The Health Effects of Weight Stigma
Weight stigma, or weight-based discrimination, is a form of stigma that is widely accepted and has been rising over the past few decades. People think that being mistreated because of your body shape or weight is deserved because a person's weight is "their fault." Some even think that "fat shaming" is a way to help people "change" and "become healthier." Today, we discuss the detrimental physical and mental health effects of weight stigma, health effects that are often worse than the documented effects of excess weight. Our guest is psychologist Christine Emmer.
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Guest
Christine Emmer is a research assistant and doctoral student at University of Mannheim in Germany. Her research focuses on weight stigma, social determinants, and consequences of health behavior and resilience research.
The Takeaways
Weight stigma - societal degradation through negative attitudes or beliefs towards a person based on their weight, expressed through negative stereotypes
Imposed liability - imposing liability on a person without evidence of fault i.e. assuming someone’s weight is “in their control” or “their fault.”
Many factors impact peoples’ weight, including their genetics, their environment, and even where they live.
Societal factors have profound impacts on health outcomes, due to lack of access to healthy food, bikeable areas, and green spaces in lower income areas.
Internalized stigma - imposing negative stereotypes against yourself.
Studies have shown that internalized stigma leads to even more negative mental health outcomes than facing these stigmas from other people.
Anticipated stigma - the belief that stigma or prejudice will be directed at yourself from others in the future.
This can lead to avoiding situations such as the gym, family gatherings, or medical appointments.
69% of women who are obese reported being stigmatized by their doctor.
Being subject to weight stigma does not lead to healthy lifestyle changes, but rather more negative health outcomes including disturbed sleep, high stress, and maladaptive eating.
Not only are there negative health outcomes from weight stigma, but also negative social outcomes in the form of increased isolation and lack of connection.
Media plays a role in creating weight stigma, but it also has the power to reverse the narrative on weight stigma.
You can follow more diverse, body positive people on social media.
Studies and Resources
How American’s Biases Are Changing (or Not) Over Time
The Impact of Weight Stigma on Caloric Consumption
Discrimination Can Be Harmful to Your Mental Health
Associations of Weight-based Teasing and Emotional Well-being Among Adolescents
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Juna We have a lot of holidays coming up.
Eddie Thanksgiving, Christmas, Hanukkah, Kwanzaa.
Juna And you know what that means.
Eddie Yes. Turkey. Stuffing pies. Okay. Gingerbread men. Fun songs. Ugly sweaters. Peppermint bark. Candy canes. And the best part. Lots of time spent with our family and friends.
Juna Well, Eddie, this time you have hit the nail on the head. Yes, because that is what I want to talk about today.
Eddie Family and friends.
Juna Close while seeing your friends and family should be a joyous occasion. I think for a lot of people, the holidays can be super stressful and challenging because let's face it, seeing your family and friends is not always the most pleasant of experiences.
Eddie Oh, you mean because we start talking about politics?
Juna Actually, I'm more meant because the holidays tend to be when a lot of people may go home and experience the oh so familiar comments from their family members that they haven't got another year. Don't you think you should.
Eddie Exercise more if you can't wait?
Juna Have you lost weight? Oh yeah.
Eddie It can be a free for all for every inappropriate comment that hasn't been made over the year. At the holidays, everything is just like let loose.
Juna Which is exactly why going home and seeing family is really hard for some people. And we've been meaning to do an episode on this for forever. So since so many people are going to be experiencing discomfort, I thought, what better time than now.
Eddie To make people feel discomfort?
Juna No. To help people with this discomfort. To alleviate the discomfort. Oh, that's.
Eddie Better.
Juna In today's episode, we're talking about weight, stigma, being mistreated because of your body shape or weight. How does weight stigma play out in our daily lives, and can it actually be unhealthier than excess weight? I'm Yuna Dada.
Eddie And I'm Dr. Eddie Phillips, associate professor at Harvard Medical School.
Juna And you're listening to Food, we Need to talk. The only podcast that has been scientifically proven to cheer you up after a particularly uncomfortable meal with that one uncle who's always saying the wrong thing. First off, we're going to read one of our favorite reviews of the week. This review comes from Al. 113 Eddie, we do the honors.
