In my last blog post, I discussed what it means to live a diet-free lifestyle. This week, I want to talk more about the negative effects that diet culture can have on both your mental and physical health.
However, before we can delve into what internalized weight bias is, lets first talk a bit about weight bias itself. What does it mean to have or experience weight bias? To put it simply, weight bias is judging a person based on their weight. This can look a lot of different ways, but some examples include thinking that a person who is overweight is lazy, that they eat fast food all the time, or that they never exercise.
People who experience weight bias often find themselves having more a difficult time finding a job or getting promoted at work because the employer may assume based on appearance that the individual is a lazy worker. They may have a more difficult time making friends as well, or finding a partner. The worst part is that often the judgement is subconscious on the part of the person doing the judging. It has been so ingrained in our society to think of overweight people as lazy and unhealthy, that we often don’t realize we’re judging someone.
As a side note, while weight bias most often occurs for overweight individuals, it is worth mentioning that judgement for weight can also occur for people who are “too thin.”
When people expect to be judged based on their size, they often give up participating in activities that they enjoy. For example, someone who likes playing basketball may choose not to play because they worry that others will judge them. Many overweight people also fear going to the gym because they think everyone there will notice that they’re out of shape. They may find it embarrassing for others to see how little weight they can lift, or how long they can walk on the treadmill, or they may feel uncomfortable in exercise clothing.
Similarly, people who are overweight may avoid going in for yearly checkups at the doctor because they worry about being judged for their weight. It’s true that the job of doctors and nurses is to help patients remain healthy; however, it is always good to remember that overweight people already know they’re overweight. As medical professionals it is our duty to help our patients maintain their health, but often pointing out their weight isn’t helpful because they already know that they are above the recommendations and end up avoiding future visits to avoid hearing once again that they need to lose weight.
So now that we know what weight bias is and a little about its impact on mental and physical health, what does it mean to have internalized weight bias (IWB)? Essentially, it’s just as it sounds; you’ve taken the bias against overweight people and now use it to judge yourself. This may manifest in a lot of ways, depending on the person, but may look like berating yourself for not eating healthy enough, or eating too much or too often, or if it gets bad enough, berating yourself for eating at all.
Have you ever had thoughts such as “I really shouldn’t eat this piece of cake” or “quit being lazy and go to the gym after work instead of going home”? Those are some examples of what IWB may sound like inside your head. As I said last week, there’s nothing wrong with motivating yourself to exercise or eat healthier, but let me ask you, do you think calling someone lazy is the best way to motivate them? If the answer is no, then apply that same logic to yourself. If you are speaking negatively to yourself, guilt-tripping yourself, or otherwise berating yourself then you’re doing more harm than good, and the chances of you making positive changes starts to decrease.
If you don’t believe me, lets take a look at what the science says about the subject. I did my final paper in graduate school on internalized weight bias and even I was shocked at the negative impact it can have on your health.
People who suffer from IWB are at a higher risk of diabetes, heart diseases, and high blood pressure than those who are of a similar weight but don’t have IWB. The reasons why that is are still being studied, but so far studies are showing links between IWB and increased cortisol in the body.
Cortisol is a steroid hormone responsible for a variety of things in the body including regulating stress, blood sugar, and blood pressure. In an acute setting, such as narrowing avoiding a car accident, cortisol is a positive thing. However, when you are chronically stressed and your body is continually flooded with cortisol, it has a negative impact on your body.
People with high cortisol levels often have difficulties sleeping, have poorer blood sugar control, higher blood pressure, and high inflammation. You could write books on all the negative effects of high inflammation in the body (and plenty of people have), but chronic pain and increased risk of cancer are two big side effects.
As we already discussed, people suffering from weight bias are less likely to go to their yearly checkups. If you combine that with the increased risks associated with high cortisol levels, you have a recipe for a health-related disaster. Early warning signs for diabetes, high blood pressure, high cholesterol, and cancer may all be missed because someone worried about being judged by their doctor, and if the person suffers from IWB, the medical professionals may not be entirely to blame for this fear.
Weight bias is baked into the fabric of our society and a lot of people have internalized the belief that their self-worth is tied to their weight. This leads to a lifestyle of frequent dieting, which as I discussed in my last blog post, often itself leads to increased disease risk.
So, this is all sounding pretty bleak right? What can we do? I don’t want to leave you with the idea that it’s inevitable that you have poor health or that there is nothing you can do. I chose my tagline “ditch the diet and choose health and happiness” for a reason. Step one for starting the journey of living a happy and healthy life, where you can enjoy food without guilt, is realizing that your weight is not equal to your worth. There is nothing morally wrong with being overweight.
And unfortunately, being overweight is not always as simple as having eaten too many calories. The reasons for why a person is overweight can be numerous, so if you’ve struggled with your weight, have been dieting your entire adult life, and find yourself perpetually frustrated that the weight is not coming off, then it might be good to know that it might not be you that’s the problem, but rather your dieting habits contributing to hormonal dysregulation in your body.
People who have chosen to listen to their body rather than a number (be it calories or weight) are often able to both satisfy cravings and prevent future cravings, and the byproduct is often weight loss. When you shift the focus off your weight, you end up with less stress, which has the cascade effect of lowering the cortisol in your body, which lowers disease risk and can help you shed a few pounds through better blood sugar control. I like to point out that weight loss isn’t a guarantee, but if your blood sugar, cholesterol, and blood pressure all improve, then is the number on the scale really all that important anyway? And when you learn to listen to your body, very often you will start to shed a few pounds.
Step one for better health and a happier life is letting go of your internalized weight bias, allowing yourself to listen to your body, and learning to enjoy foods without arbitrary restrictions. If you’d like to know more about this, please set up a consultation with me. I would love to help you achieve better health through a diet free lifestyle.
Rachel Case, MFCS, RDN 
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