*Updated October 11, 2014
This blog post is Rated R for adult language due to the serious nature of this issue.
I recently saw a post on Facebook that had an image of overweight/obese children and I found the comments disturbing. So I asked for opinions on my Facebook page yesterday.
As expected, most of the comments were thoughtful and helpful: respectful, reasonable, compassionate and congruent with the scientific literature. Not unexpected, and congruent with most American attitudes on the topic, some people chimed in with this popular attitude: “yeah fuck these stupid fat kids and their stupid irresponsible fat parents! It’s time to wake up, stop sugar coating and start guilt tripping these stupid fat people! WAKE UP STUPID SHEEPLE YOU’RE ALL GOING TO DIE!!!!!!!”
For those that don’t know, the former attitude is helpful, the latter is not.
So I figured I’d share some facts for the few people that are interested in learning more about this topic. One problem however, is that when people are being obnoxious and shaming others, they often don’t realize what they’re doing (cognitive dissonance) and have a profound lack of education on obesity.
WHAT IS FAT SHAMING?
Fat shaming is weight-based discrimination. In practical terms, it’s when you dis someone for being overweight. It’s a socially acceptable form of bigotry that has consequences.
‘Obese individuals are highly stigmatized and face multiple forms of prejudice and discrimination because of their weight (1,2). The prevalence of weight discrimination in the United States has increased by 66% over the past decade (3), and is comparable to rates of racial discrimination, especially among women (4). Weight bias translates into inequities in employment settings, health-care facilities, and educational institutions, often due to widespread negative stereotypes that overweight and obese persons are lazy, unmotivated, lacking in self-discipline, less competent, noncompliant, and sloppy (2,5–7). These stereotypes are prevalent and are rarely challenged in Western society, leaving overweight and obese persons vulnerable to social injustice, unfair treatment, and impaired quality of life as a result of substantial disadvantages and stigma.’
The Stigma of Obesity: A Review and Update
http://www.yaleruddcenter.org/resources/upload/docs/what/bias/WeightBiasStudy.pdf
‘Weight/height discrimination is highly prevalent in American society and increasing at disturbing rates. Its prevalence is relatively close to reported rates of race and age discrimination, but virtually no legal or social sanctions against weight discrimination exist.’
Changes in Perceived Weight Discrimination Among Americans, 1995–1996 Through 2004–2006
http://www.yaleruddcenter.org/resources/upload/docs/news/Obesity-2008.pdf
*‘those who reported experiencing weight discrimination gained more weight than those who did not.’
http://www.sciencedaily.com/releases/2014/09/140910214151.htm
EXAMPLES OF FAT SHAMING
1) Georgia was that special place with the ad using children. The state, like most others, has cut back on physical education, recess and even reduced nutrition programs. Exploiting children to get your bigoted message across makes you an asshole.
2) Some public relations jerks photoshopped children to make them appear larger to promote their misinformed, bigoted agenda.
3) Evolutionary Psychology Professor Geoffrey Miller Fat Shames Students
Although this demonstrated his hypocrisy (he quickly deleted his impulsive tweet, the one shaming obese students for being impulsive), he also demonstrated he is unfamiliar with the science on obesity. This asshole got schooled on Twitter which was kinda funny.
4) Bioethicist says Fat Shaming may Curb Obesity. (Spoiler Alert: It doesn’t)
http://t.today.com/health/fat-shaming-may-curb-obesity-bioethicist-says-1C8095045
5) Doctors Fat Shaming Their Patients
a) Implicit and Explicit Anti-Fat Bias among a Large Sample of Medical Doctors by BMI, Race/Ethnicity and Gender ‘
We conclude that strong implicit and explicit anti-fat bias is as pervasive among MDs as it is among the general public.’
http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0048448
b) Physicians build less rapport with obese patients
‘Our findings raise the concern that low levels of emotional rapport in primary care visits with overweight and obese patients may weaken the patient–physician relationship, diminish patients’ adherence to recommendations, and decrease the effectiveness of behavior change counseling.’
http://onlinelibrary.wiley.com/doi/10.1002/oby.20384/abstract
c) British Doctors will get Paid to Fat Shame
‘Apparently now your physicians are not only encouraged with words to call their patients “fat”, starting next year, they’ll literally get paid to do so. Never you mind that the vast majority of physicians the world over don’t have a clue what to do with their obese patients. Never you mind that the weight loss industry is an unregulated morass of snake oil and false hope. Never you mind that there is as of yet no gold-standard, reproducible treatment program. Never you mind that studies show obese patients already face cruel discrimination by health professionals, and already receive substandard care.’
http://www.weightymatters.ca/2011/05/britain-moves-to-pay-mds-to-shame-their.html
6) Vegans WTF?
The PCRM is a fake medical group made up of Vegans, who dish out nonsensical propaganda, mislead people about obesity and yeah, they also fat shame. http://www.weightymatters.ca/2012/04/since-when-did-responsible-medicine.html
GUESS WHAT?
