Equity & Inclusion
FOCUS ON: “FATPHOBIA”
Fatphobia is the explicit and implicit bias toward people who are fat. It includes attitudes of blame and judgement, and often attributes moral insufficiency and general inferiority to the fat individual. Fatphobia may even include feelings of hatred or disgust toward fat people. This bias is held by children, adolescents, and adults in many countries and communities around the world. Especially notable for those entering healthcare fields is that healthcare professionals themselves may tend toward significant anti-fat bias.
There are many different terms used to refer to people who have larger bodies and the best way to address someone is using the language that they prefer. Some people are reclaiming the word “fat” as a neutral descriptor and would like to be called fat, while others prefer to be called “plus size,” “in a larger body,” “person of size,” or something else. Many medical settings use the terms “overweight” or “obese” but these terms are stigmatizing and based on the faulty BMI system and should not be used unless they are someone’s stated preference.
BMI or body mass index is a number calculated based on one’s height and weight that classifies people as underweight, healthy weight, overweight, obese, or severely obese. Though it is frequently used in medical settings, it was created by a mathematician to measure populations and was not meant to be used as an individual health measure. Even if it was relevant as an individual outcome measure, it was only normed on white males, so it would not be accurate for other groups. BMI is not an accurate measure of health and should not be used as such.
Weight is not a direct indicator of health. Though diet and exercise are often cited as the sole cause of weight, there are many factors that can impact one’s weight such as ethnicity, genetics, history of trauma, history of disordered eating, mental health, medicines, and sleep, to name a few. People can be healthy at any size and someone’s body size does not tell you their health status. Additionally, even if a fat person is not healthy, they do not deserve to face discrimination.
FATPHOBIA AS A FORM OF DISCRIMINATION
Fatphobia is not just about feeling insecure in one’s body, but about systematic discrimination that fat people face. Body size and weight are not protected classes in the US, meaning that it is perfectly legal to discriminate against someone because of their size. For example, one meta-analysis found that employees classified as obese faced unfair hiring practices, low wages, harsh discipline, and wrongful termination at higher rates that other employees (Rudolph et al., 2009). Fat people also face stigma, discrimination, and mistreatment in healthcare settings and often do not receive the healthcare they need because their provider overemphasizes their size and ignores their health needs (Gailey, 2022). Finally, many occupations are inaccessible to people in larger bodies as environments such as airplanes, buses, movie theaters, roller coasters, restaurants, schools, and offices are often created without fat people in mind.
Gailey, J. A. (2022). The violence of fat hatred in the “obesity epidemic” discourse. Humanity & Society, 46(2), 359-380. https://doi.org/10.1177/0160597621995501
Rudolph, C. W., Wells, C. L., Weller, M. D., & Baltes, B. B. (2009). A meta-analysis of empirical studies of weight-based bias in he workplace. Journal of Vocational Behavior, 74(1), 1-10. https://doi.org/10.1016/j.jvb.2008.09.008
FOOD FOR THOUGHT: THE LIVED EXPERIENCE
I just need you to be aware of when you’re talking about what it means to be a fat person, you’re saying that to a fat person. And that can’t just be water off a duck’s back, to listen to a friend talk at length about how much they would hate to look like me.
Aubrey Gordon, in response to a non-fat friend talking about their bad feelings about their own body (on “Bustle“)
Handout with additional information
- Association for Size Diversity and Health Workshops: https://sizediversityandhealth.org/events/
- Anti-diet Fat Liberation Support Circle: https://www.radicaltherapycenter.com/event-tickets/fatphobia-support-circle-x-sonalee-8-sept-7-8p-et
- Everybody is a Babe Workshop: https://everybodyisababe.teachable.com/p/home
- Everything You Know About Obesity is Wrong (Online Article): https://highline.huffingtonpost.com/articles/en/everything-you-know-about-obesity-is-wrong/
- The Racist History of Fatphobia and Weight Stigma (Online Article): https://withinhealth.com/learn/articles/the-racist-history-of-fatphobia-and-weight-stigma
- Maintenance Phase (Podcast): https://www.maintenancephase.com/