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date: 22 April 2018

Weight and Weightism

Summary and Keywords

Weight-based stigma is pervasive and is propagated via sociocultural and interpersonal messages that influence individuals’ identity. The ideals communicated in these messages place disproportionate value on appearance and have made weight an important component of attractiveness. Some cultures, particularly Western culture, hold a bias toward thin bodies and promote a bias against those who do not fit cultural ideals of slender or lean body shapes. This bias, judgment, stigma, prejudice, and discrimination toward individuals based on their size, shape, or weight is known as weightism. Most of the research regarding weightism has been conducted on obesity and overweight individuals because of the related public health concerns. However, because weight is a continuum on which individuals are frequently evaluated, stigmatization is experienced by individuals who are either over or under cultural norms for appropriate weight and toward those who engage in deviant weight-control behaviors (e.g., purging). Thus, because individuals with eating disorders are often underweight and have deviant eating behaviors, they also experience weight-based stigma and discrimination. There are a multitude of negative effects associated with being a part of these stigmatized weight groups, including lower self-esteem, less social confidence, greater body dissatisfaction, poorer mental health, and increased substance use and self-harm behaviors. These negative outcomes create a social divide between the stigmatized weight groups and others, wherein stigmatized individuals turn to negative health behaviors (e.g., bingeing and purging) in an effort to cope with their negative social experiences. Subsequently, they perpetuate their affiliation with their stigmatized weight group and the related health conditions.

Keywords: weightism, weight bias, anti-fat attitudes, weight stigma, obesity, overweight, eating disorders, anorexia nervosa, bulimia nervosa, binge eating disorder, intergroup communication

Weight and Weightism

The way one comes to understand, interpret, evaluate, and categorize his or her body depends largely on sociocultural ideals and pressures (Calogero, Boroughs, & Thompson, 2007; Levine & Smolak, 2006a; Swami, 2015; Thompson, Heinberg, Altabe, & Tantleff-Dunn, 1999). Sociocultural theories regarding body image are centered on the idea that cultural factors regarding weight, appearance, and beauty are transmitted via sociocultural agents, including the mass media, family, and peers/friends. Such ideals vary by culture, wherein Western culture (e.g., United States, Canada, Australia, Iceland, Britain, New Zealand) tends to idealize thin bodies and non-Western culture (e.g., Kenya, Ghana, Tonga, Samoa, Tahiti, Nauru, South Africa, and Mauritania) tends to value larger figures (Brewis & McGarvey, 2000; Frederick, Forbes, & Berezovskaya, 2008; Rguibi & Belahsen, 2006; Smith, Cornelissen, & Tovee, 2007; Swami, 2007; Swami, Antonakopoulos, Tovee, & Furnham, 2006). Westernization (i.e., the process by which societies adopt Western values) and modernization (i.e., the transition to a more modern society from a more traditional society via urbanization, industrialization, and education), however, have contributed to the globalized preference for thinness (Swami, 2015). Nevertheless, although there is more global homogeneity in body size ideals, Western culture tends to endorse unrealistically attainable thin ideals (e.g., Yang, Gray, & Pope, 2005) while simultaneously stigmatizing and discriminating against fat bodies (O’Brien, Latner, Ebneter, & Hunter, 2013; Puhl & Brownell, 2001), creating disproportionate cultural value for and prejudice against different weight groups and categories in these cultures (Crandall et al., 2001; Yamaoka & Stapleton, 2016).

As such, individuals’ appearance, body, and weight have become the basis of evaluation and categorization by oneself and by others, particularly in Western culture. Weight as it relates to group membership and categorization is interesting for a couple of reasons. First, weight is a topic that people frequently talk about. In doing so, individuals heighten the salience of their own and others’ weight categories. These conversations are usually in the form of negative evaluations of self and others, which allow people to distance themselves from groups to which they do not want to belong and shame those who belong to the undesired group. Next, people can move in and out of different weight groups (unlike other group memberships, such as ethnicity/race), so there is a perceived sense of controllability and blame associated with one’s weight status. Dieting and weight-loss companies, which are multi-billion-dollar industries (Marketdata Enterprises, Inc., 2017), perpetuate and benefit from this perceived controllability and blame. Also, unlike other group memberships, different weight groups, particularly those on the extreme ends of the weight spectrum (i.e., emaciation, obesity), often have legitimate health issues associated with them (e.g., diabetes, hypertension, cardiovascular disease, depression, anxiety). And, lastly, there is stigma and discrimination associated with different weight groups. In the United States, for example, weight-based discrimination has increased substantially and now has similar rates to that of racial discrimination because of the overt, expressible, and widely held beliefs about weight (Andreyeva, Puhl, & Brownell, 2008; Crandall, 1994).

This chapter focuses on the latter aspect of weight-based group categorization due to the maltreatment and adverse consequences that result from belonging to a stigmatized weight group (e.g., Puhl & Heuer, 2010; Puhl, Moss-Racusin, Schwartz, & Brownell, 2008; Puhl & Suh, 2015). Specifically, the article discusses the bias, judgment, stigma, prejudice, and discrimination toward groups and individuals based on their size, shape, or weight—i.e., weightism (also known in the literature as weight bias, anti-fat attitudes, sizeism, weight stigma, fat stigma, anti-fat prejudice, obesity stigma; Brownell, Puhl, Schwartz, & Rudd, 2005; Miyairi & Reel, 2011). Most of the research regarding weightism has been conducted on overweight/obese individuals because of the related public health concerns (Ebbeling, Pawlak & Ludwig, 2002). However, because weight is a continuum on which individuals are frequently evaluated (Puhl & Heuer, 2010), stigmatization is experienced by individuals who are either over or under cultural norms for appropriate weight and directed toward those who engage in deviant weight-control behaviors (e.g., purging; Bento, White, & Zacur, 2012; Roehring & McLean, 2010). As such, research on individuals with eating disorders is also integrated throughout this chapter as a way to exemplify another stigmatized weight group in addition to the overweight/obese group, as both groups face judgment and stigma regarding their weight (Bento et al., 2012; Granberg, 2011; Yeshua-Katz, 2015). Perhaps more importantly, for both of these weight groups, weight-based stigma has been associated with poor mental, physical, and emotional outcomes above and beyond the medical conditions inherent in their weight conditions (Ebneter, Latner, & O’Brien, 2011; Papadopoulos & Brennan, 2015; Westermann, Rief, Euteneuer, & Kohlmann, 2015).

