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Discrimination against fat people increases the likelihood of weight gain

Research published in PLOS ONE this morning has found that people who experience discrimination based on their weight are likely to gain more of it. Similarly, negative attitudes lead people who are obese…

New findings have emerged on the impact of weight discrimination on weight gain and loss. puuikibeach

Research published in PLOS ONE this morning has found that people who experience discrimination based on their weight are likely to gain more of it. Similarly, negative attitudes lead people who are obese to not lose weight, showing that discrimination has greater implications than poor mental health for fat people.

Living with a spoiled identity (often referred to as stigma) has a strong impact on the health and well-being of members of marginalised populations.

Research on stigma, and the resulting discrimination, has found negative effects on health in racial minorities, members of the gay, lesbian, bisexual, trans*, intersex, asexual, queer community, and people with chronic illness.

More recently, this research stream has turned to the stigma placed on fat people and the impact this may have on their health and well-being. With the increasing numbers of fat activists sharing their stories online, more academics are paying attention to the impact of anti-fat attitudes on the health and well-being of fat people.

Fat Studies researchers are working to build a body of literature around fat stigma, hoping to illuminate the experiences of fat people living with discrimination and oppression.

Anti-fat attitudes are found across cultures; across the lifespan; and across professions. It’s not surprisingly then that the evidence suggests fat people experience discrimination and oppression, and that this has a negative impact on their identity, self-esteem, mental health and physical well-being.

The study

The PLOS ONE study by Angelina Sutin and Antonio Terracciano from the Florida State University College of Medicine explores the impact of weight discrimination on weight gain and loss in people over 50 years old in the United States.

The 6,000 subjects in the study had a mean age of 66 and were measured in 2006 and again in 2010. Subjects self-reported their height and weight.

Normal weight individuals who experienced weight discrimination were more likely to become obese by the follow-up than those who did not.

Obese people who experienced weight discrimination were much more likely to remain obese by the follow-up than those who did not. Other kinds of discrimination (based on sex, for instance, or race) didn’t have the same link with weight.

And the effect of this kind of discrimination was independent of factors such as age, education and ethnicity.

The authors propose several reasons why weight discrimination may lead to weight gain (or inhibit weight loss). They draw from previous research that has found that weight discrimination contributes to binge eating, lack of confidence around exercise, and decreased self-esteem.

Some context

In a 2012 study, researchers Rebecca M. Puhl, Corinne A. Moss-Racusin, and Marlene B. Schwartz concluded that fat people who internalise weight discrimination were more likely to engage in binge eating.

“Internalising” in this sense means that people integrate the negative attitudes of those around them into their identity. This usually leads to a decrease in self-worth and health-seeking behaviour.

Unsurprisingly, they also found that stigma and discrimination were not factors that motivated people to try to lose weight. I think we can make this simpler – shame is never good for anyone’s well-being.

People respond to stigma in one of four ways: withdrawal, covering, passing, or coming out. Some people with a spoiled identity simply withdraw from society; they engage with the outside world as little as possible.

Some are able to pass, to pretend to not be a member of a stigmatised group. Consider someone who doesn’t disclose her sexual orientation to her friends and co-workers or a light-skinned member of a racial minority who is mistaken as white by his peers.

Many people with spoiled identities engage in covering; an identity management technique characterised by acknowledging and openly accepting the shame of the stigma. Think of the fat person who regularly apologises for their size and openly states shame for their body.

The final identity management technique is coming out. Coming out means to embrace the spoiled identity by rejecting the ideas linked to it by the mainstream culture.

We most often seen this strategy in people who identify as gay or lesbian, but it applies to other stigmatised groups as well. I’ve written before that coming out as a fat is a way to negotiate the experience of a hostile environment.

Better ways

I’m currently working on research that explores whether people who come out as fat (who claim and develop a fat identity) are better equipped to handle the stigma, discrimination, and oppression they experience.

Similarly, researchers from Monash University conducted a study that examined how people active in the Fatosphere (an online community for fat activism) negotiate stigma and weight discrimination. They found that fat people who engaged with online communities were less likely to internalise weight discrimination, and more likely to engage in health-seeking behaviour.

Shaming fat people does not promote health or behaviours that leads to mental or physical well-being. What it does is create a culture of shame for people of all sizes.

