Weight-Based Bias Occurs Worldwide, Study Shows
— Weight Management workers urge anti-discrimination policies
by Ed Susman, Contributing Writer, MedPage Today November 3, 2021
Worldwide, adults trying to manage their weight said in a survey that laws are needed to protect people with weight problems, although currently there are few areas where weight-based discrimination is outlawed, a researcher reported at the ObesityWeek meeting.
« In 2021, it remains legal to discriminate against people because of their body weight almost everywhere in the world, » said Rebecca Puhl, PhD, of the University of Connecticut Rudd Center for Food Policy & Obesity in Hartford, who presented the findings in an oral presentation.
« To date, the scope of anti-discrimination laws has offered protection for socially stigmatized groups who are treated unfairly for characteristics viewed as ‘immutable,’ such as race, whereas societal views of body weight continue to perpetuate notions that weight is both changeable and an individual’s fault and, therefore, undeserving of protection, » she continued.
« This absence of legal protection continues despite evidence documenting pervasive and harmful weight mistreatment.
Within the U.S., there are no federal laws that prohibit weight discrimination, even with as many as 40% of Americans reporting they have experienced weight-based stigma and/or discrimination. »
As described in the study, which was published in Obesity, Puhl and colleagues surveyed 13,996 adult members of WW (formerly known as Weight Watchers) in Australia, Canada, France, Germany, the U.K., and the U.S.
Across countries, 83-93% of the participants supported the need for laws to protect people who are overweight, and 90-94% supported policies to address weight-based bullying.
Participants had differing opinions when it came to specifics, however, with support for legislation to address weight-based discrimination in employment ranging from 61-79% in the six different country groups, Puhl noted.
About 57% of other participants said they considered weight-based discrimination to be a human rights issue, and about 47% said they considered that the issue could be handled through existing disability protections.
Puhl said that while weight stigma has been documented in many countries, « the legal landscape is barren.
With the exception of the city of Reykjavík in Iceland, which passed legislation in 2016 adding body weight as a protected category in its human rights code, no countries have enacted laws to prohibit weight discrimination. »
She and her colleagues noted that to date the only legal avenues through which obesity-related discrimination has been applied is disability legislation: « The European Union has ruled that obesity is not a disability in itself, but that some people with obesity could be viewed as being ‘disabled’ if certain impairments exist or life activities are hindered because of weight, warranting protection from discrimination in some cases of obesity, » the researchers wrote.
They explained that within the U.S., amendments to the Americans With Disabilities Act (ADA) protect individuals with so-called « extreme obesity » from discrimination if they have a real or perceived disability, although courts have reached conflicting decisions about whether obesity qualifies as a disability under the ADA.
« Thus, although disability statutes may help a small percentage of people with obesity, this is an insufficient and unreliable remedy to address weight discrimination more broadly, as discrimination affects people of diverse body sizes, most of whom have no actual or perceived disability, » the team noted.
« Not surprisingly, scholars have criticized the use of a social model of disability in this legal context, arguing that disability is not an appropriate legal category to protect people from weight discrimination. »
Puhl also emphasized that weight-based discrimination can be detrimental to youth.
« Despite evidence that weight-based bullying is prevalent, policies to address it appear sparse. Within the U.S., every state has an anti-bullying law, but only three states enumerate ‘weight’ as a legitimate characteristic that places youth at risk for bullying …
Although most school districts across the country have anti-bullying policies, the language often fails to enumerate body weight, leaving youth inadequately protected from weight-based bullying, » she said.
She added that the study findings also suggest that support for such policies is present among people engaged in weight management across Westernized countries where obesity is prevalent and that they provide an « informative comparison point » for future cross-country research.
« As weight discrimination remains globally prevalent and without sanction, policies and laws may be necessary to reduce inequities and unfair treatment, » Puhl said.
« It is important to establish and monitor multinational public support for potential policy remedies. »
Asked for his perspective, Mitchell Roslin, MD, chief of Bariatric Surgery at Lenox Hill Hospital in New York City, told MedPage Today:
« We do have to consider that when obesity becomes severe, there can be consequences that interfere with performance. Exactly where, though, can be difficult to determine.
There have been many studies that demonstrate that people who have obesity miss more time at work and are somewhat less productive. »
« They frequently have conditions such as sleep apnea, which can interfere with concentration, and children who are morbidly obese have lower grade point averages than kids of normal weight, » Roslin continued.
« These are very real issues. It is above my pay grade to figure out where the line between practicality and bias is drawn. »
Ed Susman is a freelance medical writer based in Fort Pierce, Florida, USA.
Puhl disclosed relationships with WW.
Roslin disclosed relationships with Medtronics and Johnson & Johnson.