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January 7, 2007

Against Weight Bias

I've been thinking a lot lately about the issue of weight bias. One of the main inspirations for this line of thinking is the fine work of Dr. Rebecca Puhl at the Rudd Center. Her blog entry here on bullying, among many other fine pieces, casts a very careful eye on the issues surrounding weight bias as it affects overweight and obese people. I highly recommend that all of you take some time to read through Dr. Puhl's entries in the Rudd Sound Bites Blog.

Weight bias occurs when one person makes assumptions about another person's character, lifestyle, habits, moral status, or worth as a person based on his or her weight. There are many obvious examples of weight bias against overweight or obese people. Thin people aren't exempt, though. For instance, I notice that a lot of people assume that thin people are:

rich
snotty
holier-than-thou
self-righteous
health nuts
lucky
hate fat people

and that very thin people are:

anorexic
obsessive compulsive
neurotic
very rich
really hate fat people

All of this is quite silly. You can't draw accurate conclusions about a person's character, background, or motivations based on his or her BMI, dress size, or weight.

Let me state my position clearly: I believe it is wrong, MORALLY WRONG, to make judgements about a person's character based on his or her weight.

I have written at length about how hard it is for people to eat healthy and maintain a slim weight in our obesogenic environment. I have dedicated myself to citizen action to improve the food environment, so that everyone has the information, options and support to make healthy choices and live just as long and healthy as he or she would like to. I don't blame people for doing exactly what our biology dictates we will do in an environment where we're bombarded with high calorie, high sugar, high saturated fat, possibly addictive foods. I want to work to improve the environment because I think that the pre-mature death and suffering caused by this food environment is inexcusable. People deserve better choices.

In Food Fight, Brownell and Horgen go into detail about how efforts to improve the food environment often meet with resistance from people (Food industry lobbyists, even public officials) who insist that obesity is a personal problem, and can only be solved with personal responsibility. The implication is that those who are suffering lack personal responsibility. Our culture demonizes overweight people, painting them as lazy, stupid, and morally deficient. This totally absolves food merchants of any responsibility for providing healthy choices. It also ignores the role of education in teaching people how to understand and interpret nutritional information and plan a healthier diet for themselves and their families.

Weight bias is ineffective as a strategy for combating the obesity epidemic. It just hasn't worked. If people lost weight and got healthy because weight bias motivated them, everyone would be slim and trim! There's plenty of pressure to be thin: what is lacking is nutrition information, reasonable healthy affordable tasty food choices, and time + resources to make exercise a part of daily life. I believe that it is counterproductive to debate whether or not obesity is a "choice." (You can quite a few of these debates on the Rudd Center blog comments.) No one wants to be unhealthy. Everyone wants to have a range of choices, and accurate information with which to make those choices. 65% of Americans are overweight or obese, and the top New Year's Resolution, every year, is to lose weight. Blaming people for being overweight is not helping anyone. In fact, it hurts.

But for the sake of argument, I decided to do a quick thought experiment to determine whether or not, in my own experience, fat people are lazy and stupid. I'm going to mentally go through every lazy or stupid person I've ever known.

Hold on, this may take awhile.

Please stay with us... I'm still thinking.

Wow, I've known a lot of lazy stupid people. But guess what?

As a percentage, the majority of lazy, stupid people I've known in my 32 years were not overweight! Some were normal weight, some were overweight, one particularly lazy former staff member (years ago, back in Vermont) was thin as a rail. She was evil too, but that's beside the point. Point being: in my experience, the overweight are actually *underrepresented* in the ranks of lazy, stupid people! To judge from my anecdotal experience, one is more likely to be lazy and stupid if one is of normal weight or thin!

It just goes to show that you can't judge a human being by his or her body fat percentage.

Now that doesn't mean that I believe we should minimize the health consequences of being overweight or obese. I think it's important to be honest with people about the dangers of obesity, and to work towards improving the food (and activity) environment so that people have better, healthier choices. Pretending that it's normal, natural or healthy to be overweight or obese isn't going to change the cold hard facts of health risk. Sure, some people are just naturally heavier, and some people are naturally skinnier. I, for instance, am naturally a bit heavier. Even on moderate CR, I'm not skinny-looking. Eating ad lib, I look like a fertility goddess from an ancient Celtic religion. My partner is naturally skinny, and was even eating ad lib. People come in different shapes and sizes, to be sure, and people have different tastes in what they find beautiful. It's possible to affirm the value of every human being (of whatever weight) while recognizing the health risks of obesity and pursuing strategies to end the epidemic.

