If Fat Shaming Worked, Wouldn't It Have Worked By Now?

Fat shaming is often defended as "motivation," "accountability," or simply "telling the truth."

But does it actually help people improve their health? Does fat shaming encourage people to exercise more, eat less food, and eventually have a healthy and happy life?

In this episode, we take a deep dive into the research on weight stigma, fat shaming, and health outcomes. We discuss the difference between talking about health and humiliating people, the psychological effects of shame, weight stigma in healthcare, and whether public criticism of body size encourages or discourages healthy behaviors.

We also explore:
- What weight stigma actually is
- Whether shame motivates long-term change
- The impact of weight stigma on eating behaviors
- Weight stigma in healthcare settings
- Social media, fitness culture, and body judgment
- Why this topic is so emotionally charged

It is possible to discuss health, and even negative health risks, without having to resort to insults and bullying.

As always, our goal is not to take an ideological position, but to examine what the evidence actually shows.

P.S., If you want to support us and would like monthly lifting workouts, you can join the Momentum by Sohee fitness app. http://momentumbysohee.com

If you are interested in fat loss science, you can purchase Ben's best-selling comprehensive fat loss book, Everything Fat Loss. http://geni.us/EverythingFatLoss

Transcript

SPEAKER_00 0:00

Does fat shaming actually work? Today we're gonna talk about one of the most controversial and probably one of the most widely held beliefs in the whole fitness industry. Fat shaming is oftentimes mistaken for motivation, but we're gonna talk more about whether that is actually the case. Of course, we see fat shaming absolutely everywhere. I'm sure as many of you are listening to this now, you can immediately recount either personal instances or maybe stories that friends and family members have told you about themselves being fat-shamed in gym settings, in healthcare settings, even, on social media, of course, absolutely everywhere. Fat shaming is super, super prevalent.

SPEAKER_01 0:40

I have been talking about this topic for at least seven years on social media, and it is impossible for me to talk about this topic without at least one very angry shit monkey giving me grief for essentially quote unquote promoting obesity. So the first time I talked about it, I think, was seven years ago, and a sportswear brand broke the mould by coming out with a quote-unquote plus size mannequin, and people lost their shit because they viewed it as oh god, diversity's gone too far and they're promoting obesity and blah blah blah blah blah. And I found it kind of absurd because ultimately sportswear brands want to sell clothes, and unless their entire audience is a size eight, for example, their entire female audience is a size eight, it makes sense that they show clothes that fit other people. And the thing that bothered me about this is not necessarily whether they are quote unquote promoting obesity or whether they are moving into diversity or whatever, it's not necessarily that, it's the fact that people use this as a topic to be ares. That is essentially what it boils down to, and that's the reason I get so passionate about this. And it's happened with other brands, for example, a different sportswear brand posted an advert of a woman looked like she was doing yoga or something, and people in the comment section again just being gross and insulting her. Then a little bit later, a gymware brand. I think it was the first time I ever saw a fitness model on their page that wasn't shredded to the bone, and the comment section was just an absolute clusterfuck of people essentially bullying her, and it bothers me because this reminds me of things like clients who were scared to go to the gym because they were worried people would make jokes about them, etc. etc. So, yeah, this is a very, very passionate topic for me.

SPEAKER_00 2:43

Yeah. And a core underlying principle underneath all of this fat shaming is this idea that someone's body weight and body size and shape is fully under their control. Therefore, if they are not in shape or thin or in a size that is deemed acceptable by society, that is considered a personal moral failure. So that we have uh big undertones of discipline, willpower, uh laziness, things like that all coming into play here. And of course, every time we talk about this, the comment sections tend to be quite messy.

SPEAKER_01 3:21

Yeah, but we trust that people listening to this are emotionally more evolved than your average person on social media, perhaps because they care enough to listen to us talk about things for a very long period of time. But there will be some people who aren't on board with what we're saying. And to drive the point home, I want to use one of the most extreme examples of public fat shaming that I have seen in the fitness industry alone, not necessarily elsewhere. So a few years ago, I was tagged in a video, a woman sent it to me saying, Can you please respond to this? And she was quite upset. And I watched this guy's stories, and I've had to write down the quotes. So this is going to be fairly gross, these are not my words. And there was a gym clothing brand owner from South Africa who saw the previous example that I talked about about a sportswear brand that was moving into plus size modelling for the first time ever, and he went on such an angry tirade that he used this, and this is quotation marks, heavy quotation marks if you're listening. But if you are watching, you see quotation marks. He said things along the lines of that woman is not curvy, she doesn't have any sexy curves, as if that's the whole point that the woman would exist. Bitch, get on a fucking treadmill and lose the fat. She is an overweight fucking fat woman. Now, this was the owner of a small gym clothing brand in South Africa. So when we talk about fat shaming, we need people to understand that essentially this is a vehicle where a lot of people hop on it as an excuse to be absolute dickheads.

SPEAKER_00 5:06

Yeah. And right away, as you were saying that, I'm sure a lot of you picked up undertones of disgust.

SPEAKER_02 5:14

Yes, yes.

SPEAKER_00 5:15

And that's that's the problem there with the way that people talk about these kinds of situations. That's what's problematic.

SPEAKER_01 5:24

Yeah. So let's dive in. Let's go in with the definition, the definition of weight stigma.

SPEAKER_00 5:31

Yeah. Okay. Fat shaming falls under the umbrella of weight stigma. We've talked about weight stigma in uh at least one previous episode before, but weight stigma is defined as having negative attitudes and stereotypes and also discriminating against people based on their body size. Now, it can impact people of all different sizes. You can be um skinny shamed technically, but by and large, the people who are going to be most severely impacted and most frequently impacted are going to be people in a bigger body size. And also, I will say, because every time I talk about discrimination against bigger bodies, there's always someone in the comments saying, Well, skinny shame, I get skinny shame all the time too. They are not the same. It is valid, but it's not the same. So disproportionately and more seriously, people in bigger bodies are more negatively impacted.

