The Top 10 Sources of Stigma
Being overweight or obese can place a person in many stigmatizing situations. Stigma comes in many forms; criticisms, others making negative assumptions, inappropriate or nasty comments.
Here is a list of the top ten sources of such stigma.
- Family members
- Doctors
- Classmates
- Sales clerks at stores
- Friends
- Co-workers or colleagues
- Mother
- Spouse
- Servers at restaurants
- Nurses
Research suggests that people may confront a range of sources of stigma at all levels of overweight but experience more stigma from family members as their weight increases.
Younger individuals were more likely to report being stigmatized by classmates, teachers, and nurses than older individuals.
Other sources of stigma include: Employers, supervisors, siblings, dietitians, nutritionists, teachers, authority figures, mental health professionals.
This list came from the paper "Confronting and Coping with Weight Stigma", published in Obesity Vol. 14 No. 10 October 2006.
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The first 3 on that list in that order are what I hear from the people I've dealt with in weight loss. Family is always the toughest when it comes to stigmatizing the overweight and surprisingly enough, also the group most likely to sabotage your weight loss even as they criticize you about weight.
I've also heard a lot of negative comments about doctors. In fact, some people are so stigmatized by their doctors, they don't want to consult them about weight loss. And I think that's dangerous. You need a doctor you can trust.
#7 and #8 are redundant with #1, so I'm not sure why they're listed twice.
ReplyMy family never stigmatized me about my weight, but that might be because 80% of us were fat. Pot and kettle and all that.
Reply
Yeah I wondered about this - but that seems to be the way they conducted the study:Reply
I'm surprised "strangers" isn't higher.
ReplyIn medical school, one of the psychiatrists on staff told me I'd make a great one! He said there were three types, of which I would be called the 'Rambo Psychiatrist"! HaHa!!
ReplySeriously, I know obese people who stay away from doctors because the doctors tell them they are obese and need to lose weight for their health. Wow, how about that. I thought that's our job? Why aren't mirrors on the list?
I'm surprised that "MOTHER" isn't no.1!!!
Or was it just me?
ReplyI followed the title of the research paper via google and found an interesting fact. On the list of coping methods used when receiving negative commentary, 25% of the people in the study mentioned they had used Physical Violence as a way of dealing with the commentary. In other words, watch out who you call fat, one in four of them just might hurt you. ;-)
ReplyMy doctor was always pretty cool about my weight issues. He was very blunt, but nice about it...he always said "You're a little on the heavier side and if you do want to lose weight, get out there and play a little more, eat a little less but don't diet". It was his nurse that was such a horrific b#$%^ about everything. She'd always start the little bar on the scale at the 100 lbs and then when it didn't move at 149, she always said "Wow, you're fatter than you look" as she clicked the 150 bar on there. Gee thanks for the compliment. I didn't ever really get anything too negative from store clerks...I tend to avoid them at all costs, even though I'm thin. They're just plain annoying.
My family wasn't too bad about my weight...my grandma was the worst one, followed by my sister. I don't get why restaurant servers would be on the list though. It's not like they're shoveling food down your throat; they're just there to bring you what you order. I actually have a worse time with servers now because I'm always making special requests at restaurants. Once, I ordered my salad with the dressing on the side and they screwed it up. The waitress said "Honey, you don't need to put the dressing on the side! You're skinny enough to be able to afford those calories!" Yeah, whatever, it still doesn't mean you didn't screw up my order.
ReplyI not surprised that family members are on the top of the list.
I do think a lot of the pressure from family comes as a result of love and caring. People frequently just don't know how to show it or don't know how to deal with another family member who is overweight.
Brian
ReplyNo freakin' kidding...my mother is the ONLY person who's ever told me I was fat (I have never been overweight by BMI or body fat standards).
ReplyI just love how the word stigma is used here. I guess it's a stigma if people act or speak in a way that makes you feel bad. So then it leads to others being responsible for your feelings. If you focus on those stigmatizing bastards that caused your hurt feelings, you won't have to face the fact that you're fat. Yeah, that could work.
ReplyDr. J, I don't think the problem is that. It is that doctors often put it like this "You need to stop eating doughnuts and pizza all day so that you can lose weight, and to get off the couch once in a while". That is the stigma, it is not just telling the truth and saying "You're overweight and need to lose weight".
I believe that must have been at the playground. Once people are past school, their spirits are too broken to hurt anyone... they just take it.