We begin by defining overweight/obesity and eating disorders. We then discuss how individuals are socialized into and about weight groups, namely through the media, family, and peers/friends. Next, we discuss weight and identity, including weight-based stigma and discrimination toward overweight/obese individuals and individuals with eating disorders and their ensuing effects. Lastly, we discuss how individuals socially construct and perpetuate weightism through weight-related discourse and interactions. We should note here that we generally focus on and utilize research regarding Western culture’s preference for thin bodies and bias toward fat bodies due to the (1) wealth of studies that provide evidence for the myriad of negative consequences associated with weightism and (2) prevalence of extreme and unattainable beauty/weight ideals (e.g., Bucchianeri, Eisenberg, Wall, Piran, & Neumark-Sztainer, 2014; Ebneter et al., 2011; Sutin, Stephan, & Terracciano, 2015). Because some countries/societies in non-Western culture hold this same preference (e.g., China, South Korea; Wright et al., 2016), the issues prevalent in Western culture may potentially apply outside of Western culture as well. Thus, we do not make explicit cultural differentiations here.

Definitions and Differences in Weight Groups

Despite the subjective and cultural nature of weight ideals, there are objective ways in which individuals are categorized into weight groups. One way to categorize weight groups is to calculate one’s body mass index (BMI), which is computed using an individual’s height and weight (Centers for Disease Control and Prevention, 2017). Individuals who are underweight have a BMI less than 18.5, normal-weight individuals have a BMI of 18.5–24.9, overweight individuals have a BMI of 25.0–29.9, and obese individuals have a BMI of 30 or higher. We will be discussing here individuals who are perceived to be overweight or obese. Additionally, there are three specific forms of eating disorders and individuals are categorized as such using the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5). First, individuals with anorexia nervosa tend to have significantly low body weights due to their distorted body perceptions and extreme fears of weight gain. Such body image disturbance usually results in self-induced starvation and other behaviors that prevent weight gain. Second, bulimia nervosa is a condition whereby individuals binge-eat more than the recommended amount (Killian, 1994; Mayo Clinic, 2016) and then regulate the excess caloric intake through purging (e.g., self-induced vomiting, use of diet aids or laxatives, fasting, strict dieting, or excessive exercising to control weight and weight gain). Compared to people who have never had an eating disorder, those with bulimia nervosa have significantly higher BMIs and are less likely to be underweight or of normal weight (Kessler et al., 2013). Third, individuals with binge eating disorder also engage in frequent episodes of binge eating but without the compensatory behaviors associated with bulimia nervosa. Instead, during their binge eating episodes, they eat until they are uncomfortably full, eat in large quantities even if they are not hungry, and eat alone out of embarrassment, among other behaviors. Similar to bulimia nervosa, those with binge eating disorder have significantly higher BMIs and are less likely to be underweight or of normal weight compared to individuals who never had an eating disorder (Kessler et al., 2013). Although we will discuss individuals with eating disorders as one group, we acknowledge that the conditions and experiences of those who have one of the specific eating disorders (as well as those diagnosed with an eating disorder not otherwise specified) are not identical.

The issue of gender/sex is one way in which the different weight groups are similar to one another. The evaluation of appearance and the impact of weight-based stigma is disproportionately higher for women than for men (Fikkan & Rothblum, 2012; Puhl & Brownell, 2001), and men are more likely to feel and express stronger anti-fat bias than women (Fontana, Furtado, Marston, Mazzardo, & Gallagher, 2013; Schvey, Puhl, Levandoski, & Brownell, 2013). The differing experiences between men and women are grounded in the assumption and supported by empirical evidence that weightism occurs in sociocultural contexts that objectify the female body—i.e., “women are treated as bodies—and in particular, as bodies that exist for the use and pleasure of others” (Fredrickson & Roberts, 1997, p. 175). Consequently, obese/overweight women receive more negative treatment, attitudes, and discrimination than men (Bento et al., 2012; Puhl et al., 2008), and clinical eating disorders are also disproportionately higher among women/girls than men/boys (Hudson, Hiripi, Pope, & Kessler, 2007; Merikangas et al., 2010). That being said, men also experience objectification (Grieve & Helmick, 2008; Wiseman & Moradi, 2010) as well as negative outcomes if they are overweight/obese or have an eating disorder (e.g., Bucchianeri et al., 2014; Chen et al., 2007; Schvey et al., 2013). Thus, the effects of being overweight/obese or having an eating disorder, regardless of gender/sex, are the focus of this chapter because all stigmatized individuals are undesired and mistreated (Goffman, 1963).

Although both of these groups are stigmatized and discriminated against, the experiences of being overweight/obese and having an eating disorder are not identical. For instance, one way in which overweight/obese individuals and those with eating disorders may differ is by the concealability of their stigmatized identity. Being able to conceal a stigmatized condition is necessary for individuals to avoid social isolation and negative attitudes from non-stigmatized others (Smith, 2007). Although overweight/obese individuals might attempt to minimize their appearance through the way they dress, for example, they are unable to completely conceal their stigmatized status. This makes it particularly difficult for overweight/obese people to navigate social interactions and to avoid others’ stigmatizing attitudes and discrimination (Bento et al., 2012). On the other hand, individuals with eating disorders have a greater likelihood of concealing their stigmatized identity (Chang & Bazarova, 2016; Goffman, 1963). Hiding or minimizing disordered eating behaviors protects them from the stigmatizing views of others and allows them to choose when and to whom to reveal their stigmatized identity (Chang & Bazarova, 2016; Yeshua-Katz, 2015). Thus, for individuals with eating disorders, it is possible to conceal their disordered eating identity, yet overweight/obese individuals generally cannot do the same.

That being said, eating disorders do not discriminate by weight status: depending on the eating disorder, an individual can potentially be underweight (anorexia nervosa), overweight/obese (binge eating disorder/bulimia nervosa), and anywhere in between, so it is entirely possible for individuals to carry multiple stigmatized identities regarding weight. For this reason, we discuss these groups as separate identities, wherein eating disorders are discussed as a way to highlight stigmatized identities regarding deviant eating behaviors and mental health status and overweight/obesity in relation to objective weight status. This is not to say that the ensuing effects of carrying multiple stigmatized identities will be similar to those with singular and/or different combinations of weight-stigmatized identities. Because of this, we are not in a position to equate or rival the experiences of overweight/obese individuals to those of individuals with eating disorders. In fact, because there is no one body type associated with having an eating disorder, by grouping all individuals with eating disorders together, we are knowingly confounding the issue of objective weight. Instead, the aim of this chapter is to identify the ways in which weight, in general, is a category in which individuals are evaluated and criticized.

Weight Socialization

Preference for thin and bias against overweight/obese individuals is robust throughout the life span. Some research indicates that weightism develops in children as young as 2.5–3 years old (Miyairi & Reel, 2016; Ruffman, O’Brien, Taumoepeau, Latner, & Hunter, 2016) and continues into adulthood (Brochu & Morrison, 2007). This is not surprising given the overwhelming number of overt and critical weight-related messages one encounters. In line with sociocultural theories of body image (Calogero et al., 2007; Thompson et al., 1999), this section identifies the media, family, and peers/friends as key sociocultural agents that beget weightism.