SPEAKER_01 6:23

Yeah, like occasionally people have made comments about my body which are negative. I remember people being like, Oh my god, your body's disgusting. I'm not saying that that is a great thing to hear. No. But hearing that once every so often is very, very different to what a lot of people face.

SPEAKER_00 6:41

Yeah. So we have bit very obvious examples of this include assuming someone is less intelligent or that they are less competent or they're lazier simply because they're in a bigger body size. And this is portrayed, I feel like this is portrayed in min media all the time. In movies, for example, you have the clumsy kluts and how often are they bigger versus the thinner, attractive, smarter, creative person who also happens to make more money.

unknown 7:12

Yeah.

SPEAKER_01 7:12

So this is actually seen in research papers, and this is where we need people who are skeptical of this video to really pause and listen to what we're saying. So let's say, for example, there is someone in the media who is fatter or they have a bigger body, or whatever terminology you feel comfortable using, they have a higher body fat percentage, is the type of thing that I would normally go with. And a lot of people will immediately think, so that person is less healthy. For a moment, I just want to park that. We can put on a previous video if you want to look at our video talking about obesity and why it's more complicated. We would strongly recommend that video if you haven't seen it already. But let's park the higher body fat automatically means unhealthy 100% of the time. In research, this has been identified that typically, if you look in the media, it isn't just that, it is what So here said, where characters are also clumsy, lazy, unattractive, incompetent. And there are many examples, if you think of your favourite TV shows, where essentially anyone with a higher body fat percentage is essentially an imbecile.

SPEAKER_00 8:22

Right. And we also see Kevin from the office. Yes, correct. That's a great example. Yeah, and also there's that guy, I mean, there's so many we can go on forever, but I the the I d the person I thought of was that character from Office Space. I don't know if you've seen the movie. I've never seen it. Okay, maybe it's popular in America, but basically there's there's uh one of the workers is basically essentially ostracized, and he is he is in a bigger body size. Anyway, we can go on forever, but we don't have to do that. Um but we also I want to talk about the um the weight stigma that we see in healthcare settings. We can go into more of it later, but we do have many instances of doctors and other medical staff treating patients poorly because of their weight, whether that be dismissing legitimate medical concerns or talking down to them, which of course is a very serious issue when we're talking about actually addressing your health.

SPEAKER_01 9:15

We will definitely go into that in more detail later because a lot of people will automatically think, yes, but if someone has more body fat, then it is right that a medical professional will show more concern for that. Again, park that we will circle round to it, and that is not what we are talking about. Yeah. We are going to go into a lot more detail.

SPEAKER_00 9:33

Yeah. I also want to talk about concern trolling, which always happens when it comes to people in bigger bodies. It's this idea that I'm supporting you, I am your ally, I'm here to help you, when in reality they are manipulating you, they are degrading you and insulting you. So when they say, when people come up to you and say they start giving you unsolicited diet advice when you're minding your business in the gym, for example, or maybe you're in a restaurant and they're commenting on what you're eating and what you can change when you didn't ask for their input because they assume, based on your body size, that you would want their help, that would be an example of concern trolling.

SPEAKER_01 10:11

So, yeah, as an example of that, I have seen, let's say, brand posts a model with slightly more body fat than their regular modeling array. I don't know the right terminology, whatever. And people in the comment section be like, oh my god, you're promoting obesity, blah, blah, blah, blah. But then they'd be like, I'm just worried about their health. And it's like, if you're worried about someone's health, would you really talk to them like shit? I never go up to someone in a pub and say, Oh my god, you're disgusting for drinking beer, or oh my god, it is gross that you are smoking, or whatever. There are certain things that are socially acceptable despite being very unhealthy, but for some reason, weight discrimination has been described by some people as the last acceptable form of discrimination. And I'm not necessarily co-signing that, but I think it's important for people to realize the angle that we're coming at it from.

SPEAKER_00 11:01

It's pretty powerful. You know what? Great example that I thought of related to this was do you remember a few years ago on I want to say Cosmopolitan magazine, there was a plus size model on the cover, and the internet erupted in anger because again, they were accusing the magazine of promoting or glorifying obesity. But a really fantastic counterpoint to that was when when we have rail thin models on on fashion magazine covers and so on, and they're smoking a cigarette or they look sickly thin.

SPEAKER_01 11:35

How often the term heroin chic is the fact that heroin chic is a term that describes high fashion models.

SPEAKER_00 11:42

The response is very, very different. Yeah, we don't oftentimes see people getting super angry that someone's holding a cigarette in their between their fingers, and yet when it comes to body size, the response is very different.

SPEAKER_01 11:55

I'm going to say something that sounds slightly controversial. I said it before in one of my videos. When I read angry comments, a lot of the time it's from guys directed at women, if women are on the cover of Cosmopolitan, for example. But one of the things that I think is it feels stay with me, it feels like they're annoyed that that model does not fit into their own ideological wank bank. That is how I view it. It's people are angry that they don't find that person attractive. Because, like you say, if there was a super thin model, smoking, which has been long linked with fashion modeling, for example, people don't seem to lose their shit.

SPEAKER_00 12:37

The response is sexy, you look good, you look hot.

