Obesity Discrimination: Definition, 4 Types & How to Address

Obesity discrimination seems to be one of the last accepted forms of prejudice. While our culture has a long way to go before discrimination against obese people is no longer an issue, there are effective ways to avoid or address four of the most impactful types...

Definition of Obesity Discrimination

obesity discrimination

Obesity discrimination can be defined in one of several ways, including:

  • The unfair treatment of an overweight person or group on the basis of prejudice.
  • Treatment or consideration of, or making a distinction in favor of or against, an obese person based on their weight rather than their individual merit.
  • Treatment of obese people less favorably than non-obese people strictly because of their weight.
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Types of Obesity Discrimination

Obesity discrimination increases with an individual’s weight. Research on obese women conducted by the Obesity Action Coalition showed that discrimination was reported by...1

  • 10% of overweight women
  • 20% of obese women
  • 45% of very obese woment

While overweight discrimination occurs constantly all around us, this section focuses on four of the most impactful areas:

  1. Employment
  2. Health care
  3. Education
  4. Dating & Romantic Relationships

1. Obesity Discrimination at Work

Several studies have shown that being obese in the workplace means more difficulty finding a job, lower wages, fewer promotions, worse treatment and a higher likelihood of termination, especially for obese white women.

A nationally representative study of almost 3,000 adults found that when compared to those of normal weight, overweight respondents were 12 times more likely, obese respondents were 37 times more likely and severely obese respondents were 100 times more likely to report obesity discrimination at work. Of the respondents, women were 16 times more likely to report weight-related employment discrimination than men.2

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In addition, obese men and women are paid less on average than normal-weight workers: obese men receive wages that are 0.7 to 3.4% less while obese women receive 2.3 to 6.1% less.3 Put in other terms, the lower wages for white women were found to be equivalent to about 1.5 years of education or 3 years of work experience.4

Finally, obese workers have a tougher time keeping their jobs than their non-obese peers. Obese women have a 5.8% higher chance of losing their job while obese men have a 4.8% higher chance.5

(Jump down to "Addressing obesity discrimination at work", or continue reading...)

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2. Obesity Discrimination in the Doctor’s Office

Perhaps a more unsettling type of obesity discrimination occurs in a place where caring, trust and unbiased treatment should be guaranteed…your doctor’s office. Unfortunately, on average, doctors are not immune from obesity discrimination tendencies.

Believe it or not, the majority of doctors do not have a solid understanding of the causes of obesity or its treatment, and most are largely unaware of the strong correlation between obesity and genetics.

One study compared video tapes of visits with obese people against those with people of normal weight.6 During the visits with obese patients, physicians tended to:

  • Spend less time discussing health
  • Spend more time discussing exercise
  • Not discuss nutrition in relation with patients’ obesity
  • Spend more time on technical tasks (rather than interacting with the obese patient)

To dive further into the feelings behind the above observations, the following studies demonstrate the stereotypical feelings of the average doctor towards obese people:

  • Six hundred and twenty (620) primary care physicians in one study were asked what they felt was the most important cause of obesity. The vast majority rated physical inactivity as significantly more important than any other obesity factor, while overeating and a high-fat diet received the next highest ratings. In addition, more than 50% of the doctors surveyed viewed obese patients as awkward, unattractive, ugly and noncompliant.7
  • In another study of 122 physicians, on average the doctors admitted to spending less time with obese patients and to reacting significantly more negatively to obese patients in 12 of the 13 areas tested.8

Equally bad is the fact that most primary care physicians do not feel capable of properly treating obese patients:

  • Less than half of the 620 primary care physicians from the study referenced above felt competent in prescribing weight loss programs, and only 14% believed that they were usually successful in helping obese patients lose weight. Less than one-half felt that it is possible for obese patients to lose a significant amount of weight.7
  • In another study of 510 family physicians, 72% believed that they had limited efficacy in treating obesity and considered themselves not well prepared by medical school to treat overweight patients. About 60% reported feeling that they had insufficient knowledge regarding nutritional issues. Regarding prescriptions for the treatment of obesity, only 66% knew the drugs' prescription indications.9

(Jump down to "Addressing obesity discrimination at the doctor's office", or continue reading...)

