Archive for February 28th, 2012

February 28, 2012

the HAES files: can you tell anything at all by a person’s weight?

by Health At Every Size® Blog

by Deb Burgard, PhD

If you have grown up in this culture, you probably associate quite a few things with fatness and quite a few of the opposite traits with thinness.   Almost every audience comes up with the same lists:

Fat: Thin:
Out of control

Even though these associations are not something people from other cultures (or other times in history) believe, they are so strong and unquestioned in our own time that they form the basis of our weight stereotyping, bias, and stigma.

To test your own associations, go take the Weight version of the Implicit Attitudes Test.  The test does not measure whether you inflict weight bias on people, but rather how strongly you have been taught to  associate certain concepts with weight. 

It might be surprising to know that weight stigma hurts both thin and fat people.  In my work with people of all sizes who are struggling with disordered eating, it is clear that a huge factor in their misery is almost always the worry that they will be humiliated and rejected because of their weight – no matter what their weight is.  I have had people sitting in my office who look like they walked straight out of a fashion magazine who are convinced they are not thin enough, not perfect enough, and not good enough (and some of them are absolutely accurate about the impossible standards of their world of ballet or modeling or a really bad relationship).  Others have endured a lifetime of negative stereotyping and discrimination as fat children or adults, and can’t imagine loving the bodies they blame for the meanness of other people.   Still others have witnessed the humiliation of a friend, a parent, a sibling – and are petrified about such a thing happening to them.   

So some of them have had actual experiences of weight stigma, some of them give themselves the experience of stigma within their own minds, and some are convinced that it is only a matter of time before the axe falls unless they perfect their bodies to some mythical state.   No one feels safe, because everyone has times when we feel something from the “fat” column.  Busted! 

When I work with clients, we have to figure out a way to handle both the real and the self-inflicted experiences of weight stigma, so that they  can get unstuck and recover.  Part of this work is for the client to change his/her own mind about what fat and thin means.  Part of it is to change other people’s minds.

And so today in the spirit of changing other peoples’ minds, I ask that we stop for a moment and question this weight stigma stuff, and why we keep it around. 

 It seems obvious that the diet (i.e., the weight cycling) industry wants to keep it around, because how else would you sell a program that never works, over and over again, and not worry about the consumer getting hip to the fact that it is useless?  But even though it is a big honking industry (most recently estimated at over $60 billion), most of us are not making money from it and would be fine if it suddenly went out of business.   In fact, most of us would be much better off economically with our $500-1000/year safe in our own pockets rather than handing it over to Weight Cyclers.

So what about the rest of us who aren’t profiting off this industry? Why would we perpetuate weight stigma? When you look at the lists of traits associated with “fat” and “thin,” what strikes me is that they are such normal human states and traits.  Is there a week that goes by when you don’t feel like some of Column A and some of Column B?  But the “fat” traits are painful to experience – they are the things we feel when we miss the deadline, can’t get motivated, find ourselves rejected, or are diagnosed with a health problem.  We would prefer not to feel them at all, and when we are promised that just by losing weight, we will become a Whole New Person (free of all the “fat” traits!), we think that would be a pretty great deal.  That promise sucks us in.  We cave to the illusion that life does not have to sometimes feel bad, and we perpetuate the myth that by changing our bodies, we can avoid feeling bad.   In fact, according to the myth, if you feel bad, it must be your own fault for not working hard enough to get the right body.

The truth is, few people live only in the “Thin” column.  And actually, when you think about it, doing so might make you pretty insufferable.   It may be the reason some people can be so immensely clueless about the weight stigma they are inflicting on others – being cut off from your own human vulnerability makes it more possible to justify “punishing” other people.  Only someone who refuses to identify with the person across from her who is suffering, would add to that suffering. 

There are people who understand that weight stigma is causing suffering but feel like it is somehow going to make people care about their health.  Like a person will start exercising to lose weight, but not to become more healthy, so we have to keep trying to stigmatize higher weight and promote weight loss.      

It is true that people are social animals, and are very punished by being stigmatized.  But punishment is famously unpredictable as a motivator.  The things people do to leave the stigmatized group are often not at all conducive to their health.   Injecting poison into your skin, slicing up healthy body organs, starving yourself, taking drugs, and even repetitive weight loss attempts, are things that make people sicker.  Even though I don’t think people would go through half of what they do in the name of weight loss just to have lower blood pressure or better triglycerides or a lower risk of a stroke, I would argue that the net effect of the attempt to leave the stigmatized group is actually less health.  Weight loss is not like trying to quit smoking.  Weight cycling makes you sicker and fatter.  And if your weight loss takes the form of an eating disorder you have a one of the deadliest psychiatric illnesses to battle. 

And what about the health burden of weight stigma itself?  Historical studies of cultures where higher weight is not stigmatized show that people at higher weights were just as, or even more, healthy than the thinner members of the community.  And perhaps the most robust finding in all of epidemiology is that social support is the holy grail of health.  How can removing social support – and making people sicker – be a path to making people healthier?  How can the US government telling people that we are trying to eliminate them in a generation make them healthier? 

The truth is, there is no reason to demonize people of certain weights.  The far more effective message is that people can find things to do that support their health at whatever size they are.  After all, the same practices and environments support health for thin or fat people.  If the same cafeteria feeds the thin kids and the fat kids, why can’t we talk about what is on the menu that supports the health of all the kids?  Why do we have to argue that the food has to change so we can have no fat kids?  Why can’t we argue that the food should be healthy for the kids – period?   We can work to create environments that support people in their efforts to thrive and make lasting efforts to take care of their bodies.  Part of creating that environment is ridding it of the pollution of weight stigma.

I grew up during times of great social upheaval, and I have seen a lot of change when it comes to social stigma.  Though the world is far from perfect, it is a very different place now than it used to be if you live together without being married, or get divorced, or have a baby as a single parent, or work as a female airline pilot, or get around in a wheelchair, or raise kids as gay parents, or love someone of a different race or religion.  Stigma is a kind of fashion.  We can change what is fashionable.  We can make weight stigma incredibly uncool.  Because it is.

So what are you going to do today to end weight stigma, in your mind, and in the world?

 National Eating Disorder Awareness Week

 is February 26-March 3!   Get involved!

Everybody Knows Somebody.  Visit the NEDAwareness Week homepage  to register today and learn more about how you can do just one thing to help raise awareness about eating disorders and become part of the solution. NEDA’s Helpline number is: 800 931-2237

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