By Rebecca Puhl, PhD
Obesity is highly stigmatized in our society. Individuals with excess weight or obesity are vulnerable to negative bias, prejudice and discrimination in many different settings, including the workplace, educational institutions, healthcare facilities and even within interpersonal relationships.
Unfortunately, weight bias remains very socially acceptable in North American culture; it is rarely challenged, and often ignored. As a result, thousands of individuals with obesity are at risk for unfair treatment, and there are few outlets available to provide support or protection.
Weight stigma or bias generally refers to negative weight-related attitudes toward an individual with excess weight or obesity. These attitudes are often manifested by negative stereotypes (e.g., that persons with obesity are “lazy” or “lacking in willpower”), social rejection and prejudice. Weight stigma includes verbal teasing (e.g., name calling, derogatory remarks, being made fun of, etc.), physical aggression (e.g., hitting, kicking, pushing, shoving, etc.) and relational victimization (e.g., social exclusion, being ignored, avoided, or the target of rumors).
Many individuals with obesity report being treated with less respect or courtesy than thinner persons and being called names or insults because of their weight. Thus, weight stigma can emerge in subtle forms, or it can be expressed directly.
Discrimination is distinct from stigma and negative attitudes, and specifically refers to unequal, unfair treatment of people because of their weight. For example, a person with obesity who is qualified for a job but is not hired for the position because of his or her weight may have been the victim of weight discrimination.
Other examples include being denied a job promotion or fired from a job because of one’s weight; being denied certain medical procedures or provided inferior medical care because of one’s weight; or being denied a scholarship, a bank loan or prevented from renting or buying a home because of one’s weight.
In each of these cases, the behaviors directed toward an individual with obesity depict inequitable treatment with no justifiable cause, and legal recourse may be an appropriate response in these situations.
Despite the increasing prevalence of obesity, it appears that incidences of weight discrimination are only becoming worse.
In our research, we examined trends of weight discrimination throughout a 10 year period from 1995-2005 and found that the prevalence increased by 66 percent during this decade, from 7-12 percent of the general population. This finding was not a result of increasing obesity rates, but rather specifically demonstrates that more people are experiencing weight discrimination.
Given the social acceptability of negative attitudes toward individuals with obesity, it may not be surprising to learn that weight discrimination is common in the United States.
In a recent study, we examined the prevalence of multiple forms of discrimination in a nationally representative sample of 2,290 American adults and found that weight discrimination is common among Americans, with rates relatively close to the prevalence of race and age discrimination. Among women, weight discrimination was even more common than racial discrimination. Among all adults in the study, weight discrimination was more prevalent than discrimination due to ethnicity, sexual orientation and physical disability. Almost 60 percent of participants in our study who reported weight discrimination experienced at least one occurrence of employment-based discrimination, such as not being hired for a job.
On average, a person’s chances of being discriminated against because of weight become higher as their body weight increases. In our study, 10 percent of overweight women reported weight discrimination, 20 percent of women with obesity reported weight discrimination and 45 percent of women with obesity reported weight discrimination.
Rates for men were lower, with 3 percent of overweight, 6 percent of obesity and 28 percent of men with severe obesity reporting weight discrimination. This finding also tells us that women begin experiencing weight discrimination at lower levels of body weight than men.
Unfortunately, there are few legal options available for individuals who suffer weight discrimination. Currently, there are no federal laws that exist to prohibit discrimination based on weight.
With the exception of one state law (Michigan) and a few local jurisdictions that address discrimination on the basis of weight or appearance (e.g., San Francisco), the vast majority of people who experience weight discrimination in the U.S. must pursue legal recourse through other indirect avenues.
In particular, individuals with obesity have depended on the Rehabilitation Act of 1973 (RA) and the Americans with Disabilities Act of 1990 (ADA). Most cases filed under these categories pertain to weight-based discrimination in employment settings, and only a few cases have been successful. In addition, whether it is appropriate for obesity to be considered a “disability” under the ADA is questionable and could perpetuate bias further.
Overweight people who are not “severe obesity,” but who experience weight discrimination cannot file claims under the ADA because they are not considered disabled under this law. It places an unfair burden for individuals to prove that their obesity is debilitating and disabling in order to obtain fair and equitable treatment in the workplace.
These unresolved issues, in addition to public perceptions that place blame on people with obesity, have led to inconsistent court rulings and often deter individuals with obesity from taking any legal action.
Clearly, legislation is badly needed to protect individuals from weight discrimination. Massachusetts recently introduced legislation (House Bill 1844) to prohibit weight-based discrimination in employment settings. The hearing was held on March 25th 2008, with no opposition present at the hearing, and all expert testimonies were in favor of the bill. No decision has yet been made, but if this bill passes, it will be an important step in encouraging other states to follow suit.
Reducing weight bias requires major shifts in societal attitudes, and national actions are needed to establish meaningful legislation to ensure that persons with obesity receive the equitable treatment they deserve.
About the Author:
Rebecca Puhl, PhD, is the Director of Research and Weight Stigma Initiatives at the Rudd Center for Food Policy and Obesity at Yale University. Dr. Puhl is responsible for coordinating research and policy efforts aimed at reducing weight bias.
Puhl R, Brownell KD. (2001). Bias, discrimination, and obesity. Obesity Research, 9:788-805.
Puhl, R.M., Andreyeva, T., & Brownell, K.D (2008). Perceptions of weight discrimination: prevalence and comparison to race and gender discrimination in America. International Journal of Obesity. doi: 10.1038/ijo.2008.22
Andreyeva, T., Puhl, R.M., & Brownell, K.D (2008). Changes in Perceived Weight Discrimination Among Americans, 1995-1996 through 2004-2006. Obesity. oi:10.1038/oby.2008.35
Brownell, K.D., Puhl, R., Schwartz, M.B., Rudd, L. (Eds.) (2005). Weight Bias: Nature, Consequences, and Remedies. New York: Guilford Publications. For more resources on weight bias, including fact sheets, handouts, research articles, assessment tools and PowerPoint presentations, please visit www.yaleruddcenter.org.