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What is weight bias, and why does it matter?
Weight-based bullying, also called weight bias or weight stigma, is an unfortunate reality for many teens. More than 80 percent of students agree that overweight people are routinely judged and discriminated against because of their weight, according to a recent Student Health 101 survey.
“Weight stigmatization exists—and matters,” says Dr. Dianne Neumark-Sztainer, professor and division head in the Division of Epidemiology and Community Health at the University of Minnesota School of Public Health. “All of us, but especially young people who are overweight, are affected by it.”
Overweight and obese youth are often victims of false stereotyping. These snap judgments and biases can have negative effects on emotional, physical, and mental health. “I’ve been called fat before,” says Brittany, a junior from Boston. “It was absolutely devastating. Hearing someone make a judgment about me without even thinking what I would feel made me want to go home and cry.”
How stigma affects our health and body image
Weight bias is prevalent in the media, health care institutions, and society, research shows. This stigma may lead to avoidance of health care services (e.g., going to the doctor) and can make performing healthy behaviors more difficult. Why? Because weight stigma can reduce our body confidence and make us feel defeated.
“There is this cultural belief that people have to be dissatisfied with themselves in order to make behavioral changes to improve their health,” says Sara Stahlman, marketing and communication coordinator of Campus Health Services at the University of North Carolina at Chapel Hill. “In fact, the opposite has been shown; people take better care of their bodies when they hold their bodies in high regard.” Many health care professionals agree. Stigmatizing body size makes people “sicker, poorer, lonelier, and less secure,” says Dr. Deb Burgard, a psychologist in California who specializes in body image, weight, and health issues.
So how can we increase confidence to promote a healthy lifestyle and body image? Experts say the key is to focus less on weight and more on healthy behaviors. “When we think about our overall health, there are many other factors besides weight that are important, like stress levels, amount of sleep, alcohol, drug, or tobacco use, [etc.],” says Dr. Rebecca Puhl, deputy director of the Rudd Center for Food Policy & Obesity at the University of Connecticut.
Why dieting doesn’t work
Eating a well-balanced diet and exercising regularly are important. However, taking extreme measures to lose weight, such as exercising too much, starving, bingeing, purging, or fad dieting, can be dangerous and can result in gaining the weight back. “Several studies have shown that dieting and unhealthy weight-control behaviors are ineffective for long-term weight management in adolescents,” says Dr. Neumark-Sztainer. Project EAT, a study led by Dr. Neumark-Sztainer, found that teen girls who dieted were nearly twice as likely to be overweight five years later compared to those who didn’t diet.
“Rather than jumping on the latest fad diet, obsessing about a number on the scale, or worrying about the size of pants you wear, it’s helpful to instead focus your energy on healthy behaviors that you can engage in, regardless of body weight, and try to make these a regular part of your lifestyle,” says Dr. Puhl.
Healthy alternatives include:
- Setting realistic, achievable health goals
- Practicing mindful and intuitive eating
- Finding an exercise routine that is so engaging, it hardly feels like exercise
- Getting enough sleep each night
1. Set realistic goals
Regardless of what your health goals are, remember to keep your expectations in check. “It’s important to set healthy goals for yourself that are realistic and achievable,” says Dr. Puhl. Here’s an example: “One goal might be to replace your soda with water or unsweetened tea. This is a very specific, measurable goal that is not focused on achieving a certain weight, but can improve health and help to maintain a healthy body weight.” Set yourself up for success by identifying manageable behavior changes you can easily incorporate into your everyday routine.
Try these healthy behavior goals
Walk at least 4,000 steps (two miles) each day. Moving from class to class, window shopping at the mall, and walking your dog around the neighborhood all count. Wearable trackers can help you meet this goal, and they make it more fun when you compete with friends.
What do chicken fingers, French fries, pancakes, and potato chips have in common? They’re all the same color. Aim to make your plate as (naturally) colorful as possible at each meal. Think a rainbow of colors with lots of fruits and vegetables.
Do something you enjoy every day for at least 15 minutes. Doing an activity that makes you feel good, such as listening to music, reading a good book, or talking to a friend, can help fend off stress.
2. Practice mindful and intuitive eating
Practicing mindful and intuitive eating can help encourage healthy relationships between your food, mind, and body. “Slow down while you eat—notice what foods taste like,” says Stahlman. The practice of mindful eating involves paying attention to the experience of eating without judgment. Try avoiding screens and distractions while you eat and focus your attention fully on your food: See it, touch it, smell it, savor it. You’ll get more enjoyment out of your meal and feel more satisfied.
Food for thought
The concept of intuitive eating, which is closely tied to mindful eating, can help you learn how to distinguish between physical feelings (e.g., hunger, fullness) and emotional feelings (e.g., boredom, stress, loneliness). “Notice how foods make you feel during and after eating,” says Stahlman. “Stay aware of when you feel hungry and full and listen to those cues.”
A key component of intuitive eating is making peace with food and finding a balance in the foods that you eat. For example, if you want to eat chocolate cake every day, you can have it. But if you’re truly listening to your body, you might have that cake for breakfast and then naturally want something lighter and healthier for dinner. It’s about trusting your body to know what to do.