“The present research demonstrates that, in addition to poorer mental health outcomes, weight discrimination has implications for obesity. Rather than motivating individuals to lose weight, weight discrimination increases risk for obesity.”
Perceived Weight Discrimination and Obesity
http://www.plosone.org/article/info:doi/10.1371/journal.pone.0070048
Hating On Fat People Just Makes Them Fatter
http://www.npr.org/blogs/health/2013/07/26/205766456/hating-on-fat-people-just-makes-them-fatter
If Shaming Reduced Obesity, There Would Be No Fat People
‘If stigmatizing fat people worked, it would have done so by now. Obese people are already the most openly stigmatized individuals in our society, with published data showing that weight stigma is more pervasive and intense than racism, sexism, and other forms of bias.[2]Weight-based discrimination is one of the few legal forms of discrimination that remain in America, and there is substantial evidence of weight discrimination across multiple domains of living, including health care, employment, education, and media. The most heartbreaking examples of weight stigma come from the domain of interpersonal relationships. Children as young as three years describe overweight children as “mean,” “stupid,” “lazy,” and “ugly,”[3] and obese children are 1.6 times as likely to be bullied as children who are not overweight.[4] It is actually difficult to imagine how obesity could be stigmatized more than it already is.’
http://onlinelibrary.wiley.com/doi/10.1002/hast.166/full
Stigmatizing Obesity Undercuts Effectiveness of Public Health Campaigns
“By stigmatizing obesity or individuals struggling with their weight, campaigns can alienate the audience they intend to motivate and hinder the behaviors they intend to encourage…”
http://www.amednews.com/article/20120924/health/309249952/4/
Emotional Abuse and Kids
“Kids who are emotionally abused suffer the same mental-health consequences as those who are physically or sexually abused — and in some cases, psychologically abused kids may actually fare worse. “
http://nymag.com/scienceofus/2014/10/emotional-abuse-can-be-as-damaging-as-sex-abuse.html?mid=facebook_nymag
‘The prevalence of obesity in the United States increased during the last decades of the 20th century (2,3). More recently there appears to have been a slowing of the rate of increase or even a leveling off.’
http://www.cdc.gov/nchs/data/databriefs/db82.pdf
The Epidemiology of Overweight and Obesity: Public Health Crisis or Moral Panic?
“In our view the available scientific data neither support alarmist claims about obesity nor justify diverting scarce resources away from far more pressing public health issues. This article evaluates four central claims made by those who are calling for intensifying the war on fat: that obesity is an epidemic; that overweight and obesity are major contributors to mortality; that higher than average adiposity is pathological and a primary direct cause of disease; and that significant long-term weight loss is both medically beneficial and a practical goal. Given the limited scientific evidence for any of these claims, we suggest that the current rhetoric about an obesity-driven health crisis is being driven more by cultural and political factors than by any threat increasing body weight may pose to public health.”
http://ije.oxfordjournals.org/content/35/1/55.full
Modern Science Versus the Stigma of Obesity
“Obese people, who are already subject to adverse health effects, are additionally victimized by a social stigma predicated on the Hippocratic nostrum that weight can be controlled by ‘deciding’ to eat less and exercise more. This simplistic notion is at odds with substantial scientific evidence illuminating a precise and powerful biologic system that maintains body weight within a relatively narrow range. Voluntary efforts to reduce weight are resisted by potent compensatory biologic responses.”
http://www.nature.com/nm/journal/v10/n6/abs/nm0604-563.html
‘The previous belief of many lay people and health professionals that obesity is simply the result of a lack of willpower and an inability to discipline eating habits is no longer defensible.’
Richard L Atkinson, Emeritus Professor of Medicine and Nutritional Sciences, University of Wisconsin and editor of the International Journal of Obesity
http://aeon.co/magazine/being-human/david-berreby-obesity-era/
This Relationship is Complicated
From psychology to socio-economic factors, environmental issue to food accessibility to physiology – obesity is more complicated than fat shaming assholes are aware of. That’s right, people who judge and shame others are usually ignorant on the topic they are so arrogant about. Obesity System Influence:
http://www.shiftn.com/obesity/Full-Map.html
SOLUTIONS
“Messages that focus on promoting specific health behaviors are likely to be more effective.”
“Participants responded more favorably to obesity-related health campaigns that emphasize specific health behaviors and personal empowerment for health compared with campaigns that imply personal blame and stigmatize the obese.” American Medical News:
http://www.amednews.com/article/20120924/health/309249952/4/
“Participants responded most favorably to messages involving themes of increased fruit and vegetable consumption, and general messages involving multiple health behaviors. Messages that have been publicly criticized for their stigmatizing content received the most negative ratings and the lowest intentions to comply with message content. Furthermore, messages that were perceived to be most positive and motivating made no mention of the word ‘obesity’ at all, and instead focused on making healthy behavioral changes without reference to body weight.”
Fighting obesity or obese persons? Public perceptions of obesity-related health messages.
http://www.ncbi.nlm.nih.gov/pubmed/22964792/
SOLUTIONS
Too Seldom Is Heard an Encouraging Word: Why and How to Offer More Compliments
Health At Any Size