Welcome to The Weight of It All — a new series about diet culture and the way it weighs on society. Diet culture is pervasive and while it targets everyone to some extent, those who live in marginalised bodies, as well those who are female-identifying, experience the brunt of it. The weight of it is almost overwhelming. This four-part series will explore how diet culture operates, its roots in colonialism, the way shame works in the wellness industry and advice from experts on how to ditch diet culture from your life. You can read part one here.
Diet culture is so entrenched in our society that it is often considered acceptable to enquire about someone’s weight, especially in the instance where they have lost it. The question ‘Have you lost weight?’ followed by the statement ‘You look great!’ is considered a compliment. On the flip side, it is also deemed OK to enquire about someone’s weight in reference to their health. Those living in larger bodies are often bombarded with questions about their weight as a means of faux concern.
In the context of social media, writer Ashley C. Ford calls these people “concern trolls.” “If you are a fat woman with the unmitigated gall to present yourself as happy or beautiful, concern trolls will tell you that you are not healthy and should focus on losing weight,” Ford wrote for Self. “They will also often accuse you of ‘glorifying obesity’ for not publicly hating or castigating yourself for existing while not thin.”
Plus-size model Tess Holliday is constantly inundated with comments from concern trolls. In fact, Holliday’s body, coupled with her choice of career, rubs many people the wrong way and numerous misguided op-eds have been written questioning Holliday’s role in “promoting” living life in a larger body. While Holliday used to respond to these people, she no longer gives them any airtime.
“In the beginning, I used to say, ‘I’m healthy, my cholesterol’s fine, I don’t have high blood pressure, I don’t have diabetes,” Holliday told Self. “By telling people that you see a doctor, and telling people that you’re healthy, it’s perpetuating the abuse against bigger bodies and the mindset that we owe it to people to be healthy. The reality is I don’t owe you sh*t and I don’t have to prove that I’m healthy or not, because it is nobody’s business.”
The idea that your weight is the sole indicator of health is one we need to move past — but it is constantly perpetuated by society. “Health is seen as synonymous with thinness rather than the participation in health-giving behaviour,” Sarah McMahon, director of BodyMatters Australasia, which offers counselling and treatment for eating and dieting disorders, body image issues and problematic exercise, told The Latch.
“We have even seen this with diets masquerading as wellness programs. WW (formerly Weight Watchers) is a recent example of a diet company which has shifted its focus to appear more palatable. This can be tremendously confusing for anybody trying to navigate what ‘being healthy’ is.”
The concern with our own fatness as well as the weight of other people is so common that it is considered normal and acceptable. We congratulate those who have lost weight while gossiping about those who have gained it.
“Prejudice, stigma and discrimination are very real when it comes to fatness,” said McMahon. “I think one of the reasons why this continues is that it is something we can all relate to: We all exist in bodies — whether they are fat or thin. This makes these topics relatable.”
A large component of unpacking diet culture includes changing the narrative around health and size and recognising that health is not defined by how little or big your body may be. There are a number of factors that influence health outcomes — not just the food you eat or the exercise you engage in. Some of these are socioeconomic factors like education, living conditions and housing as well as social networks, age, gender and genetics.
“In fact, Australians living in the most socioeconomically disadvantaged areas lived, on average, three years less than their counterparts living in the most socioeconomically advantaged areas from 2009-2011,” non-diet and Intuitive Eating nutritionist, Nadia Felsch, told The Latch.
“Humans come in all shapes and sizes, largely determined by our genetics. Moreover, we can’t ‘see’ health or determine it from a body size and positive health outcomes aren’t limited to smaller bodies.
“You can have disease and ill-health across the full spectrum of bodies, as you can with health and fitness. Further still, you can choose to engage in health-promoting behaviours and still not have the societally-idealised version of health shown in film and media.”
The stigma attached to living in a larger body can take many forms but involves any discrimination or stereotyping based on a person’s weight or body size. Weight stigma, coupled with society’s idealisation of thinness, can also manifest in fatphobia, which is the fear of becoming fat or the disdain of fatness.
In 2019, researchers at Harvard University conducted a comparative analysis of long-term change in six social group attitudes. The research showed that the unconscious bias of Americans on the basis of sexual orientation and race has dropped dramatically over the last decade but weight bias hasn’t.
In fact, the data showed that attitudes toward sexuality, race, skin tone, age and disability are changing faster than attitudes towards weight. In the period 2004 to 2010, researchers found a 40% increase in weight bias.
The mental health outcomes of weight stigma are worrying, with a meta-analysis study from 2019 finding the greater the perceived weight stigma, the worse the mental health status of the individual. Researchers concluded that in order to improve the wellbeing and protect the psychological functioning of individuals who are at the receiving end of weight stigma, this must be addressed through education and policies.
Those discriminated against for their weight can also experience poor healthcare outcomes, with research showing that higher-weight patients often feel they are devalued in a clinical setting and frequently reported feeling ignored. “Higher BMI adults are nearly three times as likely as persons with ‘normal’ BMI to say that they have been denied appropriate medical care,” the study reads.