Eddie Absolutely. And the title is one of my most favorite podcasts. I first discovered this podcast at the beginning of COVID and it accompanied me on many long walks around my neighborhood. I absolutely love the humor, the science and the practical advice. It has really informed me and helped me think differently about nutrition and exercise, and it is just plain fun. When the show resumed earlier this year, I had fond flashbacks to listening to it on long walks during the shutdown and realizing what an important part it played for me during that period. I am so glad that you and Eddie are back and I hope they continue to make podcasts for years and years. This is my number one recommended podcast to listen to on a brisk lunchtime walk.
Juna Ah, thank you. We're her number one recommendation is not so nice.
Eddie It's very sweet.
Juna We are so happy to be a part of your walks during and after shutdown. And if you want to get your review read out loud, then feel free to go to wherever you get your podcast and leave us a five star rating and review. And there's a pretty good chance that you're going to be Shout it out on the pod. So now let's meet today's guest.
Christine Emmer My name is Christine Emmer. I'm a psychologist, a research assistant and doctoral student from the University of Mannheim in Germany.
Juna Let's start with a formal definition of weight stigma.
Christine Emmer Weigth stigma describes societal degradation through negative attitudes or beliefs towards a person based on their weight, and is usually expressed through negative stereotypes, that is, and reasons. Judgments like being lazy or unmotivated, lacking willpower, discipline. And these stereotypes lead to prejudice and discriminatory behavior like unfair treatment, social rejection.
Eddie Wow. It feels uncomfortable to even broach the subject having it happen to you. That's got to be a lot worse, right?
Juna So as you guys know, I come from an Albanian family. I was born in Albania. And it's just really different culturally. Like you are allowed to say, like whatever thought perhaps culture might just straight out the mouth. Like it's just there's no filter. So like people make comments about people's appearance, their weight, their skin, their facial features all the time, just like without a care in the world. And I have family members who have eyes like hawks, like felt like you to pounce. They know they're like, did you gain weight? You could lose you back. Did you lose weight? It's like, I don't know how they know.
Eddie They're better than the scale.
Juna So I don't even know. I haven't checked my weight and they will know what's going on with that weight, like without me even knowing. So I have to say, when I was growing up, the first time I was ever really conscious of my weight was from getting comments from family members.
Eddie And you weren't even overweight then?
Juna No, like I wasn't. I was never overweight, but it was always like, oh, have you gain weight? Oh, used to, you know, I mean, all the time.
Eddie You know. You know, what I find so interesting and disturbing about weight stigma is that it's a form of stigma that is still kind of acceptable in today's society.
Juna What do you mean?
Eddie Well, we have really cohesive and outspoken movements about preventing discrimination based on race, sexual orientation, gender identity. But for some reason, we think that mistreating people because of their weight is a legitimate way to act towards people.
Juna Eddie That is so true. And this may be because of something called imposed liability.
Christine Emmer Which assumes that the stigmatized characteristic is controllable or can be removed by the victim of discrimination in the sense that the person themself is to blame and is responsible for their body weight or to receive weight stigma, which is not the case with most of other forms of discrimination, and this assumed control ability might even lead to worse health outcomes.
Eddie In other words, people think, Well, you can't control things like your race or your sexual orientation. So discriminating because of those things, well, that would be really wrong. But your weight, that's your own fault.
Juna That's your.
Eddie Fault. So it's fine to mistreat people because of that. You know, when I was in high school, you may not be shocked to know I worked on the high school newspaper.
Juna Wow, cool kids.
Eddie And we used to love to put out our joke issues, especially like around April Fools Day. Okay. And we would make fun of teachers and principals.
Juna Okay.
Eddie And we had to go to the faculty adviser to determine, is this okay to print?
Juna Okay.
Eddie And he came up with a lovely rule. You can make fun of someone if they're doing something that they have a choice over. So what they wear cool facial hair, cool. You know, where they like to wear sunglasses. I mean, just their height now.
Juna Right where.
Eddie They're from. Now, you know, their their gender. No.
