti-fat attitudes in these environments can be especially damaging, as they’re places people go in search of guidance and treatment.
Oliver-Pyatt says this may come down to, among other things, the way restriction and weight loss are viewed compared to the type of dysregulation involved in binge eating disorders. Restriction, she says, elicits more of a caregiving response, while dysregulation is often met with more moral judgment.
The result can be the type of cold and thoughtless “treatment” recommendations for people with BED and people in larger bodies, including intensive, bootcamp-like workout regimens and calorie-restrictive diet plans that can actually trigger more binging.
This can lead to someone feeling like they’re “failing” at a treatment that’s ultimately inappropriate for their condition, which can bring on even more physical, mental, and emotional trauma. It can also make people in larger bodies more reluctant to go to the doctor for any reason.
Weight stigma is especially insidious because of all the ways it hides in plain sight. This includes everything from peoples’ behaviors, expectations, and attitudes to the physical environment itself.
Both women noted that many settings, including treatment centers or doctors’ offices, are not designed with inclusivity in mind. Chairs that are big enough to be comfortable for all bodies was just one example of this invisible stigma.
“People just want access to things that feel normal,” Oliver-Pyatt says. “They want access to love, access to acceptance. They don’t want to be punished just for being who they naturally are.”
All of these reasons provide ample motivation for raising awareness around weight stigma and its many negative impacts on both individuals and society at large.
According to the women, even healthcare workers continue to get things wrong due in part to the effects of weight stigma.
Assuming everyone with binge eating disorder is in a larger body, for example, can blind physicians and researchers to the fact that people in all body sizes struggle with this condition and continue to impact research and recommendations around the disorder.
“They still don’t understand their own diagnosis,” Turner says of BED researchers. “They continue to research it but ask the wrong questions.”
Oliver-Pyatt adds that most people don’t have appropriate language to describe weight stigma, which can lead to moral blind spots. Giving the average person an idea of the issue can help them better understand and address it.
Weight Stigma Awareness Week provides the opportunity to open up this meaningful conversation. It’s one of the biggest reasons Turner and Oliver-Pyatt thought the idea was beneficial.
Weight stigma can be extremely traumatizing, and even healthcare workers who struggle with these biases can unwittingly inflict harm. In many cases, people don’t realize they’re even expressing these views or behaviors, which is why awareness is essential.
But, as both women stress, education and appropriate resources are out there. Learning more about weight stigma and talking about it—and its harmful effects—more openly can be the first step toward creating a more aware and tolerant world.