Media

The media is thought to be an aggressive purveyor of weight-related norms and serves as a cultural indicator of beauty and attractiveness. Generally, images of thin women and muscular men dominate mainstream media (e.g., magazines, social media, television, advertisements) with very few portrayals of diverse body types. For instance, portrayals of women’s bodies on television are typically thin (76%), and overweight/obese individuals appear seldom (3%–7% of women and 7%–13% men are overweight; Fouts & Burggraf, 1999, 2000; Greenberg, Eastin, Hofschire, Lachlan, & Brownell, 2003). Because individuals aspire to look like those they see in the media (Field, Camargo, Taylor, Berkey, & Colditz, 1999), the lack of diversity and emphasis on thin bodies can be problematic. For example, research indicates that the amount of time one is exposed to thin images in the media and the tendency to try to look like those in the media is linked to eating disorders and their related behaviors, cognitions, and attitudes (Calogero et al., 2007; Field et al., 1999; Harrison, 2000; Martinez-Gonzalez et al., 2003). The media also shapes perceptions of eating disorders. O’Hara and Smith (2007) reported that newspapers construct eating disorders as a female issue (approximately 95% of articles), with some articles stating that it was only a female issue. Additionally, these articles were unlikely to discuss the clinical implications of (11% mentioned), treatment for (21% mentioned), or physical effects related to eating disorders, and only 10% of articles stated that medical attention was necessary for successful recovery (O’Hara & Smith, 2007). The minor attention to the adverse effects of and strategies necessary to treat eating disorders reinforces the view that eating disorders are controllable, benign or rewarding, and possibly a tool for some to maintain thinness. Thus, the media may be promoting unhealthy eating behaviors and perceptions that achieving the ideal weight is normal and rewarding.

The negative consequences of thin images and the lack of diversity of weight-group depictions in the media also extend to overweight/obese individuals. For instance, although media portrayals of overweight/obese individuals are scarce (Greenberg et al., 2003), weight-based stigma in the media is frequent and overt, and overweight/obese characters usually are presented at their own expense. In fact, a content analysis of television programs revealed that, in a variety of different stigmatizing incidents, approximately one-third of them were coded as weight- or appearance-related (Eisenberg, Carlson-McGuire, Gollust, & Neumark-Sztainer, 2015). Notably, these incidents were in reference to overweight and normal weight characters (Eisenberg et al., 2015), suggesting that negative weight-related attitudes depicted in the media have the ability to affect different weight groups. Additionally, overweight/obese characters are often the targets of jokes and negative commentary, are ridiculed and insulted, are portrayed less positively, are less likely to be in a romantic relationship, and have fewer positive social interactions (Fouts & Burggraf, 2000; Greenberg et al., 2003; Himes & Thompson, 2007). Such representations reinforce cultural norms and categorize individuals into different, and preferred, weight groups. As such, the overt weightism in the media tends to endorse the thin ideal, promote stereotypes about certain weight groups, and exacerbate displeasure with one’s weight status.

Family

Although both obesity and eating disorders are thought to be hereditary (Helder & Collier, 2011; Walley, Blakemore, & Froguel, 2006), the family plays an important role in teaching and encouraging attitudes and behaviors directly related to body weight, including weight-related ideals and biases. A substantial amount of research has explored the influence of the family on eating disorders and its related behaviors, particularly how children model the attitudes, beliefs, and behaviors of their parents (e.g., Arroyo & Segrin, 2013; Cooley et al., 2008; Kluck, 2010; Neumark-Sztainer et al., 2010). For instance, a weight-centric family environment (i.e., families highly concerned with eating patterns and weight) and parental weight talk (i.e., a parent commenting on his or her own weight) are associated with body dissatisfaction and disordered eating (Kluck, 2010; Neumark-Sztainer et al., 2010). Additionally, open discussion about weight loss, including criticism, teasing, and encouragement to lose weight, are consistent predictors of eating problems, dieting, a drive for thinness, body dissatisfaction, and disordered eating symptomotology (Kluck, 2010; Levine, Smolak, & Hayden, 1994; Neumark-Sztainer et al., 2010; Vincent & McCabe, 2000). This research on eating disorders in the family indicates that the family can play a vital role in the perpetuation of societal pressures regarding thinness.

Research also finds that children’s negative attitudes toward overweight/obese people resemble those of their parents (Holub, Tan, & Patel, 2011; Rich et al., 2008), demonstrating that the family is also a place where individuals learn to be prejudicial and discriminate against different weight groups. This bias is likely indirectly learned by observing parents making negative remarks about their own and others’ weight (Haines, Neumark-Sztainer, Hannan, & Robinson-O’Brien, 2008). It is likely also learned by experiencing stigma within the family through negative comments, teasing, ridicule, and name-calling (Puhl & Heuer, 2009). A majority of overweight women report that members of their family are the most frequent sources of weight-based stigma, particularly their mothers (53%) and fathers (44%) (Puhl & Latner, 2007). Moreover, negative commentary within the family, regardless of weight, is quite hurtful to those receiving it and puts them at higher risk of developing eating problems, including disordered eating, a drive for thinness, and body dissatisfaction (e.g., Benedikt, Wertheim, & Love, 1998; Vincent & McCabe, 2000; Wertheim, Martin, Prior, Sanson, & Smart, 2002). In contrast, supportive and warm relationships serve as protective factors against unhealthy weight statuses: higher family functioning and high-quality mother and father relationships are associated with lower odds of becoming obese and developing disordered eating behaviors (Haines et al., 2016). Thus, communication within the family socializes individuals toward certain weight-related biases and can categorize, protect, or shame one’s current weight status.

Peers/Friends

Weight also plays a significant role in peer relationships, as a meta-analysis finds that peers/friends, especially best friends and same-sex friends, may be the most influential agents in weight (Cunningham, Vaquera, Maturo, & Narayan, 2012). Victimization and teasing are the most researched area of peer body image (given that peers and friends are the primary source of both victimization and teasing (Webb & Zimmer-Gembeck, 2014), but peer influence occurs in less aggressive ways. For instance, many individuals perceive that their peers value thinness and therefore hope to achieve peer acceptance by conforming to those ideals (Webb & Zimmer-Gembeck, 2014). Peers also socialize individuals toward weight ideals via modeling, peer pressure, and social comparison, but one particular way in which peers socialize weight-related ideals is through fat talk—i.e., the negatively valenced everyday conversations people, especially girls and women, have with each other about their bodies (e.g., “I’m so fat!” “Does this make my butt look big?”) (Martz, Petroff, Curtin, & Bazzini, 2009; Nichter & Vuckovic, 1994). In these social encounters, fat talk has been suggested to serve several functions, such as participating to “fit in,” to obtain social validation from others, to establish a group identity, and to manage a woman’s impression during conversation (Britton, Martz, Bazzini, Curtin, & LeaShomb, 2006; Nichter, 2000; Tucker et al., 2007). Although engaging in fat talk is a social norm and is thought to be innocuous, fat talk is predictive of higher levels of depression, perceived pressure to be thin, body dissatisfaction, body shame, and eating disorder symptoms (Arroyo & Harwood, 2012; Clarke, Murnen, & Smolak, 2010; Ousley et al., 2008; Salk & Engeln-Maddox, 2011; Sharpe, Naumann, Treasure, & Schmidt, 2013). Thus, peer/friendship groups also tend to promote and perpetuate the thin ideal.

