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Weight discrimination has very real health consequences, especially when some of the most common perpetrators are medical professionals.

Hosted by: Hank Green
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Sources:
Is obesity stigmatizing...in the United States (2005)
https://journals.sagepub.com/doi/pdf/10.1177/002214650504600303?casa_token=PBVdPdFJUGUAAAAA:waQBbIyYRDYZaPv3XXukcEWvwLzU6VBxGvBE6g21jupxZELn2qxC7wFXlYSjzBn1w-KVOyMYV3M

The stigma of obesity: does perceived weight discrimination affect identity and physical health? (2011)
https://journals.sagepub.com/doi/full/10.1177/0190272511398197

Does this Tweet make me look fat? A content analysis of weight stigma on Twitter (2016)
https://link.springer.com/article/10.1007/s40519-016-0272-x

How and why weight stigma drives the obesity epidemic and harms health (2018)
https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-018-1116-5

Obesity, perceived weight discrimination and hair cortisol: a population based study (2018)
https://www.sciencedirect.com/science/article/abs/pii/S030645301830502X

Weight bias internalization and health: a systemic review (2018)
https://onlinelibrary.wiley.com/doi/full/10.1111/obr.12701
[INTRO ♪].

Tell me if you’ve heard this one before:. You, or someone you know, goes to the doctor with some kind of very specific problem—say, a severe cough—and the doctor says to lose weight.

You really didn’t think that was causing the issue, and you left without any kind of solution that actually feels /helpful/. Turns out you had /bronchitis/, and your waistline had nothing to do with it. This is actually a pretty common experience, and it’s not just doctors who might treat people differently based on weight.

And weight discrimination has concrete, measurable effects on the lives of people who experience it—effects that aren’t always what you’d expect. Anyone, small, large, and every size in between, can be a victim of weight-based discrimination. But in this episode, we’re going to be talking about the effects on heavier folks, because that’s where a lot of the research is and where a lot of the effect is.

The specific term researchers use to refer those who are /medically/ defined as overweight or obese is weight stigma. It’s a little tricky to measure, since the amount of stigma someone experiences is unique to them. An outside observer can’t really tell someone they /didn’t/ get body-shamed.

But we /can/ study these things, by asking people about what they experience. And this research tells us that medical professionals are some of the worst perpetrators of the stigma. It’s even been shown in /multiple/ studies that it can affect the quality of care they give to patients.

Which is a problem, because weight and /health/ aren’t the same thing. One 2001 review article found physician bias against people who are obese in multiple studies, with possible implications for the quality of care they receive. And a survey of obesity-related professionals in 2013, following up on another survey from 2001, found that while some attitudes had shifted over time, bias against people who are obese was still very real.

And of course, this isn’t the only way experiencing weight stigma can physically impact your body. It has measurable, physical consequences, some of which can be surprising. Like, multiple experiments and reviews show that experiencing weight stigma—or weight-based discrimination in general — makes folks /more likely/ to gain weight.

For example, a study published in the journal Obesity in 2014 followed almost three thousand older English adults from 2008 to 2013. Researchers measured their waist circumference and weight at the beginning and end of the study. They also gave them a questionnaire in the middle that asked about any perceived discrimination they faced.

If the participants thought they were discriminated against based on weight, as opposed to age, gender, or race, the researchers counted it as perceived weight discrimination. The researchers found that while only five percent of their participants experienced weight stigma, those who did /gained/ an average of almost a kilogram over the course of the study. Folks who didn’t report any weight stigma actually /lost/ weight, though less than a kilogram on average.

And it didn’t matter whether the participant was overweight or not. The weight gain associated with discrimination happened across all BMI groups. Researchers writing in the journal BMC Medicine in 2018 urged health care providers to practice compassionate care and emphasize well being and healthy behaviors instead of weight loss.

Because weight discrimination has effects on people’s lives that can be measured. And this can go beyond making them /feel/ bad; when people internalize this message, the situation can become even /more/ harmful. Researchers refer to this as weight bias internalization.

Basically, people come to agree with the negative stereotypes about their bodies—and that’s really dangerous. One 2018 review looked at 74 studies to examine the effects of internalized weight bias. Thirty of those studies looked at links between weight bias internalization and depression.

Of those, /twenty-eight/ found a positive relationship. That applied to people in a range of body weight categories. And there were links to other mental health outcomes too—like anxiety, self-esteem, and signs of eating disorders.

While the amount of research into these connections varied, the overall literature was clear:. When weight bias is internalized, it’s really terrible for mental health. It is important to note, though, that the majority of these studies are conducted on white women, which limits what we can extract from these results.

But clearly, making people feel bad about their weight doesn’t help anyone. Research indicates that the best way to help is to break down weight stigma—both within the health profession, and everywhere else. Thanks for watching this episode of SciShow Psych.

Before you go, we want to tell you about a new channel: Ours Poetica, a collaboration between Complexly and The Poetry Foundation. It’s a place for people to read poems they wrote, or that mean a lot to them. If you feel like you never really “got” poetry, this might just change your mind.

It’s simple, powerful… and it’s /ours/. Check it out at the link in the description. [OUTRO ♪].