What do you think when you see a severely overweight person going about their day-to-day life? Does your mind jump to how they should lose weight, eat better, do something different? Would you go so far as telling them?
A national survey of around 2000 people was created to explore how stigma and prejudice impact the lives of bigger Australians.
Alarmingly, the survey found that 42 per cent of obese people have experienced harassment because of their weight.
What is ‘too fat’?
The standard way to categorise a person’s body weight as overweight or obese is by using the Body Mass Index, or BMI. But the relationship between weight and health is nowhere near as straightforward as the BMI seems to suggest. Despite its prevalent use, it has some major limitations.
The BMI calculation was devised in the 1830s by a mathematician and has no medical basis. It doesn’t measure the level of fat in your body, or take lifestyle habits into account. It simply plots your weight against your height and prescribes a title of underweight to extremely obese.
Read: Facts about belly fat
For example, a very fit, muscular person could be placed in the overweight category, if they’re on the shorter side.
On the other hand, a very unfit person who regularly smokes, drinks and has a poor diet may have a BMI in the healthy range.
“BMI did a lot to shame people,” says sociologist Deborah Lupton, a UNSW SHARP professor and author of the book Fat. “It is very possible to be a thin person, or even an average size person, and still be a very unhealthy person – the relationship between weight and health is nowhere near as straightforward as the BMI seems to indicate.”
In Australia, two out of three people are considered overweight or obese, according to the BMI.
Studies have found that anywhere from one-third to three-quarters of people classified as obese are metabolically healthy. They show no signs of elevated blood pressure, insulin resistance or high cholesterol. Meanwhile, about a quarter of non-overweight people are what epidemiologists call “the lean unhealthy.”
Ultimately, habits, not your size, are what really matter. There are so many indicators that are better at judging someone’s health than looking at them from across the room. Vegetable consumption, activity level, alcohol consumption, even grip strength, can often tell more about a person than the size of their waist.
A 2016 study that followed participants for an average of 19 years found that unfit skinny people were twice as likely to get diabetes as fit fat people.
Shame and prejudice about body size can follow fat people around in all aspects of their life.
It can stop them seeing the doctor over the fear the conversation will be steered towards weight loss – no matter the reason they made the appointment.
“Body shaming, discrimination and stigmatisation often has real effects on people’s lives,” says Prof. Lupton. “There’s a lot of research now to show that if other people see you as too fat, then you miss out on opportunities, like jobs. That kind of discrimination and shaming just goes on throughout people’s lives.
“It even affects medical care. Fat people report that when they see their GP, their body size will often be brought up by the doctor, even if the health problem is completely unrelated.”
All of this makes higher-weight patients more likely to avoid doctors. Three separate studies have found that fat women are more likely to die from breast and cervical cancers than non-fat women, a result partially attributed to their reluctance to see doctors and get screenings.
The logic behind fat phobia
To some extent, there may be an inbuilt prejudice towards fat people relating back to our caveman days.
“We’re attuned to bodies that look different,” says Janet Tomiyama, a stigma researcher at UCLA. “In our evolutionary past, that might have meant disease risk and been seen as a threat to your tribe.”
Unfortunately, the stigma is starting early. One study found children as young as three were using words such as ‘mean,’ ‘ stupid’ and ‘lazy’ to describe their larger classmates.
The ‘obesity epidemic’
To make this stigma worse, terms such as ‘obesity crisis’ and ‘obesity epidemic’ can lead to a moral panic, encouraging fear and prejudice about fatness.
The turning point in the latest anti-obesity discourse happened during the late 1990s and early 2000s, says Prof. Lupton.
Leading health bodies such as the World Health Organization started noticing rising levels of obesity based on BMI measurements. This sparked an onslaught of public health campaigns and news coverage in Australia and many other wealthy countries around the world.
“There was masses of news coverage about the so-called ‘obesity crisis’ and ‘obesity epidemic’,” says Prof. Lupton.
Headlines such as ‘Obesity rates in Australia climb faster than anywhere else’ and ‘Nearly one-third of the world’s population is obese or overweight’ were popping up everywhere.
“They sent the message of, ‘Unless we all lose weight, we’re going to be a burden on the healthcare system, get diseases such as cancer and diabetes, and die early’.”
Many of these campaigns reinforce the idea that fat is always bad, and should be avoided at all costs.
But, since 1980, the obesity rate has doubled in 73 countries and increased in 113 others. And in all that time, no nation has reduced its obesity rate. Not one.
Does this show that using ‘shock’ and ‘disgust’ tactics don’t work?
Fixing the message
It seems public health institutions have become so obsessed with bodyweight that they overlook the real problem: the food supply. Fresh fruit and vegies are expensive while packaged food stuffed with unpronounceable ingredients are getting cheaper.
Adverts assault our eyes with images of delicious, high calorie treats that you can order with a click of a button. Even the way supermarkets are laid out entice us to reach for the calorie-laden snacks that make the company the most profit.
According to Prof. Lupton, a key way to tackle fat stigma starts with changing these public health campaigns.
“Public health campaigns need to take a more positive approach that avoids fat shaming and fat stigma,” she says.
“It’s a matter of giving positive messages about how everyone of any size can live a healthier life, without focusing on weight loss. Whether they’re fat, normatively thin, or in between, you just don’t know the struggles that people have had over their eating and their body weight.”
What do you think? Why not share your experience in the comments section below?
If you enjoy our content, don’t keep it to yourself. Share our free eNews with your friends and encourage them to sign up.