Weight Stigma and Bias Research Paper

I had an assignment this semester in my English class to write a research paper.  We could pick any topic, so I chose Weight Stigma and Bias.  I feel proud of what I wrote, so I want to share it here in a blog post.  It is a long paper with a lot of references, so be prepared.  Here we go!

Weight Stigma and Bias

Weight stigma and weight bias refer to the prejudice, discrimination, and stigma experienced by individuals based on that individual’s weight.  This discrimination can happen in every facet of life including employment, education, healthcare, relationships, and the media (Lee & Pausé, 2016; Puhl & King, 2013; Phelan et al., 2015; Washington, 2011; Puhl & Brownell, 2001; Blodorn, Major, Hunger, & Miller, 2016; Carr & Friedman, 2005).  Individuals can experience stigma and bias through bullying, shaming, and discrimination.  According to the Binge Eating Disorder Association, “Weight stigma depends upon three basic suppositions: thin is always preferable, thin is always possible, and thin people are better people,” (Pershing, 2013).  This is known as the thin ideal and it is socially and culturally validated by the media, clothing stores, furniture and architectural design, etc.

The media promotes the thin ideal on extreme weight loss television such as The Biggest Loser and Extreme Weight Loss where contestants are put on unhealthy extreme diets and exercise routines to lose drastic amounts of weight in short time spans.  In the case of The Biggest Loser, contestants are shamed for their weight through forcing contestants to wear barely-there outfits to weigh-ins and yelling at contestants throughout the competition, especially during workout scenes, to “inspire” them to exercise and lose weight.  This idea that shame can promote weight loss is especially present in the show despite research showing stigma and shame result in the opposite effect including weight gain, ill health effects, and negative psychological consequences (Pearl, Puhl, & Dovidio, 2014; Nolan & Eshleman, 2016).  Additionally, following the show, most contestants regain a significant amount of the weight lost and show signs of metabolic slowing with those contestants with more long-term weight loss showing greater metabolic slowing (Fothergill et al., 2016).  This is because of the dangerous, unhealthy, and unrealistic tactics used in the show to promote weight loss.

The thin ideal is also promoted in the media using ultra-thin models in magazines and runways.  The average American women is a size 16-18 (Christel & Dunn, 2016) while the average fashion model is much smaller and growing even smaller over time from weighing 8% less than the average women twenty years ago to weighing 23% less in 2012 (Jones, 2012).  Even the size of plus fashion models is decreasing from averaging between a size 12-18 ten years ago to a size 6-14 in 2012 (Jones, 2012).  The average size of a fashion model has decreased in size despite research suggesting that average-size models are more effective and do not have the same negative effect on body dissatisfaction (Diedrichs & Lee, 2010; Diedrichs & Lee, 2011; Bartlett, Vowels, & Saucier, 2008; Dittmar & Howard, 2004).  These differences can be seen when comparing models in older magazines to those today.

Research suggests that the thin ideal and the media negatively impacts individuals.  In a study of adult women by Grabe, Ward, and Hyde (2008) on body image concerns and the media, the study found a correlation between exposure to the media and the thin ideal and body image concerns.  These results were similar in study by Field et al. (1999), who studied this effect in girls.  In the Field et al. (1999) study, “The frequency of reading fashion magazines was positively associated with the prevalence of having dieted to lose weight, having gone on a diet because of a magazine article, exercising to lose weight or improve body shape, and deciding to exercise because of a magazine article,” (p. 3).  The negative effects of the media were also present in a study by Barlett, Vowels, and Saucier (2008) who studied the media’s effect on men and found the men in the study felt pressure from the media and this pressure correlated with negative body image.  These studies support the idea that the media and the thin ideal have a deleterious effect on viewers.

The thin ideal in the media is also present in social media.  In a study conducted by Mingoia, Hutchinson, Wilson, and Gleaves (2017) on the relationship of social media and the thin ideal found a positive correlation between social media use and internalization of the thin ideal.  Mabe, Forney, and Keel (2014) in their study of Facebook use and disordered eating found that increased Facebook use was correlated with greater disordered eating.  Both studies show the negative effect of social media on its users with correlations between the use of social media and body image.

