It’s worse than we thought: new weight stigma study

Content note: Discussion of weight stigma experiences and use of medicalised term ‘obesity’ and BMI categorisation.

A number of scientific studies have shown that weight stigma is prevalent and on the rise, affecting just about every facet of daily life.  More recently, numerous studies (including my own) have used a questionnaire called the Stigmatising Situations Inventory to ask people about their lifetime experiences with stigma. It has 50 questions (if any of you reading this took part in my last study, thank you SO much for slogging through it), and these are grouped into 11 different types of stigma – things like nasty comments from families, inappropriate comments from doctors, being stared and pointed at, physical barriers in daily life (e.g. bus seats, turnstiles, not being able to find clothes that fit), and even being physically attacked.

All of these studies have been pretty consistent in what they found. Women experience more weight stigma than men and that it happens at lower BMIs for women. Interpersonal events are the most common form of weight stigma, especially comments from families and friends. And other types of stigma, such as stigma in healthcare and employment settings, are nevertheless far too common. Being physically attacked because of your weight is reported by about 10% of participants in a number of studies that have looked at it, including mine. If you’d like to see some actual numbers, you can read a selection here, here, here, and here.

But because this questionnaire asks people to remember previous events over an entire lifetime, some of which might have been only minor instances or throwaway comments in conversation, there is a strong likelihood that however upsetting these were at the time, most people will not remember every single one of them, and the study results are probably under-estimating the true prevalence of weight stigma.

A new study just published decided to look at this a little more closely. The researchers recruited 50 women from online discussion boards about ‘obesity’ and asked them to keep a daily diary about their experiences that day. They used the same questionnaire with the 50 items over 11 categories, but also gave them space to include anything they wanted to add. The women had an average age of 38 and an average BMI of 42.6, with a range from 25 to 77. They were mostly White (94%), and 42% were married. They spanned a wide range of educational achievement (from high-school diploma to graduate degrees).

Overall, the women completed their diaries six days out of seven, or around 85% of the time. Over the week of the study, they reported an astonishing (or maybe not) 1077 stigmatising events, an average of over 21 per person – 3 a day. The paper doesn’t report the findings for every category of stigma (there’s never enough space to include everything you want), but 84% reported experiencing physical barriers in their everyday lives, 74% had received nasty comments from others, and 72% were stared or pointed at in public – a category that includes items like being pointed and laughed, or having your picture taken in public by total strangers, as if you were an exhibit. Despite the very short experimental time frame, nevertheless, 22% reported discrimination related to employment, 16% reported inappropriate comments from doctors, and, consistent with other studies, 12% had been hit, beaten up or attacked because of their weight. It kind of makes sense that this number is so similar to the ones seen in lifetime recall studies – being beaten up because of your size is not something you are likely to forget.

Comments from participants included one woman who said that she went to McDonald’s before attending a baby shower so that she wouldn’t be hungry when she got there and have what and how much she ate scrutinised by others. Another was mooed at by a group of teenagers. And one woman was told by her boyfriend’s mother that she was so fat because she was lazy, and was denied access to food. The authors note one ‘positive’ response from a woman grateful to have taken part in the study because it motivated her to go on a diet. Because it’s a good thing to respond to other people attacking and bullying you by trying to change yourself. Apparently. Sigh.

The authors also found that stigma experiences were related to the number of interactions you had with people on a daily basis – more meetings, more stigma – and that the more people stigma experienced, the more time they tended to spend in their own home, limiting their time outside in public. Staying out of the public eye was particularly associated with higher levels of the participants own internalised stigma – how much they believed they were worth less because of their weight – and with experiencing physical barriers.

This was a small study, and it was also not very racially diverse, so it isn’t possible to generalise what they found to all fat people. Also, these people were recruited from weight-related discussion sites. Being surrounded by people who are rude to you because of your weight might make you more likely to seek out such sites. Happy fat people with supportive friends and family may have fewer negative interpersonal encounters related to their weight, although they would still be exposed to stigma from other sources. Being fat-positive might also impact how people responded to the stigma they experience. The authors looked at eating and exercise behaviour, and found that stigma tended to make people eat more, which fits in with all the other studies that have looked at this, although they didn’t find an effect on exercise.

At the end of the day, this is an interesting but depressing study. It doesn’t tell those of us in the fat community anything we didn’t already know, but it helps to highlight the extent of the problem a little more clearly. Now if only they could do something to fix it.

 

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