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Sizeism/Weightism: How to Cope With it, and How it Affects Mental Health

By HERWriter
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A major emphasis has been placed recently on the rising rates of obesity in the United States, and an obsession with thinness has only increased. Unfortunately these focal points of society have also put a major preoccupation on the weight of people instead of who is actually inside the body.

In fact, there are currently a few terms to describe this social issues: sizeism and weightism. Both terms will be used interchangeably in the article. Experts and people who have personally experienced this form of discrimination share their knowledge on this important issue.

<< What is weightism/sizeism? >>

Ragen Chastain, a professional writer, speaker, creator of the blog “Dances With Fat,” and a three-time national champion dancer and self-proclaimed “fat person,” gave her personal definition of weightism and sizeism.

“Weightism/sizeism occurs any time we treat someone differently or because of their body size, or draw a conclusion from their size other than ... what size their body is and ... what our own prejudices about that body size are,” Chastain said in an email.

Although people who are skinny and people who are overweight both experience sizeism, she personally believes people who weigh more experience more discrimination.

“I do believe that there is a greater stigma on people of size,” Chastain said. “I think that being fat is associated with many more negative stereotypes than being very thin is. Also, fat people are often ‘blamed’ for having a body size that is not socially acceptable, while more often those who are very thin are seen as being victims. That said, this is not the Oppression Olympics and it’s not about who has it worse but about ending size-based stigma altogether.”

She personally has experienced weightism and believes it is prevalent in the U.S. society.

“I’ve had strangers comment on my food choices at restaurants (“this is why you’re fat”), moo at me from cars, make fat-bashing comments at the gym (of all places), and I write a blog about Health at Every Size where I am very clear that people have every right to choose whatever lifestyle they want, and I get death threats and hate mail every day,” Chastain said.

“[Here is] one from today: ‘Insulting, ridiculing, humiliating, debasing, and utterly destroying fat people like you mentally and spiritually is the only way to get you to be physically revolted enough by yourselves to commit suicide, because you should die, but murdering you is illegal and you’re not worth the jail time.’”

<< Coping with weightism >>

Chastain has the following tips for handling discrimination and experiencing negative treatment due solely to being a certain weight:

1) “The first thing that people of size have to do is realize that we are worthy of being treated well. In a society that inaccurately conflates body size with a host of negative stereotypes, and where we get over 370,000 negative messages about our bodies a year, that can be more difficult than anything else.”

2) “Set boundaries with consequences we can actually follow through with (i.e., my weight is my business, as is my health, and I’m not looking for outside opinions. If there are any more comments about my weight then we can’t be friends).”

3) “Educate. Open a dialog about the misconceptions about people our size and why they are neither accurate nor appreciated.”

4) “Remove ourselves from the situation.”

5) “Respond with yelling, with sarcasm etc. to feel better, regardless of how it affects the relationship.”

<< Sizeism and mental health >>

Jessica Setnick, the national director of training and education for Ranch 2300 Collegiate Eating Disorders Treatment Program and author of “The American Dietetic Association Pocket Guide to Eating Disorders,” said in an email that sizeism can go so far as to affect who gets treatment for mental disorders, specifically eating disorders.

“Our society seems to associate only those who are emaciated with eating disorders,” Setnick said. “There are some who are starting to see obesity as a potential clue to an eating disorder. But many, many individuals with eating disorders appear to be a ‘normal’ size. This leads to inaction by doctors and insurance companies who use weight as a sign that all is well. Many individuals do not get treatment for their eating disorder because of this discrimination.”

Chastain said that being focused on weight can lead to both mental and physical issues.

“Peter Muennig’s research at Columbia University shows that women who are concerned about their weight have more physical and mental illnesses than women who feel fine about their size, regardless of their weight,” she said. “He also found that the stress of stigma is correlated with many of the diseases that are also correlated with obesity.”

Mikaya Heart, a life coach and author, said in an email that people who are overweight especially can be affected emotionally by negativity from others.

“The negative attitudes of others is a huge source of emotional and mental angst for most overweight individuals,” Heart said.

“People look at them scornfully, make snide comments (especially when they see them eating in public), sneer at them, laugh openly at them, yell insults, and I have even known people to spit at them in the street. They are seen as fair game. This kind of outright ridicule is much more of a problem for most large people than any physical health problems, as it discourages them from going out, and as they tend to stay at home more and more, they get less and less exercise. Depression is common amongst overweight people, and several studies indicate that overweight people are more likely to attempt suicide than the ordinary population. The diet industry stresses the health problems of being overweight, but the worst problems stem from society's negative judgments.”

Dr. Cheryl Perlis, a gynecologist, said in an email that sizeism is prevalent in the doctor’s office and in the workplace.

“First of all most physicians do not want to take care of patients that are overweight,” Perlis said. “They tend to have multiple medical problems and are difficult to exam. I do not discriminate, but I often tell them that it is really important for not only their health ... but that people do discriminate against them in the job market. They look at them as a medical and physical liability and think they are lazy and do not care. I have found patients out of work just for this reason, even though they have outstanding credentials. The whole event leads these women to feel bad about themselves and frustrated."

Perlis continued, "I often have recommended that they do something surgically, like lap banding, as I have seen patients change their entire health and life losing weight. I feel in our society it is much easier to be liked and valued, being [at a] normal weight. It gets you in the door, as first impressions are made in 60 seconds.”

<< Solutions >>

Chastain suggests more awareness can be a solution to weightism.

“We need to recognize that bodies come in many sizes for many reasons,” she said. “We need to see that the claim that fat people choose an unhealthy lifestyle and are therefore deserving of societal vitriol is inconsistent with the fact that we are OK with people jumping out of helicopters wearing skis, choosing stressful jobs, getting drunk, not getting a proper amount of sleep, and climbing Everest even though those things don’t prioritize health.”

There are a bunch of inconsistencies in how we view health, and also how we judge and treat others, and it’s only a matter of realizing this and shaping up our thoughts and actions.

“We’re also OK with people eating poorly and being sedentary as long as they don’t get fat,” Chastain said. “We need to realize that basic human respect is for all humans, not just the humans who do what we think they should do or look how we think they should look, that people each get to choose how highly they prioritize their health, and what path they choose to meet their health goals, and finally that other people’s bodies are none of our business.”


Setnick, Jessica. Email interview. Feb. 7, 2012.
Chastain, Ragen. Email interview. Feb. 7, 2012.
Perlis, Cheryl. Email interview. Feb. 8, 2012.
Heart, Mikaya. Email interview. Feb. 8, 2012.

Reviewed February 9, 2012
by Michele Blacksberg RN
Edited by Jody Smith

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.