No, I’m not on a rant. But I sure could be. What’s funny about a chronic disease that impairs health and renders people more sensitive to deadly co-morbid factors associated with COVID-19? Nothing. Nothing is funny at all.
I write about obesity a great deal, have been caring for those with emotional and behavioral components related to the disease, speaking and teaching about it since the early 1970s, and won’t stop. When it comes to promoting health, there’s nothing I find more important. Obesity is recognized as one of the most pressing public health issues of our time.
So why are we observing an increase in jokes, memes, and weight stigma/bias during COVID-19? These behaviors contribute to the nonsensical but popular, and frequently economically driven, belief that obesity is a self-inflicted impairment. “Just learn how to change your behavior through my app, my fitness, and health coaching, my willpower increasing methods…” while whispering somewhere deep in the unconscious, “…you lazy person.”
As if living with obesity isn’t tough enough, during COVID-19 these jokes only serve to push those with the disease further away from proper health care out of shame or fear of being perceived as an onus on an already overburdened healthcare system. Weight bias also negatively affects psychosocial well-being and increases vulnerability to harmful lifestyle behaviors, leading to a reduced quality of life.
Far long before COVID-19, an ignored part of helping those with obesity are the social determinants of health including bias, prejudice, and discrimination, with their demonstrated negative impact on physical and emotional health. Types of weight bias that are commonly seen include stereotypes that those with obesity are noncompliant, lazy, lacking in self-control, weak willed, unsuccessful, unintelligent, and dishonest. Considerable research on weight bias has documented the impact of this sorrowful set of behaviors in education, health care and employment, as well as in gyms and health clubs, popular media, news media and amongst friends.
According to Rebecca M. Puhl, Ph.D. and Christopher M. Wharton, Ph.D. in ACSM’s Health & Fitness Journal, “Weight bias generally refers to negative attitudes and beliefs about body weight that are expressed in the form of stereotypes, stigma, prejudice, and unfair treatment toward children and adults because they are overweight or obese. Weight bias can be displayed in multiple forms, including verbal comments (e.g., derogatory remarks, negative stereotypes), physical aggression, and social exclusion or avoidance. Thus, it can be expressed in both subtle and overt ways.”
Here is a list of keywords identified by the Obesity Action Coalition and the Rudd Center for Food Policy and Obesity to be aware of:
Least Stigmatizing / Blaming Words
Weight • Unhealthy weight • High BMI
Most Stigmatizing / Blaming Words
Fat • Morbidly Obese • Obese
Most motivating for weight loss
Unhealthy Weight • Overweight
Least motivating for weight loss
Fat • Morbidly Obese/Chubby
Here are additional examples of how to use people-first language:
- “The woman was affected by obesity,” instead of “The woman was obese” or “The obese woman.”
- “The man with obesity just signed up for our weight loss program,“ instead of “The man who just signed up for our weight loss program is very obese.”
These organizations and others endorse using people-first language:
- The Obesity Society
- The Obesity Action Coalition
- Academy of Nutrition and Dietetics
- American Society of Bariatric Physicians
- American Academy of Orthopedic Surgeons
Try these simple, but deeply thought-provoking questions to help you determine your own biases, from Mary Forhan, Ph.D. in the Department of Occupational Therapy, Faculty of Rehabilitation Medicine at the University of Alberta.
- Do you assume a person’s health, characteristics, behaviors and abilities are based on their body size, weight and shape?
- Do you think that everyone with a larger body size or a higher BMI has obesity and needs to lose weight?
- Do you believe people with obesity are personally responsible for their condition?
- Do you let negative comments about someone who has a larger body size or has obesity go unchallenged?
- Do you avoid being around people you think have obesity?
There are many aspects of our current challenges that one can shake one’s head at. But shaking one’s head at an illness that is itself of pandemic proportion, that leads to billions suffering with it worldwide, that is closely associated with a poorer outcome of COVID-19? It’s always a good time to find something to laugh at for sure, but never at obesity.
Dr. Michael Mantell, earned his Ph.D. at the University of Pennsylvania and is one of the most sought-after behavior science experts in the world. For more than 45 years, he has been helping people find lasting change, contentment and a more awakened life as they move past crippling emotions like anxiety, stress, depression and burnout with his short-term, powerful, compassionate approaches. He has served as Chief Psychologist for Children’s Hospital of San Diego, the San Diego Police Department, Chief Behavior Science Consultant for the American Council on Exercise, co-founder and Chief Science Officer of Plus Size Certified, Inc. and is a member of the Science Advisory Council of the International Council on Active Aging. Dr. Mantell has also served as Assistant Clinical Professor in the Department of Psychiatry at UCSD Medical School.