SPEAKER_01 12:42

So this is such a big issue, especially in the media, that in 2018 there was actually a uh a piece by The Lancet which called out weight discrimination in the media specifically. And I'm going to give you some examples that they used. So there are quotes for all of these. These were all in the same year, by the way. So one of them was from the Times with the quote, Hefferlump traps will clear the NHS of fatties. I don't know if you know what he lump means. No. It is essentially a slang term for fat person. But the fact that the Times published something with the word heffer lump on it quite clearly derogatory. That isn't, even though it says clear the NHS, which is one of those concerns where people are like, well, if it's not good for people's health, then it will be a burden on the healthcare system. The fact that they are using heifer lumps shows that perhaps they're not so concerned with healthcare as much as degrading people. Do you know what I mean? Uh another one, the Daily Mail, why I refuse to let my daughter be taught by a fat teacher. Out of all the things that the teacher could be, that is the reason why someone would refuse to let their child be taught by them.

SPEAKER_00 13:56

And without actually reading the article, I'm gonna guess that they are once again assuming that they're incompetent, that they're lazy, that they're less intelligent.

SPEAKER_01 14:03

I would assume so. For all we know, they could be a marvelous teacher. But apparently just the fact that they have more body fat is enough. Uh, one from The Herald's Sun in Australia. Obese, you are probably too lazy to exercise. That's gross. Again, the connotation that anyone with a high body fat percentage is automatically lazy. Yeah. Which hopefully anyone listening to this know that that is not the case. And then the final one, which I had to check because this was the worst of them by far. This was published in Esquire. I would kill them all and render them down into candles. So that article was pulled after nearly 10,000 people signed a change.org or.com petition to pull it down. Uh, the same writer also said, I don't care if my son is an alcoholic or crack addict as long as he isn't fat. Just let that sink in for a moment. I don't care if my son is an alcoholic or crack addict as long as he isn't fat. And I'm sure people would be like, yeah, but it's comedy, it's comedy writing. But you have to understand that it's still coming from a place. Do you know what I mean? And although those are kind of more extreme examples, those are examples in national media outlets. This is not cherry-picked examples that some guy down the pub said once, but it reminds me of a video that I responded to probably a year ago, and there were two, I assume, personal trainers, I don't know if they're qualified or not, and one of them said to the other one, What is your biggest red flag in a personal trainer? And the guy immediately said, They're fat. And they both laughed. And I thought, so I responded to this, and again, people got annoyed, and everyone's like, Yeah, but if they're fat, it shows that they don't know what they're doing and they don't practice what they preach or they don't know how to diet, or all of these kind of uh intellectually lazy connotations. But the thing that actually kind of bugged me the most about it is the fact that out of all the things that people would view as a red flag in a personal trainer, they automatically go to body fat percentage. One, it's done. I know that's not a very smart argument. Two, it's very selective because if it was like a male power lifter or a male strongman, they all have more body fat a lot of the time. But people don't go, oh that's fine. They'll say, oh, that's fine, that's fine, because it's different. But why is it different? Because they go, no, because they're not lazy. It's that automatic assumption that people are lazy if they have more body fat, but only the people that they pick out and not other people. But the thing that bothered me was they went to more body fat, not are they qualified? Are they experienced? Can they get results with their clients? Do they have good people skills? All of the things that can make someone a great personal trainer, none of those were red flags. It's their fat. Yeah.

SPEAKER_00 17:00

I think it's there are so many incorrect assumptions being made there, and I have to be honest, probably 15 years ago, I would have heard that and I might I might have said, What's the problem with what they said? And the reality is when you take personal trainer certification courses, or when you're learning about fitness, you are not necessarily taught these things. This notion that body fat does not equate to your level of fitness, or even that body fat has nothing to do with how lazy you are or are not, or how disciplined you are necessarily, and that health and weight are not the same thing. You they're oftentimes they're conflated. So all of these incorrect consumptions are run rampant in the industry, and part of what we try to do collectively together and also individually is continually address those misconceptions over and over again. And the other thing I want to say about concern trolling is so often people say, Why can't I talk about your weight? I'm worried about you, but the way that they are talking about it, the way that they're communicating about it, makes it very clear that it's not really about concern, genuine concern for their health, so much as what whatever their attitude is is rooted in what's called anti-fat bias, or more commonly known as fat phobia. So the fat phobia in society is to an alarming extent, and it's the general I am disgusted. I don't want to see fat people, I don't find them attractive, I want to treat you poor I'm gonna treat you poorly and less than because of your body size.

SPEAKER_01 18:41

That reminded me of something that sounds so tangential, but it's not. I'm gonna loop it round. Years and years ago, one of my closest friends, I this was like I was a teenager that many years ago, he was worried about me. I had been through a breakup of a very, very short relationship, but it had taken its toll on young adolescent me. And he said to me, He was like, Can we chat? And he said, I'm worried about you. I feel like you are going down a dark path, and I just want to be there, I'm just kind of expressing concern. I had a very nice heart-to-heart conversation, and I remember afterwards thinking that's probably really difficult for him to say, Could we talk? I'm worried about you. Yeah, and I was so grateful that we had that conversation. But you notice the tone and the way he approached it compared to, oh my god, this person's disgusting, oh my god, they're fat, oh my god, they're lazy. If someone was really concerned, I don't think that is the way they would approach it. Like you wouldn't go into an Alcoholics Anonymous meeting, not that I'm conflating the two before anyone loses their shit, and say, Oh my god, you're disgusting, this isn't good for your health. That's not how they approach things. So I think it's very it's very transparent that people are not actually concerned about their health. Because if they were, or if that was the primary motive, they would not go at it with the level of disgust and disdain that you tend to see on social media.

SPEAKER_00 20:13

Yeah, very sad. Moving on to the next section, we're gonna talk about what the research actually says about fat shaming and weight stigma as a whole. First, a little history.

