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Obesity discrimination

Fattertainment making obesity discrimination increasingly common

The media is not the only place where obesity discrimination occurs, healthcare professionals, thanks to a lack of training in schools, are among the worst perpetrators

According to researchers at University of Alberta-based Obesity Canada, “Fattertainment”, discriminatory trend in media towards people who are overweight or have obesity, is a growing trend that goes unchecked.

The study led by Ximena Ramos Salas, a managing director of University of Alberta-based Obesity Canada, a national registered charity dedicated to reducing weight bias, explained that weight bias is an individual's attitudes or beliefs about a person because of their weight, for example, ‘That person is so fat. They are clearly lazy and unmotivated and lack willpower’.

Ximena Ramos Salas (Credit: Virginia Quist)

"When we extrapolate from many US-based studies, it's clear that weight bias is as common, if not more common than racism," she said. "And media isn't the only place where obesity discrimination occurs. In fact, healthcare professionals, thanks to a lack of training in schools, are among the worst perpetrators."

Ramos Salas and colleagues at Obesity Canada claim weight bias has been the single most significant obstacle they've faced in trying to develop a comprehensive national strategy for obesity prevention and management for the last 10 years. Her PhD research also showed that the public health system forms policies that may have negative consequences for people living with obesity, who, in turn, find public health messaging unhelpful and stigmatizing.

"Healthcare professionals and society in general need to recognise that obesity, defined by the World Health Organization as abnormal or excess fat accumulation that impairs health, is a chronic health problem, not a self-inflicted lifestyle choice," explained Ramos Salas.

She added that not everyone who lives in a larger body has obesity, and the idea that we categorise people based on their size as healthy or unhealthy is not accurate.

"However, for those who are living with obesity, there isn't a cure. It's a disease that these people will live with forever, so the key is, how can we help them manage their chronic disease like we would any other chronic disease, such as hypertension or cancer, and how can we make sure they're not discriminated against?"

She believes the first step is to raise awareness around the fact that many factors contribute to obesity beyond diet and exercise.

"Not everyone will develop obesity for the same reasons, and when we make assumptions about lifestyle choices that aren't true, the consequences are quite damaging. We know from population-based health studies that experiencing weight bias and discrimination can cause psychological problems such as negative self-esteem, lack of body confidence and stress," said Ramos Salas.

In turn, that can cause avoidance of health-promoting behaviour. For example, people living with obesity may avoid going to the gym or seeing their doctor for fear of being shamed and blamed, she explained, adding "stigmatisation and shaming only increases health disparities."

It can also increase social disparities. Ramos Salas highlighted research showing that children in educational settings who experience weight bias from teachers also encounter lower expectations from teachers.

"That has ramifications for social development, learning and future socio-economic status," she said. "A common concern is that if we accept body diversity, we are promoting obesity, but that's not true," added Ramos Salas.

Accepting someone with a larger body requires us to embrace the fact that everyone comes in different shapes and sizes, and that as long as people who have larger bodies do not have health issues, they don't need to lose weight, she said.

"In fact, helping people who have obesity isn't necessarily about weight loss either, but tackling other ways to improve their health and well-being," she said. "Certainly, making people feel bad about their body is not helpful. We need to make them feel accepted and accommodated, whether that's making sure kids at school have big enough seats or making sure there are MRIs big enough to fit people with obesity in hospitals."

She added that what's at stake is not only a person's individual health, but also population health outcomes.

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