Juna Right way.
Eddie I don't really remember, but I hope we were not making fun of people because of their weight.
Juna What a time, guys. What? It's. The 1970s. Not only that, but people have this perception about stigmatizing people because of their weight, that it'll actually lead to better health outcomes. And we hear this like all over in media.
Joe Rogan You can't like exonerate yourself from decades of being a slob and being a person who has no consideration about their health and about their obesity and about the kind of food they put in their body.
Juna So the idea that you can shame people into eating right or exercising, it's pretty pervasive and it's accepted as a fact by, like most people, I would say. Mm hmm. But is it actually true? We're going to get back to that in a little bit. Yes.
Eddie You know, you know what I find so unsettling about all of this? What? Well, there was a study from Harvard measuring implicit biases. Have you ever done one of these implicit association tests?
Juna I actually did have to do this in college.
Eddie And how did it work?
Juna Okay. Basically, it's like you have two buttons and like, you might be like men and women or like black people and white people or something like that. And then they'll flash a word or an image on the screen and you have to like choose which one you associate it with as fast as you can. The more.
Eddie You even think.
Juna About it, right? You're not supposed to think it was like press the button, like on reflex. So basically it measures all these implicit biases you have about like different groups of people. And actually I can put a link to it. I think it's actually available to the public so you can take it yourself. I'll put a link to it in our shownotes guys foodweneedtotalk.com.
Eddie Right. So they did this study using the implicit biases and the researchers found that while the implicit, anti-black or anti-gay attitudes have been decreasing over the past decade, attitudes towards high weight individuals have actually gotten substantially worse, meaning weight bias has been increasing over the past decade or so.
Juna Wow, that is horrifying. So I'm glad we're finally doing this episode. So let's break down these two facets of weight stigma, the fact that people think it's within our control and the fact that they think that it's going to make individuals lose weight. So, first of all, you all know Eddie. and I, we're all for making positive lifestyle changes.
Eddie Right. It is kind of the point of the entire podcast. And I am a lifestyle medicine doc.
Juna But that being said, we know that there are other factors besides just what you eat and how you move that affect your weight.
Eddie Of course. So, you know, we know that genetics does play a role in people's weight, their appetite and even their energy expenditure. But on top of that, we also have some other factors that people don't often think about. I would like to cue the historical sideshow. In the 1970s and eighties, we had changes to the food supply. When manufacturers started putting more refined carbohydrates into processed foods and Americans started consuming, on average, 500 more calories a day. That obviously has to do with eating behaviors, but has even more to do with food environment and food manufacturing.
Juna Which is not exactly in our control. Right? Right.
Eddie Not directly. Yeah.
Juna So it's not like all of a sudden people just became lazy gluttons in the 1970s and all of a sudden we have this, like, obesity epidemic. Right? It's more that the food supply dramatically changed to really emphasize high fat, high sugar, ultra processed foods.
Christine Emmer But there's also socioeconomic status. Be noted, poverty is actually one of the leading factors. Contributing to weight gain is because people with lower socioeconomic status actually live in different areas, especially in the U.S. as I've as far as I know, there are also the built environments look different. So people are not able to take the bike or go or by feet to the job. They don't have parks for jogging. Like, of course it's just a mean and there are differences within. But in general we can say that also unhealthier food, for example, is cheaper than than healthier food.
Eddie This is why we now understand in medicine your zip code is probably a better predictor of your health status than your genetic code. While a lot of healthy behaviors are incredibly difficult to implement, if you're a busy single parent working multiple jobs who lives in a not so good neighborhood many miles from a good grocery store.
Juna So this idea that we is 100% within our control guys is just cuckoo crazy because my sisters both exercise less than I do. I eat less ultra processed food than they do, and like I weigh more than them, which is fine, but like, it's not because of a moral failing on my part.
Eddie So let's briefly discuss types of weight stigma, because I think the form that weight stigma takes might surprise some people. You know, when you think of weight stigma, what does that make you think of?
Juna Like kids at school bullying each other, like calling a kid fat or something?