This is what happened to Rebecca Hiles, who at the age of 17, was turned away by multiple physicians and instead, told to lose weight to address her shortness of breath and coughing fits. Three years later, in 2012, Hiles was diagnosed with cancer — a slow-growing carcinoid tumour in the bronchial tube — and was scheduled to have surgery just two weeks later, where surgeons removed her entire left lung.
Another more recent example from the United Kingdom shows the devastating impact of weight stigma. In October last year, British obesity nurse specialist, Toni Jenkins, tweeted details of how weight bias and body shame perpetrated by professionals in the medical industry cost one woman her life.
“Jo attended for [a] cervical smear,” Jenkins wrote. “Nurse complained about fat making it difficult so said she should lose weight before she returned. She didn’t return. I nursed her at the end with her extensive cervical cancer with secondaries. She died aged 32.”
Health specialist and nutritionist, Patrilie Hernandez, identifies two sources of weight stigma — institutional stigma and systemic stigma. Despite experiencing weight stigma personally, Hernandez also points to the size privilege she has. “I still experience a lot of size privilege because I can sit in an aeroplane seat,” Hernandez told The Latch. “I do consider myself a large-bodied person and do experience weight stigma in my doctor’s office.
“But I can sit in a waiting room chair, [and] blood pressure cuffs still somewhat fit me. A lot of infrastructures we have in place, I don’t struggle with as much because I am still considered an acceptable size, even though I’m a large body person.
“When we talk about weight stigma, we always have to centre the folks that are most impacted. And those are the folks with the largest bodies, right? But in my professional life, because I work in public health and nutrition, I experience more weight stigma there than I do in a systemic or from an infrastructure standpoint.”
Hernandez speculates that this might be because many people who work in the nutrition industry also inherently carry a lot of fatphobia. “Either you have folks that are just naturally thin doing this work, or you have folks that are engaging in behaviours that keep their body size as small as possible,” she said.
“I used to be one of those people, but now that I am not one of those people because my size has grown, I definitely experience weight stigma in the public health sphere. And I think I experience that most when it comes to believability.”
“For example, if I’m presenting somewhere or if I’m speaking and someone can look at me, I have experienced many, many times people who doubt what I’m saying or what I’m presenting based on my body size.”
To counteract this, Hernandez compensates by making sure she is across everything associated with the topic she is presenting. In her words, she becomes a “walking bibliography. Because people are less likely to believe what I have to say about health, because what I look like, but they’ll believe the 30 studies that I cited,” she said.
Meanwhile, those who are considered fit, and especially those who are white, are often given the benefit of the doubt when they are in the same position as Hernandez. “People are more likely to take them at their word and not question their science, their methods, whether they have weight bias,” she said. “And so I see that very often, I live that every single day.”
While weight stigma is engrained into the fabric of society, it isn’t fixed. We have the agency and the ability to change the way we view fatness. For years, scientists have known that weight is not a proxy for health but this information isn’t acknowledged by mainstream media, who are largely still peddling the trope that thinness equates to health.
Being an ally for those living in larger bodies is integral in fighting against weight stigma. This includes advocating on their behalf and putting in the work to change your own behaviour. For example, think of the words you use to describe people. Using someone’s weight as a description — whether the intention is positive or negative — shouldn’t be acceptable.
Donald Trump, for example, is often criticised for his weight. While his politics and behaviour during his tenure as President of the United States was abhorrent, using fatphobic insults about his weight feeds into the culture of weight stigma. Trump happens to live in a larger body while also being a pretty terrible person. But, these are not mutually exclusive and he isn’t terrible because of his size.
“No matter how much you dislike someone for their politics, when you shame them, or when you behave in a way that attacks their body size and their looks, what does that say about a person that has a similar body size and look that doesn’t share the same politics?” Hernandez said. “I think we have to be the embodiment of not using those kinds of tactics as a way to break people down. I think we can be better than that.”
Instead, look at the ways you can actively be an ally for those in larger bodies. How can you use your voice to advocate and make infrastructures more comfortable?
“I consider myself an ally too and an example of how I use my allyship is in a work setting,” said Hernandez. “I always make sure to look around the room, [and question] what are the size of the chairs in your office? What does accessibility look like?
“Because a lot of times when you advocate for people living in large bodies, they also mirror a lot of the just general accessibility issues people have around making spaces inclusive. So when you look at trying to make a space inclusive, whether someone has a disability or they have a mobility issue, how are you making it inclusive to body size as well? So I always make sure to speak up and to advocate for inclusive workspaces.”
Using size as a yardstick for health has been programmed into us from an early age, so while it might feel hard to change your thinking on this, it’s something you must move past. The question “Have you lost weight?” is not a compliment and shouldn’t be posed to anyone. In fact, asking this question shines a light on your skewed priorities and places value on the individual for losing weight, rather than who they are as a person.
“Rather than weight, it is far more useful to focus on building wellness,” McMahon said. “Wellness is not a ‘state’ or destination but rather a process or journey we are always on. It involves exercising for pleasure, eating food because it nurtures us and also looking after other parts of ourselves, including our mental health.”