Fat people are shamed for being fat. Non-fat people are shamed for engaging in behaviours that may lead to fatness. And this shame only reinforces weight anxiety in across the lifespan. Weight anxiety may be good for the weight-cycling industrial complex, but not for individual health and well-being.

Join the conversation

47 Comments sorted by

Comments on this article are now closed.

  1. John Crest

    logged in via email @live.com.au

    Surely the best response would be for them to start exercising and eating less.

    Is this sort of analysis / effort lost on fat people?

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    1. Meg Thornton

      Dilletante

      In reply to John Crest

      John, have you ever been repeatedly and sustainedly shamed for just BEING WHO YOU ARE at any time in your life? Because your comment really reads as though you haven't. It reeks of privilege - white privilege, male privilege, straight privilege, cis privilege - the privilege of someone who has NEVER had to deal with the fact that other people WILL hate you and behave in negative ways toward you *simply for the fact that you exist*.

      Let me put it bluntly - the way being constantly belittled…

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    2. Meg Thornton

      Dilletante

      In reply to John Crest

      Also: way to go, smart guy, responding to an article about how fat stigma doesn't lead to increased weight loss with even more fat stigma. Did you have a point there, or were you saving it for Christmas?

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    3. John Crest

      logged in via email @live.com.au

      In reply to Meg Thornton

      Rather than attack me personally, why not attack the point I made?

      Or should I just assume you won't because you can't?

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    4. rory robertson

      logged in via email @gmail.com

      In reply to John Crest

      John,

      My strong sense is that millions upon millions of people globally are suffering needlessly the slings and arrows and myriad health problems - including type 2 diabetes - associated with being overweight or obese. Many are getting poor nutrition advice from health professionals, and cannot downsize no matter how hard they try. And many are trying very hard. And failing. And becoming despondent. And so it goes on. John, it turns out that your bog-standard advice - eat less and exercise more - is mostly useless for many people - or at least is very hard to do - because many common processed foods and drinks are somewhat addictive via their added sugar. It may not be your cup of tea, John, but for those interested, here’s a scientifically approved - and mostly effective - obesity-reversing diet (scroll down): http://www.australianparadox.com/pdf/why-we-get-fat.pdf

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    5. Nathan Grandel

      Exercise Physiologist

      In reply to Meg Thornton

      As a health professional who was overweight for the majority of my life and has since helped many people achieve weight loss and other health outcomes. I believe for the vast amount of overweight people it is about eating less and exercising more. There is a small percentage of people that will have medical conditions that will affect their ability to lose weight, but it is only a small percentage!
      Saying that, without a positive support system from family and/or friends (who can also be an obstacle) I believe that it is difficult to make long term positive lifestyle changes which lead to better weight management.
      Positive support will almost always be required for people to make and then sustain healthy lifestyle changes.

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    6. John Crest

      logged in via email @live.com.au

      In reply to rory robertson

      The diet you posted makes perfect sense to me. And as you are a former fattie, I assume it worked for you. So really, you DID follow my advice, didn't you?

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    7. rory robertson

      logged in via email @gmail.com

      In reply to John Crest

      Next time, John, it might be best for you to just introduce the link, and say as little as possible.

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    8. John Crest

      logged in via email @live.com.au

      In reply to Nathan Grandel

      I'm afraid your professional views and personal experience will get short shrift around here NG: it seems overweight people don't like advice that requires them to make proactive choices and sacrifices.

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    9. Nathan Grandel

      Exercise Physiologist

      In reply to John Crest

      re: John Crest

      With a success rate of just under 80% with my clients (client set goals), I would say most people can achieve a lot with the right support, advice and motivations.

      Additionally, I always like a bit of controversy when reading comments on health articles, so let’s add to my point…. The right advise means; evidence based best practice as set out by regulated bodies. Unlike some of the advice often given by crack pots referencing their own blogs or books written by layers about diets on sites like this!

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    10. James Walker

      logged in via Facebook

      In reply to Meg Thornton

      Rubbish.
      Consider how the term 'wog' changed. Used as an insult against the Greek community, they adopted it and used it themselves with pride.
      No insult can wear you down unless you let it.