Eddie Exactly. So we're going to call that overt discrimination. But in reality, a lot of weight stigma is probably more covert. So something like a person not getting a job because the interviewer perceives them as less capable or more lazy because of their weight, or, for example, a physician being rude to a patient because of their weight.
Juna So the types of stigma we've talked about so far are all according to Christine Emmer. Person to person. But there are also other forms of stigma that don't even involve somebody else.
Christine Emmer What is probably less known is internalized forms of stigma and discrimination. So I can also internalize these stereotypes and discriminate myself, kind of just what we call self stigma and means that I believe that all these negative stereotypes are true for myself.
Juna Emmer and colleagues did what's called a meta analysis, which is basically a summary of studies looking at a certain association or topic. And in this case, it was weight, stigma and mental health. And what they found in the study was.
Christine Emmer We could even show a stronger association of self stigma with mental health compared to these more known public forms of stigma.
Eddie So what we're saying is that internalizing these beliefs about yourself was even more damaging in terms of your mental health outcomes than experiencing the stigma from other people.
Juna Yeah, I mean, it makes sense, guys. Like how often you walk in the streets, somebody is like, you're ugly, you're fat. Like, like not that often, but like if you're thinking those things about yourself, you're with yourself all day long.
Christine Emmer What I assume is that people cannot hide from it. Like it will be there all the time. With public stigma, for example, if you avoid social situations, you can stop it somehow. But to deal with this forms of self stigmas, it's much, much harder.
Juna Another facet of self stigma is anticipated stigma.
Christine Emmer So people actually anticipate that they will experience stigma or discrimination and even try to avoid social situations because of that. So this is also a very important stressor when you anticipate unfair treatment or negative judgments because of your body weight.
Juna So this would be like when people don't want to go to the gym because they're afraid of being judged or like we started this episode like not wanting to go home because you could hear comments from your family members or even like not applying for a job you might be qualified for because you just think the person's not going to give you the job because of your weight.
Eddie And, you know, I'm going to take this a step beyond the gym or the holiday dinner table for a second to my wheelhouse. Take your hospital.
Juna Okay.
Eddie Weight stigma makes people not want to go to the doctor, which can be really detrimental.
Christine Emmer In health care settings, we know that weight stigma is one of the major barriers to for health care use and also leads actually to a decreased quality of care and prevention as prejudice towards patients with overweight is common among health care professionals.
Eddie So this episode, I think we're featuring a lot of disturbing research here. Here's a little more.
Juna Okay, awesome.
Eddie There's some really upsetting research on health care professionals and weight stigma. We have studies showing that doctors have less respect for their high weight patients and even feel it's a waste of their time to help their high weight patients. In one study, 69% of women who were obese reported being discriminated against by their doctor.
Juna Oh, my God. Why would you want to go to the doctor if you felt like they didn't respect you or they thought you were a waste of their time?
Eddie You don't go.
Juna Right. You just don't go. So this leads to a lot of really serious health problems not getting addressed because people just aren't going to the hospital.
Christine Emmer One of the most frequent things I heard is that people come because of one condition or because they have pain in their knee, for example. And then the doctors just tell them, Hey, you just have to lose some weight and then it's going to be fine again. But actually they have some serious condition, which is not related to the overweight at all.
Eddie So basically blaming everything on weight and ignoring the actual patient concerns.
Juna And exactly doing the opposite of what a doctor is supposed to.
Eddie Do. Right.
Juna Now, let's turn to this other part of weight stigma, which is this idea that discriminate against people because of their weight will make them act healthier.
Eddie Do we know what affects weight? Stigma has on people's health behaviors. Do they all of a sudden change their food choices and go to the gym every day because someone said they were fat?
Juna Yes. No. So contrary to what some people in media may tell you, research actually shows a very robustly guys many studies, study after study after study always shows the same thing, which is that experiencing weight stigma makes people engage in unhealthier behaviors.
Christine Emmer The experience of weight stigma as a stressor results in unhealthy behaviors like maladaptive eating, disturbed sleep because of their rumination about weight, stigma, because they're kind of engaged in the stressor and also less physical activity, emotional dysregulation. And of course, on a more biological level, the heat and stress level, inflammation and heightened cortisol levels.
