No, I’m not on a rant. But I sure could be. What’s funny about a chronic disease that impairs health and renders people more sensitive to deadly co-morbid factors associated with COVID-19? Nothing. Nothing is funny at all.
I write about obesity a great deal, have been caring for those with emotional and behavioral components related to the disease, speaking and teaching about it since the early 1970s, and won’t stop. When it comes to promoting health, there’s nothing I find more important. Obesity is recognized as one of the most pressing public health issues of our time.
So why are we observing an increase in jokes, memes and weight stigma/bias during COVID-19? These behaviors contribute to the nonsensical but popular, and frequently economically driven, belief that obesity is a self-inflicted impairment. “Just learn how to change your behavior through my app, my fitness and health coaching, my willpower increasing methods…” while whispering somewhere deep in the unconscious, “…you lazy person.”
As if living with obesity isn’t tough enough, during COVID-19 these jokes only serve to push those with the disease further away from proper health care out of shame or fear of being perceived as an onus on an already overburdened healthcare system. Weight bias also negatively affects psychosocial well-being and increases vulnerability to harmful lifestyle behaviors, leading to a reduced quality of life.
For long before COVID-19, an ignored part of helping those with obesity are the social determinants of health including bias, prejudice, and discrimination, with their demonstrated negative impact on physical and emotional health. Types of weight bias that are commonly seen include stereotypes that those with obesity are noncompliant, lazy, lacking in self-control, weak willed, unsuccessful, unintelligent, and dishonest. Considerable research on weight bias has documented the impact of this sorrowful set of behaviors in education, health care and employment, as well as in gyms and health clubs, popular media, news media and amongst friends.
According to Rebecca M. Puhl, Ph.D. and Christopher M. Wharton, Ph.D. in ACSM’s Health & Fitness Journal, “weight bias generally refers to negative attitudes and beliefs about body weight that are expressed in the form of stereotypes, stigma, prejudice, and unfair treatment toward children and adults because they are overweight or obese. Weight bias can be displayed in multiple forms, including verbal comments (e.g., derogatory remarks, negative stereotypes), physical aggression, and social exclusion or avoidance. Thus, it can be expressed in both subtle and overt ways.”
Here is a list of key words identified by the Obesity Action Coalition and the Rudd Center for Food Policy and Obesity to be aware of:
- Least Stigmatizing / Blaming Words
- • Weight
• Unhealthy weight • High BMI
- Most Stigmatizing / Blaming Words
- • Fat
• Morbidly Obese • Obese
- Most motivating for weight loss
- • Unhealthy Weight • Overweight
- Least motivating for weight loss
- • Fat
• Morbidly Obese/Chubby
- Here are additional examples of how to use people-first language:
- “The woman was affected by obesity,” instead of “The woman was obese” or “The obese woman.”
- “The man with obesity just signed up for our weight loss program,“ instead of “The man who just signed up for our weight loss program is very obese.”
These organizations and others endorse using people first language:
The Obesity Society,
The Obesity Action Coalition,
Academy of Nutrition and Dietetics,
American Society of Bariatric Physicians,
American Academy of Orthopaedic Surgeons,
Try these simple, but deeply thought-provoking questions to help you determine your own biases, from Mary Forhan, Ph.D. in the Department of Occupational Therapy, Faculty of Rehabilitation Medicine at the University of Alberta.
- Do you assume a person’s health, characteristics, behaviors and abilities are based on their body size, weight and shape?
- Do you think that everyone with a larger body size or a higher BMI has obesity and needs to lose weight?
- Do you believe people with obesity are personally responsible for their condition?
- Do you let negative comments about someone who has a larger body size or has obesity go unchallenged?
- Do you avoid being around people you think have obesity?
There are many aspects of our current challenges that one can shake one’s head at. But shaking one’s head at an illness that is itself of pandemic proportion, that leads to billions suffering with it worldwide, that is closely associated with a poorer outcome of COVID-19? It’s always a good time to find something to laugh at for sure, but never at obesity.