I've had some ideas about combatting weight bias in popular culture. Here's my idea for a television spot:

One at a time, about six different people of different races, in clothing that indicates different class status, both male and female, but all slim, smile into the camera and say, "I've lost x number of pounds." The pounds should range from 10 to 150, with most somewhere in between.

The viewer will think it's an ad for a diet plan, so he or she will pay attention.

Then in the next series of shots, each of the original people will say some version of:

"And I'm not a better person -- I'm just lighter."

"I feel healthier now, but I'm the same person I used to be."

"I was a good person when I was overweight, and I'm still a good person now."

"I wasn't lazy or stupid when I was obese... I just didn't have the choices and information that I have now."

As shots of the six characters going through their lives -- at work, at school, at home -- flash onto the screen, a voice over says, "It's wrong to judge someone by his or her weight. These folks lost weight... but they're here to tell you that they're the same person they were when they were overweight. Overweight people aren't stupid, lazy, or bad. Think before you judge."

Last shot: the six slim characters hanging out with, hugging, shaking hands with, exchanging high fives with, a cast of six overweight or obese characters.

I believe we should all make an effort to combat weight bias. I confess that I have not always been as proactive as I should be. When thin folk make negative comments about an overweight person based on his or her weight I will, in future, hold myself more accountable. I'm going to come up with some things to say when I feel like someone is unjustly judged due to his or her weight:

"Hey, it's not fair to judge that person based on his or her weight. We don't know what circumstances may contribute. Let's focus on things that are more relevant."

"You know, I don't like her either, but it's not because she's overweight. It's because she (insert valid reason for not liking her.)"

"I used to be overweight myself, and I can assure you, I was no more lazy or stupid then than I am now. Let's not make assumptions about people's character based on his or her weight, okay?"

And while we're on the subject of weight bias, I'd like to challenge a few assumptions that many people, including some of my readers, seem to have about folks who are thin:

1. That we hate fat people. We don't. Some thin people have an irrational hatred of fat people... no doubt some thin people have an irrational hatred of spiders too. But most thin people I know don't feel that way at all. Don't assume that we put overweight people down because we happen to be thin.

2. That we don't enjoy life. As Paul McGlothin so wisely said, we need to get past the idea that the amount of pleasure we receive is equal to the number of calories we consume.

3. That we're all anorexic. We're not. It is quite possible to cultivate a healthy relationship with food that involves getting great nutrition while maintaining a low, or even very low weight. I frequently hear from other healthy thin women that they are tired of being asked if they're anorexic. People who work at maintaining a healthy weight are no more obsessive, compulsive, or otherwise disordered than the rest of the population... we're just taking advantage of the tools and information we've been lucky enough to come across to make choices that we feel are best for our own health. Either pass the kale, or leave us alone!

Weight bias hurts, no matter which direction the bias goes. Let's all join cyber hands and commit to fighting for healthier attitudes towards food and our fellow humans.

Then we can go back to judging people by things that really matter, like the quality of comments they write on the blog.



Posted by april at January 7, 2007 6:19 PM

Comments

I've been fat, fatter, real fat, and kinda medium. Now I'm on the thinner side. Hard to judge myself, but I know I had the fewest morals, values, or concern for others when I was rather medium in fatness but feared for my safety, my job, or eating regularly, and I'm not talking about dieting. I do judge people by weight and other characteristics that probably have little to do with their real personhood. I hate to be judged about being heavy, short, old/older (61), female, and highly educated. Men don't chase me much anymore. As I gotten older, I've tried to care more than judge. Most of us do the best we can at the time, so I try to stay out of the judging business.

