Negative health effects of obesity are well documented by scientists and heavily covered in the media. The existence of weight-based discrimination, including in the workplace and by health care providers, is less widely known but also well documented. The intersection of health and discrimination marks another form of harm, sociologists Markus Schafer and Kenneth Ferraro show.
Schafer and Ferraro analyzed data from the National Survey of Midlife Development in the United States, which was carried out in two waves, with respondents surveyed in 1995–1996 and again in 2005. It collected information on people’s body weight and height, a series of health and disability outcomes, and discrimination they had faced.
The perception of discrimination shaped both people’s experience of their own weight status and their disability outcomes, the researchers found. People who perceived weight discrimination were more likely to understand themselves as very overweight than people who, according to their body weight and height, were in the same body mass index range.
The effect was large. The authors found that “about a quarter of Class I obese respondents felt very overweight if they had not perceived weight discrimination, [but] the likelihood of feeling very overweight nearly tripled (67 percent) if they had perceived weight discrimination.” People in the Class I obese category (the lowest BMI range identified as obese) who perceived weight discrimination were almost as likely to understand themselves as very overweight as a severely obese person who hadn’t perceived weight discrimination.
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The experience of weight discrimination shaped more than just self-perception. Over the ten years between waves of the survey, respondents predictably faced health changes, and obese and severely obese people in particular had worsening functional disability—the ability to do things like transport groceries or walk over a mile.
People who were Class I obese and had experienced discrimination “faced greater increases in disability than severely obese people who did not perceive discrimination.” Those greater increases “nearly evened the differences” between Class I obese people and severely obese people when it came to functional disability.
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When Schafer and Ferraro turned from functional disability to self-rated health, although they found that “severe obesity coupled with perceived weight discrimination produced worse health declines than did severe obesity without weight discrimination,” these effects were not statistically significant. Nonetheless, the effect of perceived discrimination on functional disability “challenge a medicalized absolutism positing that severe levels of weight pose threats only through direct physiological means,” the authors write.
It’s well established that other forms of discrimination, such as racial discrimination, can have negative health effects. Schafer and Ferraro have shown that it’s also the case with body weight that “social factors are implicated in health problems associated with obesity alongside the widely recognized physiologic causes.”
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