Peer relationships are influential in overweight/obese individuals’ lives as well, especially for children and adolescents. Although children of all sizes suffer from weight-based discrimination, being overweight/obese can disrupt peer relationships during childhood because position and value within peer networks are often influenced by physical appearance and weight status. Thin and normal-weight children are more likely to be valued and take the central position of the group, whereas overweight/obese children are less valued and tend to be marginalized by peers (Gray, Kahhan, & Janicke, 2009). Holding a periphery status in one’s peer group may lead to adverse effects for overweight/obese children, such as decreasing his or her likelihood of spending time with friends (Gray et al., 2009). During adolescence, much of the harassment individuals experience is weight-based, but male and female adolescents are victimized by weight discrimination in different ways: overweight female adolescents are more likely to be subjected to and enact relational forms of aggression (e.g., teasing, name-calling, social exclusion), whereas overweight male adolescents are more likely to encounter and perpetrate overt physical aggression (e.g., pushing, hitting) (Gray et al., 2009). Unfortunately, being the victim of weight-based discrimination increases feelings of shame about one’s weight status and inhibits one’s development of relational closeness with others (Westermann et al., 2015). Additionally, weight-related criticism and teasing have long-standing effects, wherein teasing at younger ages longitudinally predicts later-life body dissatisfaction (Anderson, Bresnahan, & DeAngelis, 2014; Lieberman, Gauvin, Bukowski, & White, 2001). As such, relationships, status, and communication within peer groups socialize individuals to value one’s own and others’ appearance and weight.

Weight and Identity

People’s identity (i.e., the specific conceptualization of self that is operating in a given context) operates at different levels of abstraction (e.g., social identity, individual), and people categorize themselves and those around them at these levels. Whereas operating in terms of social groups and broader categorizations (e.g., fat, skinny) is considered the social identity level, the individual level refers to when one is operating in terms of one’s own unique attributes and roles (e.g., self-esteem, body image; Arroyo & Harwood, 2014). Although identity has been studied extensively as a psychological phenomena (e.g., Tajfel & Turner, 1986; Turner, Hogg, Oakes, Reicher, & Wetherell, 1987), communication scholars specify mutual influences between identity and communication and the interpenetration of different identity levels (Hecht, 1993). This approach indicates that communication is not merely a product of psychological categorization processes but, rather, underscores that identity is fundamentally formed, reformed, and manifested at different levels in communication (Arroyo & Harwood, 2014; Hecht, Jackson, & Pitts, 2005). The following section discusses weight groups at the social identity level and then discusses the effects of weight categorizations at the individual level.

Weight at the Social Identity Level

Pervasive messages about weight often lead to implicit and explicit categorizations of individuals into weight groups. As a result, there are agreed-upon beliefs about and expectations for people in certain groups, and there is often a hierarchy of preferred and less valued groups. In this section we discuss how others perceive and treat individuals based on weight-based social norms and group characteristics, namely via stigma, stereotypes, and discrimination.

Stigmatized individuals often exhibit physical markings that disrupt the “normal” or culturally accepted aesthetic of physical form and appearance (Smith, 2007). Being overweight/obese is considered unwanted and unattractive because it is in conflict with cultural norms promoting the thin ideal (Black, Sokol, & Vartanian, 2010). Individuals who are extremely under the social norms regarding weight or deviate in their weight-related behaviors (e.g., bingeing and purging) are also stigmatized. As a result, overweight/obese individuals lack full social acceptance and experience social distancing from others, and individuals with eating disorders face social isolation and interpersonal difficulties (Chang & Bazarova, 2016; Ebneter et al., 2011; Granberg, 2011; Stewart, Keel, & Schiavo, 2006; Yeshua-Katz, 2015).

In both cases, the weight group encounters unique stereotypes and prejudices from others. Negative beliefs surrounding both overweight/obese individuals and individuals with eating disorders are promoted by cultural views of individual responsibility and self-discipline (Blaine & McElroy, 2002; Mond, 2013). In particular, the common beliefs about overweight/obese people are that they are friendless, lonely, shy, unhealthy, smelly, unhappy, and less intelligent than their normal-weight counterparts (Bento et al., 2012; Murray, 2005; O’Brien et al., 2013). Due to the perceived controllability of having excess weight, the main assumptions about overweight/obese people are that they are lazy or in need of self-control (Black et al., 2010; Blaine & McElroy, 2002; Ebneter et al., 2011). Additionally, a common stereotype for eating disorders is that they mainly affect young, white women (Giles, 2006; Gordon, Perez, & Joiner, 2002; O’Hara & Smith, 2007), and individuals with eating disorders are assumed to be “vain, self-centered, fragile, unreliable, attention-seeking, and annoying” (Mond, 2013, p. 1). The main stereotypes made about individuals with eating disorders are that they have control over the onset, management, and offset of their condition (Crisp, Gelder, Rix, Meltzer, & Rowlands, 2000; Roehring & McLean, 2010; Stewart, Schiavo, Herzog, & Franko, 2008).

Stigma and stereotyping often lead to discrimination, which refers to negative communication toward individuals or groups that excludes them from equal treatment (Bento et al., 2012; Brewis, 2014). Weight discrimination occurs through structural constraints, such as chairs not being large enough for overweight/obese individuals, as well as in interpersonal interactions, such as peer victimization and workplace teasing (Brewis, 2014). Interpersonal discrimination is driven by cultural weight expectations, such that individuals who endorse the thin ideal are more likely to reward those who fit societal weight standards and discriminate against those who do not during interpersonal interactions (O’Brien et al., 2013). Bento and colleagues (2012) describe three forms of interpersonal discrimination that can be applied to weight-based discrimination. First, blatant discrimination is overt and often intentional, taking the form of weight- or appearance-related teasing or aggression (e.g., calling someone “fatty,” pushing or hitting). Second, negative actions may be enacted less explicitly through subtle discrimination. This form of discrimination consists of communication and behaviors that are less visible and more covert, may be intentional or unintentional, and are driven by outgroup aversion. These behaviors may take the form of condescension, friendly harassment, and exclusion, which allow the perpetrator to rationalize his or her act as not being overt discrimination. Third, covert discrimination is intentionally perpetrated and is defined as the negative, unfair, or biased acts committed under false pretenses that make it seem as though it is not committed out of prejudice (e.g., assigning undesirable tasks and withholding opportunities because of a person’s weight). All three forms can occur in interpersonal interactions and can also be pervasive in multiple contexts and experiences.

