‘enough was enough’: the ugly truth about weight stigma in public health

weight stigma has become ubiquitous, infiltrating everything from media and education to the workplace to – maybe most concerningly – the healthcare sector. and it is within the healthcare system that ms. jackson has seen these biases reflected time and time again.

“i have experienced weight bias from colleagues who were so preoccupied with my body and how i was living in my body, that it took their focus away from providing quality care to service users,” ms. jackson said. “during those moments, shame crept up beside me like an unwanted, but familiar friend. i retreated into my proverbial shell to protect myself from the harm that came from their mouths.”

according to a 2015 canadian health measures survey , around 30 per cent, or more than one in three canadian adults is living with obesity – a main cause of type 2 diabetes, heart disease, some cancers, stroke, high blood pressure and arthritis. 

“many individuals who have obesity also struggle with issues related to their mood, self-esteem, quality of life, and body image,” states one 2018 study . “this emotional distress likely plays a role in treatment seeking but also can impact successful treatment.”

racial discrimination in healthcare is already a serious problem all on its own. racism’s impact on the health of people of colour, indigenous people and other marginalized communities is deep and varied and can affect virtually every aspect of health from pregnancy to mental health to pain treatment .

black people tend to have a lower life expectancy than white people, they have higher blood pressure on average and have a harder time accessing emergency care . bipoc (black, indigenous, people of colour) are also less likely to get vaccinated and are more likely to die from covid-19 .

it is no different for bipoc or others in marginalized communities who live with obesity. in fact, there is plenty of evidence that racism and obesity are linked and that the higher-than-average rates of obesity in racialized communities are, in part, a product of racism . 

“we could not reach them, they could not reach us,” dr. wharton said in a lecture on black health at the university of toronto. “the system was not built for them, but for those with privilege. the ability to take time off.”

there is a longstanding, incorrect and racist belief that black people have a higher pain tolerance than white people. but not only is it bizarre enough that people today actually hold this belief, one study found that a substantial number of medical students and residents also believe this same falsehood. it goes without saying that a belief such as this could have dangerous and deadly consequences for a patient.

meanwhile, caregivers must address the inequality in access to care and weight stigma present throughout healthcare settings through education. weight stigma is pervasive and entrenched in health care – even among professionals specializing in obesity . 

“the conscious and unconscious stigmatising attitudes held by healthcare professionals is a reflection of (1) exposure to consistent and widespread weight stigma,” according to a journal article published in the lancet , “and (2) the lack of training and education for healthcare professionals about the complexity of obesity as well as how to avoid bias and stigmatising attitudes that may impact care for [people living with obesity].”

the rise of these tech-based solutions during the covid-19 has been appealing to a great deal of canadians according to a study done by the canadian medical association . 

telemedicine is not only a good way to reach people unable to get to a doctor or hospital easily, it may be a necessary tool for health care professionals amid a post-pandemic surge of people looking for care after delaying it for much of the last two years. 

on december 1, both ms. jackson and dr. wharton will join obesity matters as part of our eat, play, love series of events for a conversation around weight stigma in public health and how it affects people, particularly those in the bipoc, lgbtq+ and other marginalized communities. 

“i was fed up with how i was being treated and decided enough was enough. i began doing research on family doctors in my city and when i found a health care centre, i felt would be responsive to my needs, i promptly switched and now have the best care where i’m actually happy to see my doctor,” she said. “remember the scene in the wizard of oz where dorothy is skipping along the yellow brick road? that’s how i look when i see my doctor. and i want everyone to feel that way.”