SPEAKER_01 20:23

Yeah, so I found this interesting paper. I've never I've never read this before prior to the prep for this episode. I've never seen someone talking about it before. So there was a research paper from 1961, and it asked 10 and 11-year-olds to rate people based on who they liked more. So they were presented with six drawings, and they said, which one do you like out of these two? And then it was like, okay, out of these two, and they would essentially just rank it. So there were six different children that they would rank. So the first one was a child with no physical disabilities. Then everything was identical apart from the single attribute that they would change. The next one was a child with crutches and a brace on the left leg. The next one was a child in a wheelchair, the next a child with one hand missing, then a child with facial disfigurement, and then a child with obesity. And regardless of how they broke up the subgroups, so whether it was boys or girls who voted, whether it was lower, middle or higher income kids, or whether it was like black or white kids, they all unanimously rated the child with no physical disabilities as the child they liked the most, and the child with obesity as the child that they liked the least. And the interesting thing about this paper is that is not specifically taught. There is no you should not like people who look like this, or you should like people who look like this. And this is an example of internal bias. It's something that you think you don't necessarily. Necessarily say it out loud, but it shows that even from a young age, people can have certain biases and certain kind of discriminar discriminatory thoughts that they don't necessarily act on, but it shows how big the problem is when even children would think like that.

SPEAKER_00 22:17

Yeah. I also too wonder as you're talking how much of that is learned indirectly by listening to, let's say, their family members, their parents, making comments about their own body size, especially I'm gonna I'm gonna say, especially the mom. I'm not saying only women do this, but it tends to be a high proportion of, let's say, body image trickles or you know, outward comments um in women commenting on their own bodies or commenting on other people's bodies, where they pick up over the years, oh, they're talking negatively about their bodies because um maybe she has some quote unquote love handles that she doesn't like about herself. Or I'm I I'm I'm picking up that this this adult is making a not very nice comment about someone else out there because of her body size. So maybe from stuff like that alone, they can learn, oh, this is not a desirable trait to have.

SPEAKER_01 23:10

So I want to latch on to that because you've rekindled a memory that I had in my head. Years and years and years and years ago, I must have been, I don't know, seven or eight or something like that. And I was at this summer football camp, actual football or soccer for Americans. And I remember the person doesn't matter, the people don't matter. I remember a kid that I was playing with, one of the kind of friends that I met at the football camp, said, Oh my god, that person is so fat. And I remember I know it sounds weird, I didn't really understand what they meant. I had never thought that before in my life. And when you're a child, there are certain things that you don't pick up on. So I don't remember being a kid and noticing if someone had acne or whether people were tall or short or thin or fat or or whatever, because you have to get to a certain age before those physical attributes are recognized in your head. Yeah, and I remember not quite understanding what they meant because I had never thought that about this person before, and it shows that it is something that you can learn and you can pick up on from other people talking, not necessarily something that you would think on your own.

SPEAKER_00 24:30

You know what I thought of? This is relevant to me simply because I'm now a mom. Okay, you know how a lot of moms, for example, are gonna be very hard on themselves for their postpottum body bodies. Great, great example. Maybe you have more of a belly than you used to, you're softer around your limbs. Oh my god, I feel so fat. Yeah, they're gonna say. However, so I've I've read different variations of this before where there's a mom who's really uncomfortable with her body, feeling very negative about herself, and then their toddler comes around and maybe they lay their head on her tummy and they say, I love your soft tummy. It's a very nice place for me to lay my head. And for that child who's maybe, you know, two years old, they haven't been exposed to society's this and that yet. For them, it's a place of comfort, it's something positive or neutral. But for the mom, she hates her tummy. But that reframe from the child made them reconsider, oh, it doesn't necessarily have to be something I'm so hard on myself about. So when you're really, really young, maybe it's not necessarily something that you see as a bad thing. But as you get older, based on other people's comments and remarks, you learn, oh, this is not something that I want.

SPEAKER_01 25:54

This is one of the things, like in that episode when we were talking about our daughter when she was just about to be born. When we talk about body image, it's about things that you don't say around them. So if both of us said, Oh my god, I'm so fat, and we were in the mirror and we were squeezing bits of us, and like, oh my god, I feel disgusting, or whatever, and our daughter grew up with that, that is something that can subconsciously permeate into the way she feels about herself versus being with parents who just don't comment on that kind of thing. Yeah, but I think this is a good segue into our next section, which talks about how weight discrimination and weight stigma and internal weight bias can foster over the life course. Yeah. If you want to kick us off.

SPEAKER_00 26:40

We'll start with the research in children, okay? Research has found that when children are being bullied for their weight, which we know is extremely common. I know at least when I was in elementary school or primary school, if there was anyone who was deemed chubby or fat, and I put that in heavy quotes, they were almost guaranteed to be the butt of so many jokes and of bullying, okay? But the research shows that being bullied for your weight, even as children, is going to decrease your self-esteem, increase your social anxiety, decrease your mental health, decrease your quality of life, decrease your school performance, increase the risk of eating disorders. Lots of problems there. Nothing good comes out of it.

SPEAKER_01 27:22

Yeah. So if you think back to if you were at school and you remember whether there was a kid that got picked on for their weight, for example, there is a strong likelihood that that child was less likely to get involved in PE. So for example, let's say loads of people picked on me and the way I looked and the way my body looked, I am less likely to want to go into a changing room with other people, get changed into sportswear, and then get involved in physical activity. So if you imagine being bullied as a kid for your weight, and then you are more apprehensive about exercising around other people, imagine how that can then follow you into adulthood. So I was always active as a kid. I remember throwing tennis balls and cricket balls and frisbees and whatever with my dad when I was, I don't know, five or maybe even younger. So for me, continuing exercise into adulthood was actually very easy because it was just continuation of a habit. Yeah. But how many people hated exercise as a kid because they were picked on? And then what's the likelihood that when they get into teenage years, they're like, oh yeah, I really want to join the gym now? They probably don't have the best relationship with exercise. Yeah. And also, as you have already said, the best relationship with food psychology. Yeah. They are more susceptible to eating disorders and unhealthy weight control behaviors.

