BalancedView: Addressing Weight Bias and Stigma in Health Care

Kiera, Project Manager on March 30, 2015

I started working in the area of promoting healthy weights a number of years ago. As I’ve come to learn more about healthy weights, I’ve noticed that people worry and talk a lot about their weight and appearance. Maybe it’s a comment about what they “shouldn’t” be eating, or expressing feelings about their weight. Regardless of the comment, I’ve become aware of how much we as a society talk about weight and appearance.

In our society, it is considered important to be thin and fit, and negative attitudes towards larger bodies can be common. Weight bias and stigma exist in employment, education and health care. So what exactly is weight bias and stigma, how does it impact us, and what can we do about it?

Weight bias is defined as the negative weight-related attitudes, beliefs, assumptions and judgements toward individuals who are at the ends of the weight spectrum[1]. Weight bias tends to be experienced differently by those who are overweight and obese. These attitudes can often show up as false and negative stereotypes, for example the belief that large individuals are lazy, unmotivated, and sloppy, less competent or lacking self-discipline[2].

A person may experience stigma when they have a characteristic (such as being heavy) that is not valued by the society they live in[3]. When someone is stigmatized because of their weight, it means that the way that others react to them or treat them can make them feel like a less important or less valuable member of society[4].

While it may be hard to imagine weight bias and stigma taking place in health care settings, research shows that health care professionals may endorse stereotypes and negative attitudes about patients who are overweight and obese. Evidence also shows that there is a significant impact of weight bias on mental and physical health, independent of weight. There are many impacts of weight bias on health, including:

  • Poor body image and body dissatisfaction
  • Low self-esteem and low self-confidence
  • Depression, anxiety, and other psychological disorders
  • Maladaptive eating patterns and eating disorders
  • Avoidance of physical activity

BC Mental Health and Substance Use Services (BCMHSUS) is working towards reducing weight bias and stigma in health care settings. BCMHSUS has developed BalancedView, an online and interactive resource which aims to decrease weight bias and stigma among health care professionals in British Columbia. Examples of health care providers include doctors, nurses, psychologists and psychiatrists, social workers, and physiotherapists, among others.

At the end of March 2015, the BalancedView resource will be launched and made available to health professionals across BC. BalancedView has 5 modules and contains information, videos, quizzes and activities designed to enhance the awareness, knowledge and skills of health professionals in the area of weight bias and stigma.

The BalancedView resource is just one part of a bigger movement towards promoting a focus on health rather than weight. Changing social norms related to body weight is a big task but change is happening. By shifting the focus from weight to well-being, together we can promote better overall health for all British Columbians.

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[1] Puhl, 2011; Ciao & Latner, 2011

[2] Puhl & Heuer, 2009; Rukavina & Li, 2008

[3] According to Puhl and Brownell (2003), p. 213

[4] Goffman, 1963


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