This page is for health and wellbeing professionals and Doncaster residents to learn more about weight stigma.
What is weight stigma?
The World Obesity Federation defines weight stigma as “the discriminatory acts and ideologies targeted towards individuals because of their weight and size” - this means treating someone badly because they are judged to be too big or too small.
Weight stigma can be experienced in lots of different ways, for example, negative comments, staring, physical assault or lack of accommodation in the environment, such as accessible seating.
What impact does weight stigma have?
Weight stigma has a negative impact on both physical and mental health. Weight stigma can affect health by:
- Increasing blood pressure
- Increasing cortisol secretion (stress hormone)
- Contributing to allostatic load and systemic inflammation
- Increasing levels of depression, anxiety, and body dissatisfaction
- Increasing likelihood of developing disordered eating habits
Individuals who are stigmatised for their weight are less likely to seek medical care and are more likely to experience social-isolation and avoid potentially stigmatising environments (e.g., gyms, dental practices, etc.). Weight stigma can also affect employment opportunities and educational attainment.
Through local and national research, we know that weight stigma or body shame is not an effective motivator for behaviour change. Weight stigma can often lead to worsened health outcomes and elevated weight in the long-term.
Weight Stigma in Doncaster
78% believe people who are overweight or obese are discriminated against.
55% believe there is a stigma to attending weight management services.
Respondents believe that obesity stigma is mainly caused by a belief that obesity is largely caused by laziness(38%) and that obesity can be resolved through lifestyle and willpower (31%)
32% of participants have experienced negative or hurtful behaviour 'fairly' or 'very' often in the last year because of their weight.
You can read the full highlights of our Doncaster Talks consultation here: www.doncastertalks.com/survey-results
Pupil Lifestyle Survey
Since 2015, Doncaster Council has conducted the Pupil Lifestyle Survey, which has provided data on children and young people’s health behaviours, through an anonymous school-based questionnaire. The survey covers a broad range of topics, including some questions which provide insight for the Compassionate Approach.
- Primary pupils: Physical attributes are most often the target of bullying, with 31% of pupils saying they were bullied because of the way they looked and a further 27% because of their size or weight. However, size and weight has decreased slightly since last year.
- The way you look is the third highest thing they worry about (exams and tests and schoolwork higher) 21% of primary pupils worry about how they look. Girls/Year 6 (30% respectively) worry about the way they look more than any other group.
- Nearly half (47%) of secondary pupils who say they have been picked on or bullied, say it was because of the way they look and a further 43% say it was because of their size or weight. This suggests physical appearance is by far and remains the biggest ‘target’ for bullying. Secondary pupils: the way you look is the highest thing they worry about, moving up from the second highest in 2020/21, with 39% of secondary pupils worrying about how they look
- For the first year since starting the PLS, ‘The way you look’ has overtaken exams and tests as the no. 1 thing secondary pupils worry about. Girls worry much more than boys about the way they look (57% v. 21%)
The following case study is an example of the lived experience of weight stigma from a Doncaster resident.
Can you describe your experiences using health care services as a person living with obesity?
Weight stigma in Health & Wellbeing settings is something that’s happened many times over the years – for example, seeking help for a cough and it seemingly being blamed on weight. Two experiences particularly come to mind.
After an emergency C-section with my little girl, I attended hospital due to a problem with my cut. I explained the issues and was told “Well, you are rather large”. It felt like I was being blamed for the problems, and that miraculously losing 6 stone overnight would cure the problem (it wouldn’t - and this would also be impossible to achieve!).
The worst experience I ever had… I’ve struggled with my weight all my adult life. I’d describe myself as a yo-yo dieter, forever putting on weight, going on a diet, losing weight, then putting it back on and more. After the birth of my daughter, I knew I had to make a change. I was watching what I ate, I’d got a friend to go to the gym with. We were going to the gym, doing circuits, classes, swimming… You name it, we did it, and at least 4 times a week. After a year of gym membership, and dieting, I’d lost the grand total of…………… 1lb. At this point, I knew I needed more help. I needed to know if there was something underlying, surely there was something, how can you do all that work and lose 1lb? I plucked up the courage to ask for help, or for a referral to someone who could. I poured my heart out at the appointment. I explained what I’d been doing – my dietary habits and exercise routine. One sentence crushed me. I was told, “Well. You’re obviously not doing enough, are you?” They continued, “It’s simple, you’re putting to many calories in from what you’re burning, you need to reduce your intake.” That was that. End of appointment. No help offered.