Fashion further reinforces that thinness is the ideal through clothing retailers.  In the US, clothing sizes in the average women’s clothing retailer range from 0-12/14 (straight size) with plus size starting at 14/16.  The average women’s clothing retailer does not make clothes for the average woman.  The average woman instead must shop at retailers who carry plus size clothing, which can be hit or miss.  Simply because a retailer carries plus-size options does not mean that those options are fashionable, stocked, or priced the same as straight size even within the same store (Banjo, 2016; Bellafante, 2010; Cheng, 2017; Hanbury, 2017; Reagan, 2015).  However, there is reason for hope.  The plus size market is continuing to see a growth in annual sales and the growth is larger than that of straight sizes (Banjo, 2016; Hanbury, 2017; Reagan, 2015).  While there may be a growth in sales, a widespread change in the industry has yet to happen.

This sizing for smaller bodies is also present in furniture design.  The design of seating, for example, is not always created to accommodate larger bodies (MacVean, 2010; Park, 2012).  This is present in restaurant booths, chairs with arms, and airplane seats where larger bodies may or may not fit.  This reinforces and promotes the idea that all bodies must fit a certain size.  Though there is change occurring in the industry with increasing options for accommodating furniture (MacVean, 2010; Park, 2012), the industry still has a long way to go, especially in regards to airplane seats, which are shrinking in size rather than increasing (Associated Press, 2017; White, 2017).

This culture of thinness and shame creates even more shame and stigma.  From 1995-1996 to 2004-2006, discrimination based on weight increased the most when comparing weight/height, race, age, gender, and ethnicity discrimination rates (Andreyeva, Puhl, & Brownell, 2008).  In that study, weight-based discrimination increased the most over that time span.  There were comparable results in a study by Latner and Stunkard (2003), who studied the stigma of childhood obesity.  The study showed children various drawings of children from healthy to disabled to obese and compared the reactions from 1961 and 2002.  The results of the study were that children in both 1961 and 2002 liked the drawing of the obese child the least and the bias against the obese image increased from 1961 to 2002 (Latner & Stunkard, 2003).

And yet people are not getting any thinner.  The weight of adults and children has increased from the 1980s to the 2000s (Flagel et al., 2002; Ogden et al., 2006).  People are subscribing to this thin ideal and turning to things like the weight loss market to avoid the stigma and shame with being overweight (“U.S. Weight Loss Market To Reach $58 Billion in 2007”, 2007).  The more people weigh, the more weight stigma there is.  The more weight stigma there is, the more people weigh.  In a study done by Stevens et al. (2016), “…an increase in BMI was associated with a significant increase in lifetime weight stigmatization,” with “…weight status directly affect[ing] psychological outcomes.”  Weight stigma begets weight stigma.

In a study by Ashmore, Friedman, Reichmann, and Mustante (2008) on the correlations between weight stigma, psychological distress, and binge eating behavior, the results suggested that weight stigma predicts psychological distress and binge eating behavior.  Comparable results are found in O’Brien et al. (2016) who studied the relationship between weight stigma and eating behavior.  The O’Brien et al. study found, “…weight stigma was significantly associated with all measures of disordered eating, and with weight bias internalization and psychological distress,” (p. 70).  These results of weight stigma correlating with psychological distress and eating disturbances are consistent throughout the literature (Stevens et al., 2017; Nolan & Eshlemann, 2016; Vartanian & Porter, 2016; Puhl & King, 2013; Thompson et al., 1995; Stice, Marti, & Durant, 2011).  The consensus from these studies is that weight stigma has negative consequences.

The negative psychological consequences of weight stigma and bias include body image dissatisfaction, depression, anxiety, suicide ideation, and other psychological issues (Puhl & King, 2013; Durso & Latner, 2008; Ashmore, Friedman, Reichmann, & Mustante, 2008; O’Brien et al., 2016; Vartanian & Porter, 2016).  These negative psychological effects can result in internalization of the stigma and declines in physiological health including causing unhealthy eating habits and eating disorders (Culbert, Racine, & Klump, 2015; Durso et al., 2011; Durso & Latner, 2008; O’Brien et al, 2016; Webb & Hardin, 2016).

