Ending Weight Bias: The Easiest Way to Tackle Obesity in America



Discrimination is diminishing, giving way to progress…all the way to the White House. And we're all thinking about the challenges ahead for America. The key to addressing one of our biggest health challenges—the obesity crisis—may lie in making size discrimination illegal.

The journal Obesity published a special issue on weight bias in November. The bulk of it consisted of articles you'd expect to see—ones that follow the path of how our attitudes about fat develop. Studies showed preschool kids associating pictures of fat children with words like ugly, selfish, and stupid, teenagers teasing and stereotyping, and overweight girls with low self-esteem getting caught in vicious loop of unhealthy, disordered eating.

And, according to one study, it doesn't get any easier as we age. Obese job candidates applying for a management position were rated as less likely to succeed and less likely to have leadership potential and were assigned lower starting salaries than their thinner counterparts. There is no shortage of examples of size discrimination in real life: Simply read comments people leave on news stories about weight or look at the size of airline seats. Size can hurt your paycheck or your chances of marrying, and celebrities face plenty of criticism when they put on pounds. (See which celebrities have healthy BMIs.) Even doctors and nurses show bias against their heavy patients.

These studies and examples show how little we expect from people who are overweight and obese, and how little we feel they may deserve. They also show how little overweight and obese folks can expect of—and for—themselves.

Fighting weight bias
But the last article in this special issue, by Jennifer Pomeranz at the Rudd Center for Food Policy and Obesity, is food for thought for anyone interested in tackling the nation's obesity crisis. She says that as a nation, we can't really solve the obesity crisis until we first address weight bias. (You can also read a Rudd Center policy paper on weight bias.)

Pomeranz uses the examples of discrimination against blacks and gays to make her case. In the early 20th century, African Americans had a high death rate, and leading physicians at that time attributed it to a "lack of self-control" and a "lack of physical and moral cleanliness." Decades later, researchers realized the real problem was low economic status. Only when cases like Brown vs. Board of Education began to give blacks better access to equal education, health care, jobs, and pay did the death rate change.

In the same way, Pomeranz says our society didn't start rallying around HIV/AIDS prevention, treatment, and care until laws that made homosexuality illegal were overturned. In both cases, once society stopped blaming people for their conditions, began listening, and acted out of tolerance, compassion, and basic humanity, health problems were addressed.

She may have a point. Think about it: It's OK, in our society, to talk about fat if you're thin. But if you're fat, you're left out of the conversation. Docs aren't even consistent in talking to obese patients about losing weight. Can we really expect to solve a problem by leaving the people with the problem out of the loop?

So as our new president takes on health care, what do you think it'll take to turn the obesity crisis around? Do we need to officially call obesity a disease? Laws to make fat discrimination illegal?