Obesity Stigma

Here is the social follow-up to my previous BMI Rant.

One of the classes I am currently taking requires us to find, read, summarize and pose questions based on an article based for that week's topic.  This week the topic is Leisure Constraints for which I found the following article and my summary.  It is long but really, really good and will remind us all that prejudice in any for is completely and absolutely unacceptable:

Obesity-Stigma as a Multifacted Constraint to Leisure 

The word obesity has been mentioned increasingly in health research, physical education, recreation, leisure, and the media over the recent decade.  Most of the researches in these areas measure obesity by using one measure, the Body Mass Index (BMI).  (It was recently altered by the NIH in the United States to line up with the WHO international guidelines, which moved 25 million Americans from the normal weight range into the overweight range, and moved people 12.5 million American from the overweight category to the obese category.)  This shift in size levels of individuals and an increase of a sedentary lifestyle by many people, has been interpreted by many governments and professionals as a quick decline in health within many countries. 

 In addition, there are social and cultural anti-fat biases or obesity-stigmas that have developed parallel to the changes in health assessment.  Many professionals see these attitudes as the final form of acceptable discrimination as this very visible experience stigmatizes and marginalizes people.  Participants that demonstrate such prejudice can include family members, friends, co-workers, children, teens, young adults, adults, health and wellness professionals and the general public.  Interestingly, people in the overweight or obese categories have been studied and their biases towards other people in the same category can be as judgmental.  It is hypothesized that anti-fat bias continues to grow because unlike other marginalized groups, larger people are socially marginalized and do not form self-support groups or blame the prejudiced attitudes on the perpetrators (called self-protective properties), instead they internalize the stigmas and prejudice as their own personal flaws (called attributional ambiguity). 

This culmination of this research should have a profound effect on the leisure, recreation, physical, and kinesiology fields but the work currently in place is not effective, as there is strong psychological and self-worth component that these professions are not addressing.  These leisure constraints create a psychological cycle of feeling too big to participate in leisure, which decreases participation and the access to benefits, and lower participation keeps self-worth too low to motivate participation.  Leisure constraints for people who fit outside the 'average' size include lack of access to the correct size of exercise clothing, equipment made for shorter and smaller people, negative attitudes and demeaning judgments of individuals at recreation facilitates, and assumptions that one's participation is to lose weight rather than for other benefits.  Individuals in the recreation, health and physical activity field also carry a great deal of prejudice and judgment towards larger individuals, especially undergraduates in the kinesiology and physical education streams. 

Lewis and Van Puymbroeck suggest the following work should be completed in order to truly be effective professionals and change the socially acceptable fat-bias that is so prevalent:
1.) Reduce our individual obesity stigmas as we do our best to understand this complicated leisure constraint issue.

2.) Change our focus from appearance to overall health and wellbeing.

Look beyond traditional health models and include addressing the socially constructed attitudes in our society that create these stigmas of prejudice.

3.) If we are the gatekeepers of health and wellness, what type of accessibility (or lack thereof) are we creating?  Change the gatekeepers to change the exclusive environment.

4.) Focus on intrapersonal and interpersonal constraints as research continues.

5.) We need more qualitative and evidence-based research that integrates themes of leisure constraints.

6.) We must not assume that it is always the goal of the larger person so lose weight. 

 Lewis and Van Puymproeck summarized with this paragraph:

"With twice as many people affected by overweight than not in this country, related opportunities for both leisure researchers and practitioners abound.  Children who are overweight are often seen as undesirable playmates.  Social interactions across the lifespan are often limited due to the presence of obesity.  People who are significantly overweight not only face social judgement and discrimination in many aspects of their lives, but also discriminate against others who are overweight.  These forms of prejudice and discrimination are likely to significantly impact the leisure experience of people who are overweight across the lifespan." (p. 584)

Two last comments by the authors:

"Current interventions are not succeeding, and more research is quickly needed." (p. 585)

"We must decide the identity we wish to assume related to this current health crisis." (p. 585)

My questions for the class:

1.) If we are going to broaden our perceptions of health to include more than appearance, why are we using the BMI as the primary measure of health?  It is time to develop an improved, more accurate, increasingly helpful way to measure an individual's over-all health.   

2.) How do we balance the desire to create healthier less costly (health wise) cities, provinces and countries while decreasing the social and cultural prejudice that is so rampant?

3.) What social and personal stigmas do you have attached to your own body size and type?  Is this attitude affecting your view of others? How so?

4.) What new interventions can we develop to increase the overall health of the people who freely choose to access our services as leisure, recreation and Kinesiology professionals?  

Lewis, S. T. & Van Puymbroeck, M.  (2008).  Journal of Leisure Research, 40(4), 574-588.