SPEAKER_00 28:50

And I also want to acknowledge that when with my coaching clients, very, very common for people to have a lot of eating issues or complex relationships with their bodies and exercise. Super, super common. Especially those are the kinds of clients that we I get, especially because that's the kind of content I put out there, educational content addressing those topics. And almost always the client is going to have stories and memories stemming from their childhood. Okay. Of, well, my mom said this to me one time, or a friend or a classmate treated me in this way because of my body size. And that basically what I'm trying to say is that can lead to lifelong struggles with food and exercise and your body.

SPEAKER_01 29:34

Oh my god, I have so many examples. This is I don't I don't want to get like too angry and and too ranty. Example number one, I remember someone telling me that they were told they were chubby when they were probably four years old or whatever, and they were told that they might need to lose weight, and they remember that way into their 30s, 40s, something that affects their food psychology even now. I remember a client coming to me, lovely girl, and I said to her, What's your preferred motivation tactic? Some people like being shouted at in the gym, some people prefer quiet questions, quiet encouragement. Yeah, thanks, babe. I like to know what wavelength I could get on to try and motivate people the most and get the most out of their workouts. And she said to me, It cuts me, cuts me deep. She paused and said, Call me fat just repeatedly. And I was like, I'm obviously not going to do that, but why? And she said, Oh, it's just what my ex-boyfriend would say to me all the time. And the fact that that was the first thing she said.

SPEAKER_00 30:42

I'm glad she said ex-boyfriend though.

SPEAKER_01 30:44

Yeah. But it's just there's only so many stories you can hear about this from clients before you get kind of protective of them, and that's part of the reason that I go to bat on social media so much. This reminds me of a quote, it was actually from James Corden in response to Bill Maher talking about fat shaming and going off on one of his rants. And I know James Corden is not the most universally liked person, but I agree with what he said here. And it was something along the lines of if bullying kids or bullying people for their weight worked, there would be no fat kids in school.

SPEAKER_03 31:22

Yeah.

SPEAKER_01 31:23

And I thought that's something to let percolate in your brain.

SPEAKER_00 31:27

Yeah. Or even amongst adults.

SPEAKER_01 31:29

How many kids are picked on for their weight in school? Does it does it help? Do they go on to a lifelong of healthy, happy relationship with exercise and food? Or are they more likely to have maladaptive behaviors, less likely to exercise, less likely to eat well?

SPEAKER_00 31:47

And also on a more general global level, obesity rates wouldn't be rising over the decades if that were a thing that worked.

SPEAKER_02 31:55

Yeah.

SPEAKER_00 31:56

And yet people think the solution is, oh, we're not fashioning them enough.

SPEAKER_02 32:00

Yeah.

SPEAKER_00 32:01

Which doesn't make any sense. Yeah. But there's also, by the way, research in adolescence with weight stigma showing that in addition to worsening mental health, and this is very delicate, it also increases the likelihood of substance abuse and suicide. So it gets quite serious.

SPEAKER_01 32:20

Yeah, I feel like suicide is very serious, not even quite serious. Yeah. Um, so part of it with adolescence, which is obviously a continuation of childhood in terms of risk, but one of the things that was pointed out by one research paper is there is the interception of social media. So all of the things that can happen to a child in terms of being picked on and being on the butt of the jokes and all of that stuff, all of that is the same, but then it evolves because you're looking at things on social media, you're seeing more uh kind of body ideals, you're perhaps seeing more uh fat shaming and weight stigma online, and yeah, that's not great.

SPEAKER_00 33:01

There's also a cool study that was done on adults across multiple different countries, and many, many, many participants were included.

SPEAKER_01 33:08

So think about it like this: it's actually quite hard to measure the impact of weight stigma because it's not the type of thing that you can immediately impose on people. It's more like the kind of thing that they've been exposed to over the course of their life. So, this research paper it took participants from six countries under the WW formula formally Weight Watchers umbrella. So there were 14,000 participants from six different countries, and they essentially asked them for their experiences with weight stigma and weight discrimination, and over half of them reported being a victim of weight stigma, so not everyone, but a decent chunk. And the thing they were more likely to report higher levels of were eating to cope, gym avoidance, stress, as well as reduced eating self-efficacy and exercise self-efficacy. Yeah. And as in yeah, do you want to go?

SPEAKER_00 34:10

Well, I was gonna say for c define self-efficacy.

SPEAKER_01 34:12

Oh, go, go for it.

SPEAKER_00 34:14

And to clarify, self-efficacy is which is something that I covered in my PhD thesis.

SPEAKER_01 34:19

I was gonna say it. You can take it, you can take it.

SPEAKER_00 34:21

No. All it all it means is self-efficacy refers to your belief in your own ability to do things.

SPEAKER_02 34:26

Yes.

SPEAKER_00 34:27

This means that if you have low exercise self-efficacy, you're going to have a big attitude of I can't do that in the gym, which of course is going to discourage you from wanting to even try. That's it.

SPEAKER_01 34:39

So yeah, the theory is that a lot of people have is if we fat shame, it will have a positive knock-on effect. But in people who report being victims of weight discrimination, it shows the opposite, where people are more likely to avoid exercise, more likely to have a worse relationship with food, and more likely to eat. Now, this kind of research is observational. You ask people uh questions on a survey, but that gives you an idea because you can ask lots and lots of people, and lots and lots of people tend to report that the results are womp womp not good.

