Three Ways to Combat Weight Stigma and Eating Disorders
If there’s one thing I wish more people understood about eating disorders, it’s this: Weight stigma is a pervasive barrier preventing many from seeking treatment and accessing care. Research indicates 94% of people with eating disorders are at or above a “healthy weight,” yet the stereotype that only thin people have “real” eating disorders persists.
Eating Disorder Stigma and Weight Bias in Healthcare
Weight stigma is deeply entrenched in our government and healthcare systems. Insurers and healthcare agencies often use weight to gatekeep access to treatment — those in higher weight bodies can be deemed “not sick enough” to qualify for help. Here in the UK, where I live, wait times for treatment have skyrocketed since the pandemic. For those with higher BMIs, whose eating disorders are considered “less severe,” wait times can exceed a year.
What is Weight Stigma?
Weight stigma is also intertwined with racism, ableism, transphobia, and economic inequities. Scientific research on eating disorders has largely taken place in treatment centers, among a population that can afford care costing more than $1K/day. This has entrenched the idea that eating disorders mostly occur in thin, wealthy, white, cis-gender women. The ‘war on obesity’ has further legitimized fat phobia and the pathologization of bodies that do not fit conventional models of health, wellness, and beauty.
From our work at Eat Breathe Thrive, we know that shame and stigma are significant barriers to seeking support. People of all ethnicities, ages, and gender identities get eating disorders, but often, when they seek support, they receive harmful treatment, often from well-meaning providers. Many treatment approaches still assume weight is a reliable indicator of health and recovery, despite evidence showing that BMI is a poor measure of health.
“Many treatment approaches still assume weight is a reliable indicator of health and recovery, despite evidence showing that BMI is a poor measure of health.”
How to Support Someone with an Eating Disorder
If someone you care about has an eating disorder, it’s crucial to be aware of the subtle ways we can inadvertently perpetuate weight stigma. Here are some simple things you can do to avoid this and support your loved one:
1. Focus on functionality: Encourage your loved one to appreciate what their body allows them to experience, not what it looks like. Researchers call this functional appreciation of the body, and some evidence suggests it may play an important role in preventing and helping people recover from eating disorders. Functionality comes in many forms – it’s not just about being physically strong or flexible. We can also appreciate the ways our body allows us to connect with others, experience pleasure, or create art.
2. Avoid weight-based language: Be mindful of the language you use when talking about yourself or others. Avoid criticizing your own body for its appearance, as these criticisms can subtly convey that some body appearances are more valuable than others. Be cautious with phrases like “burning calories” or “shedding pounds,” which are ubiquitous in today’s culture but can reinforce weight-based assumptions and biases.
3. Reframe Body Positivity: When someone you love has an eating disorder, it’s tempting to reassure them: “Your body is perfect just the way it is.” However, these messages don’t always land well, especially for those experiencing dissonance between their body and gender identity. Try using body-neutral language instead – acknowledging that our feelings about our bodies may not always be positive, can fluctuate day to day, and emphasizing the importance of self-care when we’re feeling down.
About the Author
Chelsea Roff is the Founder and Director of Eat Breathe Thrive, a nonprofit organization that helps people overcome eating disorders. A certified yoga therapist, research collaborator, and educator, she has spent the better part of a decade developing and delivering mind-body programs to people with eating disorders.
Prior to her work in the charitable sector, Chelsea worked as a researcher in psychoneuroimmunology under the supervision of Dr. Andrew Baum. She is currently working with Dr. Catherine Cook-Cottone on four studies to evaluate the efficacy of Eat Breathe Thrive as a preventative and complementary treatment intervention for eating disorders.