Internalizing fat shaming — being judged differently because of weight — can be particularly damaging to a person's health and well-being, doctors and other experts say.
They were interviewed ahead of Eating Disorder Awareness Week in Canada, which wraps up Tuesday. The week, declared by the National Initiative for Eating Disorders, also involves lobbying for better ways to support people with eating disorders.
In Canada, the U.S. and much of the world, there's an expectation of extreme thinness, said Dr. Scott Kahan of Johns Hopkins Bloomberg School of Public Health in Baltimore.
People who experience fat stigma have higher blood pressure and increased stress hormone levels that increase their risk of health concerns, Kahan said.
"There's been two studies showing that it actually increases the likelihood of premature death," said Kahan, also director of the National Center for Weight and Wellness in Washington, D.C. "It also predisposes to unhelpful behaviours, so it increases the risk for binge eating. It increases the risk for emotional eating. It decreases motivation for exercise."
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There is a common misconception that stigma might help motivate people with obesity to lose weight and improve their health, Kahan said. But that's inaccurate, and such discrimination can have the opposite effect.
Psychologist Jennifer Mills at York University in Toronto conducts experiments on body image and eating behaviour.
In one experiment, Mills and her team brought participants into the lab and had them complete one of three tasks: read a mock newspaper article about the dangers associated with obesity, read about the dangers of sun exposure, or do a word search as a neutral control.
"What we found surprisingly was reading the anti-obesity article, it made people feel worse about themselves," Mills said. "Right after reading the article, it didn't change their eating."
The findings show stigmatization of obesity in the media probably isn't helpful, she said.
"We don't want people feeling discouraged," Mills said. "We want people feeling like they have some control over their lives."
Not the type of reassurance needed
Jill Andrew, whose doctoral research focuses on women and beauty, started a petition aimed at getting discrimination based on size and physical appearance included in the Ontario Human Rights Code, and supports similar #Sizeismsucks movements in Manitoba, Alberta and British Columbia.
Andrew said she was recently ill and needed emergency surgery. As she was on the surgical table, she heard the team talking about fat felines.
"They're talking about their cats and their pets, and their pets that are 'obese,' she said. "Their pets that are lazy. And I'm sitting there or lying there thinking to myself, 'What do you think about me?'"
A few hours earlier, Andrew said the surgeon spoke to her about how surgery tends to be more difficult in "people with abdominal girth."
"When you're in a life-defying moment and this is the person you're looking for to save you, this is not the type of reassurance or reinforcement that you need."
This idea of wanting to "size down" cuts across different ethnic, religious and class lines, Andrew said.
Growing up, she said, relatives sometimes told her to suck in her stomach.
Kahan has specialized in obesity for more than 10 years. While more information is emerging about the health effects of weight stigma, he said few physicians and dietitians pay attention to stigma and help those experiencing it to get past it with counselling.
For family member or friends wanting to help someone with obesity and concerned about their weight, Kahan recommends against giving advice.
Instead, "I would offer your empathy and support," he said.
An earlier version of this story said Jill Andrew helped organize Ontario's petition. In fact, she started the petition and is the national lead for the campaign.Feb 08, 2017 8:52 AM ET