Posted by: Marti at January 8, 2007 4:34 PM

I don't give a rat's ass what people think about me. I've had my weight ups and downs and I surely was more chased when I was in my downs. But since I don't give a rat's ass by being chased either, (I find it very animalistic behaviour) I am content at my current weight, which is 40 pounds higher than the recommended at my height. I want to lose weight gradually and only because of my health and I've eaten very healthly all my life but my body type is plumb. At least, I am 40 pounds overweight but still very healthy due to my healthy eating. I don't have high blood pressure, diabetes or any of the other diseases that come with having extra pounds. Just to say that it's possible to be overweight and eat healthy too. I've eaten olive oil, goat's cheese, tons of veggies, fish, beans and lean meats all my life since birth, plus some rice and pasta and some wine, o.k lots of wine. I think I am still better off than someone who ate margarine and Mcdonalds and Kentucky Fried Chicken and hamburger helper and macaroni and cheese for 10 years of his/her life, regardless the weight.

Posted by: istanbulwitchy at January 8, 2007 6:25 PM

Very well written, again! I appreciate what you are doing. So few people have such an interest and many more should, especially those in the field of health and nutrition. I can certainly personally relate to the weight bias, just as much as anyone. I think about people that are younger than me, growning up a little over weight or a bit under weight and being picked on that I see in the course of my daily life. For me I thought it was too late to really be effected or make change in my life (at 26 I have realized CR can be an helpful step in the right direction, though) but these kids, I saw hope. They are at such an impressionable age. And now reading what you have to write, I know that hope is out there waiting to find them. I admire your strength to pursue this and your creative edge may be just what this bias needs to put up a good fight. My personal focus would lean more towards children. I always felt my calling was to work with kids. So, if you need a partner in crime to help spread the word..I am in! Good luck with the battle!!

Posted by: carolyn at January 8, 2007 6:58 PM

WOW, you made such great points, as usual.

I must say though, in my experiences, that I have noticed that society now judges fat people to be well adjusted people who have a healthy attitude towards acceptance of their bodies, as well as having a healthy attitude towards life.

And I have noticed that the hostility towards thin people continues to grow.

We are seen as vain, neurotic, etc...

At least this is what I am noticing. What I am seeing and hearing around me and the media. I really cannot quote anyone directly, this is just a feeling I am getting from society.

Quote: "I wasn't lazy or stupid when I was obese... I just didn't have the choices and information that I have now."

I must disagree, there is a wealth of information on dieting and healthy eating available in bookstores, magazines, t.v., and on the internet. This information is easy to get, extremely accessible. ( I don't think overweight people are lazy or stupid though)


Overweight people do have the choices that they can freely make. Everyday I see overweight people choose gak over nutritious food. I also see them choose to eat when they are not even hungry, they actually laugh and admit it, saying "this looks so good I will just have some, even though I am not really hungry".

But yes,, weight bias is wrong, and April, your post was a great eye-opener for all of us! Thank-you!

Sheila

Posted by: sheila at January 8, 2007 8:52 PM

I think there are a lot of important points here. You are, of course, absolutely right that the number of pounds a person carries around on her body says nothing about her character. Obesity is as much a product of genes and the toxic environment we're all exposed to as it is of personal choices.

Sheila, it's true that there are lots of dieting books out there, but I must point out that many of them give incomplete or in some cases totally false information. Some dieting gurus tell people to cut fats almost completely from their diet but say nothing about carbs. Others say carbs are the enemy and fats - even huge amounts of fats - are just fine. It has taken me years of persistent effort to wade through all the false claims and come to the much more complex picture of nutrition I now have. And I have degrees in scientific fields, a strong educational background and peers who encourage me to think about my health. What about those who don't have all this? How are they supposed to separate fact from fiction when it comes to dieting info.? There may be fantastic diet and health information out there but it can't do much good if it's diluted by all the terrible advice that permeates bookstore shelves, magazine racks and television.

Istanbulwitchy brings up an interesting point. Everyone always assumes overweight people are unhealthy and normal weight or skinny people are healthy. To my knowledge, most studies looking at the health of overweight and obese people do not distinguish between those who are overweight but eat healthy foods and those who are overweight and eat gak all day. On the flip side of the coin, we all know skinny people who subsist on pop-tarts and cheetos. Thinness doesn't necessarily go hand-in-hand with health. Our culture places so much emphasis on *looking* healthy when we should be focusing on *being* healthy. It's an important distinction that the popular press doesn't often make.

