Weight Stigma & School Weigh-Ins
What is weight stigma?
“Weight stigma refers to societal devaluation on the basis of body weight so that people of higher weight are subject to prejudice and discrimination.” It also refers to stereotyping individuals based on their weight which generates health disparities (1) and can lead to the development of eating disorders (2).
Weight stigma is present in all aspects of society including education, healthcare and the media. It is estimated that weight discrimination is one of the forms of discrimination most often reported by adults.
The use of BMI inspires weight stigma, contributes to eating disorders, and affects people's body image and mental health. BMI is an inaccurate measure as there is no distinction between lean and fat mass, no representation of fat distribution and it is inaccurate for some ethnic subgroups of the population. Adopting a Health at every size approach would be more helpful and inclusive. Health measurements that focus solely on BMI will lead to more harm than good, and it’s inventor, Adolphe Quetelet, actually intended it to be used only at population level and not to assess the health of individuals.
How weight is presented in the media
Weight stigma is perpetuated in the media as the idealisation of certain body types are favoured whilst others are shamed. The media bombards the public with negative messages portraying individuals who are overweight as lazy and assuming individuals lack will power and control when it comes to weight.
It is important to be aware that the diagnosis and treatment of obesity is not straightforward. The aetiology of obesity is the result of the interplay of many factors which all need to be considered. Messages such as ‘EAT LESS AND MOVE MORE reinforce blame and guilt onto people who are overweight and disregard their emotional health and well-being.
Moving Forward
On the 9th April 2021 The Women and Equalities Committee published a report on Body Image (3). It has the potential to revolutionise the way we practice medicine moving forward. The report highlighted the need to erradicate weight-based discrimination within the national health service, as well as the need to include body image education in the national curriculum. The report also deemed the government's new measures to tackle obesity ‘ineffective’ and highlights the need for further research to shed light on the rise of eating disorders in the UK.
The issue with School Weigh-Ins
From September, the government plans to reintroduce regular school weigh-ins to address lockdown health concerns and potential weight gain. A key issue with this proposal is the use of BMI as a focal measurement and the disregard for the embarrassment and discomfort this will cause many children. The pandemic has been extremely difficult to adjust to for all age groups, but concerns over children’s mental health are prevalent given the long breaks from school and social settings.
The programme of regular weigh-ins where a numerical measurement is intended to spur a sudden lifestyle change is lacking in understanding of obesity as a societal issue and one with many layers. Fixating on the outcome of a weigh-in at such a vulnerable stage could propel an obsession with body size and even disordered eating habits. Testimonies from those who experienced regular school weigh-ins at a young age speak of long term embarrassment and shame surrounding their body image, something no one should experience from such a young age. It’s important to note that different councils and different schools may have varying policies, but an ‘opt-out’ option is generally accessible to parents who don’t wish for their child to be weighed in school. (check resources below for link to template letter)
Childhood obesity is a serious, widespread issue which needs to be addressed, though tackling it by solely focusing on body weight has the potential to cause deeper problems. The Womens and Equalities Committee has also raised concerns about the hyperfixation on body weight and the subsequent impact this may have on self esteem and confidence through life (4).
How does weight stigma affect patients?
- Loss of trust
- Breakdown in communication
- Poor compliance
- Avoidance
What can I do?
1. Consider your environment
2. Focus on behaviour not weight loss
3. Educate and keep up to date!
Resources:
1. Template letter to Opt out of weigh-ins at school- https://www.instagram.com/p/CQZDqpvnV7o/?utm_medium=copy_link
2. Workshops for teachers-https://www.bodyhappyorg.com/body-happy-kids-workshop
3. For parents- Body Happy Kids book by Molly Forbes-https://www.bodyhappyorg.com/shop/body-happy-kids-book
4. Changing the perfect picture: an inquiry into body image -
https://committees.parliament.uk/work/226/changing-the-perfect-picture-an-inquiry-into-body-image/
Written By: Zoe Panaretou (ANutr) and Caitlin O’Nions
References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866597/
https://committees.parliament.uk/publications/5357/documents/53751/default/
https://www.bps.org.uk/news-and-policy/plans-regular-weigh-ins-primary-school-children-are-concerning-says-decp