Main Body
Problematizing Anthropometric Body Measurement Assessments
It is important to problematize the assessment and evaluation of anthropometric body measurements and reflect on how these measurements are used since they are biased and not neutral. For example, these body measurements may bring to the forefront body image issues that are closely related to one’s personal identity (Puhl, 2022). Additionally, the origins of these measurements are deeply embedded in racist, sexist, and ableist discourse. Evidence concerning how to use these measurements has shifted and is continuing to shift. We delve into this evidence in this chapter.
It is important to be attentive and critical of how weight and health are constructed within society, and especially within the media. In Western society, dominant body ideals of thinness have existed for many years. In many of today’s cultures (including Western society), a thinner body often suggests an illusion of health (Farrell, 2011). But this is not necessarily true, and it is important to NOT assume someone is healthy just because they are thin. Additionally, when a person does not fit this thin ideal, their body image and personal identity can be adversely affected leading to and/or exacerbating physical and mental health issues.
We live in a culture where fat shaming is normalized; people who are overweight and obese are stigmatized and made to feel ashamed of and blamed for their body size and medical issues that may arise (Dolezal & Spratt, 2022; Spratt, 2021). The cultural stigma surrounding weight/obesity inhibits the ability to fully examine health issues and health outcomes (Farrell, 2011). This stigma can limit individuals (such as healthcare providers) to identify and recognize medical concerns versus aesthetic concerns (Farrell, 2011).
Contextualizing Inclusivity
In the context of healthcare, a discourse can be marginalizing because it can negate the influence of social determinants of health. It also reinforces a shaming/blaming discourse in which the individual is solely responsible for their weight. Similarly, while body positivity and the Health At Every Size movements have recently come to frame wellness as acceptance and empowerment, this also places an onus on the individual to achieve “health” and prove health through other forms of measurement such as blood pressure, heart rate, and cholesterol levels (Gibson, 2022). It is important to see how such discourses may place a moral obligation on individuals to project health, whilst ignoring the social and biological influences which may constrain efforts (Gibson, 2022).
These kinds of discourse can have a negative impact on physical and mental health in which the person may gain additional weight as a result of a negative feedback loop (Brewis & Wutich, 2019; Meulman, 2019). The stigma surrounding obesity can also lead to eating disorders and mental health conditions such as depression (Chakravorty, 2021; Puhl et al., 2014). It assumes that obesity is a choice and negates social determinants of health such as structural and socioeconomic factors (Dolezal & Spratt, 2022). This neoliberal and shaming/blaming discourse is problematic because: it assumes a singular notion of health; it assumes that access to healthy food choices and healthy lifestyles is equal across populations; and does not address the complex causes of obesity (Spratt, 2021).
Knowledge Bites
See FoodShare TO’s (2021) panel titled “Dismantling fat shaming and weight stigma in health and wellness spaces.” This panel discussion problematizes the singular notion of health and will help you understand the concept of “fat oppression” and “body liberation” and the important role you play in activism.
References
Brewis, A., & Wutich, A. (2019). Lazy, crazy and disgusting: Stigma and the undoing of global health. Johns Hopkins University Press.
Chakravorty, T. (2021). Fat shaming is stopping doctors from helping overweight patients—here’s what medical students can do about it. BMJ, 375. https://doi.org/10.1136/bmj.n2830
Dolezal, L., & Spratt, T. (2022). Fat shaming under neoliberalism and COVID-19: Examining the UK’s Tackling Obesity campaign. Sociology of Health & Illness, 45(1), 3-18. https://doi.org/10.1111/1467-9566.13555
Farrell, A. (2011). Fat shame: Stigma and the fat body in American culture. New York University Press.
Gibson, G. (2022). Health(ism) at every size: The duties of the “good fatty”, Fat Studies, 11(1), 22-35, https://doi.org/10.1080/21604851.2021.1906526
Meulman, M. A. (2019). Sizeism in therapy: Fat shaming in supervision. Women & Therapy, 42(1–2), 156– 163. https://doi.org/10.1080/02703149.2018.1524072
Puhl, R. (2022). Weight stigma, policy initiatives, and harnessing social media to elevate activism. Body Image, 40, 131-137. https://doi.org/10.1016/j.bodyim.2021.12.008
Puhl, R., Luedicke, J., & Grilo, C. Obesity bias in training: attitudes, beliefs, and observations among advanced trainees in professional health disciplines. Obesity (Silver Spring) 2014; 22: 1008-1015. https://doi.org/10.1002/oby.20637
Spratt, T. J. R. (2021). Understanding ‘fat shaming’ in a neoliberal era: Performativity, healthism, and the UK’s ‘obesity epidemic’. Feminist Theory, 24(1), 86-101. https://doi.org/10.1177/146470012110483
in the context of healthcare, refers to an emphasis on personal autonomy and individualism.