Weight stigma’s negative impact on body image and eating behaviors are supported by eating disorder research, which suggests a correlation between weight stigma and body image dissatisfaction and eating disorders (Culbert, Racine, & Klump, 2015; Stice, Gau, Rohde, & Shaw, 2017; Stice, Marti, & Durant, 2011; Thompson et al., 1995).  In a study done by Stice, Marti, and Durant (2011), “…body image dissatisfaction was the strongest predictor of risk of onset of any eating disorder,” (p. 7).  Though the research suggests a correlation, none of the studies referenced found any causation.

Weight stigma and bias exist because of the thin ideal.  The thin ideal is socially and culturally validated, which reinforces weight stigma and perpetuates the negative physical and psychological effects of this unattainable ideal.  Men, women, and children all face negative consequences because of the thin ideal and weight stigma.  Perhaps if the thin ideal was debunked and denounced, individuals would no longer suffer from the negative effects and one risk factor of eating disorders would be eliminated.



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BEDA Inspirations and Future Posts

It has been a crazy couple of weeks since the Binge Eating Disorder Conference!  I arrived home with a ton of exhaustion, but a whole bunch of new ideas to contemplate and soak in.  It has been over these past couple weeks that I have been thinking about everything that I learned, re-learned, and was inspired by.  Here are my favorites:

1. Graduate school. This seems to pop up a lot in my post-academic life and this conference reminded me how much I love learning.  I want so much to be able to go back to school, stay in the Seattle area (?!), and get a graduate degree in psychology.  I know what my passion is, but I do not quite know what it looks like just yet.  (If anyone does, please let me know!)

2. Exercise for enjoyment. One of the topics presented on was exercise and having a positive relationship with it.  It was reassuring to hear from more individuals (other than my providers) about the importance of shifting my focus from compulsive overexercising and punishing myself to the activities I love to do such as dance and football/soccer.  It inspires me to continue to fight my urges to overexercise and engage in the activities I love within the limits I am able.

3. We are not alone. I had an incredible heart-to-heart with another woman there who is a mother of a son who suffers from BED.  In her past, she similarly suffered as I did with weight stigmatizing remarks and bullying because of her weight.  It was so meaningful to share that experience with another person knowing that I was not alone.  In fact, there were plenty of other individuals there who had similar experiences.  It reminds me that none of us are alone in our suffering or in our recoveries.  There are others out there who know and who understand and that connection is out there.

I am also inspired to write a couple of posts.  I simply have not found the time… yet!  On my agenda is to write a post about the upcoming Seattle National Eating Disorders Association (NEDA) Walk.  I know last year’s Walk was less than desirable and I want to touch on that as well as discuss openly what is going to happen this year because it will be so, so much better.  Also I have a very personal post coming up that I have yet to talk about and pretty much you will have to wait and see about that one.

Thanks for reading.  Remember: Recovery is possible!


BEDA 2014: Opening Night

I have been anxious for days over what to expect coming here. What was this conference going to be like? How would it differ from the NEDA one? Would I “fit” in? All the anxiety brought me to a pretty steady tremor and by the time I went up the elevator to the conference, I thought I would burst into an anxiety attack!

But then I saw the people I knew, the people I care about and that care about me, and I took a deep breath and slowly dove in. I am so glad I did because it was such a rewarding start to this conference!

It is incredible to meet all these individuals and see those I already know. It feels so fulfilling and deeply satisfying to be able to share my story and what I am passionate about as well as discuss what others are passionate about. The collaboration and networking fulfills this need that I have that I do not often get to fill at home when I am writing by myself.

I look forward to tomorrow and what more I will learn and who else I will meet. I feel so hopeful and filled with possibilities.

Keep checking my Twitter (@kristinseattle) all day for tweets on the BEDA Conference presentations and what I am up to!

My Recovery Journey: From Self-Hate to Self-Love

When I was younger, I was bullied for my weight and mental health issues.  My peers poked fun at my body and openly harassed me during some of my classes.  It almost felt acceptable because no one ever really got into any real trouble for any of it.  That feeling of acceptability that was relayed to me through a lack of concern and action and a frequency of attacks, lead me to internalize all of it and turn it into a narrative about myself that still defines who I am.

