What is Weight Bias?

Weight bias or weight stigma is defined as having a negative viewpoint towards someone based on their weight.  I am sure that many patints have experienced this at numerous points in their life. At the core of weight bias is the incorrect belief that someone’s weight is completely within his or her control.  Therefore, being overweight is completely someone’s fault.  Common sayings include “that person must be eating 5,000 calories a day”, or “if that person would just move around, they would get skinny”.  Obese people are just “lazy” or “weak-willed.”  We know that this is 100%, completely, and absolutely false. 

Obesity is an extremely complex disease.  This disease is the result of the interaction between a person’s genetics, gut microbiome, and hormones that then shape how the metabolism responds to the environment.  The belief that a simple diet and/or exercise can completely cure this disease fails to take into account the myriad of complex factors that cause this disease. Patients have tried every diet and exercise regime in the past without any durable results. This failure is not a sign of a lack of effort.  It is a sign that the disease is not being completely treated.

There is no shame in having a disease.  People with high blood pressure, autoimmune diseases, heart problems, and cancers all have a disease and no one shames them.  No one should shame someone with the disease of obesity.  To fight weight bias, we need to truly start treating obesity like the disease it is.  Just like any disease treatment, medications are often a first step.  The new generation of weight loss medications, the GLP-1 agonists, can be a first step for some. However, once medications fail, we need to continue the treatment paradigm with surgery.  With weight stigma, there is also the common belief that taking medications or having surgery to treat obesity is the “easy way out” or “cheating,” that had you just dieted enough or ran 10 miles every day, the weight would have been lost.  Again, this is completely false.  As any bariatric surgery patient will tell you, having surgery -- choosing to undergo an invasive procedure and committing yourself to a new lifestyle -- is NOT the easy way out. Bariataric surgery is simply a medical treatment that makes weight loss possible for those resistant to typical weight loss methods.  What choosing to have bariatric surgery actually is, is choosing a successful way to treat the disease of obesity.

Let’s fight weight bias, treat obesity like the disease it is, and end the stigma!