Juna Having someone critique your appearance can obviously be very, very stressful.
Eddie So we've done a whole separate episode on stress and why it could be so detrimental to our health and weight. Stigma is a psychosocial stressor. So even though it's not a physical threat, your body treats it like one. And we know how we respond to stressors.
Juna Right? Not by eating more veggies and going to the gym.
Eddie Exactly. Being stigmatized for your weight and stress, which makes people make poorer food choices and not want to exercise at all. Because after all, going to the gym probably means encountering even more weight stigma.
Juna So one study I saw had women who are overweight and women who are normal weight, and they saw a video showing weight, stigma and like a more neutral video. And then afterwards they had snacks that they could eat, just like available in the room. And like in the.
Eddie Movies, like movies.
Juna They watched, they watch movie, there's snacks available, whatever. And basically the researchers found that for the overweight women when they were shown the video showing weight stigma, they ate three times as many calories. After seeing that video, then the women who are normal weight. And that's probably because like they've experienced weight stigma so much throughout their lives. It's so stressful to them. It causes all this stress eating.
Eddie They were just triggered by it. So even just seeing a video depicting weight stigma is affecting their eating behaviors.
Juna Right. So they didn't even have it happen to them. They were just watching it happen. And that's how distressing it was. Like they ate three times as much afterwards. So this effect is pretty consistent with other health behaviors, too. So experiencing weight stigma makes you exercise less. It makes you sleep worse. It increases your likelihood for disordered eating or binge eating.
Eddie Okay, so these are the physical health effects. Not good.
Juna Now, what.
Eddie About the mental health effects of experiencing weight stigma?
Juna So glad you asked that, because honestly, it might be even worse than the physical effects. So in the study that Christine Emmer and colleagues conducted, weight stigma was associated with basically every negative health outcome.
Christine Emmer Overall mental health outcomes we got, which were really a lot. It was anxiety, self-esteem, depression, stress in general. Mental health had an effect on all of them.
Eddie You know, what we know about mental health is that it doesn't exist in a vacuum. Your mental health then impacts your physical health, right? If something is making you depressed, are you going to be in the mental health space to cook a nourishing meal for yourself?
Juna Yeah. No.
Eddie And in a way it's a self-perpetuating cycle. The weight stigma leads to poor mental health, and poor mental health leads to worse health behaviors which impact your weight, right? Which then leads to more weight stigma.
Juna It's like a positive feedback loop. So if you're listening to this, you may be wondering why does experiencing weight, stigma or any sort of stigma lead to such detrimental health outcomes? Like why is it so damaging to us as humans?
Christine Emmer The social consequences of weight stigma such as poor social support, social isolation represent serious health risk, as these are the like basic psychological needs. Connectedness, for example, but also autonomy. Because you lose control of a lot of not only social situations, but also more hard life outcomes like your job or housing.
Eddie So I think back to the beginning of our conversation here. We want to show up at that holiday dinner table. Right?
Juna Right.
Eddie Socialization is like key to our humanity. It makes total sense. We're social creatures. Listen, we involved in tribes, right?
Juna So if you're being rejected by the tribe, which is kind of, what, like this social rejection is, right, then you'd probably have a much lower chance of survival. So it makes sense that has this really, really profound impact on our health.
Eddie I mean, we have decades of research showing that discrimination increases, rates of drug abuse, alcohol abuse, and it even changes the way that our brain is functioning.
Juna Okay. So for all the people out there who are like tough love, everybody is just being a special snowflake. Like, everybody's too sensitive, like guys. It's documented in it's not people being sensitive. It's not something that, you know, only Gen Z feels like this. It's actually a really robust effect that's shown across all age groups. And the effects of weight stigma are actually even more shocking when it comes to children.
Christine Emmer Children and adolescents do have a stronger focus on appearance and less resources to cope with stigma or to be empowered against stigma. Because weight stigma can stem even from parents, from peers, from educators, and then also from the media. So it's really hard to save yourself from these kind of experiences.
Eddie Yikes. I'm having flashbacks to hearing parents lovingly call their children chubby.
