APA's Adams (2022) observed that weight stigma is firmly embedded in our culture, where thinness is regarded as a positive attribute. Thinness is seen as the result of such core values as hard work and the power of the individual. Larger people are often assumed to have too little willpower and not enough self-control.
In the July issue of the Scientific American, Sole-Smith reported that weight stigma itself was shown in a 2016 study on 21,000 U.S. adults to be significantly associated with increases in heart disease, stomach ulcers, diabetes, and high cholesterol, even when the BMI was controlled. The APA's Adams (2022) reported that weight stigma, like other forms of negative bias, causes psychological suffering that potentially increases the risk of anxiety, depression, substance abuse, eating disorders, and suicide. Leading to less healthy behaviors, it is associated with less physical activity, health care avoidance, and, ironically, weight gain. It seems clear that that weight stigma compromises both physical and psychological health.
The Editors (2020) themselves of the Scientific American Mind weighed in (pun intended) on this topic. They emphasized how our healthcare providers also can be biased against the overweight. Physicians all too often prescribe weight loss without thoroughly examining their patients who weigh too much. Research shows that the time doctors spend with them is shorter on the average.
The APA commented on what doesn't work. Confrontation and tough love don't work. Unfortunately, they are most often used by family members, romantic partners, and physicians. These are the people one would expect to be most supportive, but they can be also the most critical. Moreover, no data supports supports the long-term effectiveness of dieting. Information does show that 95% to 98% of those who diet fail at sustained weight loss. As many as two thirds end up heavier than when they began their diets.
The Editors (2020) were reminding doctors as well as the rest of us that there is more to the health equation than weight. While acknowledging the ample evidence supporting the association between weight and health, the Editors point out that additional factors need to be taken into account. After all, there are people who are in good health in that all their numbers, except weight, are normal.
Sole-Smith (2020) also pointed out that the link between health and body weight is complex. Whereas research has shown that mortality rates do increase for those with the lowest and highest BMIs, there is no increased risk for those in the middle range when compared with people in the normal range. Another study, lasting 14 years on 11,761 adults, looked at BMIs and lifestyle habits. This study found that no matter their weight, people lived longer when they did not smoke, drank alcohol moderately, ate at least five servings of fruits and vegetables daily, and exercised 12 or more times per month.
Against dieting, the Editors (2020) assert that the most effective treatment approach is to advocate positive behavioral change This change would include healthy eating with fruits, vegetables, and whole grains as well as more physical activity and smoking cessation. No less important would be the reduction of bias and prejudice in others and ourselves. In conclusion, as for weight, a healthy lifestyle and self-acceptance are the best paths.
Abrams, Z. (2022). The burden of weight stigma. American Psychological Association on line, 53(2). https://www.apa.org/monitor/2022/03/news-weight-stigma
Editors (2020). Weight is not enough. Scientific American Mind, 322(2), p.10.
Sole-Smith, V. (2020). Treating patients without the scale. Scientific American, July, pp.22-31.