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I write and talk a lot about weight stigma and its negative impacts on health. Today I want to talk about a study that looks at how we can protect ourselves. In September of 2022, Angela Meadows and Suzanne Higgs published “Challenging oppression: A social identity model of stigma resistance in higher-weight individuals.” Big thanks to Dr. Meadows who read a draft of this piece and offered commentary which is quoted below.
This study was the first to attempt to identify what factors predict whether a fat* person does or does not internalize weight stigma. They begin by explaining that, while higher-weight people make up about two-thirds of the population in western countries, weight stigma is still ubiquitous in every area of life including education, healthcare, employment, interpersonal interactions, and in the media. They also point out that being immersed in a culture of weight stigma leads many fat people to internalize that stigma, leading them to devalue themselves.
They explain that “the most fundamental component of weight-related stigma directed at oneself remains the endorsement of negative stereotypes attributed to higher-weight individuals, applying those stereotypes to oneself, and exhibiting reduced self-worth as a result of one’s higher weight status.”
The next piece of this is the fact that internalized weight stigma had been linked to “a wide range of negative health and behavioural outcomes in both treatment-seeking and community sample.”
Given this, the ability to avoid internalizing weight stigma is “generally associated with superior psychological and physiological outcomes compared with stigma internalisation or inaction.”
In order to identify predictors of weight stigma resistance, they examined factors including the alignment with the group “Fat.” They start from social identity theory, which is, as Meadows explains
“A theory of intergroup behaviour that was developed in the 60s and 70s. Evidence from many types of marginalised groups suggest that where people can leave a devalued group, that is usually the strategy they pursue. This is what we knew from experience, but it hadn’t previously been applied to the idea that weight controllability beliefs constitute that permeable/impermeable group boundary, so should predict activism or alternative behaviours.”
In the context of that framework, the assumption was that those who think weight is changeable are likely to be working to leave the “Fat” group to enter the “Not Fat” group, whereas those who have come to the conclusion that long-term significant weight loss is improbable (including through their own experience of weight-cycling) may come to view themselves as permanent members of the “Fat” group. For those members of the “Fat” group, the next determinant of stigma resistance becomes if they believe that they deserve lower status, or if they think that lower status is being unfairly foisted on them.
The study authors created an online survey to measure perceived stigma, level of identification as an “overw*ight*/fat” person, perceived legitimacy of anti-fat discrimination, group permeability, stigma resistance, internalized weight stigma, and global self-esteem. Based on their answers, subjects were sorted into three groups: about a third were “Internalisers” who “tended to agree with statements relating to internalised weight stigma beliefs.” About 17% of the subjects were classified as “Indifferent” - they “tended to disagree or had no strong opinion about statements relating to either weight stigma internalisation or weight stigma resistance.” Finally, 50% were “Resisters,” those who “tended to disagree with or have no strong opinions about internalisation statements and tended to agree with statements about weight stigma resistance.”
In the subsequent analysis, “perceived legitimacy of weight stigma” was the most important predictor of internalized stigma. Meadows explains
“I think it’s easier to understand conceptually if you think of it as a kind of continuum (even though it’s not fully linear with internalisers at one end and resisters at the other). The point here is that legitimacy beliefs were the best predictor of whether people tended to be internalisers or resisters – internalisers had higher perceived legitimacy beliefs (although still not ‘high’) whereas resisters were waaaay down at the bottom of the measurement scale.”
Investment in the “fat” group also predicted resistance, but people were able to reach “Resistor” status even if they didn’t invest in the “fat” group. Meadows says:
To me, this is the most exciting and important piece. Group identity is usually considered the major determinant of activism/resistance. That resisters existed who weren’t identified with the group was super interesting – you could use an allyship angle. Everyone needs to fight stigma, whatever their own body looks like or their relationship with it. It’s a place we can start even if we haven’t quite got to full acceptance yet – as is the case with many of us who have discovered fat acceptance/liberation movement. We get it in principle but it’s hard to overcome all that brainwashing. But we can still fight stigma because stigma is bad.
Group investment brings benefits on its own – ingroup identity is associated with improved wellbeing across marginalised groups.
This study is groundbreaking and the authors themselves point out that there is much more work to be done. Still, what actions might we take based on these findings?
First, we can recognize that weight stigma is all around us, and that internalizing it can do real physical and mental harm.
We can become conscious of our own current thoughts about higher-weight people (including ourselves and others) and start to question the legitimacy of the weight-stigma-based beliefs that we have internalized. (I have a video workshop to help with that if you’d like more support and there is a pay-what-you-can option so that money isn’t a barrier.)
Understanding that we get many weight-stigma messages from so many places, we can acknowledge (and keep reminding ourselves) that the work of learning that weight stigma is not legitimate is ongoing. We can seek out messages (books, articles, social media accounts and more) that help us to constantly and consistently remember that weight stigma is real, that it is wrong, and that while it may become our problem, it is not our fault and it should not happen.
We can also choose that, instead of thinking of ourselves as potential future thin people, we can identify as fat people, and insist that as fat people we have the right to exist without shame, stigma, bullying, or oppression no matter why we are fat, if there are any “health impacts” of being fat, or if we could become thin.
Until we live in a world that affirms our right to thrive in fat bodies, we can push back against any message that tries to convince us otherwise.
Speaking of research, the research around weight and health can be daunting, dense, confusing, and downright misleading. This month, my online workshop “Understanding the Research About Weight and Health” will give you the skills to wade through the weight stigma and get to the truth! There is a pay-what-you-can-afford option, an unlimited Q&A, and a video is provided to all registrants. Find out more here!
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*Note on language: I use “fat” as a neutral descriptor as used by the fat activist community, I use “ob*se” and “overw*ight” to acknowledge that these are terms that were created to medicalize and pathologize fat bodies, with roots in racism and specifically anti-Blackness. Please read Sabrina Strings Fearing the Black Body – the Racial Origins of Fat Phobia and Da’Shaun Harrison Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness for more on this.
Wow, this is really heartening news. I mean, we have a long way to go, but still.
Heck yeah, Team Fat.
This is very reassuring! Both to me as an individual (I've seen quite a few articles highlighting the dangers of weight stigma lately and I'd had moments of feeling a bit doomed as a fat person even though I am fat positive myself) and also as a therapist who can support clients to resist the internalising of weight stigma with an evidence base to support that work.