I felt absolutely devastated. That might sound dramatic, but 12 months of work – being proud of what I had achieved in terms of fitness, if not weight loss, felt totally pointless; what had I wasted the last 12 months doing? What was the point? I cancelled my gym membership, stopped bothering about what I ate. If no-one else cared, why should I? I cried for hours, and then got angry, at the world, the health professional, and myself. It took months for me to get over it and book an appointment, specifically to see a different health professional.
If the healthcare professional had a better understanding of the complexities of weight, I would have had a better experience. It is NOT just as simple as Calories in vs Calories out – there are so many other factors involved. Underlying health issues, mental health issues, environment, income – this all has an impact. Also, if I had received an offer of help, even just “let’s do some bloods to rule basic things out”, I would have had a better experience.
I actually returned to the service a few months later – I saw a different health professional, and the difference in approach was night and day. I was listened to, not made to feel like it was entirely my fault. We ruled out underlying issues, and I was then referred for further help. I’ve now lost 8 stone. Almost half my body weight.
Learning about Doncaster’s Compassionate Approach to weight has changed my perspective on my experiences. I now understand that it wasn’t me that was the problem, it was the health professional who was at fault in their approach, through a lack of understanding and compassion for people who are overweight.
A more compassionate approach to weight would absolutely improve patient experience in the future. A greater understanding of the complexities of weight and a compassionate approach to the condition (it is a condition) will hopefully mean more people who want help will seek it and will not feel the weight of the stigma associated. More people will be empowered to take control of their health with help from professionals, families and friends, and will be supported to start taking action.
People may experience weight stigma from all kinds of people and professions. Weight stigma is a very dominant narrative in our society - in media, in healthcare, in education, and in our social networks. The examples of negative practice in the above case study are a product of the stigmatising narratives that dominate our society (e.g., the assumption that weight is as simple as calories in vs calories out). The purpose of this case study is not to single out any group of health professionals, nor to blame, shame, or guilt people due to their previously held beliefs about weight.
Nevertheless, now that we are aware of the negative impact of weight stigma, it is important to change our practice. When we know better, we should strive to do better. The above case study also has examples of positive practice, where the individual felt listened to and supported. We want to be solution-focused in addressing weight stigma and are therefore developing a training package to support health and wellbeing professionals to address and challenge weight stigma in the sector. More information about this training will become available on this website.
How can we address weight stigma?
Doncaster residents believe it is wrong to stigmatise people for their weight, shape, or size.
83% believe that people should not feel stigmatised about their weight.
So, what can we do to reduce levels of weight stigma in Doncaster?
1. Acknowledge bias
Weight stigma is very common in our society, so it is likely that you have some level of bias towards people based on their weight or size. Acknowledge this and identify opportunities to change.
2. Improve knowledge
The first step to changing unconscious bias is improving your conscious knowledge on the topic. Find out more about weight stigma, where it comes from, what it looks like, and how it impacts people. This webpage is a good place to start. It may also be useful to reflect on where these biases have come from – for example, the media you consume, or your social network.
3. Change language
Our words can have a profound impact on the lives of others. Think carefully about the language you choose and how it might promote weight stigma. If in doubt – ask!
4. Listen to those with lived experience
When addressing any kind of bias or stigma, it is essential to listen to those who are victims of that stigma. Talk to individuals about their experiences of weight stigma and how it has affected them and, importantly, believe them.
5. Be compassionate with yourself
It is not your fault if you have unconscious bias, but it is your responsibility to address it. It can be challenging to change old ways of thinking. If you are struggling, please ask for support.
What is Doncaster’s Compassionate Approach to weight?
To help to address weight stigma in Doncaster, we are adopting a more compassionate approach to weight. You can read more about this approach here: www.doncaster.gov.uk/services/health-wellbeing/doncaster-s-compassionate-approach-to-weight
Additional Resources to aid in combatting weight stigma
- Food Active Weight Stigma Checklist: https://foodactive.org.uk/wp-content/uploads/2021/03/Weight_Stigma_Checklist_FoodActive_FINAL.pdf
- Healthy Weight Coach eLearning for Healthcare: www.e-lfh.org.uk/programmes/healthy-weight-coach/
- If you do require additional support, please consider contacting the following:
- Your local IAPT service
- Or your personal healthcare professional, such as your GP or Therapist
- Get in touch if you have any questions or would like to be involved in our Public Engagement Group: firstname.lastname@example.org
Downloads & Resources
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