Posted by: Robin at January 9, 2007 6:16 AM

An interesting page being blogged everywhere, maybe useful for all the friends/family who want to drop weight but think weighing your food is "weird": http://www.wisegeek.com/what-does-200-calories-look-like.htm

Posted by: Brooke at January 9, 2007 7:20 AM

As usual, some wonderful insights. Your blogging always inspires me.
That 200 calorie web-site is a great reference, not to mention gorgeous photography.
I find that I do have a hard time with this thought process: "How did so-and-so let themselves get like that??" I try very hard to give them the benfeit of the doubt..but I admit..this thought will cross my mind, often.

Posted by: Deborah at January 9, 2007 8:53 AM

Hi April, Inspiring blog. Thank you! I have a few (off topic) questions for you about nutrition, as a vegetarian who thrives on protein. 1) How bad do you think eating light tuna on a regular (say 5 times a week) basis is? Would you do it, if you ate fish? 2) I find store bought eggwhites difficult to digest; is that common? is it maybe a preparation issue? and 3) How much protein do we truly need each day, in your opinion, for feeling optimally energetic? Thanks for your blog.

Posted by: Becca at January 9, 2007 11:39 AM

Hi Becca!

great to hear from you!

I actually do eat fish, but I'd worry about the mercury in tuna. How about tilapia? I love tilapia!

Re: protein, my unscientific rule is 70 g per day for women. Do you eat dairy?

april

Posted by: april at January 9, 2007 12:33 PM

"I believe that it is counterproductive to debate whether or not obesity is a "choice." (You can quite a few of these debates on the Rudd Center blog comments.) No one wants to be unhealthy."

I assume you refer to adults. I wonder what you think about anorexia which primarily afflicts teenagers and young girls, many of whom actively shun eating and medical treatment.

Anorexia is being promoted as a lifestyle choice by the so-called pro-ana websites, and acceptance of obese people without bias or discrimination is what NAAFA dedicates itself to. There is a lot of noise about pro-ana websites gaining ground but none against the growing number of fat acceptance groups. Is NAAFA promoting unhealthiness?

Thanks.

Posted by: Shefaly at January 9, 2007 1:34 PM

Hi Shefaly!

Thanks for your comment! I enjoy reading your blog!

I attempted to address the issue of "fat acceptance" in this paragraph:

"Now that doesn't mean that I believe we should minimize the health consequences of being overweight or obese. I think it's important to be honest with people about the dangers of obesity, and to work towards improving the food (and activity) environment so that people have better, healthier choices. Pretending that it's normal, natural or healthy to be overweight or obese isn't going to change the cold hard facts of health risk. Sure, some people are just naturally heavier, and some people are naturally skinnier. I, for instance, am naturally a bit heavier. Even on moderate CR, I'm not skinny-looking. Eating ad lib, I look like a fertility goddess from an ancient Celtic religion. My partner is naturally skinny, and was even eating ad lib. People come in different shapes and sizes, to be sure, and people have different tastes in what they find beautiful. It's possible to affirm the value of every human being (of whatever weight) while recognizing the health risks of obesity and pursuing strategies to end the epidemic."

I believe it is possible to treat every individual with respect while recognizing that obesity is a serious health problem. In fact, I believe that if we were to treat obesity as a health issue, not as a moral issue, we would make more progress in ending the epidemic.

april

Posted by: April at January 9, 2007 1:44 PM

Hey April...Going back to Becca's question about protein.

If you recommend 70 grams per day for women, how can you adjust the CRON-O-METER to go with what your personal goals are. I look at my data daily and think I am low on protein and other areas because it doesnt say 100%.

Any newbie advice?

Thanks!

Posted by: carolyn at January 9, 2007 2:23 PM

Hi April,

Not to be the voice of dissent here, but I did want to make a few comments.

Of course, I am against bullying overweight children (or adults!), and of course I agree that it is pretty nonsensical to judge someone's character based on their weight. But some of your points/arguments -- like your thought experiment to determine if fat people are lazy and stupid -- seem a little simplistic. Of course, it was amusing -- but I highly doubt if any of your blog readers really needed to be informed that fat people are not, in fact, lazy and stupid!