Juna Oh, my gosh.
Eddie I remember my grandmother gently grabbing my face and pinching my cheeks.
Juna Ouch. Ouch. And we have research in adolescence that shows that depression and other negative mental health outcomes are more associated with the experience of weight stigma than with their actual weight.
Eddie So being called fat or whatever is actually more likely to negatively impact your mental health than your actual weight.
Juna Right. So you could be normal weight and being called fat is worse for you than being overweight and not being called anything. So, I mean, if that doesn't tell you how powerful the human psychology is, I don't know what does. Another reason why people may be experiencing these negative health effects from weight stigma is something called stereotype threat.
Christine Emmer And you are aware of these kind of stereotypes that, for example, some of the things that you are lazy, then your outcomes also in cognitive tests for example, or a performance test are then also worse. And you're kind of realizing these kind of ideas someone has about you, these kind of stereotype.
Eddie In other words, stereotypes are almost like self-fulfilling prophecies. If you think that people think that you're lazy, you're more likely to act lazy.
Juna Right. It's kind of counterintuitive, but I think it goes back to this idea of self stigma. The story you tell yourself about yourself is so important, and if you're being told by stereotypes that like you're this certain way, then you act in accordance with that way. You know what I think people think, wait, stigma is like.
Eddie Why.
Juna There's this one classic holiday movie. Perhaps you've seen it. It's called Just Friends. Have you seen it?
Eddie No, I must have missed that one. Oh.
Juna No, no, it's so, guys, this pause podcast, you have to go watch the movie.
Eddie Just friends, okay?
Juna It's so good. Okay. It's a classic. Basically, this guy, Chris Brander, played by Ryan Reynolds.
Eddie I could have.
Juna Guessed, is a chubby kid in love with his hot cheerleader best friend Jamie.
Eddie Who says something that I've been meaning to say. Jamie.
Juna There you are. And when the other kids find his note in her yearbook saying how he really feels about her, you're my best friend historically.
Eddie But I want to be more than that.
Juna Of course, they're all horrible to him, and they all call him fat, and they're like, Try your salad, blah, blah, blah, try a salad. Chris So he rides off into the night on his bike saying, I'll show you.
Eddie Oh, yeah, let's go. All of you.
Juna Fade to black. Scene opens up in the future. It's like ten years later or whatever. And he is a hot, sexy music executive who dates models, who refuses to eat sugar. And it's like the super fit guy. He's totally changed his life, all because the kids were mean to him in high school.
Eddie So what you're saying is life does not work like a Hollywood movie?
Juna Eddie That is exactly what I'm saying. In today's eye opening revelation of the day, mind blowing, making fun of someone does not metamorphoses them into being hot.
Eddie Ryan Reynolds Okay, so if it doesn't work to make fun of people, to get them to change their behavior is what are we going to do about weight stigma?
Juna Eddie I'm so glad you asked. That is exactly what we're going to talk about right after this break.
Eddie And we're back.
Juna One of the reasons why tackling weight stigma can be so hard is because so many of these biases about we are actually quite implicit. They're subconscious.
Christine Emmer So we know that all these stereotypes get activated really automatically, and we have them because of our socialization, right? We live in the in the world where people still discriminate a lot. We see this in schools and in children's media and sayings.
Juna So think about the way that overweight characters are portrayed in media.
Fat Albert Hey, hey, hey it's Fat Albert.
Eddie And I want to say.
Christine Emmer We have this already from, like, really children's media to it gets more adults being less intelligent or lazy, like the funny character.
Cartoon: You're so fat, you are even fatter.
Christine Emmer You have this, for example, in Simpsons or Family Guy.
Cartoon: I'm sorry, sir. You're too fat to ride the coaster. Yeah. Why don't you go back to your part, Hippo.
Christine Emmer Or the meme character? We also had us like the bad guy from Disney movies. For example, in Mickey Mouse. We have this. How is it call? I think Peg Leg peed or something.
Cartoon: What the heck was that, huh? Oh, hi, Pete. Don't.
Christine Emmer Oh, hi. And then Ursula from Ariel. Yeah.
