I know, for a lot of people, that ‘holidays’ do not really start until November. But on the spectrum of eating disorders and weight stigma, I think we need a new calendar.
Seasons for Everything
In that calendar, the seasons would look something like this:
‘New Year, New You’ Shame – from the overwhelming ads about a ‘reset,’ diet and exercise ads, and all of the nonsense that says that we will gain a ton of weight over the winter if we are not careful.
Then you have a dose of Relationship Uncertainty in February and, for students, a run up to Spring Break Panic (especially if they are going to a beach and/or wearing a bathing suit with their ‘pasty’ skin).
This is usually followed with some flavor of Easter Freak Out (since it is a family event for many, and the first big one of the year, coupled with Lent). For students, again, this leads to Finals Freak Out, then the dreaded Summer Pressure. After all, we all need to be ‘beach ready,’ right?
This lasts through August, when we then get the Back To School Shopping Mania, with all the pressure to present a certain way.
Then the Halloween Costume Crisis – peer pressure into a ‘sexy’ something, or funny costume this year?
Finally, Holiday Anxiety starts, with another dose of Finals Freak Out, Relationship Uncertainty (this time focused on family events and various parties, especially New Years Eve) and the inevitable Guilt & Shame Spiral that happens sometime in there.
Oh, and I forgot the whole Seasonal Affective Disorder (SAD) issue, coupled with rising depression and suicidality in the winter and especially around holidays.
Doesn’t that all sound like fun?
Last week, I gave a presentation to a group of providers on weight bias and stigma. And no one really had a lot of questions – the moderator reported that this was because everyone was stunned and overwhelmed by the information presented. We covered weight bias & stigma, the top 6 places we see that, and how not to reinforce it (especially over the holidays). So here are some highlights:
First up, what is bias?
A bias is any belief that we have about something – they are neutral in and of themselves. But we tend to charge them emotionally. We reinforce them in a variety of ways. And we usually do not examine them much.
What is weight bias & weight stigma?
Weight stigma is that bias in action. For instance, we almost all hold the belief that it is better to be thin than to be fat. Have you ever thought about why?
Why are they stigmatizing? Well, they start off with that assumption, and add on to it that you will like yourself better if you are thinner, if you are trying to lose weight, and that the act of losing weight is a positive. In fact, we can all think of instances where this is a bad thing (cancer, anorexia, failure to thrive, etc.). The saying ‘you can never be too thin or too rich’ was originally referring to carburetors, not people – apparently it was Truman Capote who said it first on a talk show in 1958. It was then picked up by the Duchess of Windsor (late 60’s) and Joan Rivers (early 80’s) – it was kind of akin to ‘let them eat cake’ and seen as an elitist view for socialites, not real people. Somehow, we have adapted it, even though neither thinness or wealth seem to determine happiness.
Here are some infographics on the effects of Weight Bias on Adults, In Different Racial and Ethnic Populations, and with Kids, if you want to look at all the stats.
Weight stigma tends to come up in certain places:
Healthcare –
Weight bias in healthcare is alive and well, and in the same study, providers are reported to spend 29% less time with people who experience obesity than those that are a ‘normal’ weight. Even though BMI does not meet most scientific or statistical standards, it is still used to make diagnoses and as part of required insurance information.
Anyone else think it is just the insurance lobbyists making it harder to access care?
Health At Every SizeⓇ (HAES)- has a great video called Poodle Science that explains some of this background.
Diet/Exercise Culture –
The way we think about diet and exercise is unbelievably skewed. Since 95% of diets fail, we have to ask ourselves – are we encouraging people to develop eating disorders with all of the 1000 diets that have been promoted in the last 100 years? It is an industry that pulls in over $60 billion a year – if you cannot think of where you have seen it, you must not be participating much in the world.
Fat Talk/Negative Body Image/Negative Food Talk –
Can food be an addiction? Are there good foods and bad foods? How do you talk about your body?
By the time kids hit school, they have been exposed to diet culture, and start talking about their food and their bodies with this stigma in mind. 40% of kids who are bullied report that it is weight related. 90% of adults believe weight bias exists – which probably means they have seen it, heard it, and said it themselves without even realizing. It is kind of a hard thing to get away from.
Media & Social Media –
This is, obviously, linked to the others, but media and social media are full of negative weight bias. Most of us are aware of it, but do not necessarily realize the extent and potential harm that this causes.
Family/Friends –
72% of respondents said they have experienced weight bias from family members!
What to do instead
First, take the Implicit Attitudes Test on weight (and any of the others) at harvard.edu/implicit.
Next, think about your own views about weight, obesity, and your own body.
Last, think about how you put that out into the world.
So about that calendar I mentioned – the most important thing you can do, that you have control over, is to assess your own bias. This can be towards yourself and others. You have the power to change the messages you send out into the world, to change your own social media feed, and to contribute in positive ways.
I am sure we will talk about it more…