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?
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Comments (27)
I’m so sick of hearing naturally think people like you, Don, brag and brag and brag (and brag, and then brag some more) about how wonderful they are because they were born thin. You know what? I do everything you’ve said to do, and it hasn’t work AT ALL. I’ve been a vegetarian my entire adult life, I love to exercise, and I’m morbidly obese. Stop patting yourself on the back, stop looking down on people who were born fat, and start thanking your lucky stars that you won the genetic lottery when it came to weight.
Judy,
First of all, thank you for your message post. If you read both of my previous posts very carefully, I believe you will realize there is not a hint of any bragging in my commentary. Indeed, it would be physically impossible for me to pat myself on the back because 76.5% of it was surgically-fused in a brutally difficult procedure when I was only 16 years old, to mitigate severe lateral scoliosis. Also, Judy, I must point out that you have mis-spoken about me being “born thin.”, in effect implying that I am the recipient of fortunate genes. May I carefully say that my father was obese, and died of heart disease. I was credited with saving his life when he had his first serious coronary at age 59 years old. My older brother is obese–you see, the same genome, but I have made different LIFESTYLE CHOICES to effect a radically different outcome in my epigenome. Your arguments, Judy, are all specious and without merit. Wouldn’t it make more sense to set aside the denial and focus instead on making essential lifestyle changes to eliminate your morbid obesity? Your vegetarian diet, for example, can still have vastly too many calories (i.e. chocolate is not meat but is quite fattening). You say you love to exercise–but do you perform at least moderately vigorous (i.e. fast walking) at least an hour each day? I run 10,000 meters at a very fast pace each day (i.e. I am living authentically).
Judy, it has been shown that fully 75% of the cost of healthcare in the U.S. is directly related to the overweight/obesity problem–for example, heart disease, stroke, type 2 diabetes, cancer, and senile dementia. This is ALL preventable. This is the key reason that healthcare premiums have “gone through the roof.” Simply by using a bathroom scale every day, charting your weight, making healthy dietary choices, including an hour a day of moderate, or a half hour of vigorous exercise, into your regular routine, your morbid obesity is entirely reversible! You do not have to subscribe to the psychological phenomenon of “learned helplessness.” You can first repeat (frequently) that you will CHANGE what you are doing, and then EXECUTE on this idea, and make substantive changes by which to completely reverse your morbid obesity. Otherwise, you will die a lot sooner and the quality of your life will be orders of magnitude below what is readily achievable. Judy, I struggle with a profound disability-and yet, I (unlike my obese sibling) am in the so-called “caloric restriction” range–like those laboratory mice that live approximately 50% longer lifespans. It is not that I am restricting my calories, but that I make healthy food choices and engage in vigorous physical exercise (i.e. running) every day. Judy, this is not bragging nor patting myself on the back. This is simply stating facts. My genes would lead me quickly into morbid obesity as well, absent my careful lifestyle choices. Why not take prompt, regular, decisive action today and end your morbid obesity? You can do it too! All it takes is courage and discipline. Every single day. And you have to measure it to know if you’re changing it (i.e. weight on your bathroom scale, and chart it in a notebook each day–just like I do).
I will be happy to answer that question. Over 50 years ago, researchers experimenting with mice discovered that by feeding mice a calorically-restricted diet (approximately 2/3 of what they would otherwise eat), that their lifespan was increased about 50%. Even more recently, Dean Ornish, M.D. has verified that not just mice or plants but humans can stimulate their sirtuin genes by a combination of healthy diet (i.e. fewer calories and healthy food choices like more vegetables & fruits along with less meat-especially red meat), and moderate to vigorous physical exercise. With 2/3 of adults and 1/3 of kids in the U.S. either overweight or obese, and autopsies on kids revealing cardiovascular disease comparable to people 30 or more years older, it is clear that each individual must take the initiative to adopt a healthy lifestyle-healthy diet and moderate to vigorous exercise per the recent ACSM (American College of Sports Medicine) and AHA (American Heart Association) joint guidelines–and remember, these are MINIMUM exercise guidelines. Just dieting, or taking diet pills has not made any significant difference in obesity. Our healthcare premiums are unaffordable now because the overweight/obesity epidemic has caused an explosion in type 2 diabetes, cardiovascular disease, stroke, cancer, dementia, and many other entirely preventable diseases-at vastly younger ages than in the past. This trend will not be meaningfully changed by being in denial about one’s obesity. It will only change when each individual takes personal responsibility and changes their lifestyle to a healthy one. Remember that I am 57 years old, an 6 feet, 0 inches tall, weight 136 pounds, and my back was surgically fused from severe scoliosis at age 16, from L3-T3 (that’s 76.5% of the back). My BMI is 18.50, and I am a middle distance runner, competing in USA Track & Field-sanctioned running events against able-bodied athletes. In the USA Track & Field Outdoor Rankings, I am listed as #16 in the U.S. at the 3000 meter distance. My point is that you must believe that you can meaningfully change your overweight/obesity through taking action in terms of lifestyle changes including both healthy diet and moterate to vigorous physical exercise. In doing so, you will lengthen your life, have a higher quality of life, and you will be directly lowering the mushrooming cost of healthcare premiums for everyone else who is trying to be healthy but forced to pay much higher premium rates because 2/3 of adults and 1/3 of kids are overweight/obese, causing a huge increase in healthcare costs for everyone. The solution is not to be in denial but to individually take action to live a healthy lifestyle.