Cartoon: Poor unfortunate soul.
Juna But if media can be used to create negative stereotypes, it can also be used to create positive ones.
Christine Emmer Media has two kinds, like always. When we talk about media, so it can be really harmful, but it also can help.
Eddie Oh, I love it. Using the power for good instead of evil.
Juna So we've had movements like body positivity, health at every size, body neutrality. There's even more plus-size models in a lot of different companies campaigns.
Christine Emmer We also see these kind of anti fake movements like the app be real, for example, where it's not even possible to use filters or Photoshop for your pictures to share with your friends. And of course, there is still a lot going on with weight discrimination or discrimination because of other characteristics. But in general, I would say that something is changing when I compare it to my youth when I was 13 with all the magazines and paparazzi. So it was kind of a different story.
Juna So for me, changing the types of people I follow on social media is one thing I really consciously do to see more body diversity in my feed.
Eddie That sounds like different types of eating diversity in your feed, but I know what your feed is.
Juna The posts that cover that Instagram or take it up or feed you.
Eddie It's not having.
Juna It's not your.
Eddie Food, new vegetables, not your diet. Okay. So changing media is a kind of like addressing larger societal issues. But what can we do as individuals to address weight stigma?
Juna So Christine says the first step is to wake up and acknowledge that this is something that we might be even participating in ourselves.
Christine Emmer The first thing is to be aware of these kind of automatic processes and these stereotypes we have. We cannot control them easily, so we have to be aware of them. And then in the next step to reflect and rethink them and then change the thoughts and practices till these automatic activation stops and the more adaptive activation starts.
Juna So Eddie and I were chatting prior to this episode, guys, and we were just reflecting and Eddie, do you want to share what we discussed? Like, what do you think that you yourself as a physician engage in weight stigma?
Eddie Hi. So this is really giving me a lot of pause. And I just think back even to the few patients that I saw earlier this week. And as they walked in the room, the first thing that you judge or the first thing that I see is how big is their belly? Right. And I'm thinking back and I really have to do some deeper dove on this that I think I had lower expectations for what my overweight patients were going to be able to do with my advice. So most of them are coming in because something hurts their back, their neck, their knees, and I'm going to give them advice and I'm going to try to treat them as best I can with medications or injections or give them exercises. And I guess I have an expectation or a hope for how far they could go. And I think as I start to examine this, that my expectations for the slimmer patients was probably higher. So I'm going to plead guilty here and work on this.
Juna Wow. Amazing. I mean, I've noticed it myself. Guys like obviously we do this podcast, I'm around this stuff all the time. So I try not to like, I try my best, but like I have to say, even I think, like if I think of, I don't know, like somebody a trainer who is more overweight than other trainer, like I'm going to perceive them as less capable as a personal trainer because they have excess weight. So I think it's something that all of us can work on. Like no matter how much we make a conscious effort, it's still something to be continuously working on because nobody is perfect. So, I mean, I hope that's something that everybody can think about themselves. Like just because you talk about it a lot, does it mean that you're not necessarily engaging in it yourself.
Eddie And to maybe turn towards a positive side with this with this whole issue of weight stigma, if we go back to that Harvard survey that we talked about with the implicit attitudes towards, let's say, gay people, for example, that has decreased by a third in the past decade. And they're predicting that our attitudes about gay people will be neutral within the next 20 years. And that's just remarkable progress.
Juna Okay. Another really important intervention that's also concrete, I would say, is to think about the way we use our language.
Eddie Right. So if I think back to my youth, what we call gay people and what you call black people, those are really harmful words and they are now appropriately taboo.
Christine Emmer Language creates reality. And I think one of the easiest interventions or preventions we can do for weight stigma is to to see the person first.
Eddie So instead of saying an obese person, we should say a person with obesity, or maybe let's just like medicalized this and say there's a high weight individual or person in a bigger body.
Juna Right. I like that so much better just personally.
Eddie And I think in health care settings, doctors have especially have a lot to work on. And instead of seeing weight as a moral failing, that's a person's fault. Seeing is that it's something that's impacted by all of those factors we talked about, not the least of which is their socioeconomic status, their home environment, how they grew up and their genetics.
