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How "weight bias" is harming us all

- January 11, 2019

Fat-shaming is everywhere and research shows that it is very bad for our health. (Flickr/Obesity Canada), CC BY-NC-ND
Fat-shaming is everywhere and research shows that it is very bad for our health. (Flickr/Obesity Canada), CC BY-NC-ND

is Professor of Health Promotion and Scientific Director of the Healthy Populations Institute at . Her co-writers on this article include (Concordia University), (Nothern Ontario School of Medicine), (University of Alberta) and (University of Calgary).

People who live in large bodies find themselves the target of fat-phobic and body shaming messages on a daily basis.

Ellen Maud Bennett died of cancer on May 11, 2018, and she . She is not alone. Weight bias is everywhere in our society today 鈥 from images in the media and jokes on television shows, to comments from educators, health-care professionals, employers, family and friends.

Such acts are not only hurtful, . They have social consequences. Research shows that Caucasian women who do not conform to the 鈥渢hin鈥 ideal may . And , which also has economic impacts.

Weight bias and discrimination can 鈥 causing anxiety, depression, suicidal thoughts, binge eating, avoidance of physical activity and avoidance of health care. And research evidence has firmly refuted the effectiveness of body shaming as a motivator for weight loss. In fact, it has the opposite effect, .

These consistent findings have implications for all members of society, but especially for health-care providers, for whom 鈥渄o no harm鈥 is a fundamental principle.

Although public health efforts to address obesity over the last two decades were well intended, we now know that messages promoting weight loss or a 鈥渕ove more, eat less鈥 narrative have contributed to .

When your doctor thinks you are lazy


Just as weight bias has shown to be pervasive in all sectors including education, employment and public settings, .

Many people do not realize they carry implicit judgements and biases about people living in larger bodies. (Flickr/Obesity Canada),

When an individual living with obesity visits a doctor or nurse and experiences a judgemental response of disgust, anger or blame because of their size, this jeopardizes their care.

Research shows that . Some are willing to devote less time educating patients with obesity about their health.

This can negatively impact that person鈥檚 future health, because they avoid seeking care in order to avoid the embarrasment; there is evidence, for example, that women with obesity are .

Improving clinical practice guidelines


To draw attention to the harm caused by weight bias, we represent a group of researchers and health-care practitioners from across Canada. We are working in collaboration with to reduce weight bias and discrimination.

Collectively, we have explored weight management from many perspectives. We have identified , the problematic discourses within and the critical need for .

Our work, and that of others, emphasizes a need to provision and raise skills and competencies among health-care professionals and others.

Called the , we are also highlighting the impacts of weight bias and discrimination within new Canadian clinical practice guidelines, due for release in 2019.

This represents a global first for embedding recommendations for reducing weight bias and discrimination within a national health-care system. It will serve as a template for other countries.

Do you have subconscious weight bias?


Identifying our own biases is a critical step towards weight bias reduction.

There are a and and other topics.

These tools ask questions to measure attitudes and beliefs that people may not know that they hold; they help them to learn about these biases as a first step in addressing them.

In addition, a fundamental driver of weight bias is a lack of understanding of obesity, which is . Our current food and physical activity environments and societal norms .

We need to improve how obesity is understood, so that people with obesity are not defined by their body shape or weight, but seen as whole people with social, physical and emotional needs like anyone else.

New Canadian clinical practice guidelines will explain the impacts of weight bias in the health-care system. (Shutterstock)

Shift the focus from weight to health


Rather than blaming and shaming, people respond better to empathy and support. There are now a variety of , and .

Also key is to showcase positive, empowering images in the media, like those from this , also featured in this article.

We encourage everyone to work with us to reduce weight bias and discrimination. You can do this through using , which means respectfully addressing people with , rather than labelling them by their illness.

Let鈥檚 challenge weight bias and discrimination whenever and wherever we encounter it. We all have a role to play in respecting everyone as human beings first and foremost and in shifting the health-care focus from weight to health.

The authors gratefully acknowledge the contributions of Ximena Ramos Salas to this article.The Conversation

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