ReplyI'm in my mid thirties and have been on both sides of the fence as far as weight. I've been extremely thin and now in recent years about 35-40 pounds overweight. I definitely notice the difference in how I'm treated in stores. When I was thin the salespeople would come right over when I was browsing through clothes. Now it's like I don't exist. The same with strangers, when I was thin I noticed a lot more eye contact, people holding doors, etc....being overweight all of a sudden I'm invisible. Family is sympathetic to some degree, actually they were a lot more concerned when I was starving myself and getting too thin than when I've been overweight. But the stigmas are very real and unfortunately in our society I don't see it changing any time soon.
ReplyIn some ways I was lucky, no one ever told me I was fat.
ReplyNot even when I was teetering on the edge of overweight (at fifteen my bmi was 24.8). I had to figure it out myself, the first time I used a scale in my aunts bathroom.
My first thought, however, was along the lines of 'Why didn't anyone say something?'.
I think the reason some doctors are seen as stigmatizing fat people is that some doctors assume we don't know that we're fat (we do!) and they assume that we don't that the way to lose weight is to eat less and move more (we do!) People need motivation and real assistance with weight loss, not just judgement and obvious "advice".
Replypsychsarah!
ReplyI'm not sure that's always true! As for me, I was told by my karate instructor while in my 20's that I was FAT and I really hadn't noticed, and for me it was a life changing event. I have very kindly pointed out to friends that they were getting way too heavy and I have been told thanks but I don't think I am. You will have to trust me on this one, but they were easily 50 pounds over an ideal weight. I also think studies have been done where it's been shown that 'overweight' people frequently do not feel they are. It's obviously a challenging problem.
I agree with Jan about strangers...when I was obese, I received more nasty comments from strangers on the street than anyone else.
I also agree with Dr. J and the misconception about the word "obese". I've talked with many women who got upset when their doctors called them obese, even though the term is clinically correct. Since to them the word obese meant something very bad, they assumed the doctor was calling them something very bad, when in fact that's not the case.
HOWEVER I also agree with Jan's point about the type of stigma that comes from doctors. I did have a doctor who wouldn't take me seriously when I said that I was doing everything I could think of to get off a weight loss plateau. He just assumed that I wasn't really exercising and dieting.
ReplyI agree with Dr. J. A lot of people may not realize that being obese is not a healthy condition to be in. Some people may even realize that they are overweight, but don't think that there is any reason to get into better shape.
ReplyDr. J-Good point! I guess I've just been so acutely aware of my weight for so long, I forget that some people live in blissful ignorance. I guess it comes down to bedside manor and sensitivity-if you feel your physician is going to be supportive, you're more likely to accept his/her important message about your health while if you feel you're being judged, you may become defensive (i.e. I know people bigger than me, I can't possibly be obese!)
Jen-I agree that people hear "obese" as a bad word. Although it is clinically correct, the incredible stigma about being fat makes obese a value-laden term in our society. For many people, hearing that you are obese equals hearing that you are lazy and a drain on the health care system!
ReplyNurse is incompetant. If someone weighs more than they appear, then they are solid (muscular).
Not "fatter than you look". That is impossible.
In fact, it's the stupidest thing I've ever heard!
If nobody calls you fat until they see or hear of your weight or BMI, then you are probably not fat.
ReplyI think that, even in societies that admire more full figures, obesity is seen as ugly. Looking at the number of comb-overs and over made-up faces, there's a heap of denial going on.
ReplyDr. J I think there is a great difference there betweeen men and women. A man who is 50lb overweight probably does not feel fat at all, and unless presented with the health problems his weight can cause, might not care. A woman who is in the low-end of the healthy weight range probably feels fat already, and one that is even 5lb over the HWR probably feels very fat.
ReplyYou're right Jan. I didn't specify, but they were men that I told were too heavy. And yes, I was and am concerned about their health.
ReplyThis post illlustrates perfectly why "doctor" is so high on the list. Doctors go WAY past recommending weight loss to exaggerated scare tactics and insults, as illustrated by this particular post by Dr. J.
ReplyIt's true, doctors are not perfect and I expected a response like that after I posted. I don't mind doctors being criticised including me, just as long as people take responsibility for their problem and do not blame the doctor for the problem they created for themselves.
ReplyThey've got it spot on when they say that family is the number one stigmatising group. About 3 and a half months ago, I was 7lbs too heavy (though still within the 'healthy' BMI range) and my sisters were awful. One evening, I was about to open a bag of chips when my sister made a bitchy comment. She told me not to eat it because I'd put on some weight. I replied, saying 'its only one bag of chips, thats not going to change much', then she went on in an apocalypic way about how I'd put on huge amounts of weight and treated me like an imbecile, and my other sister agreed with her and joined in with the comments.