Out of the bullying built the narrative that I am only defined by two things–my body and my mental illnesses.  I wholeheartedly believed that I was not good enough, unlovable, disgusting, fat, and crazy among other things.  I thought that this would be how my life would be for the rest of my life.  Things, however, changed when all the self-hatred, other issues, and a seemingly innocent diet collided.

It was in college that I decided that I was going to lose weight.  I no longer wanted to be all those horrible things that I defined myself by and I figured that losing weight would fix it for me.  Of course I was completely wrong and losing weight would not fix how I felt about myself, but I started to lose the weight regardless.

The changes I made were small, gradual, and healthy at first.  It was after losing enough weight that people started to notice my weight loss that I started to take notice myself of the progressive increase in compliments, friends, and life experiences I enjoyed.  With each pound I lost, a new narrative started in my mind that I was actually good enough, lovable, etc. if I was thin enough.  This change in my narrative shifted my behavioral changes from healthy to disordered and soon into a full-blown eating disorder.

I have spent years recovering from my eating disorder and it has only been within the last two that I have finally been able to stay behavior free.  But what about that narrative I had about myself that I was only good enough, lovable, etc. if I was thin?  I am still fighting it.  Nearly every day.  It is probably one of the most ingrained thoughts in my head, more-so than the eating disorder behaviors themselves.

I think about why I am still so stuck on believing I am only good enough if I am thin and it makes me reflect on how as a culture we have made fat shameful, unacceptable, disgusting, and something to avoid at all costs.  We have taught children to start hating themselves at younger and younger ages and believing that they have to diet and be thin.  It makes me so incredibly sad to hear children start believing what I believe about myself knowing what I did to myself to try to achieve an ideal that was never achievable.

But it also inspires me to fight.  It inspires me to fight against the self-hatred for my body that I have had nearly all of my life.  It inspires me to love my recovery body that I fought so hard for.  It inspires me to get involved and let people know that diets, disordered eating, and eating disorders do not fix your problems or change how you feel about yourself for the positive.

My journey has inspired to become involved in organizations such as the Binge Eating Disorder Association (BEDA), the National Eating Disorders Association (NEDA), and the Provincial Eating Disorders Awareness Campaign (PEDAW).  I believe wholeheartedly in loving the person you are and being able to recover from an eating disorder is absolutely possible.  I am incredibly fortunate to work/have worked with these organizations and spread that message.

The next step in my journey and involvement is next week when I attend the BEDA Conference in Denver, CO.  I cannot express how excited I am to attend this conference with some of the greats in the field.  It is another step towards learning more self-love and acceptance and getting more involved.  I look forward to immersing myself in topics on self-care, self-acceptance, health at every size, and weight stigma.

I hope you will all join me next week as I live-tweet (@kristinseattle) from the BEDA Conference and blog on my experiences there.  I know that there will be lots to learn and grow from as I continue to learn how to love my recovery body and believe for myself that my worth, goodness, lovableness, etc. is not tied to my weight.

My Life of Recovery

My life feels like a hurricane with mostly controlled chaos.  There is a lot to get done at the moment, but I am not shying away from what I have to get done.  Everything I am working on is dedicated to recovery and advocacy and it is the most fulfilling work of my life.  It is worth some of the extra chaos of figuring out how to get it all done!

If someone would have told me several years ago that my life would be the way it is today, I would have never believed them.  Throughout my childhood and in the early stages of recovery, I believed that I was simply not good enough, would not amount to anything, and that I would never be able to do what I truly wanted to do.  It is incredible the power of recovery and the drive that it gives you to persevere and work towards the things in life that truly matter to you.  Recovery allows you to discover that true part of yourself that you have denied or forgotten and believe in yourself again in order to achieve the things you want in life.

I am so grateful every day that I gave recovery a chance and I fought for it every minute, every hour, and every day.  Recovery has given me the ability to go to the NEDA Conference last October; go to the BEDA Conference this spring (April 24-26th); work on the Seattle NEDA Walk, which I promise will be so incredible; write in this blog; and finally have the chance to write for others including BEDA and PEDAW (so far…!).  Recovery has also given me the chance to heal, start to love myself, read and write again, have the ability to be active again (I love to dance!), and participate in my life!

