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Fat is a metabolically active tissue that plays a role in hormone control and regulation, keeps us warm, cushions our organs, and acts as storage for energy and vitamins. Fat is a vital and irreplaceable part of our bodies, and yet the word “fat” is almost exclusively used derogatorily. There are few words in our vocabulary that carry as much weight as the word “fat”. We live in fear of being called “fat”, go to extreme lengths to avoid gaining fat, and harshly judge others who we perceive to be “fat”. Though many individuals are choosing to reclaim the term “fat” as an objective descriptor of a body, much in the same way tall and short are used, fat bias is real and harmful.

Some studies suggest that fat bias, also known as weight stigma, is more prevalent and embedded into our society than discrimination based on race or ethnicity. Bias towards fat persons is on the rise, and it leads to poor social, mental, and physical health outcomes for those targeted by it. Many adverse health effects commonly attributed to obesity can be worsened or even caused by weight discrimination. People who have experienced weight discrimination have a 60% increased risk of death compared to those who have not, regardless of their BMI. This increased risk is attributable to several factors, one of them being the increased stress felt by those facing the discrimination. Another is the fat bias prevalent in the healthcare system. In a 2014 survey of medical students, two-thirds demonstrated overt bias toward fat patients, and half described them as “lazy, unmotivated, noncompliant, and unhealthy.” Whether this bias is conscious or implicit, studies show that doctors build less emotional rapport and spend less time with obese patients.

With fat bias being so ingrained into our society, dismantling the negative connotation of the word “fat” will not be easy. However, you can begin to dissect and act to change your personal biases using these steps from activist and author Aubrey Gordon:

1. Acknowledge your own fat bias. It will be uncomfortable, but becoming aware of your attitudes and beliefs is the first step to changing them. 
2. Diversify your social media. Fill your social media feed(s) with people of all shapes and sizes. We have grown up believing there is one ideal body type out there, and that is not realistic. Begin to immerse yourself in a world where bodies that don’t look like the traditional ideal are still deserving of love. 
3. Do some research. Educate yourself on the wide-reaching effects of fat bias. Begin to break down some of the myths about size and weight that we have been taught to believe, such as “weight loss is easy if you just exercise and eat well”. Start with the studies linked in this blog, and then continue to learn more. 
4. Have conversations with fat friends and family members. This one may be difficult, but it’s important to understand the experiences of those who may have experienced weight stigma. Ask how you can better support your loved ones in a world where they are or have been judged based on their size, and not who they are as people. 
5. Speak up. When you see fat bias or become the target of it, do not just let it go on. Challenge the thoughts of those who make comments or openly discriminate. This not only brings awareness to those involved, but it sends a message to the fat people around you that you are an ally in this fight for equality. 

All people, no matter the size or shape of their body, deserve to be valued and treated equally. Let’s start taking the steps to make this a reality.  

Sources:

Gordon, A. (2020). 7 Ways to Uproot Your Anti-Fat Bias. Medium. https://humanparts.medium.com/7-ways-to-uproot-your-anti-fat-bias-54f01d76ec3b.

Gudzune, K.A., Beach, M.C., Roter, D.L. & Cooper, L.A. (2013). Physicians build less rapport with obese patients. Obesity;21(10):2146-2152. doi:10.1002/oby.20384 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3694993/

Hebl, M. & Xu, J. (2001). Weighing the care: Physicians’ reactions to the size of a patient. International Journal of Obesity;25:1246–1252. https://doi.org/10.1038/sj.ijo.0801681 https://www.nature.com/articles/0801681

Phelan, S., Dovidio, J., Puhl, R. et al. Implicit and explicit weight bias in a national sample of 4,732 medical students: The medical student CHANGES study. Obesity. 2014;22(4):1201-1208. doi:10.1002/oby.20687 https://onlinelibrary.wiley.com/doi/pdf/10.1002/oby.20687

Tomiyama, A., Carr, D., Granberg, E. et al. How and why weight stigma drives the obesity ‘epidemic’ and harms health. BMC Med 16, 123 (2018). https://doi.org/10.1186/s12916-018-1116-5 

Written by: Maddie Gottfried, Dietetic Intern, The Ohio State University

Reviewed by: Jenny Lobb, Family and Consumer Sciences Educator, Ohio State University Extension Franklin County

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