This week I wanted to jump on and do a really quick little post about weight bias. I’ve mentioned this term before but I haven’t really talked about. My favorite statement around weight bias is this:
Weight Bias is the only socially acceptable form of discrimination in our country.
That one can sting a bit. Just think about it. Let it sink in. When was the last time you judged someone’s motivation, character or morals just on their size? Prior to COVID and social distancing, I bet you could think of a moment in the previous few days, if not day.
Is Weight Bias really an Issue?
Weight bias is pervasive, especially in health care (over 60% express weight bias). Read about it here, here, here and here. We see then undesired effects of an unhealthy lifestyle and are programmed to associate them with weight alone. We are told that if people just exercised more and ate better they could all be thin and healthy and we wouldn’t be battling endless complications from diabetes, heart disease and kidney disease.
The worst part about this – patients know it. They have felt discriminated against by their providers. They avoid medical care because their providers treat them differently or judge them. Going to the doctor leaves them feeling empty and shameful for who they are. Would you go to the doctor if you knew you’d be judged and minimized? Better believe I’d stay home.
Weight vs. Behaviors
But as any of you who have read my blog before know, I don’t believe this direct association (here’s one of the many articles where I talk about it). Weight in itself is not the problem. Behaviors are the problem that lead to the medical issues above. Weight is just around for the ride. Some with gain a lot of weight from the behaviors. Others won’t gain any. Yet, we fixate on the one piece of the equation that we have little control over.
No one can guarantee they can weigh a certain number on a certain day. They CAN guarantee if they get out and move.
There are a handful of medical problems I see that are directly related to weight. But these are much less than what I see related to behaviors. So why do we focus on weight?
I believe it’s because it’s easy to focus on. If we are focusing on weight, we can visually see if someone is doing what they “should” do. We can measure it directly. We can give blanket advice and our hands are wiped clean of responsibility. If the patient doesn’t lose weight, well I told them what to do and they just didn’t do it. If the patient says the did, well they must not understand how to actually do that or must be lying.
These are comments health care professions (and the general public) think regularly. Because we have weight bias. We think life is black and white. You are either healthy or unhealthy. Thin or fat. Good or bad. Strong or weak. Something or nothing.
Pervasive and Conflicting Messaging
How did we get here? Our society has trained us from a very young age to believe these things. And to believe that weight loss is something to strive for. We hear messaging about diets and weight starting at a young age. And then we hear conflicting messages about “bad foods” and how they are just so good. TV commercials telling us to eat more and we’ll experience bliss or friendship. And we buy into, get a dopamine hit when we eat them, and feel guilty afterwards.
What can we do?
First, acknowledge the bias. Harvard has an awesome collection of Implicit Bias tests you can do for free here. After you take it, come back and tell me how it went. A word of caution – this test does NOT mean you are a bad person. I have weight bias. It is has been ingrained in my for 30 years. The difference is, I acknowledge it and actively work towards dispelling the story my brain was trained to believe. You can too.
Next, acknoweldge when this bias shows up in your day. When you think about food as good and bad. When you think about fat as good or bad. When you do things for weight and not health. When you judge others.
Next, consider another perspective. People around you are all experiencing life through a different lens. Try to put their lens on. Remember, most of us are doing the best we can given our circumstances. Try to actively reframe how you think about others in the moment. For example, you can tell you’re judging someone else about their weight. Pause. Put their lens on for a bit and try to reframe to experience empahty and compassion for others.
Last, begin to actively change the conversation. If you hear someone judging another, don’t jump in and add fuel to the fire. Saying nothing is still something. As you become more comfortable, consider offering a gentle counter argument.
Stop back and tell me how this story touched you. Are you being discriminated against because of your size? Did you find out you have strong weigh bias? Did you learn you are discriminating against others? I’d love to hear your takeaways and experiences.