Breaking Free from Internalized Weight Stigma : A Comprehensive Guide to Understanding and Overcoming Body Prejudice

1. What is Internalized Weight Stigma?

   Internalized weight stigma, also known as fatphobia, refers to the acceptance and internalization of societal attitudes, biases, and stereotypes surrounding body weight and size by individuals who are themselves targets of prejudice.

   Individuals with internalized weight stigma believe consciously or unconsciously that negative stereotypes and discriminatory behavior directed toward people with larger bodies apply to them. These people often perceive themselves as too heavy, regardless of actual body size.⁽¹⁾ It leads to a range of negative consequences, including diminished self-esteem, body dissatisfaction, and adoption of harmful weight control behaviors.

2. Significance of Understanding Internalized Weight Stigma

   Having an understanding of internalized weight stigma is important for several reasons: 

   • It can lead to negative self-perception, low self-esteem, depression, anxiety, and eating disorders.⁽²⁾ Recognizing and addressing it is crucial for mental health.
   • It also has negative effects on physical health. It may deter individuals from seeking necessary medical care leading to unhealthy behavior like extreme dieting and over-exercising, which can be detrimental to overall health.
   • Internalized weight stigma limits the opportunity and diminishes the overall quality of life of the affected individuals.
   • Recognizing this condition is essential for preventing individuals from engaging in harmful weight-controlling behavior.
   • It can be helpful in challenging and dismantling harmful stereotypes and biases and promoting a more accepting and challenging community.
   • It can be helpful in advocating for policy changes that promote inclusivity, diversity, and equity in various sectors, including healthcare, education, and the workplace.
   • It can be helpful in achieving long-term public health goals.

   Understanding internalized weight stigma is important for promoting mental and physical health, fostering inclusivity, and working towards a more compassionate and equitable society.

Being weight-biased is believing that certain weights or body sizes are more desirable or valuable than others. People with weight bias believe that those with larger bodies are: 

• Not attractive
• Lazy or undisciplined
• Less deserving of success or love
• Personally, to be blamed for any health issue they experience
• Less intelligent
• Less deserving of success or love

Turning this bias into action is known as stigma. Weight stigma includes any actions, comments, and policies that discriminate against people, based on their actual or perceived body weight.

Some of the examples of weight stigma in the society include: 

• Bullying based on weight
• Employment discrimination
• Hurtful comments from family and friends
• Negative stereotypes portrayed by the media

In internalized weight stigma, a person starts applying weight stigma to themselves. They take others’ beliefs and use them to inform their behavior and decisions.

Some of the examples of internalized weight stigma include: 

• Avoiding having their pictures taken or looking in mirrors
• Avoid being naked or having sex
• Having difficulty in accepting compliments about appearance
• Frequently criticizing their body weight or size
• Covering their body while swimming, at the beach, or in changing rooms
• Not feeling motivated to exercise, if they feel they cannot reach a lower weight
• Punishing themselves for not reaching their goal weight or for eating certain foods

Internalized weight stigma may affect anyone, regardless of body weight, age, sex, gender, race, or ethnicity. There are certain groups that are suspected to have more internalized bias than others, including: 

• Overweight people: A study performed on 225 ethnically diverse women found a correlation between higher body mass index and higher levels of internalized weight bias.⁽¹⁾ This suggests that those with higher body weight internalize bias to a greater degree.
• Females: A study was done in 2017 on 2,378 diverse men and women.⁽³⁾ It found that the rates of internalized weight bias were similar across racial groups, they were not the same across gender. Females were more likely to report higher levels of weight-biased internalization than males.
• Eating disorders: Those with eating disorders may experience weight stigma due to their body size or shape, regardless of specific eating disorders.
• Young People: The study done in 2017 also found that younger people had more internalized weight bias than other older participants.⁽³⁾
• Individuals Seeking Medical Care: Some people in the fear of being judged differently by healthcare providers may avoid seeking medical care.
• Athletes: Individuals engaging in sports or physical activity may face pressure to conform to specific weight or body composition standards within their respective sports or fitness communities. A review found weight bias among exercise and nutrition professionals such as weight trainers, nutritionists, and physical therapists.⁽⁴⁾

Internalized weight stigma may affect individuals across a wide range of demographics and its impact can be pervasive in various aspects, which may include physical and mental health, relationships, and overall wellbeing. Recognizing the groups affected by internalized weight stigma is crucial for developing inclusive and effective strategies for support and advocacy.

In weight stigma, a person has a belief that a type of body shape and size are inherently better than the other in terms of attractiveness, health, cleanliness, morality, or a mixture. Chronic exposure to such beliefs as well as pressure from close family or peers may make a person accept these opinions subconsciously.⁽²⁾

Knowing how it occurs is complex. However, there are various factors that can be responsible for its occurrence: 

• Believing a thinner body is a sign of good health is a very common reason, which is not true. A low body weight can also be maintained in a very damaging way that may cause a long-term impact on health. People having high muscle mass can have a high BMI. Only medical test reveals the actual health status of an individual.
• A sociologist Sabrina Strings argued that weight-related stigma started growing as a result of colonialism.⁽⁵⁾ Earlier in the 17^th century a European artist depicted females with rounded figures as beautiful. Later the curvaceous figure became a portrayal of enslaved black women. In a reaction to this people started regarding lower body weight as superior.
• Pressure to look in a certain way affects females more. A study done in 2020 on 676 females in Italy found that the participants with higher rates of internalized sexism or weight bias were more likely to report self-objectification.⁽⁶⁾

People of any size can have weight bias, which may affect how they see themselves and treat others. There are a number of strategies that can be helpful to people to unlearn harmful biases about weight that they may have internalized. 

• Education and Awareness: Educational initiatives that teach body acceptance should be encouraged. A diverse relationship between beauty and health should be taught. Programs that teach critical thinking skills to deconstruct and challenge unrealistic beauty standards perpetuated by media should be implemented.
• Healthcare Provider Training: Healthcare professionals should be trained in providing unbiased care, focussing on competence in treating patients of all body sizes. The importance of compassionate, non-judgemental communication in healthcare interactions should be emphasized.
• Promoting Positive Media Representation: Media campaigns that feature diverse body types and challenge conventional beauty norms should be promoted. The media industry should be encouraged to adopt and enforce ethical guidelines regarding body image portrayals.
• Supportive Environment: An environment in which individuals feel accepted and valued should be established. Educational settings to prevent weight-based bullying should be implemented.
• Practising Self-compassion: Self-compassion is known to be associated with physical and mental health.⁽⁷⁾ Self-compassion is low in people who experience weight-based bullying. A person can learn how to practice self-compassion by joining support groups or with the help of a therapist.

By implementing these strategies, individuals, communities, and institutions can by working together challenge weight stigma. These can be helpful in creating an inclusive and supportive environment for people of all body sizes and shapes.

Internalized weight stigma occurs when a person learns biases about certain body types and sizes and starts applying the belief to themselves. These people gradually start avoiding certain activities, turning down opportunities, and altering their eating patterns. All these can negatively impact a person’s physical and mental health status. Internalized weight stigma is known to be associated with low self-esteem in people, and disordered eating behavior, and can affect people of any shape and size.

Understanding and addressing weight stigma is essential for fostering a more inclusive, empathetic, and healthier society. Self-stigmatization has far-reaching consequences on the quality of life of a person.

A collective effort can create a world where individuals are celebrated for diversity, where self-worth is not tied to a certain body size, and where everyone can access the resources and support the need for holistic well-being. Challenging weight stigma can pave the way for a more compassionate and empathetic future, where individuals can thrive, regardless of body shape and size.