“I generally try to eat good portion sizes and incorporate all parts of a healthy meal,” says Paula, a senior. “At the same time, I try not to deprive myself of the foods I want to eat. I think everything in moderation is okay.”Try this
Avoid labeling foods as “good” or “bad,” or feeling that you’re good when you eat lighter or bad when you overeat. These rules can lead to guilt and shame and help perpetuate a cycle of unhealthy eating habits. Instead, try to:
- Eat when you feel hungry
- Listen to your body when it tells you that you’re full
- Keep healthy food options easily accessible and make less healthy options inconvenient
- Find alternative ways to process your feelings (e.g., boredom, stress) without using food
3. Get moving
Aside from the health benefits, exercise has been shown to improve memory, body image, concentration, mood, and mental health. But if hearing the word “exercise” makes you think of slogging away on a treadmill, it’s time to redefine it. “Find ways to move your body that you enjoy and incorporate more enjoyable movement into every day,” says Stahlman. Finding an activity you look forward to, whether it’s doing body rolls in Zumba class or playing soccer with friends, will help make it a regular habit.
How students say they get moving
“Swimming is really fun because it’s very easy on your body and you don’t feel like you are really working out.” —Maria, sophomore
“Go with a friend, make a game of it, pick up a team sport or activity. When you hang out with your friends, play a game of some sort.” —Kate, junior, Winnetka, Illinois
“Take your pets for walks or runs.” —Calvin, sophomore, Indianapolis, Indiana
“I like using the pedometer on my phone and competing with friends for higher mileage.” —Tricia, senior
“Walking around the mall shopping or dancing!” —Emily, senior, Indianapolis, Indiana
4. Catch some Z’s
Not getting enough sleep increases hunger cravings and decreases energy, research shows. This means that you’re less likely to fit in that routine exercise we just talked about and more likely to reach for an unhealthy snack. The National Sleep Foundation suggests aiming for 8–10 hours of sleep each night to function at your best.
Tips for getting more sleep
Create a pre-sleep routine. Take that last hour before you hit the hay to unwind. Whether that means cozying up with a good read, making a steaming mug of chamomile tea, or jotting down stressful thoughts in a journal, find a relaxing activity and make it your nightly habit. Performing stressful activities before bed (like homework or Facebook stalking) can cause the body to release the stress hormone cortisol, which is associated with increased alertness. The more alert you are, the harder it will be to fall asleep.
Stick to a (somewhat) consistent bedtime and wakeup schedule, even on the weekends. Waking up at 8 am on a Saturday morning probably sounds about as appealing as going to the dentist. But going to bed and waking up at close to the same time each day will set your body’s internal alarm clock, making it easier to fall asleep and wake up when you need to.
Avoid naps in the late afternoon. A 4 pm catnap may sound great when you’ve hit that afternoon energy lull, but it could be making it difficult for you to fall asleep at night. If you need to nap, try to make it a powernap (up to 30 minutes) between 1–3 pm. If it’s after 3 pm, try jumping jacks, a brisk walk, or snacking on fruits and vegetables for a pick-me-up.
Avoid caffeine close to bedtime. You might need the pick-me-up in the morning, but it’s best to avoid caffeine (found in coffee, tea, chocolate, soda, etc.) after 3 pm; otherwise it can mess with your sleep.
Learn different ways to think about health and weight.
There are generally two perspectives when it comes to thinking about health and weight:
The weight-normative approach emphasizes weight as the main indicator of how healthy you are. Many doctors and health care providers have traditionally used this approach (e.g., measuring BMI and suggesting overweight or obese patients use diet and exercise to drop pounds). Although weight can play an important role, gauging a person’s health solely by the number on the scale doesn’t take into account other factors and can make patients feel helpless if they’re unable to reach a certain weight loss goal.
As an alternative, the weight-inclusive approach emphasizes that everyone is capable of being healthy, regardless of their weight. Doctors who use this approach encourage patients to work toward sustainable healthy habits (e.g., eating a healthy diet, exercising regularly, getting enough sleep) rather than a specific number on the scale. Promoting overall well-being can set patients up for a lifetime of good health.
“The only difference between a weight-normative and a weight-inclusive health intervention is removing the focus on weight,” says Sara Stahlman, marketing and communication coordinator at University of North Carolina at Chapel Hill Campus Health Services. “Using a weight-inclusive lens allows for folks to feel good about healthy behaviors even if their weight never changes.”
An important note on weight and health
Being underweight, overweight, or obese can increase the risk of certain diseases, though the exact role of body weight in influencing disease is not well understood, according to the Society for Science-Based Medicine, an organization that evaluates the evidence relating to medical treatments and illness.
Thin and underweight people can experience weight bias, too. Learn more.
It’s not just overweight teens who experience stigma; thin or underweight teens do too. “I am rather small and skinny,” says Martin, a senior in Boston. “Most recognize that larger people are harassed and bullied for their size, but don’t realize that skinny and thin people are picked on seemingly just as much.”
A study conducted at Rhode Island College found that subjects who weighed both the heaviest and the lightest were judged more negatively than those whose weight was in the middle. “My family constantly tells me that I’m skinny, which makes me feel pressured to maintain my weight and makes me feel abnormal and too skinny,” says Laila, a sophomore in Boston, Massachusetts. “While I know that society sees it as a compliment and my family simply cares about me, hearing what you look like constantly or being compared to any extreme is hurtful.”
More research needs to be conducted to find out how weight bias against thin or underweight people affects their health and well-being.
Deb Burgard, PhD, psychologist specializing in body image, weight, and health issues, Los Altos, California.
Dianne Neumark-Sztainer, PhD, MPH, RD, professor and division head in the Division of Epidemiology and Community Health at the School of Public Health at University of Minnesota.
Rebecca Puhl, PhD, professor in the Department of Human Development & Family Studies and deputy director of the Rudd Center for Food Policy & Obesity at the University of Connecticut.
Sara, Stahlman, MA, marketing and communication coordinator at University of North Carolina at Chapel Hill Campus Health Services.
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