I don't mean to be attacking. I guess what your posting is making me think of is the difference between making judgments based upon weight, on the one hand, and making judgments based upon someone's food and exercise behavior (whether or not they are overweight). I am also thinking of the distinction between making sweeping generalizations about masses of people ("fat people," "people practicing CRON," etc.), and making judgments about people whose eating and exercise habits (or lack thereof) one has personal knowledge of. For example, I *do* have judgments about people I know who, in my opinion, eat unhealthily and/or never exercise. Because I know these people, I know that they are not doing these things because they don't even know about healthy foods, or can't afford to shop at Whole Foods or join a gym, etc., etc. And what would my judgment be? Well, no, of course I don't think, "So-and-so is a lazy and stupid person overall," because they are not. But I might think something like, "So-and-so is making a stupid decision about what to eat," or, "So-and-so is being lazy in regard to exercise." I don't really see that thinking something like that is all that different from thinking, "This person I know (and care about) is making a stupid decision about whom to date," or, "This person I know (and care about) is being lazy about finishing that assignment for work." I make similar judgments about myself, too, in regards to the choices (a loaded word, I know!) I make, in different areas of life, food included. Of course, I wouldn't blurt out my judgment to someone -- that would be cruel and tactless, and I don't particularly have any desire to do so, anyway. And, sure, to be honest, I probably wouldn't use the words lazy and stupid, even in the privacy of my own mind. But I think that many people do things, in various areas of their life, that could be crassly and simplistically described as lazy or stupid. Now, is it helpful or compassionate to view people this way? No, probably not. And anyone who spent a significant portion of their time making such judgments would probably be a bitter, unpleasant person! But, I simply do not believe that it is somehow "morally wrong" to occasionally think that someone (one's self included) has made a not-so-smart decision, or is acting in a not-very-efficient manner. That doesn't mean that this person (or one's self) is a "lazy and stupid" person overall -- but simply that there is perhaps some not-so-smart or kinda-lazy behavior going on in an area of one's life.

While I understand the importance of political correctness (as well as simple old-fashioned compassion and tolerance), I don't think this should mean that all judgments of people are now somehow morally suspect. It may not be particularly nice or even constructive to be judgmental -- but that doesn't mean it's morally wrong, in my opinion. Of course, there needs to be some *connection* between the judgment, and the "evidence" that the judgment is based upon -- and as you've pointed out, being overweight is insufficient evidence to support a judgment that someone is a lazy and stupid person.

On a separate point, I also was thinking about your proposed TV spot, and the idea that people are "the same" after they've lost weight. Again -- of course, I think it's wrong to judge people's virtue or lack thereof based upon weight, and to think that someone is somehow a better person if they've lost weight. But, I think that your posting kind of ignores the possibility that losing a lot of weight (or making any other big change, really -- becoming more physically active, stopping smoking, going back to school, ending a destructive relationship, learning a new skill, etc.) can change people, in a good, empowering way. I've had periods in my life when I was eating less healthily and exercising less, and periods when I was eating more healthily and exercising more -- and I do feel different in the latter periods, and not just physically. I feel happier, I guess. Better about myself. So, while of course I wouldn't say that I'm a morally worse person if I'm eating crappily and being inactive, and that I somehow magically gain virtue when I eat well and exercise, I would say that I am a somewhat different person. So, no, contrary to what your proposed TV spot would say, I'm not "the same person." And I'm glad about it! It can be an empowering, positive thing to feel "different" than one did before.

I know that, again, you were focusing on others' biased judgments. I just wanted to point out what I felt was kind of getting swept away by your posting, and proposed TV spot.

Thanks!
Rachel

Posted by: Rachel at January 9, 2007 3:48 PM

Hi Rachel,

I think you make many valid points. It's quite possible to look at someone's behavior, be it in the realm of eating and exercise, or work performance, or anything else, and say, "I think that person is making a bad decision right now." The problem with weight bias is that too many people (and i have been guilty of this many times) make a whole host of assumptions based on the simple fact of a person's weight. Just looking at a person, or reading his or her weight stats, isn't enough information on which to judge his or her character. Many of us wouldn't do that anyway, but as Dr. Puhl's most recent entry in the Rudd blog points out, many people do.

