BEDA promotes cultural acceptance of, and respect for, the natural diversity of sizes, as well as promoting a goal of improved health, which may or may not include weight change. The views expressed by our featured bloggers are their own.
Susan Ringwood is Chief Executive at Beat, the UK’s leading charity supporting people affected by eating disorders and campaigning on their behalf.
Susan was a member of the National Institute of Health and Care Excellence guideline development group for the treatment of Eating Disorders and is a Fellow of the Academy of Eating Disorders and Chaired the Academy’s Patient and Carers’ Committee.
She led the development of the World Wide Charter for Action on Eating Disorders, and was the 2008 recipient of the AED Meehan/Hartley award of Leadership in Advocacy and Public Service.
Susan is a member of the Royal College of Psychiatrists Eating Disorders section Executive Committee, and on the Advisory Board of global advocacy group FEAST.
Combating Weight Stigma
Weight stigma covers so many domains the visual imagery typically used to cover news stories of the ‘obesity epidemic’; the far from innocuous fat teasing children experience in the school playground; and the serious psychological distress that can overwhelm someone with weight concerns among others.
Challenging weight stigma means being vigilant and active across all these arenas, and there is much to be done.
In the UK, we have become more tolerant, accepting and less judgmental in so many ways over recent years. Sometimes it is with the backing of legislation designed to combat discrimination, and in other cases maybe just the times have moved on.
When it comes to race, religion, age, gender, sexual orientation or disability there are very few people who would consciously cause gratuitous offense with a comment or action. As a society, we may not have changed our views or inner prejudices, but we are careful not to cause offense and may edit what we say or do in public as a result. Such thoughtfulness is a start towards the true acceptance we need.
But with weight and shape, there is no such filter. It is the last domain where anyone feels entitled to make a personal, pejorative remark without fear of censure. There is no legislative framework to combat this, and very little by way of public opinion that this needs to stop.
The typical route to change the landscape in relation to tackling discrimination and disadvantage is to reach a tipping point in public opinion, then to back that change with the law. Putting laws in place ahead of a groundswell of grassroots support is ineffective. We are governed by consent.
So, where does that consensus lie in relation to weight and shape? There is a welcome growing understanding that eating disorders are a serious, treatable mental illness and not a lifestyle choice. The media says it follows public opinion, not leads it, but we know that having an active, engaged and positive media presence can help shift that public opinion.
At Beat, we have tracked an increasing trend of responsible, compassionate reporting of eating disorders in the press. We hope our activism over the last 25 years has played a part in this. We haven’t yet seen a corresponding change in the reporting of weight and shape.
The inclusion of Binge Eating Disorder (BED) in the DSM 5 did make the news in the UK, even though it has much less influence over our provision of treatment in the publically funded health care system.
Several opinion pieces in the main stream, news-led press chose the example of binge eating to illustrate the inherent weakness of the DSM by pathologising everyday aspects of life and making pseudo conditions appear valid. Binge eating was compared to “shopaholicism” by one commentator. We have a long way to go.
We conducted a simple research study back in 2008, in collaboration with the Girl Guides. The report was titled ‘Under 10 and Under Pressure’, and looked at a range of aspects of pressure affecting young people’s lives. One domain was the influence of views about weight and shape on young girls aged 7, 8 and 9 in the junior band of Guides- the Brownies.
Small groups of Brownies were shown line drawing of girls who represented their age, but in a range of sizes. The range wasn’t extreme, but did vary from slender to large. The Brownies were asked to talk about these girls, and say what sort of person they were likely to be. Their discussions were recorded, transcribed and analysed by the research team and the results were stark.
The drawings which depicted girls who were the most slender were unanimously described as happy, healthy, good at sports, someone to be friends with, and successful at school.
The girls who were shown as larger were described as unhappy, lazy, bullied, not someone to be friends with and no good at sports.
The Brownies were 7 years old and they already knew that the size and shape of your body alone told the world what sort of person you are. They had internalised those weight stigmatising messages that surround us daily.
But, perhaps because they were Brownies, they also said ‘it’s what’s on the inside that really counts’.
And that’s where we need to start- with the 7 year olds- and with their younger brothers and sisters. Their message that what’s on the inside counts, really should count. It should be part of every public health message, instead of telling the parents of 5 year olds their children are obese and at risk of premature health problems from heart disease as we do in the UK now.
That message should be in the press, on the web and in social media. People need to hear it’s not their fault, they didn’t choose this. Let’s make weight stigma as unacceptable as sexism and disability discrimination. It has no place in our lives. Out of the mouths of babes –it’s what’s on the inside that counts.