Weight Bias and Stigma: Ever Present and Challenging

At FNCE yesterday, weight bias was very much on the minds of 1,401 participants. That’s how many nutrition professionals tuned into the hour-long session we moderated. Colleen Tewksbury, Kellene Isom, and Rebecca Pearl offered impressive insights on challenging weight bias.

Clearly, weight bias is all around us. In fact, a new study finds that 57 percent of a large sample of adults report having experienced weight stigma. Worse yet, 24 percent reported high levels of self-stigma. Because it is so prevalent, weight bias is a challenging problem to confront.

Most Adults Experience It

The new study appears in Obesity Research & Clinical Practice. April Prunty and colleagues recruited 3,821 adults of any weight to participate in a 17-minute survey online. Not only is weight stigma common, but people of all body sizes experience it. Thus, we are left wondering why empathy would not kick in to discourage people from expressing this noxious bias. At some point in their life, most people have been made to feel bad about their body size.

Even more troubling is the finding that one in every four persons has taken that stigma to heart. Self-stigma about weight harms a person’s health.

Widely Divergent Views

These are polarized times and it seems that bias is something that evokes diverging viewpoints. As we presented on weight bias at FNCE, those diverging viewpoints were evident in the questions that arose. One questioner asked:

“Using the term ‘obesity,’ which continues to be done in this presentation, is also very stigmatizing. How can professionals be learning if we are not demonstrating ways to change this critical language?”

Another questioner presented a contrast:

“There seem to be two schools of thought in reducing weight stigma. One is to highlight that obesity is a medical condition and not a behavioral issue as you all have pointed out. The other is to view obesity as not a problem at all (such as in the HAES community). What are you thoughts on this second school of thought?”

Dr. Pearl went right to the heart of these questions during the live Q&A:

“I think with both of these questions, it comes down to patient-centered care and what the patient prefers. There is a range of different approaches that clinicians bring and also, a range of different patient needs. When patients have certain kinds of medical conditions that an obesity care model is appropriate for, then clinicians don’t need to shy away from talking about that.

“In terms of language, I recommend asking patients what they prefer.”

Simply said, providers and patients may have a range of different views on the very personal subject of weight and health. But it is absolutely critical that providers recognize their own biases, set them aside, and put the needs of the patient first.

Click here for the study by Prunty et al and here for slides from the FNCE presentation yesterday.

Large Bather, painting by Raoul Dufy / WikiArt

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October 19, 2020