Unpacking Anti-Fat Bias
By Ally Tompkins, LCSW
As a therapist treating a range of eating disorders, I talk directly and indirectly about anti-fat bias every day.
What is anti-fat bias?
While you may have heard the term “fatphobia” used in the past, anti-fat bias most accurately describes the judgement and discrimination that is unjustly placed on those living in larger bodies.
Where does it come from?
Anti-fat bias is not new—it has deep and racist roots in American history as far back as the slave trade. Today we see it continue to rise in the public domain every day.
For many of us growing up in America, we were taught that fatness was an illness to be feared and avoided, and we were also led to believe that our weight was easy to control through food and exercise. Somewhere along the line, fatness came to be perceived as both a terribly bad condition and also an avoidable one.
These narratives completely disregard the numerous factors that contribute to our weight, like biology, heredity, access to preventative medical care, socioeconomic status, access to nutritionally diverse food, and mental health, just to name a few. They also ignore the fact that intentional weight loss has a 95% failure rate.
We saw this play out in real time as Covid-19 unfolded. Early in the pandemic, some false and disproportionate correlations were being drawn between weight and infection risk of covid-19, with very little consideration for the myriad variables that put someone at risk of becoming seriously ill or dying from the virus. Since weight has been deemed a “disease” formally and informally for decades, medical experts were quick to correlate weight and risk of infection when Covid-19 took over our lives.
When vaccines started rolling out, and many people were outraged that fat people were given priority access to the Covid-19 vaccine despite their bodies being shamed for decades by medicalizing their weight as a “disease.”
How you may encounter anti-fat bias
It’s really no surprise that anti-fat bias shows up everywhere. I see it show up literally, I see it show up subliminally, and I see it show up unconsciously. I see it show up as fear, and as shame, and as outrage. Anti-fat bias looks like:
The hypocrisy in demonizing fatness as a shameful illness in one breath, and then crying outrage when that illness is prioritized for medical care before those who are thin.
The frustration and self-loathing I hear from friends and family about gaining weight despite their otherwise adequate markers of health.
The fear and uncertainty I hear from clients in eating disorder recovery who can’t fathom living in a larger body than the one they’ve idealized.
The doctor’s office when a provider recommends weight loss without considering symptoms or reviewing labs.
The movie theater and the airplane and the restaurant booth where inclusive seating is nowhere to be found.
The “plus size” section of the store where larger bodies are not only an afterthought, but sectioned off separately from where the smaller people shop.
The fact that the average model we see in the media has a 25-inch waist while the average American woman’s waist is 37 inches.
To upend and dismantle the deep anti-fat bias in this country will take time, hard work, and lots and lots of energy. Below are a few tips to get things started in your everyday life.
Tips for dismantling anti-fat bias
Don’t judge fatness. Take active steps to notice how you internally and externally judge large bodies and commit to challenging and rewriting these narratives in the future.
Don’t praise weight loss. This just reinforces that shrinking ourselves is an accomplishment to be valued. Praising weight loss leads to shame and embarrassment 95% of the time when weight regain occurs, and it ostracizes the people who are *not* receiving praise for their bodies.
Don’t try to convince someone they aren’t fat. If I had a dollar for every time I heard someone say “I feel fat” and without missing a beat someone else interjects “You’re not fat!” A person battling body image concerns needs validation just like anyone struggling with complex emotions. Validate that the world we live in puts so much undue pressure on us to look and be a certain way. Don’t try to convince someone that their changing body isn’t changing, or that fatness is absolutely not something they are/could ever be.
Normalize removing body size commentary from the dialogue altogether. The size of someone’s body has no bearing on their value as a human or their worth in the world. Nobody goes to their deathbed thinking “I’m so glad I spent life in the company of so many average-sized individuals.” You choose to be around people for far better reasons than the size pants they buy, so learn to let go of discussing that variable in such depth.
Don’t demonize foods. Going on and on about how “bad” you are for eating pizza and how “guilty” you feel for not exercising is unhelpful to you and those around you. These types of comments imply that there is fear and risk involved in these choices, and they only serve to reinforce that anything that could potentially lead to gaining weight is bad.
Reframe how you define health. One of the most important things any of us can do in pursuit of dismantling anti-fat bias is to challenge the belief that weight and health are synonymous. They aren’t, and believing this requires us to redefine what health really means. I constantly tell my clients that health is holistic: it’s physical health, mental health, financial health, healthy boundaries, healthy relationships, adequate rest, access to pleasure and fulfillment, etc. Figure out what this means for you and move in the direction of those things, giving far less energy to the number on the scale.
Be an ally. Try to notice and be aware of the issues and unmet needs your friends in larger bodies may face. Ask them to choose where they’d like to go shopping or which table they’d prefer at the restaurant. Consider intervening if you notice a stranger or a sales clerk or a flight attendant make anti-fat comments in the presence of someone in a larger body (perhaps ask them if that is something they’d like you to do). Start a dialogue with them about the ways in which they have felt this world overlooks them. Be willing to learn without trying to fix.