SPEAKER_00 35:14

What is womp womp? This is an inside joke.

SPEAKER_01 35:19

That's an inside joke.

SPEAKER_00 35:20

You didn't know what that womp womp meant about six years ago, towards the beginning of our relationship.

SPEAKER_01 35:24

I said, What is womp womp? And she literally just said womp womp. And I was like, you can't repeat it and expect me to know what that means.

SPEAKER_00 35:31

Anyway, hopefully everyone knows what womp womp.

SPEAKER_01 35:35

There is another research paper which I will let you spearhead.

SPEAKER_00 35:39

Yeah. Okay. This research paper was done on over 2,000 participants, and they found that when you are fat shamed, when you are bullied, when you are the victim of weight stigma, the responses varied. Okay. Common coping strategies included 79% of participants said they turned to food, so eating.

SPEAKER_01 36:01

Some people did report a positive response. So 86% reported self-love and self-acceptance, which I have included here on purpose, because it helps give you an idea of why the body positivity movement exists. A lot of people are like, I don't want to be weighed, I want to feel happy with how I look. Yes, I have more body fat, but I'm still confident. And that riles a lot of people up because they think they should be ashamed of how to do that.

SPEAKER_00 36:27

How dare you feel okay?

SPEAKER_01 36:29

But a lot of that is a reaction to the fact that they have been victims of weight discrimination and they're trying to have a more positive result from it.

SPEAKER_00 36:38

Yeah. We have 76% of participants who resorted to humor and woody comebacks as a coping mechanism.

SPEAKER_01 36:44

74% said they cried and isolated themselves. Three quarters. Three quarters of people.

SPEAKER_00 36:53

And we also have 75% of participants who said they would refuse to diet in response to weight stigma. Again, we see the opposite of what a lot of people think that fat shaming will do to people.

SPEAKER_01 37:07

So moving away from this kind of observational research into more intervention studies, does fat shaming work? Does fat shaming make people eat less food and have a happy, healthy relationship with exercise?

SPEAKER_00 37:21

Uh-huh. Okay. Let's talk about one of the studies where they had women watch video content. Okay. So they either had them watch stigmatizing content where uh people were being made fun of for their weight or being they were being portrayed as lazy and clumsy, or they watched a more neutral video, like an insurance commercial, for example.

SPEAKER_01 37:39

And then after they watched this stigmatizing clip, they were given access to snacks, things like jelly beans, MMs, and they're not aware of the purpose of the study. It's just watch this video, here's some snacks, fill in some forms. The purpose of the study is disguised.

SPEAKER_00 37:54

Yeah. And they actually found that when they watched the weight stigmatizing content, participants who were deemed quote unquote overweight, they actually ate three times more food watching that stigmatizing content compared to when watching a neutral video clip. That's quite significant. Three times more.

SPEAKER_01 38:13

And here is a direct quote from the authors, which I think is very pertinent. This directly challenges the notion that pressure to lose weight in the form of weight stigma will have a positive, motivating effect on overweight individuals.

SPEAKER_00 38:28

There's actually another study. Okay. So in this study, women were asked to read an article that was either called Quit Smoking or Lose Your Job or Lose Weight or Lose Your Job. And they did not know what the purpose of the experiment was.

SPEAKER_01 38:42

Same thing afterwards. They were then taken into a room where snacks were available. They didn't think they were being observed. They didn't think this was part of the study. It's just, oh, come into this room. Here are some snacks. Help yourself. We'll be back in a little bit.

SPEAKER_00 38:54

Yeah. So we actually have different responses from people who were quote unquote overweight versus people who were normal weight. Whereas in in that, those who were normal weight, I again I put that in quotes, they had a more expected response to this kind of content where they exhibited higher dietary control. But in the overweight women, the response was the opposite, wherein they ate a lot more food.

SPEAKER_01 39:20

Yeah. So basically the research that we have not only shows that fat shaming and weight stigma does not have a positive effect in terms of improving people's diet quality and improving people's exercise habits, but it can have a directly harmful and opposite effect.

SPEAKER_00 39:39

Yeah. And it's not only about refusing to diet or eating more calories, it's also directly linked to an increased incidence of binge eating. Also things like eating in secret, where maybe when you're around other people or during the daytime, you would eat a measly salad or you're skipping meals, but then when you're home or in the privacy of your pantry or something like that, that's when you start eating copious quantities of food in a short period of time.

SPEAKER_01 40:06

I have known people who said that people would always comment on what I eat. Therefore, I would eat salads when I'm around people, then I would go home and that's when I would eat junk food. And side note, that is why one reason why I hate, I hate, hate, hate, videos where people online stitch someone else's content to comment on what they're eating when they didn't fucking ask.

SPEAKER_00 40:31

That is so weird to me.

SPEAKER_01 40:32

It's so like if you're on holiday and you're like, oh, I did this and I had a day at Disneyland or whatever, and I ate this and I ate this, and then some personal trainer or dietitian wades in and they're like, let's judge what they're eating. Oh my god, get in the fucking sea. I cannot stand it. It would be very different if they said, Here is what I think is a healthy diet. Everyone should do this. That is open for criticism. That is giving people advice, and if the advice isn't helpful, that warrants criticism. I would do that all the time.

SPEAKER_00 41:00

Or if someone said, Here's my diet, what I ate today, what do you think?

SPEAKER_01 41:04

Sure. If they ask for Please critique me. If they ask for it, that's fine. But here is what I'm eating while I'm on holiday, and then someone's like, Oh, that doesn't have enough protein or the calories are too high. Oh my god, fuck off. If they didn't ask, mind your business, Jesus wept.