I almost developed an eating disorder in January because, although I had managed to curb my appetite effectively and was beginning to lose weight, I just wanted to lose weight so quickly and have my sisters complimenting me and stuff.
Last week, they told me I looked slimmer and they were like 'the girls in this family are all slim, yay!'...
So, it influences me a lot. If they're slim, I don't want to be fat, I want them to love me and accept me. But its unreasonable to expect someone to be slim all the time, its cruel when your own sisters tell you what a disgusting fatty you've turned into. People should accept you the way you are, but they didn't.
ReplyTo some of these comments... just because you're overweight does not mean others have a right to make you feel badly about it.
ReplyWell someone else's weight might effect you eventually (with government healthcare and whatnot), making them hurt is a really, really ineffective way to prompt change in this arena much of the time.
If I'm close enough to someone, I'll let them know there's a problem so they aren't blinding themselves to it, but carefully, carefully... if I'm not close enough to say it and have it taken in the right light, then I leave it. Typically, so far as healthy behaviors, I try to lead by example.
I'm overweight. My wife is overweight. We're both trying to lose weight for one reason. Health.
I don't give a damn what anyone thinks about my weight (except my wife).
ReplyI agree with the top stigma- family members. I know my mother and sister mean well, but their efforts seem to have the reverse effect on me. Listening to them really dampens my spirits, and it makes me even less motivated to do anything. I do admit that I do comfort eat- just to numb the hurt they unknowingly lash out at me.
Also, I should note that BMI is not exactly a good indicator of health- firstly, its extremely general, because second, it doesn't take into account things like race, illness, build.
ReplyExactly, that is why doctors get that stigma. I am obese, so obviously, I am laying on a couch all day ramming donuts and pizza down my gullet. The assumption that because I am obese, I must be eating all this junk. The last time I had real pizza (as in not one of the awesome lean cuisine brick ovens) is at least 4 months ago, longer for the last time I had a donut. I don't eat much junk. My job involves walking all day and lifting.
I just hate it that it is assumed I am lazy and eating junk. How about asking about my typical diet and activity, and then helping me to eat the right things in the right amounts and how to add activities in the areas I need, docs?
This is the reason that I haven't been to a doctor in years, I don't need criticized and pushed out the door, I need honest evaluation and help on how to become more healthy. Unfortunately I have yet to find a doctor in my area that wants to offer that kind of service.
ReplyNathan!
Perhaps this link will help you find a helpful, empathetic doctor in your area.
http://www.asbp.org/
ReplyYes! I got the stigma even when I was thin, that is what is worse. If you even say any fat-related word, you'll get it, no matter what you weigh!
My GP suspected a thyroid problem and sent me to an endocrinologist. I weighed 113lb at the time, and even though I'm short, that is not a weight anybody can call fat - BMI 21. The endocrinologist didn't even take a look at my thyroid scans, didn't ask me to step on a scale, just looked at me sitting down in the chair and said "You need to stop trying to fool yourself that there is anything wrong with your thyroid. Every fat woman thinks that, they want that excuse. Here, take this copy of a 1,200 calorie diet. You'll lose some weight and stop inventing illnesses where there are none". I spent 3 years that I was still thin and getting this type of treatment from doctors, as my health deteriorated. I finally put on 100+ lb and my body completely shut down (my resting heart rate was 37). Of course in the year I was fat I didn't even bother seeking treatment - if they'd refused to treat me and called it an excuse when I was thin, imagine now that I was obese. The only reason I finally got treatment and didn't go into a coma was that my cousin who was in med school treated me. I was sure I had some sort of mysterious illness and was going to die, since so many doctors had told me it could not be the thyroid, I was convinced they couldn't possibly all be wrong.
ReplySix weeks after she got her roommate, who had already graduated med school, to prescribe me thyroid hormones and actually went to my house to shove them down my throat the first time and instructed my husband to do the same, I started to feel normal. My face started to unbloat, I started remembering where I kept the cups in my kitchen (by then I'd stopped working, cause I used to be a teacher, but I couldn't even remember what bus I was supposed to take to work a year before that, much less what lesson I was supposed to teach). My hair started growing back and I had energy to move. A couple weeks later I was back in the gym, since I'd been active before that, and 1 year later I'd lost 90lb.
ReplyThere are some compassionate doctors out there and they're worth looking for. After going through a few, I found a doctor who treated me with respect. She simply looked me in the eye and said, "We need to discuss the weight issue." And we did, like adults. I'm grateful she had enough sense or training or maybe just personal integrity to behave in a kind way.
Reply