Discrimination based on weight is particularly evident for overweight/obese individuals in multiple domains, including education, the workforce, and healthcare. In education, teachers often report neutral explicit attitudes (Greenleaf & Weiller, 2005) but also hold strong implicit anti-fat attitudes toward their students (Fontana et al., 2013). These implicit attitudes may manifest toward overweight/obese students in subtle ways, such as having lower expectations, being slightly less friendly, and interacting less frequently with them than with normal-weight students. Next, in the workforce, overweight/obese individuals are less likely to be hired and generally have lower wages than their normal-weight counterparts (Fontana et al., 2013). Employers often hold negative views of their overweight/obese employees, including perceiving them to be lazy, incompetent, or emotionally unstable (Glass, Haas, & Reither, 2010). This discrimination tends to be heightened more for women than men (Morris, 2006; Pingitore, Dugoni, Tindale, & Spring, 1994). Lastly, in healthcare, research finds that physicians spend less time with their overweight/obese patients during medical consultations (Foster et al., 2003). Limited care and attention required to fully address patients’ physical conditions or concerns, particularly problems associated with weight, likely create a barrier for overweight/obese individuals to seek help and support in managing their weight-related health concerns. We should note that this discrimination is directed toward and affects both men and women, yet reports suggest that women are targeted more often and more acutely than men for their weight status (Puhl et al., 2008).

When an individual identifies with a stigmatized group, the ensuing stereotypes, discrimination, and the related weightist messages influence his or her individual identity and self-perceptions (Bucchianeri et al., 2014). Individuals make sense of who they are and to which groups they do and do not belong to through a process of self-categorization (Turner et al., 1987). These self-categorizations bring structure to the world and provide norms and behavioral guidelines for individuals in their respective groups (Hogg, 2000). As such, we now turn to weightism and identity at the individual level.

Weight at the Individual Level

Individuals who are overweight/obese or have an eating disorder learn to internalize their devalued labels and experience negative outcomes (Phelan, Link, & Dovidio, 2008). In fact, the effects and perceptions of weight-based stigma are so strong that, in a sample of diverse body types, individuals reported that they would rather give up at least one year of life (46% of respondents), be divorced (30%), give up the possibility of having children, (25%), lose a limb (5%), and be blind (4%) than be obese (Schwartz, Vartanian, Nosek, & Brownell, 2006).

Furthermore, there are a multitude of negative effects associated with being a part of a stigmatized weight group, including lower self-esteem, decreased self-efficacy, less social confidence, greater body dissatisfaction, poorer mental health, and increased substance use and self-harm behaviors (Bucchianeri et al., 2014; Ebneter et al., 2011). Such effects are apparent even after controlling for other possible factors, such as BMI, gender, age, and weight condition onset (Friedman et al., 2005; Rosenberger, Henderson, Bell, & Grilo, 2007). Unfair treatment because of one’s weight also increases one’s risk of mortality (Sutin et al., 2015). In two independent samples, Sutin et al. (2015) found that weight-based discrimination increased overweight/obese individuals’ mortality rate by nearly 60%. They also found that the effects on mortality of weight-based discrimination were stronger than other forms of discrimination, including race, disability, and sexual orientation. Together, these findings suggest that the prejudice, stigma, and discrimination individuals face due to their weight condition might be more harmful than actually being overweight/obese or having an eating disorder.

These outcomes highlight the importance of how communicating about and labeling individuals affects those who identify with the groups being labeled. In line with labeling and modified labeling theory, a label of an undesirable group carries stereotypes about that group that are attached to the person by themselves and by others and can have substantial consequences (Mustillo, Budd, & Hendrix, 2013). Once individuals are labeled as either “obese” or “fat,” for example, their identity and self-perceptions are negatively altered because of the negative attributions associated with those labels (Mustillo et al., 2013). This is also apparent for individuals with eating disorders, as being labeled as someone with an eating disorder is accompanied by the label of being mentally ill. Individuals with mental illness have different standards and expectations imposed upon them that are distinct from the standards of non-mentally ill people (Easter, 2012; Griffiths, Mond, Murray, Thornton, & Touyz, 2015; Yeshua-Katz, 2015). As a result, an individual with a mental illness feels rejected by society, experiences social stress and isolation, and reports that carrying this label is as stigmatizing as being labeled a prostitute, drug addict, or ex-convict (Brand & Claiborn, 1976; Wright, Gronfein, & Owens, 2000).

Because labels carry distinct stereotypes, it is important to understand the attributes associated with the multiple labels used to refer to weight categorizations. Even though there are quantitative and objective differences in weight groups (i.e., people are categorized as either underweight, normal, overweight, or obese in accordance to their BMI), a variety of labels are used to describe individuals of similar groups (e.g., a person with excess weight can be considered fat, overweight, obese, full-figured). The subjective meanings and interpretations of different labels have implications for how people ascribed those labels are perceived. For example, “obese” people are usually rated as least favorable, most disgusting, and least healthy in comparison to other weight groups (Puhl, Peterson, & Luedicke, 2013; Smith, Schmoll, Konik, & Oberlander, 2007; Vartanian, 2010). Additionally, the term “fat” is perceived to be stigmatizing, blaming, and offensive (Lin & Reid, 2009; Puhl et al., 2013) but more favorable and less disgusting than obese (Vartanian, 2010). One pilot study found that participants viewed the term “fat” as offensive, and, as a result, the authors used the term “overweight” in subsequent studies (Lin & Reid, 2009); this might imply that the term overweight is less negatively valenced. Though often the terms “obese,” “fat,” and “overweight” are used interchangeably, some reject the terms “overweight” and “obesity” because these labels have been imposed on individuals with higher body weight by the healthcare industry and the medical field. Instead, activists who promote fat acceptance reclaim the term “fat” as a more positive way to promote diverse body types and to describe bodies that break away from societal ideals of weight (Saguy & Riley, 2005). In line with this, one label that appears to be less stigmatizing is “full-figured.” In comparison to fat, overweight, and obese individuals, those labeled full-figured are perceived to be healthier, less fat, and attractive (Smith et al., 2007). Although there is nuance in the meanings of each of these labels, each one is generally associated with undesirable characteristics. And, perhaps more importantly, the ways in which people label weight groups promotes and reinforces a negative cycle of weightism, which, once in the cycle, proves difficult to exit.

Cycle of Weightism at the Social and Individual Levels

The negative impact of a stigmatized social identity creates a cycle that adversely affects one’s individual identity as well as his and her social and personal relationships and health outcomes. Specifically, weight-stigmatized individuals internalize their stigmatized labels and ultimately report a host of negative self-evaluations and outcomes. These negative evaluations and outcomes create a larger social divide between the stigmatized weight groups and others, wherein stigmatized individuals turn to negative health behaviors (e.g., bingeing and purging) in an effort to cope with their negative social experiences and subsequently perpetuate their affiliation with their stigmatized weight group and the related health conditions. Next, we explain this cycle for both individuals who have an eating disorder and who are overweight/obese.