      Excess weight reduces your ability to function, and will kill you. If you wish to belong, then get fit. The alternative isn't social exclusion, it is an unnecessary death.

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    11. Gary Cassidy

      Monash University

      In reply to John Crest

      RE: "Surely the best response would be for them to start exercising and eating less.
      Is this sort of analysis / effort lost on fat people?"

      Unfortunately this is just too simplistic and doesn't work as a solution. It's like saying that a road is congested because there are too many cars on it. To prevent congestion all you need to do is have less cars on the road. While this solution to car congestion sounds completely logical, trying to reduce car congestion via this solution would be ineffectual.

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    12. Gary Cassidy

      Monash University

      In reply to John Crest

      Well obviously, that's why it's ineffectual! Just as obvious as the road being congested because cars don't stop driving on it.

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    13. Mike Smith

      logged in via Facebook

      In reply to John Crest

      The fatter you are, the harder it is to start exercising and continue. That doesn't mean you shouldn't, but I'm just pointing it out. Diet, aka eating less is pointless without exercise.

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    14. John Crest

      logged in via email @live.com.au

      In reply to Mike Smith

      Well, we can agree that getting fatter is not the answer to being fat.

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    15. Mike Smith

      logged in via Facebook

      In reply to John Crest

      Suppose someone came on here, advocating that you gave up chair moistening ( no, I dare not ask why you do it) would you take it in good spirit?

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    16. John Crest

      logged in via email @live.com.au

      In reply to Mike Smith

      If chair moistening was bad for my health and made me feel "shamed for just BEING WHO [I AM]", then I would ask myself two questions:

      1) do I want to change?
      2) how do I change?

      If the answer to 1) was "yes", then I would DO what was suggested in 2).

      What I wouldn't do is 3) moisten chairs more!

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    17. Mike Smith

      logged in via Facebook

      In reply to John Crest

      The point is, you don't have to do (3) for the analogy. Just keep on chugging along with the *same* imbalance of energy in and out.

      Annoyingly, though, you didn't explain the chair moistening. :^)

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    18. rory robertson

      logged in via email @gmail.com

      In reply to Nathan Grandel

      Ng of Melb, if that was a reference to me or Gary Taubes in your comment above, please note that Gary Taubes is the widely respected former science writer at The New York Times, and the author of the best-available history of nutrition science, Good Calories, Bad Calories.

      Taubes reportedly was given a $600,000 advance that allowed him five years to sit down and write the book. After five years of researching the bulk of the nutrition science experiments and findings (including some involving…

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    19. Kem Augustsson

      logged in via email @augustsson.net

      In reply to Nathan Grandel

      May I ask for how long you have maintained your new lower weight? Research tends to show that almost everyone can lose weight in the short term, but that almost everyone regains that weight, and sometimes additional weight within 2 to 5 years.

      An Australian research team studied (http://www.nejm.org/doi/full/10.1056/NEJMoa1105816) people who had lost weight in an effort to understand some of these changes. A year after their initial weight loss:

      A hormone that suppresses hunger and increases…

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    20. rory robertson

      logged in via email @gmail.com

      In reply to Kem Augustsson

      Hi Kem,

      My peak was 97kg and I lost 10kg between May and December 2011, with no increased exercise. I have been hovering either side of 87kg over the past 18 months. If I have a "bad food day", I try to follow it with a good one, using this approach as a guide to what is healthy: (scroll down) http://www.australianparadox.com/pdf/why-we-get-fat.pdf

      For those interested, here's an upgraded version of my son's class talk on the revamped Australian Dietary Guidelines in February: http://www.australianparadox.com/pdf/talktoyear3boys.pdf

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    21. rory robertson

      logged in via email @gmail.com

      In reply to rory robertson

      And Kem, I'm not sure I'm convinced by the research you cite in trying to argue that overweight and obesity have nothing much to do with longevity and well-being. I'm pretty confident it's the case that many/most sufferers of type 2 diabetes also are overweight/obese, with a greater risk of heart attack, kidney disease and blindness, amongst other sub-par outcomes.

