What does weight stigma have to do with eating disorders?

For the first decade of my advocacy around eating disorders I thought I could do that work without addressing the toxic influence of weight stigma. I didn’t even have a term for it. Now, I do, and I no longer think it is credible or possible not to make it central to the work.

To be completely frank, I didn’t WANT to deal with weight stigma.

For a long time it seemed like a distraction. I didn’t need yet another fight. Discussing weight stigma might lead to even more misunderstandings about eating disorders. It might pit me against people who are otherwise my allies in the fight for eating disorder advocacy but are themselves believers in weight control and weight loss for those in larger bodies. I didn’t want to engage in debates on the “danger of obesity” and “unhealthy weight.”

But I know now that “weight stigma” is, at its core, prejudice, and silence is unacceptable. The insidious and harmful belief that humans should be and should want to be as free of body fat as possible is too widespread to ignore. It’s wrong on the science. It’s actively harmful to those predisposed to eating disorders for an advocate like myself to remain silent. This prejudice often masks itself as concern about health, or moralizing on lifestyle, but it is at its core appearance-based bullying.

It is necessary for advocates like myself to be clear on my position: I recognize and stand against weight stigma. I have to practice this daily in my relationships and in my own self-care. I am not immune to prejudice and have to check myself and do ongoing and challenging work on my own assumptions and beliefs.

• Unlike many others who also decry weight stigma, I do not believe weight stigma is a cause of eating disorders. EDs are brain disorders. Brain disorders often seize upon the values and fears of society, and EDs are an example. Society’s value of order and cleanliness does not cause Obsessive-Compulsive Disorder. But make no mistake: widespread and deeply embedded weight stigma creates a toxic environment for all of society that is all the more complicated when an eating disorder predisposition is involved.
• I do not use or believe in the terms “obesity” or “overweight.” These are stigmatizing terms for weight status that are meaningless. Weight alone is not useful for healthcare unless it is individualized to that person’s history and growth and as only one in many assessment tools.
• Weight status is not an eating disorder. Not at high weights or low weights. One’s weight MAY be impacted by their mental illness when untreated or poorly treated.
• I practice a HAES approach to my own health.
• The appearance and weight status of others tells me nothing about their health.
• I believe weight stigma is harmful in our homes when we are caring for someone with an eating disorder. Parents’ weight stigma can make us collude with eating disorder thinking. Our weight stigma can make us fearful of necessary treatment. Our weight stigma can keep us from choosing and supporting successful treatment.
• Treatment providers who have weight bias pose dangers to our children’s health.

It is our job as parents to recognize, call out, and fight against weight stigma. We can’t afford to have our children surrounded by weight stigma among their siblings, their peers, their medical providers, their media, and our communities. It is not their job to fix that, but ours to realize it and stand against it, and loudly.

We can’t stop at weight stigma: we have to not only reject weight stigma we need to move all the way to a joyful and sustained and courageous embrace of natural size diversity.