First, individuals with eating disorders experience stigma due to their appearance and seemingly deviant health behaviors (Roehring & McLean, 2010; Stewart et al., 2008; Swami et al., 2008). Consequently, they experience self-stigmatization, increased shame, poorer mental health, and lower self-efficacy during social interactions with others (Ebneter et al., 2011; Griffiths et al., 2015; Mustillo et al., 2003; Westermann et al., 2015). Because of these negative outcomes and their influence on social interactions, individuals with eating disorders experience social withdrawal, anxiety in social situations, and fear of negative evaluation (Schutz & Paxton, 2007; Zonnevylle-Bender, Van Goozen, Cohen-Kettenis, Van Elburg, & Van Engeland, 2004). Disordered eating behaviors are then used as a compensatory technique for dealing with social incompetence and negative emotions (Holm-Denoma & Hankin, 2010). Unfortunately, these behaviors continue to perpetuate negative self-views and confirm others’ perceptions, ultimately stimulating a downward spiral for individuals who internalize the stigmatized label of having an eating disorder.

Likewise, there is a similar cycle for overweight/obese individuals. There are significant psychological and physical ramifications for overweight/obese individuals because of the stigma attached, including lower self-esteem, poorer mental health, shame and negative self-views, relationship disruption and social isolation, and increased stress (Brewis, 2014; Bucchianeri et al., 2014; Gray et al., 2009; Papadopoulos & Brennan, 2015; Westermann et al., 2015). As a result, overweight/obese individuals often engage in unhealthy eating behaviors, such as overeating and maladaptive dieting, as a means to cope with being the victim of prejudice and discrimination (Brewis, 2014; Himmelstein & Tomiyama, 2015). This ultimately decreases their likelihood to engage in physical activity and exercise and increases the likelihood of gaining weight (Gray et al., 2009; Haines, Neumark-Sztainer, Eisenberg, & Hannan, 2006). This process can begin in childhood and continue into adulthood, such that there is a greater likelihood that children who are obese will also struggle with obesity as adults (Mustillo et al., 2013). Therefore, it seems that the effects of weight-based stigma inhibits overweight/obese individuals’ ability to lose weight and exit their stigmatized identity, so they too are caught in a negative cycle that adversely affects their mental health, physical health, and social relationships.

Communication and Weight Identities

Through communicating with others, people come to develop a shared understanding about reality and themselves. For example, in testing of the contact hypothesis (Allport, 1954), positive interactions with an overweight/obese person decrease thin and normal-weight persons’ negative attitudes, whereas negative interactions lead to increased prejudice and perceptions of controllability (Alperin, Hornsey, Hayward, Diedrichs, & Barlow, 2014). Moreover, all interactions with overweight/obese people increases thin and normal-weight individuals’ body surveillance and body talk (Alperin et al., 2014). Since weight and group membership is fluid, these interactions appear to make weight salient and motivate non-overweight people to consider their position and group affiliation in relation to overweight/obese people as well as evaluate their own risk of becoming part of the stigmatized group.

Because individuals’ identities and interpretations of their identities are influenced by contact and communication (e.g., labeling, social isolation due to stigma), this section discusses social interactions and disclosures about weight as a way in which individuals of different weight groups socially construct the meanings attributed to weight. Such discussions are important to note and further investigate because, by participating in conversations about weight in group settings and interacting with people of other weight groups, “humans, in concert with one another, create symbolic worlds and how these worlds, in turn, shape behavior” (LaRossa & Reitzes, 1993, p. 136).

Communication as a Means of Self-Categorization into Weight Groups

As previously stated, negative attitudes can be applied to oneself when one self-categorizes into a stigmatized group (O’Brien & Hummert, 2006). Communication is a significant part of the self-categorization process, as identity is developed and maintained through communication (Hecht, Jackson, & Pitts, 2005). Individuals talk about themselves and others in terms of categories, and those discussions contribute to the elaboration and reification of the category systems (Reid, Zhang, Giles, & Harwood, 2010).

Weight as a category is a frequent topic of conversation, making it a mechanism through which individuals categorize themselves and others into particular weight groups. Researchers have explored how individuals ritualistically talk about their own and others’ weight (known in the literature as fat talk, negative body talk, weight talk, and appearance-related communication; Arroyo & Harwood, 2012; Engeln-Maddox, Salk, & Miller, 2012; Nichter, 2000), which includes comments about one’s own weight/shape/diet, fears of becoming overweight, and other people’s shape/appearance. Although weight-related communication occurs in people of all different body types, including individuals with eating disorders, individuals of normal weight, and overweight individuals (Martz et al., 2009; Stice, Maxfield, & Wells, 2003), those with eating disorders engage in these conversations more frequently than others (at least once a day; Ousley, Cordero, & White, 2008).

Arroyo and Harwood (2014) theorized the connections between weight-based communication, category systems, and identity. In doing so, they created a typology of comments referencing weight status (e.g., we-talk, talk about groups as abstractions, discussing coping/mobility) and discussed how these comments are related to individuals’ social and personal identities. Although such talk is motivated by individual level characteristics and outcomes (e.g., body dissatisfaction, social comparison, self-objectification), they argued that weight-related communication has implications for how individuals make sense of their weight groups. For example, people sometimes make self-identifying comments about their weight (e.g., “I’m so fat”) or engage in we-talk (e.g., “We’re big and we’re beautiful!”) as announcements of group membership. Both types of talk indicate a sense of collective membership to a group and can also build group solidarity. Making a comment such as “I’m feeling fat today” can be used to establish a group identity because it tends to elicit positive responses from others, which signifies that the group is supportive and cohesive. Such talk is also apparent among individuals with eating disorders in a perhaps more pathogenic form. On pro-anorexia and pro-bulimia websites, individuals establish and share a collective social identity via ingroup support and outgroup denigration (e.g., “It is not us who is at fault, they kill their bodies with fats and grease but we give our bodies nothing at all so, you see, we really are the purest of the pure nothing but skin and bones”; Borzekowski, Schenk, Wilson, & Peebles, 2010, p. 1530). Individuals can also talk about groups as abstractions in a way that groups and group-related phenomena become topics of conversation independent of a specific person (e.g., discussions of obesity as a societal problem, weightist jokes, explicit prejudicial statements). Furthermore, discussing coping/mobility and expression of fears both capture dimensions of weight-related communication as a social identity process wherein individuals talk about moving between categories. The malleability of weight as a category in this way highlights how group members cope with their perceived low status. For instance, trying to move out of a group (e.g., lose weight: “I wish I were skinnier”), creatively interpreting group membership (e.g, “I’ve got more to love”), and even engaging in social competition (e.g., “Large and in charge!”) fall in line with Tajfel and Turner’s (1986) social identity theory.