      I think as you say it is true that exercise is somewhat protective against those various maladies. Importantly, however, the desire to exercise often follows weight loss, which can be promoted in the first place by the "no sugar, no starch" diet I linked to above. That diet also seems effective for the long run, in part because the basket of foods always on offer - meat, fish, eggs, cheese, nuts, green veges, avocado, etc - promote satiety in a way that today's popular refined carbs and foods containing added sugar do not.

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    22. Chris Saunders

      retired

      In reply to Nathan Grandel

      Hello NG ofMelb, I don't know what you mean by 'the right advice means evidence based best practice as set out by regulated bodies' when it is patently obvious people following it are becoming fat and obese. I'm with Rory, give up the sugar and limit your consumption of fructose to 2 pieces of fruit a day. Three out of three people in my family of varying age and sex have done it and it worked. Their appetite lessened and things like bread and pasta and deep fries were no longer attractive. It…

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    23. Chris Saunders

      retired

      In reply to Kem Augustsson

      Kem thanks for all the links but there are a number of points to make: Cutting sugar is not a diet per se although it does lead to a lessening of appetite and therefore eating less. Exercise makes you hungry and entices you to eat more. Exercise in its own right does not prevent cardiovascular events. If you are healthy, fit and obese then weight loss won’t result in significant health improvements, there are some obese in this category, and for them the self-esteem boost in a slimmer non-stigmatised against body is a worthy goal in itself. There are some arguments that cholesterol levels are not an indicator of anything. http://www.ravnskov.nu/cholesterol.htm

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  2. Gerard Dean

    Managing Director

    I am not so sure that all is what is seems.

    When I was kid growing up in the 60's in the Wimmera, any kid that was overweight was called a Fatty - not nice, but that is how it was. When I mentioned this to my grown up children, they were horrified and said that it never happened at their city schools in the nineties and naughties.

    What's changed? I imagine that firstly, there are more overweight children and secondly, kids are nicer to children that are different than themselves. Certainly children of different races and sexuality in higher schools are much more tolerated than in my days at school.

    I understand the author's point that perhaps overweight people should adopt a more accepting attitude to their size, rather than hiding away or hiding the fact, However society in the 21'st century is far more forgiving than in the 'good old days'

    Gerard Dean

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    1. rory robertson

      logged in via email @gmail.com

      In reply to Gerard Dean

      Thanks for your piece, Cat. I agree that the overweight and obese often are treated poorly, both by people around them and not least by type 2 diabetes and other related maladies.

      Cat, it is not widely understood but modern rates of sugar consumption - especially via sugary drinks - are a key driver of global obesity and diabetes, together the greatest public-health challenge of our times: http://www.ncbi.nlm.nih.gov/pubmed/20693348

      Moreover, it is clear that giant-sized serves of sugar…

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  3. Liam J

    logged in via email @gmail.com

    Important finding: 'Shaming ... does not promote health or behaviours that leads to mental or physical well-being.' Great to have good evidence for it.

    I'd suggest same applies to smoking & drug abuse too, but theres too much money being made from shame and prohibition for public policy change.

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  4. Jonathan Marshall

    Founder

    Firstly I have to strongly agree that it is shameful to "shame" people a blot on a civilised society.

    But then again how civilised are we when we let big corporations promote food that is scientifically unhealthy - not even as a treat (we just say that it is OK to make ourselves feel better). Food is pure and simple fuel to energise and repair our body - nothing more nothing less and if you start messing with this simple principle things start to get unstuck.

    Add in a reduction from 8 hours…

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  5. James Jenkin

    EFL Teacher Trainer

    Maybe the obsession of public health professionals with obesity - dodgy stats to show an 'epidemic', overhyping the effects of being overwieght - contributes to this stigmatising.

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    1. Nathan Grandel

      Exercise Physiologist

      In reply to James Jenkin

      As a teacher trainer I’m sure you are the best person to make the decision on what effect being obese or overweight has on the individual or society and the unnecessary health professionals’ obsession.
      Any idea how much more expensive it is to have a bariatric patient in hospital then a healthy weight patient????? The equipment cost alone increases the expense, plus the extra need for staff when moving the patient and managing their complex health related conditions.
      Additional, any idea how we determine what overweight is???????? Overweight is defined as abnormal or excessive fat accumulation that impairs health.
      Very simply put – being overweight = bad for your health and bad for the community.

