Today is World Mental Health Day. This year’s theme is ‘Make mental health and well-being for all a global priority’. If we are serious about prioritising mental health and wellbeing for all, one place we can start is by eliminating fatphobia.
In far too many places around the globe, it remains socially acceptable to publicly shame, harass and discriminate against fat people because of their weight. To state the obvious, shame, harassment and discrimination negatively impact mental health and have no place in efforts to promote health.
Fatphobia is pervasive worldwide. Studies show that fat people experience discrimination in employment, education, media, interpersonal relationships, politics and especially health care. Despite these findings, fatphobia is rarely seen as an important social justice issue and global social problem. This is because, unlike other marginalised identities, we are taught to think of fat as a ‘choice’, and more to the point, a bad choice. In many countries, fat bodies are viewed exclusively through medical and public health frameworks that label fat bodies as diseased and therefore in need of prevention, intervention and cure, regardless of the risks involved. This creates an environment in which fat people are blamed for their own oppression and makes it socially acceptable to censure, intimidate, harass and discriminate against fat people because of their weight. In this context, fat people are viewed as ‘the problem’, while fatphobic policies, practices and institutions that regularly harm (and even kill) fat people are seen as acceptable or even justified. There are several potential avenues where progress can be made in the quest to eliminate fatphobia. We focus on three broad areas that are strong targets for initial interventions: (1) education; (2) public health; and (3) policies and laws.
Efforts to reduce fatphobia must start early. One place children learn fatphobic attitudes is schools. To combat fatphobia, school districts should eliminate any policies, practices and/or curricula that equate weight with health and frame weight control as a health behaviour. When required by law, school wellness programmes should be based on weight-neutral approaches, such as the principles of Health at Every Size(R), and include media literacy training that promotes an inclusive view of all body types. We also need to support legislation that prevents weight bias and eating disorders in schools. Finally, a critical weight studies curriculum that problematises the medicalisation and pathologisation of fat bodies should be a part of any college or university degree that already considers other forms of prejudice and oppression.
When it comes to addressing fatphobia in public health, we need to shift the focus away from problematising fat bodies to problematising fatphobia. Ceasing to run blatantly fatphobic public health campaigns is an important first step. In fact, public health campaigns do not need to mention weight at all. Coursework in critical weight studies is also imperative for any programme that trains health care professionals given fatphobia has been documented across multiple specialties, including primary care physicians, gynaecologists and obstetricians, paediatricians, nurses, pharmacists, nutritionists and dietitians, psychotherapists and physiotherapists as well as providers specialising in the care of higher-weight patients. Finally, funding bodies should consider allocating additional money for rigorous exploration of weight-neutral approaches. Such funding would enable larger trials, longer follow-up periods and the development and evaluation of scalable intervention programmes. These research endeavours are needed if the weight-neutral perspective is to grow into feasible and sustainable public health policies that eliminate fatphobia and promote health equity for all.
In addition to addressing fatphobia in education and public health, we also need to enact policies and laws that protect fat people from discrimination. Currently, there are only two states in the US, Michigan and Washington, and a few cities, including San Francisco, Santa Cruz, Binghamton and Washington, DC, that have antidiscrimination laws based on weight. In the Australian state of Victoria, physical appearance is legally protected from discrimination. However, there is no country in the world with a national law that reliably protects fat people from discrimination. In the absence of these laws, some have tried to file claims of weight discrimination based on disability discrimination law, but this has rarely been successful because fatness is not typically defined as a disability. A suitable antidiscrimination law would not only guarantee that fat people have a right to equal treatment (for example, in the workplace), but also have a right to suitable accommodation (such as an accessible office chair). Finally, legislation change at the national level is often slow, but gains can be made in the meantime at state and local levels. In sum, solving the problem of fatphobia will not be easy but it is achievable if we are willing to exert the political will and direct the resources necessary to do so. On World Mental Health Day, let’s commit to doing both.
Laurie Cooper Stoll is Professor of Sociology in the Department of Sociology and Criminal Justice at the University of Wisconsin La Crosse, Angela Meadows is a Lecturer in the Department of Psychology at the University of Essex, and Stephanie von Liebenstein is Founder and Vice-President of the Association Against Weight Discrimination in Germany. All are contributors to the Global Agenda for Social Justice 2.
Global Agenda for Social Justice 2 edited by Glenn W. Muschert, Kristen M. Budd, Heather Dillaway, David C. Lane, Manjusha Nair and Jason A. Smith is available on the Bristol University Press website. Order here for £14.99.
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