Thursday 29 September 2016

Obesity is our last great prejudice

In 2016, it's not acceptable to discriminate against nationality, religion or sexuality, but weight is still an issue

Mike Gibney

Published 29/05/2016 | 02:30

'This prejudice extends to the health care industry where some doctors, nurses, dietitians and physiotherapists display an entirely different attitude to the overweight and obese than they do to lean patients. Doctors simply cannot hack obesity'
'This prejudice extends to the health care industry where some doctors, nurses, dietitians and physiotherapists display an entirely different attitude to the overweight and obese than they do to lean patients. Doctors simply cannot hack obesity'

Over the years, we have faced up to many of our national prejudices involving ethnicity, sexuality, religion, suicide and more besides. There is one prejudice that is rarely addressed and one that affects a very large proportion of our children and adult population. It is the stigmatisation of fatness.

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Even nutritionists are not immune to such prejudice either. I was recently at a self-service restaurant in an international airport when a member of our group slammed down their tray muttering under their breath. When asked what bothered them, they commented: "That stupid fat woman, with layers of chips and other fatty foods and of course the token can of diet fizz, spent an age rummaging in her untidy bag for her purse and then proceeded to sift through endless coins to pay her flaming bill. So annoying was that fat woman." Spoken like a true bigot.

My colleague hit on several of the typical fat bigot buttons. The fat lady was stupid, she ate badly, she was untidy and, altogether, she was not very 'with it' as they say. At no stage did my colleague note that because the lady was fat she had a higher than average energy requirement and needed more food to maintain her weight.

It didn't dawn on my colleague that the lady in question might have spent a week in the company of someone as intolerant as my friend and was delighted to be free to let loose at the airport. Maybe she was embarking on a sad trip, or maybe she didn't like flying and also maybe she lived in a jurisdiction with a different currency and wanted to get rid of as much change as possible.

No, my friend operated a System One mindless reaction to the fat lady. Their reaction is absolutely ubiquitous in society - even from a very young age.

Just over 50 years ago a study was published exploring the attitudes of school children to obesity. The study was repeated in 2003. The school-goers were shown six drawings of children of similar height, similar clothes and similar features in general. They differed, however, in one respect. One drawing was of a healthy child with no disfigurement or obvious impediment. Another depicted an obese child. The remaining four depicted children with some level of physical impairment. One was in a wheelchair, another with a brace on their left leg. One had their left hand missing and finally, one had a facial disfigurement. Of all the pictures shown, the drawing of the obese child ranked worst, both for boys and girls.

The rankings were more or less the same in 1961 as they were in 2003. This very clear and persistent bias against the obese in children as young as 10 or 12, emanates from parents, schools, the media, and just about every facet of society.

This prejudice extends to the health care industry where some doctors, nurses, dietitians and physiotherapists display an entirely different attitude to the overweight and obese than they do to lean patients. Doctors simply cannot hack obesity.

Many studies of physicians' attitude to the obese elicit the following descriptive adjectives: poor hygiene, noncompliance, dishonesty, poor self-control, lazy, lacking will power and so on. Almost 90pc believed that obesity was a form of compensation due to lack of love or attention and 70pc attributed obesity to emotional problems. Nurses didn't fare too well either. One third of nurses in one study would prefer not to care for an obese person and, in another, a quarter agreed or agreed strongly that caring for an obese patient repulsed them.

Across industry in general, the overweight and obese are discriminated against in both hiring and in promotion. Greedy, lazy, inquisitive, deceitful, slothful, self-important and conceited. These are the common adjectives of obesity stigmatisation and you can throw in dishonest, unreliable, untrustworthy, unpunctual and other such negative attributes.

In Ireland today we do not discriminate on the grounds of religion, nationality, sexuality or income. But we do discriminate against the obese and overweight. We see their problem reflecting their negligence of themselves and really, to us, nobody can help them but themselves.

And yet there are so very few among us that haven't had to shed a few pounds at some stage of our lives.

For the overweight and obese, consider the following: the failure rate in unsupervised weight loss is 95pc in five years. For many struggling with their weight, the future itself is bleak and we add to that by stigmatising their inadequacy in both gaining and in losing weight.

So the next time you are in a supermarket queue and you see an overweight customer ahead of you, remember, nobody wakes up some morning and declares himself or herself committed to getting fat. It happens, stealth-like, significantly through genes and partly through the environment - and possibly through health or mobility issues.

Try asking yourself the question: are they happy and content in their lives for that surely is their concern? Then worry about yourself.

Mike Gibney, Professor of Food and Health UCD, is author of 'Ever Seen A Fat Fox? Human Obesity Explored', published by UCD Press

Sunday Independent

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