Toward that end, the ways that individuals discuss their own and others’ weight and associated weight groups are a manifestation of societal ideas about the meaning of weight. Individuals make sense of their social environments through social interactions, wherein reality is reproduced by language and shared meaning (Blumer, 1969; Cooley, 1902; LaRossa & Reitzes, 1993). Weight-related communication is such a common phenomenon in everyday talk (Nichter, 2000) that it is a likely mechanism by which individuals perpetuate and come to understand personal and societal pressures and desires about weight and appearance. For example, by making comments that state one is trying to move out of a group (e.g., “I need to lose weight”), a person is insinuating that his or her current weight status is undesirable and unpreferred and is representing culturally held beliefs about weight. Thus, it is through communication that group members understand, express, and construct the meaning of weight for themselves and their groups.

Communication as a Means of Understanding Permeable Weight Boundaries

Comments that describe change (e.g., “Ugh, I’ve put on so much weight”) undermine the groupness of weight-specific identities, acknowledging the permeable boundaries between different weight categorizations (Arroyo & Harwood, 2014). Sociocultural messages and expectations implicitly and explicitly encourage individuals to shift their weight, wherein the malleability of weight in this way makes it different from other group categorizations. Compared to more rigid group memberships (e.g., race/ethnicity), people move along the weight continuum across their life span—perhaps multiple times in both directions. Additionally, as previously mentioned, weight is associated with multi-billion-dollar industries (e.g., cosmetics, cosmetic surgery, and diet product industries) designed to avoid and alter stigmatized physical signs associated with weight as well as give individuals opportunities to move in and out of weight groups. And, because different weight categories have legitimate health issues associated with them (e.g., obesity is generally understood as a public health concern), individuals are often encouraged to change their weight. In fact, some public health experts endorse weight stigma as a strategy and incentive to reduce obesity, asserting that shaming and blaming overweight/obese individuals will encourage them to lose weight (e.g., Callahan, 2013).

Therefore—and echoing our point about weight-based stigma—one of the major reasons individuals want to change their weight is to reduce the stigma associated with it (Fardouly & Vartanian, 2012; Mattingly, Stambush, & Hill, 2009). Indeed, for many overweight/obese people, it is often believed that losing excess weight will be a “panacea for their problems” (Porter & Wampler, 2000, p. 44). Although some research suggests that moving into a normal weight category improves social outcomes (Rand & MacGregor, 1990), other work indicates that this stigma re-emerges if it becomes known by unaware others that one was previously in a more stigmatized weight group (Levy & Pilver, 2012; Schvey, Puhl, & Brownell, 2014).

The fluctuation of weight, especially in extreme cases, makes communicating about weight and its associated behaviors (i.e., diet and exercise) challenging for people who have changed their weight and moved into a different weight category because they have to manage their new identity and possibly experience residual stigma (i.e., “an invisible mark of shame that can surface if the truth about one’s former deviant trait is discovered or disclosed;” Goffman, 1963, p. 1145; Romo, 2016). Recent work has found that, although some people choose not to disclose their former weight in fear of residual stigma, disclosing one’s previous weight to those who did not know them before generally does not put these individuals at risk of residual stigma; as a matter of fact, there are some positive benefits and reasons to share one’s weight change, including revealing an effort to inspire others and to build relationships via trust (Romo, 2016). Instead, negative judgment from others tends to be experienced by people who knew the person before his or her weight change (i.e., friends, family, colleagues). This stigma stems from the perception that he or she is violating group norms by engaging in behaviors considered too rigid and too healthy and therefore deviant (Romo, 2016). Romo (2017) termed this bias by others as “lean stigma” to refer to “the ways in which lean people are looked down upon for their healthy weight management habits” (p. 24). As a result of this stigma, newly lean individuals need to enact various strategies to reduce the judgment associated with their weight-management behaviors, including avoiding social situations that involve food, strategically and proactively discussing their personal choices, and eating small portions of unhealthy food in the presence of others to assimilate with the in-group. What is interesting about this finding is that, whereas attributions of controllability stimulated weight-based stigma, lean stigma is generated in part for demonstrating that very control (Romo, 2017).

Toward that end, although weight groups are objective to some degree (i.e., using one’s BMI to categorize him or her), weight and its related stigma are socially constructed based on others’ beliefs, judgments, and perceptions (Dovidio, Major, & Crocker, 2000; Neuberg, Smith, & Asher, 2000). Even those who may currently fit cultural standards of normal weight but previously did not (i.e., were overweight/obese or recovered from their eating disorder) face residual effects of being a part of a stigmatized group when interacting with other people. Thus, individuals come to develop a shared understanding about weight and group membership through self-categorization, and it appears as though communication is the mechanism by which they learn to identify and label themselves and other weight groups. It is by understanding more about the personal and social identity processes that propagate weight-related communication that we get closer to understanding precisely how weight is constructed socially.

Discussion of the Literature

Research consistently demonstrates that weight-based stigma is pervasive and is transmitted via sociocultural and interpersonal messages that influences individuals’ identity. The ideals communicated in these messages place disproportionate value on appearance and have made weight an important component of attractiveness, particularly for women. These messages promote unrealistic pressures and standards regarding weight—favoring thin, slender, and lean bodies—and serve to construct an environment of weightist discourse and stigma toward bodies that do not conform to those ideals. As a result, individuals who belong to a stigmatized weight group are subjected to discrimination and experience a host of negative social and health outcomes that often further perpetuate their weight condition. Thus, research regarding weightism should be further explored as an ongoing effort to reduce weight stigma. In this section, we suggest potential areas for future scholarship on communication within, between, and about different weight groups.

This chapter focused on weight stigma for both overweight/obese individuals and individuals with eating disorders because weight is a continuum and stigma is prevalent at both ends; however, research focusing on stigma surrounding eating disorders is sparse. Although people who have eating disorders do face stigma because of their weight condition and eating behaviors, a complete picture of these experiences is needed. Future work on weight bias surrounding eating disorders might investigate the extent and experience of stigma, how internalized stigma influences eating behaviors and psychological distress, and the attitudes and behaviors of mental health professionals and primary care providers toward individuals with eating disorders (Puhl & Suh, 2015). Additionally, research in this area would benefit from comparing the conditions and experiences of both overweight/obese individuals and individuals with eating disorders as a means to promote healthier weight statuses and behaviors for both groups. For instance, although eating disorders are considered a mental illness, being obese is not itself an illness or disease. However, research has shown that there is support for classifying obesity as a disease because it would allow for better access and support (Puhl & Liu, 2015). Just as eating disorders are now viewed as a serious and disabling condition (Mond, Hay, Rodgers, Owen, & Beumont, 2004), classifying obesity as a disease (Jung, 1997) might limit prejudice and discrimination and perhaps promote more positive interactions between individuals of different groups.

