Toolkit For Individuals, Friends and Family

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Understanding Weight Stigma:  What You Can Do to Help Those Who Struggle with Binge Eating Disorder

“What I remember most from grade school is being teased about the way my legs jiggled when I ran. I hated that feeling.”

“I am constantly aware of how my body might look to other people. I’m constantly trying to look as thin as I can.”

“My doctor wouldn’t believe my symptoms were serious. He said ‘you’re too thin and fit to have diabetes.’”

“I got promoted after I lost 50 pounds; my boss told me I didn’t represent the company properly when I was overweight.”

“My 13-year-old daughter is starting to develop, and she is “overweight” according to her doctor; she is terrified of gaining any more. How do I help her see her body is not her enemy?” 

 

What is Weight Stigma?

The above statements are the voice of weight stigma.  Its power is immense – it can make people feel ashamed of themselves, interfere with their productivity, damage their health, and lead them to develop binge eating disorder (BED) and other eating disorders.

Even given all the power it has, and all the forms it can take, the definition of “weight stigma” is simple: “Bullying, teasing, negative body language, harsh comments, discrimination or prejudice based on a person’s body size or weight.” (BEDA, 2010). As the above reflections suggest, weight stigma depends upon three basic assumptions: thin is always preferable, thin is always possible, and thin people are better people.

Who is impacted by Weight Stigma? What is the Nature of the Impact?

Weight stigma happens everywhere. Simply leaving the house in a larger body can be an emotionally challenging experience. Shopping for clothing, going to the beach, or eating a meal may all elicit public ridicule, and thereby anxiety and shame. In addition, weight stigma is especially likely to be internalized by those with BED, many of whom are already impacted by toxic shame in other areas of their lives.

It is commonly believed that weight stigma is an issue only for girls and women, and only for those in bodies larger than our culture deems acceptable. In fact, weight stigma has a profound impact on us all. For those in more socially “acceptable” bodies, there is often a fear of weight gain, and of losing “thin privilege”. Increasingly, boys and men are being pressured to focus on weight and shape as well. Having “six pack” abs and muscle definition, in addition to being tall and trim, is a highly reinforced cultural goal.

The statistics tell some of the story of the scope of weight stigma:

  • Weight discrimination occurs more frequently than gender or age discrimination (Puhl, Andreyeva, and Brownell, 2008).
  • Weight discrimination has increased 66% in the last decade (Puhl 2009).
  • Peer victimization can be directly predicted by weight (Griffiths, et. al, 2006).
  • Obese youth who are victimized by their peers are 2-3x more likely to experience suicidal thoughts and behaviors than those who are not victimized.

The impact is additionally powerful because it is socially validated. There is almost no support in the surrounding environment declaring weight stigma unacceptable. Indeed, most of us would find it strange to hear someone say they feel good about their body and its appearance. Further, it is supposed that any weight-related psychological damage happened principally through one’s own fault. Simply lose weight and problem solved, so the advice goes. However, we know diets have a dismal success rate, especially over the long term. And yet, the notion that this is the fault of the individual is pervasive. As a clinician, I would posit this: It is the stigmatizing experience (because it induces shame), not the weight itself, which contributes to adverse outcomes, including eating disorders such as BED, and long term weight cycling. 

Adding to the impact, there are powerful forces invested in weight stigma. The weight loss industry is a $60 billion per year money maker, predicated on the notion that being thin is a valuable personal goal, somehow reflecting an internal strength of character.  Given that weight loss by diet is a near impossibility, this goal is one very rarely attained; it must be chased continually. While men and boys are an increasing target of this industry, women are still the principal audience. As Naomi Wolf asserts in The Beauty Myth (1991),  “a culture fixated on female thinness is not an obsession about female beauty, [it is] an obsession about female obedience. Dieting is the most potent political sedative in women’s history; a quietly mad population is a tractable one.” Indeed, what might happen if suddenly women were encouraged to be at home in their bodies? Where might our energy go if we stopped chasing the fantasy of thin?

How Does Weight Stigma Affect Those w/BED?

Weight stigma creates a place for the shame of BED to live, and a place for the “when I’m thin” fantasy. The yo-yo dieting cycle, and resulting self-blame for the inevitable “failure”, is often a core contributor to binge eating. Changing this pattern is at the heart of recovery.

Additionally, weight stigma creates problems in recognizing the severity of BED, and of receiving proper diagnosis and treatment. BED has been viewed as a problem of willpower, low self-esteem, or depression, and not as a legitimate eating disorder. As a result, treatment, if offered at all, has been largely focused on weight loss.

Research shows that a diagnosis of BED makes a person a target of more blame than other psychological disorders LaPorte, 1997; Mond & Hay, 2008; Wilson et al., 2009; Becker et al., 2010; Crisp, 2005; Mond et al., 2006; 2007. In a study of 1013 women who belonged to a national non-profit weight loss support organization, a profound connection between BED and weight stigma was noted. In this study, women who internalized experiences of weight  stigma, and blamed themselves for this stigma, engaged in more frequent binge eating. This was true even after accounting for self-esteem, depression, and amount of stigma experienced (Puhl, 2007)

How Do We Make Changes? A Call to Action

Making changes to these messages in a culture that is dominated by weight stigma requires great courage. We need to bring to the task a willingness to challenge the current system, and a wellspring of hope for our daughters and sons to be able to see beauty in a much broader way. Internally, this call requires a profound desire to have a different relationship with our own bodies. This means sitting with the feelings, including fear, anger and grief, which arise when we work to love, honor and protect the body we’re in.

Although everyone’s path is different, there are a few critical steps to change. The first, and perhaps most profound, is to begin to understand our body as our “home.” Our bodies are not billboards. They do not exist to attain approval, or to prove worth and value. Our body is the place where we each will spend our entire lives. It is doing its very best, every moment of every day. We must work to develop compassion for the incredible journey through which our body has come. It may begin with something Marsha Hudnall calls “body neutrality”. Body neutrality is “focusing on what your body does for you, or what you appreciate about your body, rather than what it looks like.  Body neutrality acknowledges what is rather than longing for what isn’t. (Beyond the Binge: A Woman’s Guide for Overcoming Emotional Overeating). It is in this process most of all we come to see that offering our body anything less than the best care is about external rules, internalized shame, or old messages. It is NOT about our body’s deservedness, no matter its size, shape, gender or age.

Second, learn the myths and the facts about the relationship between health and weight. Much of the information we receive about weight and health does not prove causality, nor does it necessarily apply to any given person. We need to pay attention to our body’s unique physical needs, and develop a relationship with food and movement that is based on immediate internal cues and desires, a general respect for nutrition, and an overall wisdom about our body’s responses to our behavior.

Finally, we all must work on developing “weight stigma eyes”. We have a duty to ourselves and to our communities to consume images critically. If a message or an image makes us question our own body’s value, we need to back away. Look for resources that celebrate a variety of shapes and sizes, and those that recognize beauty is about far more than meets a given eye. When in public places, really look for the beauty in others. What appeals to your eye? Take back the power to define beauty, including your own, from a system invested in taking it away.

We hope that the information contained in the toolboxes we have produced for Weight Stigma Awareness Week 2013 will help you advocate for yourself, your loved ones, and us all when it comes to combating weight stigma.

Thank you for joining BEDA in making Weight Stigma Awareness Week one important step in the call to action. Together, we can come to see beauty everywhere we look, including our own mirror.

Amy Pershing, LCSW, ACSW

2013 Chair, BEDA