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3. Obesity Discrimination in Education

Obesity discrimination in schools is a major concern not only because of the emotional distress it can cause obese children, but also because students who are discriminated against may be less likely to succeed:

  • A study in Sweden including over 700,000 men found that young men who were obese at age 18 years had a much lower chance of attaining a high education than their normal-weight peers, even after adjustments were made for intelligence and the socioeconomic position of their parents.10
  • An English study of 15,061 people had similar findings, where obesity was associated with lower educational attainment in both men and women.11
  • Finally, an American study of almost 11,000 participants found that obese girls were less likely to attend college compared to nonobese girls, especially when they attended schools in which obesity was relatively uncommon. Interestingly, obese boys, did not differ from their peers in college enrollment.12

Despite the above findings, opposing research does exits regarding educational outcomes for obese students. For example, one study of 8,490 participants found that obesity limited to childhood “has little impact on adult outcomes.”13

(Jump down to "Addressing obesity discrimination at school", or continue reading...)

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4. Weight Discrimination in Dating and Romantic Relationships

When it comes to finding a romantic partner, obesity appears to play a big role, especially for women.

One study of 449 college students found that the least-preferred partners were obese and that men, compared with women, provided significantly lower ranks for obese partners.14

Another study found that obese women are less likely to live with a partner or to marry. While obese men are less likely to live with a partner, their marriage rates appear to be unaffected by their weight.15

(Jump down to "Addressing obesity discrimination in dating and romantic relationships", or continue reading...)

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How to Effectively Deal with Each Type of Obesity Discrimination

In a moment we will review the best ways to avoid the above types of discrimination against obese people. Before we go there, it’s worthwhile to briefly discuss the ideal solution: weight loss. In addition to improving obesity discrimination, you will likely improve any existing obesity health problems or, at a minimum, reduce your risk of contracting them.

As you’re probably sick if hearing, finding the right diet and exercise program for you is the most appropriate first step. If you have tried several in the past and have been unsuccessful, consider a medically supervised program. Research has shown diet and exercise programs supervised by a medical professional to be much more effective than going it alone.16

If you are morbidly obese (body mass index over 35) and attempts at sufficient weight loss, even under a medically supervised program, have yielded no results, you may be a candidate for weight loss surgery. Surgical options range from minimally invasive to complex, and the proper surgery type depends on the profile of each patient.

Following are ways to address the four types of obesity discrimination reviewed above…

  1. Employment
  2. Health care
  3. Education
  4. Dating & Romantic Relationships

1. Addressing Obesity Discrimination in the Workplace

If you feel that you are being discriminated against at work, there are three things you should do according to the Council on Size and Weight Discrimination:

  1. Start a file, including your employment records and the evaluations that you have received from your supervisor.
  2. Take notes for all job-performance and weight related conversations/issues that arise, including the people you spoke with, date, time, people present and what was discussed.
  3. Address the issue if you are convinced there is a problem. Make an appointment with your supervisor or human resources representative and discuss your file and notes. Find out if they agree with your impressions and, if they do, ask what can be done to fairly address them. Document what is discussed during the meeting(s).

If you don’t feel that the problem has been properly resolved after your meetings with your supervisor and/or your human resources representative, it may be time to take legal action. Some cities and states have laws directly applying to obesity discrimination which will make your case easier to prosecute. Even if there are no specific laws in your area, several federal laws can be referenced, including:

To find a lawyer in your area, visit the American Bar Association’s online referral service.

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2. Avoiding Obesity Discrimination in Health Care

The thought of your own doctor providing less than ideal care just because of your weight is extremely worrying. But how can you know what’s going on in your doctor’s head?

One study found that doctors who are male, older, heavier-set, have a positive emotional outlook on life, have friends who are obese and indicate an understanding of the experience of obesity are much less likely to have a weight bias.17 Even if you doctor fits this profile, unfortunately there’s no way to be sure.

If you suspect that your doctor may have a weight bias, ask for a referral to a new doctor from the office of a good local weight loss surgeon. Not only do good bariatric surgeons tend to partner with doctors who are more knowledgeable about caring for obese patients, but they also work with doctors who are empathetic towards the difficulties of being obese.

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3. Avoiding Obesity Discrimination in Education

If you have an obese child, especially an obese girl, and you have a choice in school systems, the research suggests that your child will be more likely to succeed in schools where obesity is more common.

