Why is it that most people would never make fun of people with cancer, diabetes or heart disease but still think it was ok to make fun of people who are obese? It has been said that obese persons are the last acceptable targets of discrimination. Anecdotes abound about overweight individuals being ridiculed by teachers, physicians, and complete strangers in public settings, such as supermarkets, restaurants, and shopping areas. Fat jokes and derogatory portrayals of obese people in popular media are common. Overweight people tell stories of receiving poor grades in school, being denied jobs and promotions, losing the opportunity to adopt children, and more.
Weight discriminations can harm all aspects of a victim’s life, negatively impacting their school, work, and social life, and even the standard of care they receive in a doctor’s office. American culture perpetuates unrealistic ideals for bodies and even encourages prejudice attitudes toward those who don’t fit that often unattainable ideal. Our mission is to change the narrative and eliminate discrimination based on size. To do this, we must examine existing biases—conscious and unconscious—and then work toward increasing awareness and education about how weight discrimination causes very real and harmful setbacks for those facing discrimination first hand, and on a larger scale, for society as a whole. No other organization has attempted to do this.
Unfortunately, attitudes surrounding obesity lead many to place blame on obese people for their situation, even though the realities around obesity are much more complicated and nuanced than that. Cancer victims are no different. The unfair assumption that obesity is a symptom of failure at dieting, emotional issues, or a lack of self-control only fuels the acceptance of discrimination around it.
Research supports this, suggesting that if a person’s obesity is understood to be caused by circumstances that they cannot control, such as a thyroid condition or because of medication, then they face discrimination on a lesser scale compared to someone whose obesity is understood to be caused by personal lifestyle choices like overeating or lack of exercise. The reality however, is not so black and white.
Discrimination in the Workplace
Weight discrimination is one of the most harmful problems in the workplace, and many times the discrimination is covert enough to go unnoticed. It can begin at the hiring phase, with employers typically favoring potential employees of a “normal” weight. Once hired, obese employees may be affected by inaccurate prejudices and stereotypes around the disease, with co-workers and supervisors unfairly assuming they are lazy or lack self-control. These attitudes can affect an employees work relationships, changes for advancement, and how much income they make over their career.
Research has shown that a person’s physical traits affect their hiring potential, regardless of their qualifications and aptitude for the position. A person’s height, gender, race – and weight—can all unfairly bias an employer against a well-qualified job applicant. Only recently have legal cases started challenging employers who have discriminated against or even fired employees because of their weight.
Workplace discrimination can show up in a variety of areas, such as in the hiring process, salary and benefits packages, opportunities to grow within the organization, and eventually termination. When an applicant at any position is obese, they may be unfairly perceived as having low self-control, a lack of potential for leadership, a lack of productivity, less likely to hold more professional types of jobs, being lazy, or offered a job that doesn’t have personal one on one interaction.
Discrimination at School
Students from kindergarten through college can face challenges because of weight discrimination. Obese students are often victims of bullying and ridicule from other students, and perhaps even worse, they are subject to discrimination from their teachers in the form of both conscious and unconscious biases. Weight discrimination can even lead to fewer acceptances from college.
The depth of the problem can be illustrated by how early children begin to discriminate against others based on body size. Children as young as preschool age (3-5) have been shown to demonstrate biases against their overweight peers, perceiving them as being ugly, stupid, and not having friends. Weight discrimination permeates education, showing up as early as preschool, and carrying through to higher education. And the perpetrators can be other students and peers, teachers, and even school administrators. No matter the grade over 50% of obese boys and girls say they have been bullied and discriminated. That is a number that no one realizes. Teachers can be as easily to blame thinking obese children are sloppy, unhappy and less successful.
Discrimination by Healthcare Providers
Once of the most insidious forms of obesity discriminations takes place in healthcare settings, by the very people charged with taking care of one’s health: doctors, nurses, psychologists, dieticians, and other health care professionals. Perhaps not surprisingly, even those who specialize in treating obesity have discriminatory behavior. In fact, their problematic attitudes toward obesity may have been what prompted them into their field.
Unfortunately, when a healthcare provider holds prejudice attitudes toward a patient for any reason—race, socioeconomic status, gender, education, or weight—it can negatively impact the standard of care given to the patient. Further, when a patient feels discriminated against by a doctor, they are less likely to seek healthcare when needed, delaying and cancelling appointments. To begin with, seeking healthcare often puts a patient in a vulnerable position. It is uncomfortable for many people to have to be weighed, undress for a virtual stranger, or answer questions about one’s lifestyle, and be told what they are doing “wrong.” For patients struggling with their weight, these problems are multiplied with medical gowns, tables, and equipment that are too small.