If you are struggling, give recovery a chance because you never know what kind of things you can achieve with recovery.  Believe in yourself, fight for yourself, and know that recovery is possible.  You can recover.


To support me in the Seattle NEDA Walk and help me eliminate eating disorders, please follow this link: Kristin’s NEDA Walk Page.

On Accomplishing a Milestone in Recovery

The last few days I have felt a keen sense of accomplishment.  It feels as though I have past a milestone that I have had for myself for years, or at least I am coming close to passing it.  I had feared for the last two years that I would never recover or at least would have to repeat inpatient/residential treatment every two years.  I did not want to make that a pattern.  I wanted that to be simply a span of time between my first and my second times in treatment.  And it has been.

It has been a long two years of tough work to make it to this point.  I was not always on the path of recovery.  I struggled and strayed for a while after treatment.  It was once I made that decision and the reasons why I wanted to recover were clear and present that I stuck with recovery.  I was going to recover.  Period.

That is one of the reasons why going back to Denver to the Binge Eating Disorder Conference feels so incredible and rife with so much emotion.  It is going back to same place where I was two years prior but now as a professional, not a patient.  Logo - ColorInstead of arriving at the airport, staying at the hotel for a night, then checking in to treatment the next day, I will be at this conference networking, learning, and growing.  It is the mere difference that two years can make and it is simply incredible, which seems to be the only word I can use to describe it.

It makes me acutely aware that recovery is possible.  It may take time, effort, a ton of hard work, and some slips along the way, but it is completely and wholly possible.  It is possible to heal from those things that have held you back for so long.  It is possible to overcome obstacles that have been in your way.  It is possible to achieve the things in life you never believed were possible.

Two years ago, I went to Denver to recover.  This April, I go to Denver to follow my dreams.  Recovery and healing is possible.

Two Years of Recovery

Two years today.  That is how long it has been since I checked myself into treatment at Eating Recovery Center (ERC) in Denver, CO.  It is strange and also wonderful to think that it has been that long.  It makes me reflect on how far I have come in that span of time and all the improvement I have made.  It is incredible to think of just how far I have actually come and the accomplishments I have made considering even four years ago entering inpatient/residential treatment the first time around I believed that I had little to no hope and even at ERC I had days where still felt there were things that I did not believe I could overcome.

In two years I have changed my life for the better…

Today I am back to doing what I love, which is writing.  I am able to write and read, which is something I was worried that I had lost forever.  In the throes of my eating disorder, I was unable to do either because of my lack of concentration.

Today I am able to participate in life again and not miss out on the things that I love most.  I am able to go to football and soccer games, watch them at home, feel the joy of fanaticism that I have always had in my heart.  ercThere is nothing like finding that joy again and embracing that part of myself that I love.

Today I am able to have relationships with people.  I have the kind of friendships that I want and deserve and that my friends deserve.  I am not so caught up in my eating disorder that I am unable to have any other relationship but with my eating disorder.  I am not alone and isolated, losing relationships because I would rather have my eating disorder instead.

Today I am overcoming and have overcome many issues that have plagued me for many years.  My fear foods list is now down to a very small number of items when I used to have a huge list of fears and only a small list of safe foods.  My eating disorder is nearly faded away.  The thoughts linger, especially in tough times, and haunt me sometimes, but behaviors are nowhere to be found.  Slowly, but surely, I am working on my body image and it is always improving.  I constantly work on trauma and rape and I have gone from not even being able to really mention it four years ago, barely talking about it two years ago, still blaming myself a year ago, to today and within the last six months finally not blaming myself and working through what happened.  The OCD will be next on my list to tackle though I have worked through quite a bit already.

Next month I will be returning to Denver, CO.  I will return to the area where I truly began my recovery journey.  I will return as a professional, not a patient.  I will return to attend the Binge Eating Disorder Association’s 5th Annual Conference.  There are few words to express the joy that I feel at this moment.  My life has shifted from illness to wellness, from existing to living.  Two years from now, I can only imagine what I will have accomplished, what will have changed in my life.  I am only too excited to find out and to go on that journey!