And I completely agree that getting healthy can be an empowering experience! Getting control of my own nutrition, health and (as a result) weight has been one of the most empowering experiences of my life... all of you know that because I've written about it so much. It's exciting and satisfying to help others make the same transition. I love working with others on a one on one level to get healthy, and I would like to help change the food environment in ways that make it easier for people I'll never meet to make better choices too. My point is that I am not a better, more virtuous person now that I am thinner. I was not a bad person before. I am making wiser decisions now, for sure. But I don't see that in moral terms. It doesn't make me better than anyone else. It makes me healthier, happier, and easier to pick up and move from place to place. It's been a wonderful, empowering journey, and the journey never stops! But I was a good person before, there was just about forty pounds more of me.

I think you and I agree on many things, so it's helpful to have your questions to help clarify my statement. I appreciate your well-thought out comment, and please be the voice of dissent anytime!

a

Posted by: April at January 9, 2007 4:22 PM

Thanks for your response, April! I do eat dairy. So, non or low fat dairy may be a good option for me. Any thoughts on Edamame, April or others? Anyone here like to eat Kashi lean? Do you think that is worth it, April?

Posted by: Becca at January 9, 2007 5:34 PM

I love Kashi lean. I eat like once a week for breakfast. I think it is a good way for personally to feel balanced and like I am not restricting one particular thing from my diet. I love GO LEAN!

Posted by: carolyn at January 9, 2007 6:14 PM

I agree with Robin. It was a real struggle for me to sort out what really is a healthy diet and which diets would work to lose weight in a healthy way. This was true even though I have two masters' degrees and can read scientific articles on nutrition without difficulty. It is no help at all that the government produces ridiculous guidelines like the food pyramid. Recently I saw an old Frontline program made in 2004 called the Diet Wars. In this program it showed the FDA holding hearings in which they were trying to sort out which diets were healthy and which ones work. If the FDA cannot sort this out with all their resources how can the average person be expected to do so? I should say that a large part of the problem is research bias based on the funding source. Yesterday I heard on NPR that if the research for nutrition is funded by a group that stands to gain from the research findings (e.g. the National Dairy Council, but many other groups as well) the studies are 9 TIMES MORE LIKELY to show results favorable to the funding group as compared to research funded by an unbiased funding source.

Posted by: Jen at January 10, 2007 8:42 AM

Hi April,
Thanks for responding to my comment. I am glad you like my blog - I focus on going beyond food, into exercise, genetics, psychology etc as well as treatments and emerging technologies.

Did you see what WG wrote on my blog? He said obesity is seen as a social concern while anorexia is seen as a disease. But because doctors see more obese kids than anorexic ones, they are inured to the former's ill health but horrified by the latter. I think as a physician, he is being honest but that still does not change how we address obesity (or anorexia) as a 'whole' issue rather than one magically curable by diet issues alone.

Thanks.

Posted by: Shefaly at January 10, 2007 9:42 AM

Hi April
Thanks for your comments on being accused of being anorexic, something I had to endure from my two sisters during the holidays. My two cousins didn't use the word on me but said I was too skinny. Even my mom is asking questions about what if I got sick, would it be dangerous to be skinny, and saying that I don't look as good as I could look. Needless to say, it's taken an emotional toll on me and I'm slowly getting back to my routine. Practicing my CR and yoga has been challenging the past two weeks. Your writing reminds me that I'm not alone.

I remind myself that all of my siblings have been morbidly obese; two still are. One is dying from renal failure brought on by diabetes caused by obesity, another is in denial of her health problems - while suffering from super high blood pressure, and another is normal now due to gastric bypass. I felt uneasy eating with one of my sisters and her husband at various restaurants, where they would order drinks, appetizers that were as big as main courses, main courses and desserts. Then they would spend an hour describing to others in detail how fabulously their food was prepared - explaining the ingredients, the preparation used, the spices, the resulting tendernes. If they would be describing meals like the healthy ones you prepare, where reading your descriptions is heavenly, that would be great; but they were describing the preparation of gak. In one instant my sister raved about the preparation of a deep fried fish empanada, oozing with grease. She thought it was prudent to blot the grease out with a napkin. I told her why she was surprised that it was greasy, it had been swimming in lard a minute prior to being brought to the table. It's just astounding to me and now I'm want to get past it and be centered on what I know is good for me. Somehow I haven't gotten that footing yet and I look forward to being able to say in a week or two that I've had a good CR week. Sorry to rant on and on.
Cheers
Arturo

Posted by: Arturo at January 12, 2007 9:22 PM

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