Of all professionals, doctors seem to have the most discriminatory actions. They see obese people as untruthful, uncooperative and actually uneducated. From the duties of a nurse who might have feelings of repulsion in the overall care to psychologists who harbor discriminatory attitudes of unhealthy pathologies, obese people are feeling it at every level. The standard of care can be very detrimental in helping the obese person to receive the kind of quality that they like everyone else deserve.
Negative Outcomes of Weight Discrimination
The negative outcomes are everywhere. Prejudices and poor attitudes surrounding obesity affect ones social life, career, income, and the healthcare they receive. Discrimination can be overt and covert, conscious and unconscious. Regardless, the victims of this form of prejudice face rejection in every aspect of their life, amounting to profound negative outcomes for their entire quality of life. Their mental health consequences suffered as a result of weight discrimination will affect their entire core and will include severe and negative social, psychological and physical changes.
Stopping Weight Discrimination
This is the time to stop shaming people. American culture encourages narcissistic attitudes, idolizing impossible standards of wealth, youth, and beauty. Media, marketing, movies, social media, and TV bombard us everywhere we are, enforcing cultural attitudes stigmatizing obesity. The AOA mission is to transform these prejudices and help enact laws prohibiting weight-based discrimination in the workplace and elsewhere. It is illegal to base hiring decisions on race, religion, disabilities, and gender, and body size needs to be included in the law books as an unacceptable form of discrimination.
The Importance of Self Advocacy
The first step that overweight individuals can take is to advocate for themselves. This can be a challenging and intimidating situation to be in, in the face of discrimination. It may ever seem unfair: after all, prejudices attitudes toward you are not your fault, why should you be the one to have to solve the problem. While this is true, it is often the victims of oppression in any situation that make the decision to effect positive change, because they are the ones who stand to benefit from change. First challenge negative attitudes when you see them. At the same time find support. If you don’t have family or friends who are supportive, look in your community or online for support groups – there should be plenty of them in the local area. Next, you have to find an inner motivation to conquer your internal feelings. This seems hard to do but you need to feel comfortable in as many settings as possible. Remember to see that ignorance is all around and you have a personal gain in knowing how to conquer that societal ignorance. Finally, speak up and find ways to be successful in the midst of all this discrimination. How will you be and feel better?
Support from Doctors
The support should start here for a serious action plan. The doctor’s office is often a place where people feel the most vulnerable. For anyone, visiting a doctor can be an anxious and negative experience, and these feelings are only exacerbated when patients are faced with very real attitudes of prejudice. Doctors must learn to recognize their own biases and how they negatively impact the standard of care they provide.
Doctors and other health care professionals can start by identifying their conscious and unconscious biases, and listening to their patients’ experiences in an open and respectful way. In addition to their patients’ physical well-being, physicians must be prepared to treat mental well-being, as these two aspects of one’s health are closely linked and affect each other. To that end, health care professionals should provide advice that includes finding activities and support groups that will improve one’s mental and physical health.
Patients who receive a more holistic approach from their health care providers are more likely to overcome the shame and depression associated with being a victim of weight discrimination. To learn how to approach healthcare in a more holistic and positive way, medical professionals must continue to check their own attitudes and biases. Research has shown a number of groups—racial, socioeconomic, and obese—that routinely receive poorer standards of care as a result of prejudice. Doctors must recognize the far-reaching consequences of their negative personal attitudes and do everything they can to correct it. Medical schools and associations must include training on unconscious bias in their curriculums and requirements for continuing education.
Physical spaces must also be accommodating to all ranges or people. Bathrooms, chairs, exam tables and gowns must be able to accommodate all sizes of patients, and without putting the patient into a potentially embarrassing situation. Healthcare facilities should hire a consultant to conduct a walk-through to evaluate everything from reading material in the waiting rooms promoting unrealistic beauty standards to medical equipment available in sizes to fit everyone, to assistance with mobility challenges. Be on the lookout for ways to improve examination accommodations in every aspect that relates to your better health.
The Body Mass Index (BMI) has been a standard for years but recent literature suggests that it is not as important to one’s health as previously thought. Medical professionals must shift their thinking from the numbers on a scale and BMI to a more holistic approach, encouraging a focus on healthy eating and activities that can be practices and improve one’s life regardless of their size.