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Why 'Fatphobia' May Be Just as Toxic as Poor Diet, According to Dietitians

Though sometimes fatphobia can rear its head in more obvious ways, other times this bias is more subtle.

Most of us have experienced someone in our lives wanting to lose some fat on their body, assuming that carrying less weight is better. Whether you're claiming to want to have a "bikini body" or need to achieve a flat tummy, avoiding being labeled as "fat" is a goal that is quite popular in today's modern culture. However, there can be another side to the weight-management coin that doesn't get as much or enough attention—but it should. While having a goal of achieving a certain body size may sound innocent enough, some people may have what is referred to as "fatphobia," which can drive some incredibly unhealthy practices that may cause more harm to your physical and mental health than good.

As Boston Medical Center explains, fatphobia "is the implicit and explicit bias of overweight individuals that is rooted in a sense of blame and presumed moral failing. Being overweight and/or fat is highly stigmatized in Western culture." More recently, the intrinsic connection between fatphobia or having an "anti-fat" mentality and other forms of systemic oppression, like racism, classism, and misogyny, has been made and called out in the mainstream media, especially on various social media platforms, by those aiming to promote a health-oriented, body positive perspective. To better understand what fatphobia really is and how it can potentially have an adverse impact your health no matter your size, we spoke to a few diet and nutrition experts to get more information on this controversial topic. 

What is 'fatphobia'?

"Often referred to as anti-fat, fatphobia is an internalized fear of fatness, which may present in a variety of ways," explains Sarah Anzlovar, MS, RD, LDN, certified intuitive eating counselor and dietitian for moms at Sarah Gold Nutrition, LLC, to Eat This, Not That!

So, being fatphobic doesn't mean that a person is necessarily afraid of being fat. Rather, the term suggests that they may have a prejudice against those who visually appear to posses more body fat than what is believed to be acceptable. This threshold can be extremely subjective—sometimes this prejudice is exhibited more overtly; other times, this form of bias reveals itself via more passive microaggressions.

"[Fatphobia] may be more obvious, such as fat shaming or bullying," adds Anzlovar. "Though it's often more subtle, such as someone commenting on how certain clothes make you look thinner or complimenting weight loss."

How fatphobia & weight bias are interrelated
Plus-size woman sad by scale cyberbullying

People's negative feelings toward being overweight, unfortunately, doesn't simply affect the individual who holds these beliefs and thinks this way. Fatphobia can have true negative implications for many people in our society, as it is strongly interconnected with weight bias.

Weight bias is a "bias against fat people along with the belief that being fat is a moral failing, or representative of a lack of personal responsibility," shares Christine Byrne, RDN, a dietitian focused on disordered eating. Modern society has adopted negative beliefs that obese individuals are lazy, irresponsible, and lack self-discipline—even though genetic, socioeconomic, and environmental factors play a role in the development of obesity.

In fact, results of a review and meta-analysis published in Obesity shows that even health care professionals demonstrate implicit weight bias. Specifically, a large quantity of medical doctors, nurses, dietitians, psychologists, physiotherapists, occupational therapists, speech pathologists, podiatrists, and exercise physiologists hold implicit and/or explicit weight-biased attitudes toward people who were considered obese.

The weight stigma is a growing concern, as it has reportedly increased by two-thirds in the last decade. And research has shown that weight stigma leads to adverse physical and psychological health consequences for this population.

One example of these consequences is highlighted by, Lauren Harris-Pincus, MS, RDN, the founder of and author of  The Everything Easy Pre-Diabetes Cookbook.

"Due to this inherent bias, only 10% of people with obesity seek medical care for the condition," says Harris-Pincus. "This leaves the rest on their own to seek self-care, often in the form of fad diets and weight loss scams peddled by 'influencers' without training in the care and treatment of people with obesity."

"Repeatedly experiencing weight stigma can increase a person's overall stress and reduce their quality of life," adds Bryne. "Weight stigma at the doctor's office—constantly being told to lose weight by your doctor, or being denied certain treatments or procedures until you lose weight—can worsen a person's quality of care, and it can discourage them from getting regular check-ups and screenings."

Numbers on the scale aren't the only predictors of health

dont want to step on scale to weigh herself

Many health care providers are in the practice of weighing patients, measuring their height, and then calculating their body mass index, or BMI. The BMI value then determines whether a person is considered to be in certain weight classification pockets, including underweight or overweight.

Harris-Pincus explains that leaning solely on the BMI is flawed, as this measurement is "based on Met Life insurance tables in the 1930s and '40s. It's not science-based and does not take into account racial/ethnic or gender differences or variations in body type/composition."

Byrne added that the BMI "was never meant to measure health, and yet the medical system uses it as an indicator of how healthy someone may or may not be. This is problematic because it overemphasizes the link between weight and health." Beyond the fact that BMI doesn't differentiate between fat and muscle weight, it tells us nothing about what is going on inside someone's body health-wise.

"It's possible to be fat and in good health, just as it's possible to be thin and in poor health," says Byrne.

Both Byrne and Harris-Pincus agree that other health metrics can give a good snapshot of a person's health and should be taken into account. Blood pressure, cholesterol levels, and blood sugar levels are some examples of indicators of a person's health that do not take weight into account. Byrne also adds that often overlooked, other determinants of a person's health like access to health care, access to fresh food, social connectedness, a good environment, lack of stress, quality sleep, and overall genetics also play a huge role in a person's health, too.

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The bottom line

While diet culture has trained many of our brains to believe that having a body like the celebrities we see on the big screens is what we should aim to achieve for maximum health benefits, the science simply doesn't confirm this link. While it is true that obesity is linked to a greater risk of developing certain conditions like type 2 diabetes and high blood pressure and that those who are considered obese are at an elevated risk of experiencing stroke and even early death, it isn't the only determinant of a person's health. It is entirely possible to have a higher-than-ideal BMI and be completely healthy.

Additionally, having obesity is certainly not an indication of a person's motivation, lack of willpower, or other factors, as elements like genetics and environment—factors that are out of a person's control—can have an impact.

Having weight bias and fat phobia can have serious consequences on a person's well-being, regardless of whether it is coming from a health care provider, a peer, or even from an internal voice in a person's head. Fat shaming is linked to depression, anxiety, low self-esteem, eating disorders, and exercise avoidance. Too, the more people are exposed to weight bias and discrimination, the more likely they are to gain weight and develop obesity, even if they were thin to begin with. They're also more likely to die from any cause, regardless of their body mass index (BMI). Weight stigma may also drive adverse psychosocial health outcomes, such as anxiety, depression, body image dissatisfaction, and negative self-esteem.

Just like we are encouraged to check our bias at the door when it comes to a person's race, culture, age, gender, or sexual orientation, exploring the implicit bias people may have toward weight will help us move away from this culture of assuming a person's appearance is an indication of their health or their personality. We need to remember that being thin does not automatically mean being "better." Instead, focusing on a person's lab results, lifestyle, mental health, dietary choices, and other factors can help shift this conversation in a more positive and impactful light.

Lauren Manaker, MS, RDN, LD, CLEC, CPT
Lauren Manaker is an award-winning registered dietitian, book author, and recipe developer who has been in practice for almost 20 years. Read more about Lauren
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