Confronting Weight Bias


My heart was broken three times this week. A client of mine told me a story of how a neighbor left a set of dumbbells on her front porch with a note that said, “You might want to try these.”  I sat in a gathering of women, all of whom made critical comments about themselves as they were looking through photos.  And I met with a school administrator who told me about a student who was made fun of by her fellow 7 year olds for bringing a bag of Cheetos in her lunch – the other kids pointing at her and saying “those aren’t healthy! You’re gonna get fat!”

We live in a time and place where thin and fit bodies are afforded privilege and respect, and large bodies are subject to prejudice and discrimination.

This makes me crazy.

What makes me even crazier is the ways that we use the “health” argument to perpetuate this system of social injustice.  But it’s not healthy to be overweight.   Living in Boulder, I’m particularly sensitive to the ways words like “health” are used.  Even a local obesity prevention organization says: “It’s not about vanity, it’s about health”.  And now even third graders are bullying each other in the name of health.  The latest statistics from the Youth Risk Behavior Survey in Boulder County show that harassment due to weight and physical appearance is three times higher than harassment due to ethnicity or sexual orientation. Weight bias is everywhere.

Health At Every Size ®

I am a psychotherapist who works with eating and weight concerns, and I’m a woman who has lost people close to me (literally and figuratively) to our cultural obsession with weight.  Using the Health At Every Size philosophy has revolutionized the way I work and the way I live. It is a weight-neutral approach that helps people integrate sustainable self-care practices and celebrates the fact that human beings come in different shapes and sizes.

The tenets of Health At Every Size are:

  1. Accepting and respecting the diversity of body shapes and sizes
  2. Recognizing that health and well-being are multi-dimensional and that they include physical, social, spiritual, occupational, emotional, and intellectual aspects
  3. Promoting all aspects of health and well-being for people of all sizes
  4. Promoting eating in a manner which balances individual nutritional needs, hunger, satiety, appetite, and pleasure
  5. Promoting individually appropriate, enjoyable, life-enhancing physical activity, rather than exercise that is focused on a goal of weight loss

In almost every talk I give about Health At Every Size, there is a lot of agreement, and then some form of “Yes, but….”

But what about the person who binges and IS overweight?  But what about the child who weighs 300 pounds?  But don’t some people really DO need to lose weight?

I don’t think these are the questions we should be asking, but rather: what are the odds that trying to lose weight will actually make someone weigh less? What if we took a truly weight-neutral approach and helped people find the practices that support their health and well-being at whatever size they happen to be?  Unlinking weight and health is not easy.  It’s sneaky – the ways that we often get stuck in thinking that people of average weight or slightly higher weights can learn to relax their obsession with weight, but those at high weights we still need to “help”. The truth (and good news!) is that research on Health At Every Size has demonstrated that many health conditions can be improved independent from weight loss.

I once went to a physician for my annual wellness exam.  She took lots of tests, ran blood work, and checked me over.  She said, “You’re the perfect picture of health. You should lose weight.”  Isn’t that so confusing?  It can be subtle or blatant, but often there is lingering belief that weight loss is still a desired outcome.

Kids and adults alike have learned to project things like: lazy, stubborn, unmotivated, sad, and unhealthy to fatness, and things like: successful, desirable, popular, confident, and healthy to thinness.  These assumptions, when unquestioned, allow weight stigma to thrive.

I believe we can’t make assumptions about other people’s health or their habits based on the size of their body.

A friend and colleague, Deb Burgard, says “working backwards from a person’s body size to what their health practices must be is like working backwards from a person’s bank account to how hard they must be working.

And here’s the thing – people everywhere on the weight spectrum are hurt by weight stigma. We all feel the effects of it, whether it’s the person who blames her large body for all of the harassment she’s received, a thin person who can’t get thin enough to feel immune from potential rejection, or the person who saw a parent made fun of for their weight and has resolved to never let that happen to them.

Going back to the examples I started with: I want my client to be able to not internalize the implied message from her neighbor that said “you’d be better if you were smaller. All you need to is exercise more.” I want her be able to engage in activity that makes her feel vital and alive without a weight loss goal. I want us to appreciate photos  not based on whether or not they make us look thinner, but on how well they convey the essence of who we are. I want all children to learn to appreciate difference and for parents to be mindful of what they are handing down to their kids. I want for Cheetos and snap peas to peacefully co-exist in a lunch box.

September 24-28 is the Binge Eating Disorder Association’s Weight Stigma Awareness Week. What can you do to help create a society where people of shapes and sizes can feel at home with who they are?

Curious about working with me, but need more information? Have a question? Want to say hi? I’d love to talk about how I can best support you.

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