Distressing experiences such as this lead many heavy women to avoid doctors’ offices altogether. As a result, fat women are less likely to get Pap smears and other important medical screenings, and have higher rates of cervical cancer and other preventable illnesses. One studyeven showed that many doctors refuse to perform Pap smears on heavier women.
For insurers, weight is a reason to deny health-care coverage by classifying “morbid obesity” as a preexisting condition. While the Patient Protection and Affordable Care Act will make it illegal to deny health insurance based on preexisting conditions, the new law allows employers to charge overweight employees higher insurance premiums.
Anti-fat attitudes also take an emotional toll. For instance, fat children are more likely than their thinner peers to be bullied. And weight-based bullying does not end with childhood: Women speak of young men hurling insults or even food at them in public spaces. Fear of such humiliation leads many heavy women to avoid exercising in public. In extreme cases, these women might not go out at all, depriving them of the face-to-face social interaction that is vital for mental and physical well-being.
We know that anti-fat prejudice harms average-size and thin people as well, as the fear of becoming fat drives many of them to develop eating disorders and body-image problems.
Yet, the way we talk about fatness as a medical issue and a public health crisis brought on largely by reckless personal choices may be worsening anti-fat prejudice and related health problems. Public health campaigns, product ads and news reports about the “obesity epidemic” often feature images of headless torsos with overflowing guts, intended to elicit disgust, or fat children looking forlornly into the camera.
Messages about the need to wage war on fat are everywhere. First lady Michelle Obama has made eliminating childhood obesity the biggest issue on her agenda. Starting in 2011, Children’s Healthcare of Atlanta ran an aggressive ad campaign that included billboards with fat children blankly staring at viewers, accompanied by captions such as “Chubby kids may not outlive their parents.” Even Coca-Cola, whose sugary drinks are widely regarded as a major contributor to weight gain, has a new advertisement reminding consumers that “all calories count.”
Do such messages inspire people to lose weight? We don’t know. However, they seem likely to reinforce perceptions that overweight people are ugly, lazy, unhealthy and unlovable. Could these campaigns make fat children feel worse about themselves than they already do? Might they even make bullies and weight bigots feel justified?
To test this theory, I conducted several controlled experiments with a psychologist and a UCLA sociology graduate student. We found that people who read news reports that discuss obesity as a public health crisis were more likely to agree with stereotypes of fat people as unlikable, untrustworthy and less intelligent than thinner people, compared with those who hadn’t read such articles.
Other studies have shown that individuals who think people can control their weight are more likely to believe that weight-based discrimination is justified. And my research has found that news media discussions of obesity overwhelmingly blame personal choices — rather than social or biological factors — for Americans’ rising weights.
In our rush to cure the obesity epidemic, we are not only ignoring but may be worsening anti-fat prejudice and size profiling. If medical professionals want to improve public health, they might start by renewing their pledge to “first, do no harm” by treating patients of all sizes with dignity and respect.
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