Furthermore, although women and men experience obesity at similar rates (Flegal, Carroll, Ogden, & Curtin, 2010), weight is often viewed as a debilitating condition for women. After gender and age discrimination, weight-based discrimination is the third most prevalent cause of perceived discrimination among women (Puhl et al., 2008). And, as previously mentioned, not only do overweight/obese women receive more negative treatment and discrimination (Bento et al., 2012; Puhl et al., 2008), clinical eating disorders are also disproportionately high among girls and women (Hudson, Hiripi, Pope, & Kessler, 2007; Merikangas et al., 2010). For these reasons, it would be beneficial to explore communication regarding weight from a feminist perspective (Fikkan & Rothblum, 2012). Given the disadvantages women inherently face (Jamieson, 1995), weight-based stigma in addition to other sources of discrimination likely have cumulative effects on women’s everyday experiences (Clarke et al., 2010). A feminist perspective would examine the premises upon which women are supposed to prescribe to the social norms of a patriarchal culture, specifically the notion that women should literally and figuratively consume less space (Jamieson, 1995). This is not to say that weight is only a woman’s issue, just that it is disproportionately and unfairly problematic for women compared to men. Classifying weight as a woman’s issue may detract some men from acknowledging and treating conditions related to weight. This might be especially true for men with eating disorders. Because it is a common misconception that eating disorders only affect women, men often do not acknowledge, report, or seek treatment when they have an eating disorder (Drummond, 2002; O’Dea & Abraham, 2002; Strother, Lemberg, Stanford, & Turberville, 2012); however, in the event that they do seek social support from other individuals with eating disorders, it is likely that men will be considered outsiders or “honorary members” (Giles, 2006, p. 472).

Next, although interventions have been formulated and evaluated as ways to reduce weight-based stigma (Gloor & Puhl, 2016; O’Brien, Puhl, Latner, Mir, & Hunter, 2010), further attention to this effort is needed—particularly by communication scholars. First, communication scholars can focus efforts on promoting interactions between and about individuals of the more stigmatized weight groups. Eating disorder therapy, for example, encourages families to increase communication, reduce criticism or hostility, and manage emotion dysregulation as a means of treatment (Stewart, Voulgari, Eisler, Hunt, & Simic, 2015); similar efforts to improve communication skills might prove to be beneficial for overweight/obese individuals. Such interventions might also explore contact with different weight groups as a way to eliminate non-stigmatized individuals’ bias and increase their empathy toward individuals who are overweight/obese or who have eating disorders. Because research finds that the valence of contact interactions matters (Alperin et al., 2014) and weight-stigmatized individuals tend to lack communication competence during interactions (Ebneter et al., 2011; Miller, Rothblum, Barbour, Brand, & Felicio, 1990), these interventions would benefit from teaching social skills and encouraging social interactions for stigmatized individuals as well. Interventions might also include the promotion of more positive talk about different weight groups. Research suggests that just learning that others have positive attitudes toward obese people can improve one’s own attitudes toward obese people (Stangor, Sechrist, & Jost, 2001), even if these positive attitudes are shared in one brief interaction with an unfamiliar person (Zitek & Hebl, 2007).

Lastly, as stated as the onset of this chapter, some countries/societies, such as Tonga, Samoa, Tahiti, Nauru, South Africa, and Mauritania, idealize larger bodies, so future research would benefit from exploring cross-cultural weightism. In cultures that prefer overweight/obese bodies, it would be interesting to explore the extent to which there are negative stereotypes and stigma associated with thin bodies, as well as the related outcomes of maltreatment due to low body weight. For instance, do thin people in these cultures receive lower-quality medical care or have a harder time entering romantic relations similar to the experience of overweight/obese people in Western culture? Additionally, because research indicates cultural differences in weightism (e.g., Puhl et al., 2015), continued cross-cultural comparisons would be insightful. As an example, the individualism-collectivism dimension (Hofstede, 1980) has been shown to differentiate between how people view their own and others’ bodies, as well as attributions for control and responsibility of weight status (Crandall et al., 2001; Taniguchi & Lee, 2012). Specifically, cultural value and prejudice (e.g., “fat is bad” ➔ “fat people are bad”) are closely linked in individualist cultures due to the perception of controllability and promotion of individual achievement, but this is not the case in collectivist cultures (Crandall et al., 2001, p. 36; Yamaoka & Stapleton, 2016). Finally, just because Western culture places a higher value on appearance and weight compared to other cultures (e.g., Yang et al., 2005), this does not mean that weight-based experiences do not occur there. Thus, in lieu of only conducting cross-cultural investigations, specific insight into less studied populations and cultures is needed in order to assess the experiences and outcomes associated with weight-based stigma and prejudices in an effort to minimize it.

We conclude by acknowledging that it will be difficult to completely eliminate—or even change—individuals’ weight bias because of the myriad of complex stereotypes surrounding weight, beauty, and appearance ingrained at the sociocultural level. However, because communication is the mechanism that socially constructs and promotes weight-based stigma, prejudice, and discrimination, communication can also be the mechanism by which individuals reconstruct culturally held ideals and expectations about weight.

Further Reading

Arroyo, A., & Harwood, J. (2014). Theorizing fat talk: Intrapersonal, interpersonal, and intergroup communication about groups. In E. L. Cohen (Ed.), Communication yearbook 38 (pp. 175–206). New York: Routledge.Find this resource:

Brownell, K. D., Puhl, R. M., Schwartz, M. B., & Rudd L. (2005). Weight bias: Nature, consequences, and remedies. New York: Guilford.Find this resource:

Ebneter, D. S., Latner, J. D., & O’Brien, K. S. (2011). Just world beliefs, causal beliefs, and acquaintance: Associations with stigma toward eating disorders and obesity. Personality and Individual Differences, 51, 618–622.Find this resource:

Granberg, E. M. (2011). “Now my ‘old self’ is thin”: Stigma exits after weight loss. Social Psychology Quarterly, 74, 29–52.Find this resource:

Puhl, R. M., & Heuer, C. A. (2009). The stigma of obesity: A review and update. Obesity, 17, 941–964.Find this resource:

Puhl, R., & Suh, Y. (2015). Stigma and eating and weight disorders. Current Psychiatry Reports, 17, 1–7.Find this resource:

Schwartz, M. B., Vartanian, L. R., Nosek, B. A., & Brownell, K. D. (2006). The influence of one’s own body weight on implicit and explicit anti‐fat bias. Obesity, 14, 440–447.Find this resource:

Stewart, M. C., Keel, P. K., & Schiavo, R. S. (2006). Stigmatization of anorexia nervosa. International Journal of Eating Disorders, 39, 320–325.Find this resource:

Swami, V. (2015). Cultural influences on body size ideals. European Psychologist, 1, 1–8.Find this resource:

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