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Health mythbusters is a regular column in which FHP researchers challenge widely held beliefs about health issues.  This month, Dr. Sara Kirk takes on weight bias amongst health care providers. Dr. Kirk is Scientific Director of the Healthy Populations Institute, Canada Research Chair in Health Services Research at the School of Health and Human Performance, Dalhousie University and cross-appointed with Community Health and Epidemiology and the IWK Health Centre in Halifax. Her research program, Applied Research Collaborations for Health (ARCH) uses a social-ecological approach to understand lifestyle factors influencing health status and health services utilization, particularly in relation to excessive weight gain.

"Telling someone that they have a weight issue will encourage them to do something about it."

Shaming people about their weight, or “fat-shaming” as it is most commonly known, is an often-used tool in our modern society. The belief is that telling someone that they have a weight issue will “encourage” them to do something about their weight – to eat less, or move more. This myth is perpetuated so frequently that even health care providers will use fat-shaming tactics in an attempt to stimulate behaviour change, yet such tactics do more harm than good.

To “do no harm” is a fundamental principle in health and medicine. When an individual living with obesity has contact with a health care provider who overtly expresses attitudes that contradict with this value, they may be less likely to seek support for other health issues when they need it, and more likely to be denied access to evidence-based treatments that might help them, such as bariatric surgery. This is particularly the case when blame and shame comes into the discussion, as my own research has found¹.  

Focus on the positive

So, it is important for health care providers to be aware of the biases they hold towards individuals experiencing obesity, and to ensure that individuals are not defined by their body shape or weight but as a whole person with physical, emotional and spiritual needs. We need to better understand that obesity is complex, that people experience challenges with their weight or shape for many different reasons, and that a ‘one-size-fits-all’ approach to weight management does not work. People respond better to empathy and support than a lecture from an ill-informed and out-of-date practitioner, so focus on positive changes (e.g., lower blood pressure or reduced depressive mood) instead of the negative (e.g., no weight loss). And if we come across fat-shaming, we should all be challenging it, not allowing it to continue. This is one myth that must be well and truly busted and we all have a role to play in shifting the focus from weight to health.

1. Kirk SFL, Price S, Penney TL, Rehman L, Lyons R, Piccinini-Vallis H, Vallis TM, Curran J, Aston M (2014). Blame, shame and lack of support: A multi-level study of obesity management. Qualitative Health Research, 24: 6, 790-800. doi:10.1177/1049732314529667