Sunday 20 October 2019

Weight and obesity are complex issues and weight-stigma harms, not helps

Research shows that reinforcing common stereotypes regarding people in larger bodies is having a detrimental effect on their mental health and well-being, says Marita Hennessy

PIC: World Obesity Imagebank
PIC: World Obesity Imagebank
(stock image) Photo: PA

Every day, we see stories about weight in the media. How the 'obesity epidemic' is killing us on a grand scale. How childhood obesity is a 'ticking timebomb'. How people should 'take responsibility' for their health/weight and eat less and exercise more. How a certain celebrity lost dramatic amounts of weight on that latest fad diet. How taxing sugary drinks - or now confectionary items - will help the 'war on obesity'. A media personality or lifestyle guru directly calling out, shaming and blaming individuals in larger bodies - often parents, and especially mothers.

You just can't avoid stories like these. And then there are the images accompanying such news items. Images of adults or children in larger bodies feasting on burgers, children in larger bodies playing computer games sitting on a sofa, or a headless person in a larger body dressed in minimal clothing on a beach are commonplace. Such imagery portrays individuals with a higher weight as gluttonous, lazy, lacking willpower, and unworthy of a head or a face. And then you get the comments below the articles - do not go there!

So that's okay, right? This is all newsworthy stuff. It's fair game to call out individuals for living in larger bodies - and parents for 'causing' their children to be larger in size - and to use any and all necessary language and imagery to highlight their wrong-doings and save them from themselves?

That would be a resounding no. Stories and imagery such as this are actually harmful, and research backs this up. When people hold negative weight-related attitudes or beliefs towards people in larger bodies, this is known as weight bias. When expressed as discrimination, stereotyping and social exclusion, this is called weight stigma. Common stereotypes include that people in bigger bodies are lazy, unintelligent, gluttonous or lack self-control. Many people believe that using such shame-inducing tactics to change people's behaviours in terms of weight will 'help' them to lose weight. In fact, the opposite is true.

Weight bias and weight stigma impacts on physical and mental health, and can drive people in larger bodies to engage in behaviours that result in poor nutrition and more sedentary behaviour. It can also cause people in larger bodies to avoid appointments with health professionals and be excluded from society in general. People in larger bodies frequently report experiences of weight bias in health care and often feel disrespected by health professionals.

They also think they will not be taken seriously by health professionals because of their weight, report that their weight is blamed for their medical issues (even if unrelated), and are reluctant to address their weight concerns with providers.

While we don't have statistics for Ireland, research in the US has found that the prevalence of weight discrimination is on par with that of racial discrimination. It also develops from a very young age. Often, however, the greatest source of bias is held by people living in larger bodies themselves, when they internalise weight stigma and blame themselves for their perceived overweight.

Fiona Quigley, PhD Researcher, Ulster University, says: "Living every day in a larger body, you are aware of what people think of you - after all, you are told often enough! You are so happy to go through one day when someone you meet looks at your face and engages with you like a human, rather than constantly looking you up and down. Why is this judgment necessary? I've been of a higher weight since I've been seven years old and have had a lifetime of looks and judgements. But I am still a person, like you. I can't tell what is going on in your head or life, but you think you can judge my life just because of my body? It is relentless and constant talk of the 'obesity crisis' adds to the continuous stress. If I could choose to have a smaller body, I would. But, for me, it is not a choice and that is what many people don't understand. Obesity is not a choice. It is a condition which makes it very difficult to maintain a lower weight.

"If the media and general public was interested in finding out more about this and understanding the facts, they could easily do this. But facts don't make great headlines. Addressing the drivers of obesity - poverty, health inequalities and our obesogenic environment - is where we all should spend our energy. But no, it is much easier to write shaming headlines than it is to get curious about how we might actually help people."

Weight and obesity are really complex issues. Contrary to popular opinion, it's not as simple as eat less and move more. Weight is determined by many different things, including genetics, biology, the environment and economic factors. A person's weight is 40pc-70pc determined by their genes.

Research on Irish media reporting of obesity is limited, however work by Dr Aoife De Brún and colleagues found that coverage has increased over time. What we don't see enough of in the media is the wider issues around weight and obesity, such as poverty, employment, education and commercial influences. Each and every one of us has a role in ending weight stigma.

 

* Marita Hennessy is currently completing a PhD within the Health Behaviour Change Research Group in the School of Psychology at NUI Galway and is a member of the Health Service Executive's Healthy Weight for Children Working Group, the Irish Heart Foundation Nutrition Council, and the Association for the Study of Obesity on the island of Ireland Committee (Communications Lead).

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