by More than 71% of American adults are affected by overweight and obesity (Centers for Disease Control and Prevention, 2018). Millions of these individuals regularly experience weight bias. Biases—including weight bias—are often based on stereotypes. As a health and exercise professional, you are likely to encounter individuals affected by weight bias and discrimination. Before diving further into the topic of weight bias, here are a few helpful definitions:
- A stereotype is an exaggerated belief about a person or group. Stereotypes are often based on images in mass media, or reputations passed on my family members, friends, and other members of society. Stereotypes can be positive or negative, but even positive stereotypes can be harmful.
- Bias or prejudice is an opinion or attitude about a group or its individual members.
- Discrimination is a behavior or action that results in people being treated differently because of their group membership. Discriminatory behavior often begins with negative stereotypes and prejudices.
- Weight bias is defined as negative weight-related attitudes, assumptions, and judgments toward individuals affected by overweight and obesity (Alberga et al., 2016).
The Consequences of Weight Bias in Society
Weight bias has several negative consequences. Weight stigmatization has been linked to discrimination in hiring and promotion opportunities, ultimately reducing a person’s earning potential. This is especially true for women. Additionally, weight bias has been shown to affect the quality of care for patients with obesity, leading to poorer health outcomes and increased risk of mortality. When weight bias is internalized, it can lead to poor body image, low self-esteem, disordered eating, avoidance of physical activity, anxiety, depression and even suicidal ideation (Friedman and Puhl, 2012).
Weight bias is everywhere—in workplaces, schools and even healthcare settings. A report published by the World Health Organization (2017) revealed that:
- 54% of adults with obesity experience weight prejudice from coworkers
- 69% of adults with obesity report experiencing weight prejudice from healthcare workers
- School-aged children affected by obesity are 63% more likely to be bullied than their non-obese peers
- 72% of media images stigmatize individuals affected by obesity
Like other types of bias and discrimination (on the grounds of race, gender, ability, sexual orientation, etc.), weight bias is often rooted in ignorance and misconceptions. Overweight and obesity are caused by a complex combination of behavioral, biological, social and environmental factors. However, the narratives around overweight and obesity are often oversimplified. How many times have you heard variations of the “Eat less; move more” message? Probably too many to count. These messages, though well-intended, can be counterproductive as they fail to address the complex process of behavior change and the myriad factors related to overweight and obesity.
Reducing Weight Bias in Health and Fitness Settings
Weight stigmatization is far-reaching. One study published by the American Psychological Association tracked 46 participants with a mean BMI of 30.52 for 14 days. On average, the participants reported experiencing 11 episodes of weight bias during the two-week study period. Furthermore, the more frequently weight bias was experienced, the less motivated study participants were to diet, exercise and lose weight (Vartanian, Pinkus and Smyth, 2018). Unfortunately, health and fitness settings are just as vulnerable to weight stigmatization as other spaces. As a health and exercise professional, what can you do to reduce weight bias? Here are some practical ideas to help get you started:
1. Evaluate your own biases. Do I make assumptions about a person’s level of fitness based solely on his or her weight or size? Do I ever conflate thin with healthy and overweight with unhealthy? Keep in mind that bias does not always operate at a conscious or explicit level. In fact, our implicit attitudes are sometimes better predictors of our behavior than our explicit attitudes and beliefs. Fortunately, once we become aware of our own biases, we can do something about it. You can learn more about implicit bias here.
2. Create physical activity spaces that focus on behavior, not body size or weight. Educate your clients about the current Physical Activity Guidelines, and help them to create behavioral and action-oriented goals (e.g., “I will attend two group exercise classes this week,” or “I will aim to get the recommended 150 minutes of moderate-intensity physical activity this week.”) Weight-loss goals are not bad, but if these are the only goals a client is working toward, disappointment is inevitable. When a client who is trying to lose weight hits a plateau, behavioral goals can still be celebrated. For example, “You didn’t miss one workout this week!” When we focus on behavior, clients can feel successful even when short-term weight-loss goals are not met.
3. Set clients up for success with appropriate exercise program design. It is important to avoid making snap judgments when working with clients affected by overweight and obesity. At the same time, be aware of (and, when appropriate, provide) variations for resistance exercises, high-impact activities and other types of exercise that could place excess stress on the joints.
References
Alberga, A.S. et al. (2016). Weight bias: A call to action. Journal of Eating Disorders, 4, 1, 34.
Centers for Disease Control and Prevention (2018). Obesity and Overweight.
Friedman, R. and Puhl, R. (2012). Weight Bias: A Social Justice Issue.
Vartanian, L.R., Pinkus, R.T. and Smyth, J.M. (2018). Experiences of weight stigma in everyday life: Implications for health motivation. Stigma and Health, 3, 2, 85-92.
World Health Organization (2017). Weight bias and stigma: Considerations for the WHO European regions.
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