SPEAKER_00 41:19

I love when you say that. Jesus wept. Okay, moving on. We're gonna talk about weight stigma in healthcare, and I think this warrants some airtime because this is a very serious topic. And anytime that I have talked about this on social media, I have gotten hundreds and hundreds of comments of people recounting their own personal negative stories of weight stigma in healthcare.

SPEAKER_01 41:41

Yeah, so we have circled back to this. I said earlier that we would people will think, yes, but if someone has more body fat, it is right that medical professionals will treat them differently because more body fat is worse for their health. Therefore, the medical professional needs to bring it up. Park that. That isn't what we're saying. We could address that, but we're not going to at the moment. So, as an example, here are some things from research papers. So, number one, medical professionals often spend less time than they do with thinner patients.

SPEAKER_00 42:12

That's sad.

SPEAKER_01 42:13

Yeah.

SPEAKER_00 42:13

Yeah.

SPEAKER_01 42:14

Less time tends to mean worse care.

SPEAKER_00 42:16

Right. And on a very related note, because people in bigger bodies tend to be more dismissed, it also increases the likelihood of missing legitimate diagnoses. Now, this reminds me, uh, some of you might remember this actually from a few years ago. This woman went viral on social media and she was talking about her own experience trying to get a proper diagnosis. She was having some cramps, she was having loss of appetite, she was losing weight, couldn't figure out what was wrong. She went to a gastrointestinal specialist who then said, when in response to the fact that she was losing her appetite, she said, um, the doctor told her, maybe that's not such a bad thing. And rather than running proper diag uh and rather than running proper tests to follow up with her complaints and figure out what was happening, that's what she was told and sent on her way. Turns out she had stage three colon cancer. And imagine being dismissed for weeks and weeks and months and months because of your body size like this. A misdiagnosis could mean life or death for you. Yeah. Yeah.

SPEAKER_01 43:21

Speaking of which, brief side tangent, but when you say people in bigger bodies, I know some people are like, oh my god, what a term. That is just because it's very difficult to find a term that everyone agrees on. Because if you say the word fat, some people are like, Yes, I like that you say that because we shouldn't stigmatise it, we should just use it as it is. Other people find that highly offensive. If you use the term obese or obesity, some people prefer it, some people don't. There are whole research papers on this, and it's argued and it's no clear thing. You try to use terms that people are okay with hearing it, if anyone's losing it, uh losing their shit. Anyway, next one on your point, people with higher. BMIs, more body fat, way more, however you want to phrase it, often have lower rate of pap smears, meaning they are getting less frequent gynecological cancer preventative tests because they are more likely to feel embarrassed or feel disrespected by medical staff, which puts you at higher risk of death.

SPEAKER_00 44:24

Right.

SPEAKER_01 44:24

Not ideal.

SPEAKER_00 44:25

And also super related, women in bigger bodies are more likely to have bad negative experiences during labor and childbirth.

SPEAKER_01 44:33

One particularly damning study, which I think is very important, because again, if people are like, well, you know, medical professionals have to treat people differently if they're concerned, blah, blah, blah, blah, blah, I said park that. And there's a reason I said park that. So in one study, nearly half of actual medical professionals witnessed other medical professionals using discriminatory behavior towards patients, including things like smirking or looks of disgust, name-calling, mocking, facial expressions, and insults. This is nearly half of medical professionals notice colleagues doing things like this towards patients that have more body fat. That is unacceptable.

SPEAKER_00 45:19

And it makes me wonder what happened to do no harm.

SPEAKER_01 45:23

Hmm. Great question.

SPEAKER_00 45:25

If that's their if is it called an oath, they have an oath to do no harm. Yeah. And I feel like a lot of times people take that to mean do no physical harm.

SPEAKER_01 45:34

And I feel like that's a nice way to kind of round off this section because people will go, yeah, but medical professionals, they're just worried about their health, they have to treat them differently, or oh, we're just worried about their health, so we have to talk about them differently, or whatever. But the point is, whilst you're arguing whether that is justified, we are literally seeing research where people do things like name-calling, facial expressions of disgust, mocking people for their weight. Right. And this discussing being concerned about people's health does not warrant bullying.

SPEAKER_00 46:07

Right. And I feel like this is an important thing to cover because this is almost always the response that I get when I talk about the dangers of Weight Sigma is well, you're you're enabling obesity.

unknown 46:19

Yeah.

SPEAKER_00 46:19

You're enabling unhealthy behavior.

SPEAKER_01 46:21

Absolutely bullshit. Absolute bullshit. This whole glorifying obesity, just because you talk about things with uh more compassion and more nuance is fucking nonsense. So I remember when uh I did that book event in London, and I remember someone saying to me as a question, hand up in the crowd, and they said something along the lines of how do you manage to talk about the risks of having more body fat whilst not making people feel worse about it? And I basically said in stronger terms than I will on this podcast, but don't be a massive ball bag because it is actually very easy to say there are risks with having more body fat, there are risks with high amounts of visceral adiposity or whatever. See that to me, I'm that that's fine to say without using that as an excuse to treat people like shit.

SPEAKER_00 47:19

Right. So consider your tone of voice, consider have they asked you for your advice? Do you know them? How often do people approach strangers in the gym because of the body size? And then let me give you some advice that you can ask for. So stuff like that.

SPEAKER_01 47:34

I think one thing that is important to acknowledge is there is a fringe subgroup of people where even if you talk about health risks of body fat, they will very strongly deny that there is even a possible relationship there. And I think it's important to say that that is not the case. We have a lot of research literature from various different angles, whether it's observational or genetic studies or intervention studies showing that there are risks when people have a lot of visceral fat, for example. Yeah, but it is okay to talk about that and not make people feel shit. Yeah. And talk about things with more compassion and in a way that doesn't make them one feel worse, but actually do it in a way where people are more likely to have a beneficial relationship with food and exercise.