Juna Okay. So now let's talk about for anyone who's experiencing weight, stigma, what they can do.
Christine Emmer People use a variety of adaptive and maladaptive coping strategies. Maladaptive coping strategies are, for example, emotional eating and isolating themselves, which of course doesn't help with self stigma and adaptive coping strategies. For example, positive self-talk, self loss, humor and religion or seeking social support, but also being visible, educating self and others about weight stigma. These coping strategies actually help offset the stigma, but also public stigma.
Juna So I think developing positive coping strategies is not just the key to dealing with weight stigma. It's like the key to everything in life. Guys, if you can find a way to not self-sabotage when somebody makes you feel like crap, you're going to win guys. Like you're never going to be taken down by somebody else.
Eddie Well, all right. It sounds like a big part of this is having the self-awareness to recognize when you may be engaging in maladaptive self coping behaviors. Right. And then taking the initiative to try to come up with better coping strategies.
Juna Exactly. I have such a good example of this. Can I share my story.
Eddie Please?
Juna It's so relevant. And it literally happened last week. Like, it's almost like it happened like just for this episode. But anyways, basically a family member made a comment and it was like along the lines of like, oh, you should really like do some more running or something like so you can look more elegant or slimmer or something like that, whatever.
Eddie Like lift west left.
Juna Lift that last, run more something along those lines. And it's like, that's just like one way. Triggers. I hate getting comments like that because like my parents just make out with that all the time. Growing up, I just I hate it. Anyways, I was like at the gym and I was so upset and I was like, why do people never learn? And anyways, in the past this would have triggered all sorts of just like a really bad behavior. Like either I would not eat the next day until dinner or I would probably have some sort of like binge or emotional eating episode after or something.
Eddie So restrict or too much just to say screw you.
Juna Right. Exactly. Like some sort of way to get back at them through like some sort of bad pattern. And I was like, I'm an adult. I can do this. What do I do instead? So I was like, Oh my gosh, I am going to turn this into a TikTok video. There's so many people who have like immigrant family members that do this to them. And I was like, This is such a funny video. You didn't. I did. It was so good. And like the premise of the video, I started a series that was called Things that immigrant parents say to kids with eating disorders.
Eddie That need to change with.
Juna Eating disorders. And like it was so big, I play piano. It was so funny. Like, I thought it was really funny. Anyways, I don't know if other people thought was funny, but whatever the point is, I was so proud of myself because I turned something that in the past was very negative into something that was helping me, you know, turn your trauma into content goes anyways. Hopefully hearing about how implicit stigma can be and how prevalent it is in today's society will prompt some of us to do some serious self-reflection. It has prompted me to do some self-reflection now and maybe even confront that uncle at the dinner table who's always saying the wrong thing.
Eddie And maybe not be that uncle at the dinner table.
Juna Guys, don't be the uncle, guys, don't be the uncle.
Eddie And we're not going to base our treatment of other people off of a Ryan Reynolds Christmas movie that I swear to watch.
Juna Wow. Such a great advice from Eddie. Andy, promise. Guys, we have to hold on to it. We have to hold on to it for this year that he has to watch just friends. That is going to be it for today's episode. Thank you so much. My guest, Christine Emmer. You can find her study as well as all the other studies that we mentioned in today's episode on our website foodweneedtotalk,com you can find me @theofficialjuna on Instagram and Juna Gjata on YouTube and Tik Tok you can find Eddie.
Eddie I will seriously be doing the implicit association test and I will get back to you with the results.
Juna Amazing. Food We Need to Talk Is a production of PRX.
Eddie Our producers are Morgan Flannery and Rebecca Seidel.
Juna Tommy Bazarian is our mixed engineer with production assistance from Isabel Kirby McGowan.
Eddie Jocelyn Gonzales is executive producer for PRX Productions.
Juna Food, We Need to Talk was co-created by Carrie Goldberg, George Hicks, Eddie Phillips and me.
Eddie For any personal health questions, please consult your personal health provider to find out more. Go to foodweneedtotalk.com.
Both Thanks for listening.