When making a decision about where to live, visit the schools that your child may attend and observe the students. All else being equal consider choosing the school with the higher percentage of overweight students.

For more information about adolescent and childhood obesity, see our pages on Teen Obesity and Adolescent Bariatric Surgery and Child Obesity Statistics and Teenage Obesity Statistics.

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4. Avoiding Obesity Discrimination While Dating

If you find that your weight is getting in the way of your romantic relationships, there are two options that may help:

  • Consider dating partners who are also overweight or obese
  • Choose partners who are willing to get to know you as a person before judging you only by your appearance

Both of the above are easily made possible through the use of a good online dating service, where you can browse profiles of others from the comfort of your own home.

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References

  1. Rebecca Puhl, PhD. Weight Discrimination: A Socially Acceptable Injustice. Obesity Action Coalition. Available at: http://www.obesityaction.org/magazine/oacnews12/obesityanddiscrimination.php
  2. Mark V. Roehlinga. The relationship between body weight and perceived weight-related employment discrimination: The role of sex and race. Journal of Vocational Behavior. Volume 71, Issue 2, October 2007, Pages 300-318
  3. Charles L. Baum II, William F. Ford. The wage effects of obesity: a longitudinal study. Health Economics, Volume 13, pgs 885-899. 2004.
  4. John Cawley. The Impact of Obesity on Wages. The Journal of Human Resources, Vol. 39, No. 2, pp. 451-474. University of Wisconsin Press. 2004.
  5. Kaan Tunceli, Kemeng Li, L. Keoki Williams. Long-Term Effects of Obesity on Employment and Work Limitations Among U.S. Adults, 1986 to 1999. Obesity (2006) 14, 1637–1646; doi: 10.1038/oby.2006.188.
  6. Bertakis, Azari, Obes Res 2005;13(9):1613-23 (AHRQ grant HS06167)
  7. Foster GD, et al. Primary Care Physicians' Attitudes about Obesity and Its Treatment. Obesity Research (2003) 11, 1168–1177; doi: 10.1038/oby.2003.161
  8. M R Hebl, J Xu. Weighing the care: physicians' reactions to the size of a patient. August 2001, Volume 25, Number 8, Pages 1246-1252.
  9. Fogelman Y, et al. Managing obesity: a survey of attitudes and practices among Israeli primary care physicians. October 2002, Volume 26, Number 10, Pages 1393-1397.
  10. Nina Karnehed, Finn Rasmussen, Tomas Hemmingsson, Per Tynelius. Obesity and Attained Education: Cohort Study of More Than 700,000 Swedish Men. Obesity (2006) 14, 1421–1428; doi: 10.1038/oby.2006.161
  11. Wardle, Jane, Waller, Jo, Jarvis, Martin J. Sex Differences in the Association of Socioeconomic Status With Obesity. Am J Public Health 2002 92: 1299-1304
  12. Crosnoe R. Gender, obesity, and education. Sociol Educ. 2007;80:241-260.
  13. Russell M Viner, Tim J Cole. Adult socioeconomic, educational, social, and psychological outcomes of childhood obesity: a national birth cohort study. BMJ 2005;330:1354
  14. Eunice Y. Chen, Molly Brown. Obesity Stigma in Sexual Relationships. Obesity Research (2005) 13, 1393–1397; doi: 10.1038/oby.2005.168
  15. Sankar Mukhopadhyay. Do women value marriage more? The effect of obesity on cohabitation and marriage in the USA. Review of Economics of the Household, Vol 6, Issue 2, pgs 111-126. June 2008.
  16. E. Logue, K. Sutton, D. Jarjoura and W. Smucker Department of Family Practice, Summa Health System, Akron, OH. Obesity management in primary care: assessment of readiness to change among 284 family practice patients. Jour Am Board of Fam Medicine. Vol 13, Issue 3 164-171, 2000.
  17. Schwartz MB, Chambliss HO, Brownell KD, Blair SN, Billington C. Weight bias among health professionals specializing in obesity. Obes Res. 2003 Sep;11(9):1033-9.
Disclaimer: The information contained in this web site is provided for general informational purposes only. It is not intended as nor should be relied upon as medical advice. Rather, it is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her existing physician(s). Before you use any of the information provided in the site, you should seek the advice of a qualified medical, dietary, fitness or other appropriate professional. Read More