      With more than 50% of Australian overweight or obese, I would say “epidemic” is a suitable term

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    2. James Jenkin

      EFL Teacher Trainer

      In reply to Nathan Grandel

      You make expert points about the medical costs of obesity - no argument there.

      However we're dealing with people and their self-esteem, so the message has to be very smart. Saying certain people are associated with an 'epidemic' does suggest 'you are a problem'.

      Incidentally 'as a teacher trainer' I would advise against too many question marks! :)

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    3. Joe Gartner

      Eating Cake

      In reply to James Jenkin

      That's amazing how you could sidestep two unassailable points about obesity:
      a. that it is epidemic in proportion
      b. that it reduces health
      by attacking punctuation.

      The message to fat people should not be couched in morally loaded terms, it is true, and (for once) I agree with Cat Pause's assertions. Neither of these points alters the deleterious and pervasive nature of obesity in our society.

      Whilst 'don't be fat' is a message that may never work, perhaps 'be healthier' is. Ignoring the problem or waving it away as a negative social construct won't alter rates of obesity related disease.

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  6. John Zigar

    Engineer, researcher

    Some of the comments here today are uninformed and bullish. Just leave fat people alone. End of story.

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  7. Joe Gartner

    Eating Cake

    I do not dispute the author's assertions and this seems to reflect the lived experience of fat people who are in our community.
    We should be careful that the take home message of this is: let's not subject the obese to discrimination.'

    The message is not: 'let's ignore obesity as a personal and public health issue".

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  8. David Thompson

    Marketing Research

    "Fat Studies?" WTF?

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  9. David Thompson

    Marketing Research

    Being fat is like being a trannie or black or a quadriplegic? Our taxes are paying for this "academic" sham? FMD.

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  10. John Doyle

    architect

    Which comes first?
    The low self esteem leading to overeating etc., or being obese leading to low self esteem?
    That seems a major issue for many obese people.
    Of course there are those who still are high achievers whose size has not stopped them;
    I am thinking of Harold Mitchell and Clive Palmer for example
    Harold writes he lost weight because he was told he would otherwise die early.
    So now he is 90kg instead of 160 kg.
    If we need a reason dying young is sure to grab one's attention.
    Many obese people are from lower socio-economic groups, who choose fast food - a notoriously bad choice, descend into bad health and find it difficult to change.
    They really are victims of the fast food industry's vested interests.

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  11. Suzanne Arnold

    Co-ordinator

    Being fat is so bad for anyone's health. That's the bottom line. There are so many grossly overweight people in the western world with an exponentially rising medical bill. And so many fat people doing their best to make being fat okay, changing the language, screeching discrimination etc etc.
    Diet, exercise, acknowledging that fat is not only very bad for you but its gross to look at and no wonder people stare. Try sitting in a long distance flight next to one of these folk and experience the misery of being hemmed in like a sardine.

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  12. Jane Daly

    PhD Candidate at RMIT University

    Thankyou for this piece Cat! The findings of these research projects are really interesting and I think it is important research.

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  13. Chris Saunders

    retired

    I must say that the stigmatization of fatness or obesity or for that matter drug addicts and alcoholics (and I am not for one minute equating the three) does not reach anywhere close to the stigmatisation of the disabled, although the latter two have been included in the designated EEO disabled group and no doubt it is only a matter of time before the former does too. Compassion for the mostly like us is so much easier than those nothing like us at all. On the one hand, you have a group of people…

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  14. John Wright

    Director

    One of the problems it seems to me with both article and many of the responses, is our desire, need almost, to categorise and then demonise people.
    It is easy to create marketing slogans, "eat less, move more" pass them of as solutions and then chastise those who fail.
    We have run for the last 2 years a small number of pilot metabolic weight management clinics, in the UK, Spore, an here in W.A, staffed by relevant health professionals, medics, EP's, Dieticians, and in one group a clinical psychologist…

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    1. Chris Saunders

      retired

      In reply to John Wright

      Breaking them down into the three groups like this certainly makes sense and gives you broader options to help the individual client. The only flaw I see is that not everyone wants professional help for any number of reasons, albeit not all rational. That is why self-help programs which recognise the nonsense of one size fits all (although I guess the self help industry is disdained by medical professionals for good reasons) available to the public would be immensely beneficial.

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