SPEAKER_00 48:23

Yeah. And by the way, that reminds me, I think it's safe to say that the people who make those kinds of arguments are also the people who are going to be making the claim that 95% of diets fail.

SPEAKER_01 48:34

That's true. Watch that video if you haven't watched it.

SPEAKER_00 48:36

Which yeah, we have an entire podcast episode going over that entire misconception that 95% of diets fail. It is not that straightforward.

SPEAKER_01 48:45

Um Should we wrap up with some takeaways? Yes. I feel like now would be a good time to do it.

SPEAKER_00 48:50

In conclusion, fat shaming is not an effective behavior change strategy.

SPEAKER_01 48:55

Can you repeat that just once more? Because I think it's important.

SPEAKER_00 48:59

Fat shaming is not an effective behavior change strategy. If your goal is to hopefully motivate someone to get healthy, reduce their calorie intake, lose the weight, it's actually more likely to have the opposite effect.

SPEAKER_01 49:15

Now there are some people who say, but I was fat-shamed and I started going to the gym more and it was beneficial for me. We are not denying that there are people out there where that exists. We are not denying that. We think it's very important to acknowledge people's own personal experiences. That is not the norm.

SPEAKER_00 49:31

Yeah. But my question to people who say that, because I have gotten that response as well, is okay, how's your relationship with food? Is it actually healthy? How's your body image? How's your relationship with exercise? Because you can lose the weight, but maybe you are highly anxious around food now, right? Maybe you have anxiety every time you miss a workout.

SPEAKER_01 49:54

I also think it would be really good. Wouldn't it be great to get people to have more positive relationships with food and exercise without having the collateral damage of their mental health and making them feel like shit? Yeah. To me, that seems smart. Anyway, there's a quote that I love, which I'm going to pass over to you because this is one that I think is just right on the money.

SPEAKER_00 50:16

Right. You know what's so funny? When you f when you were reading aloud this quote to me earlier when we were prepping for this episode, you f when you said the first two words, I said, I know who the author is. Yeah. Because I read her book. Okay. The quote is this Shame corrodes the very part of us that believes we are capable of change. Brene Brown. Very, very well known quote. Some of you will recognize this one.

SPEAKER_01 50:37

If I repeatedly call someone a lazy piece of shit, are they going to go, actually, I feel super proactive today, super productive, I'm going to go and do loads of things. Or does it reduce their feelings of self-efficacy and make them less likely to want to do those?

SPEAKER_00 50:54

Essentially, you should not have to make someone feel worse about themselves to elicit positive change. That's a nice way of putting it, isn't it?

SPEAKER_02 51:03

Yeah.

SPEAKER_00 51:03

Additionally, it is entirely possible to talk about health or risks of obesity while being compassionate without being what you would say a bell end about it.

SPEAKER_01 51:15

Yeah. And I think importantly, people deserve to be treated well regardless of their body shape. It doesn't matter if they want to diet or not, it doesn't matter if they want to exercise or not. You don't I know this sounds controversial, you don't owe anyone health. If you are doing something that I disagree with, you don't have to change what you're doing because I think you should do it. If I went around all the pubs and said you should never drink alcohol, you should never smoke, you should never eat these foods, people will tell me to fuck off. Right. But that is essentially what people do with body fat.

SPEAKER_00 51:52

That actually reminds me, think of the drastically different response to a thin person eating a burger and french fries, for example, versus a fat person doing the exact same thing. If someone thin is eating a burger, they're quirky, they're fun, they're adventurous. If it's someone fat, it's oh my god, you're disgusting, you don't care about your health, right? Two completely drastic, drastically different responses.

SPEAKER_01 52:14

That is actually one of the reasons I hate the unsolicited, let me critique this person's diet on social media. Because if you if you see them eating that, it is a snapshot in their life. It's like you can criticize someone for eating a burger, but for all you know, that is the first burger that they have eaten.

SPEAKER_00 52:29

You have no idea what else they're eating, you don't know what their goals are, you know if they're coming back from an eating disorder where maybe they were overly restricted with their food choices. You don't have you don't know the context.

SPEAKER_01 52:40

Anyway, I part of the reason I talk about this so much, and I know someone actually said to me when we were presenting together at IFS, how can you talk about this so much when you look the way you do? And it was a very good question, and it is because I'm talking on behalf of people I care about. Sure. When you have repeated numbers of clients who come to you and say, I don't want to exercise in the gym because people believe me for my weight, or can we go and exercise outside where no one can see me because I won't feel self-conscious, or people used to mock me for my weight as a kid, so I started eating in secret so no one would see when I wanted to eat something that was not diet-friendly or whatever. Once you have heard countless numbers of these stories, you go to bat for those people, and that is why I talk about this a lot, and it makes me very passionate.

SPEAKER_00 53:32

Hopefully, we've given you something to think about. Hopefully, if you didn't quite understand what the big deal with fat of with fat shaming was before, maybe you've changed your tune by this point. That would be a very positive outcome for us.

SPEAKER_01 53:46

And to sign off, I did this on the last episode, it's extra important on this episode. If you have experience with weight discrimination or fat shaming and you feel okay sharing, I would love to read it in the comments because this is one of those examples where people will angrily disagree with us. And if the comment section is full of people saying, Yes, this happened to me and it fucked me up because this, this, this, for example, not that I'm asking for selective reviews, it will be more eye opening for people who are naive to this phenomenon. Yeah. If you're okay sharing. Okay.

SPEAKER_00 54:20

Thanks for tuning in. Catch you at the next one. Hi five.