Health, Weight Stigma & Fatphobia

Health is so much more than a number on a scale or your BMI – it’s about sleep, mental health, activity, stress levels, relationships with others, and much more. 

You may have heard the term “healthy weight” or “normal weight” before, and we often don’t stop to think about what that really means. It usually refers to the section in the middle of the Body Max Index (BMI chart), the small section which deems people’s weight to be “normal” or “healthy”. However, this chart has shown not to be reliable or fit for purpose, in fact the Women and Equalities Committee called for people to move away from using BMI to a more size-inclusive approach in their 2021 report.

A “healthy weight” is different for everyone and can’t be standardised. A “healthy weight” is whatever you are when you’re not restricting food in any way, dieting, purging, or bingeing, and when you’re not worried about food/your body.

BMI – Did you know…?

  • The BMI chart was devised in the 1830s by a mathematician/astronomer
  • It was based on average white European men, excluding entire other groups of people.
  • For the purpose of statistics, not for individual health
  • It was updated in 1998, so 25 million Americans became “overweight” overnight!

Source: The Bizarre and Racist History of the BMI | by Your Fat Friend 

There often is a reliance on the BMI chart in medical settings. Sadly, many people struggling with eating disorders report being told they are “not thin enough” for a referral for treatment. Hope Virgo is a dedicated eating disorder campaigner who set up her “DumpTheScales” campaign from her own experiences of this. I to Hope about BMI, recovery and more in the “In Conversation” video series, here on YouTube.

Lots of people are technically a “healthy weight” but have a lot of worries and distress around food. Many people drastically restrict their food intake, as well as sometimes bingeing, purging or using compulsive exercise to “burn off” food, but even then, they can still be deemed a “healthy weight”. This sadly means many people are dismissed by their GP because their weight seems “normal”, and often means they then wait until the problem gets worse before they can access help. 

Harmful stereotypes

For people at higher weights, their relationship with food can often be ignored and weight loss strategies may be suggested instead. This may end up only making any disordered eating much worse. Many people in larger bodies are wary of visiting their GP for this reason – not being believed, being palmed off to a weight management service, for being judged and stigmatised, treated like a stereotype. Sometimes this perceived or anticipated weight stigma is just as harmful.

If you’re a person in a larger body, you may feel like your weight is your own fault for not having enough willpower or for being out of control. Society often makes assumptions about larger people being lazy, greedy or weak-willed. There might be assumptions made about the way you eat, and people may have offered weight loss advice, even if you didn’t ask for it. One of the very worst things to suggest to people having a difficult time with food is dieting or restriction – it can be one of the very reasons they’re struggling in the first place.

Stereotypes and myths about eating disorders are harmful for most people struggling who aren’t thin – which is the majority… 

Less than 6% of people with eating disorders are underweight – ANAD

For thin people, there can also be assumptions around what you eat too, and you may have experienced hurtful remarks about being “too thin” or people assuming you don’t eat enough. Nobody can tell how anyone eats just by looking at them. Your body, your choice.

Thin people can have binge eating disorder, and fat people can have anorexia, and anyone of any weight, gender or ethnicity can have any kind of eating problem. Eating disorders are about thoughts and behaviours, so shouldn’t be judged on body size. 

Weight stigma

Anyone of any size can struggle with disordered eating and/or negative body image. However, the discrimination people in larger bodies have to deal with can cause even more problems. This is called weight stigma and refers to the ways that people in larger bodies are treated, which may not be obvious as it is something that is very normalised and is “systemic” – meaning the issues run from the top through systems, policies and practices. So weight stigma is more likely to show up in ways that are subtly woven through everyday life. Examples of this may be: chairs and seats being limited in size, clothes only sold up to a certain size, workplace initiatives that encourage weight loss. A common hypocrisy is the pressure on people in larger bodies to exercise more, but activewear being more difficult/expensive to buy in larger sizes, plus the fear of getting ridiculed at the gym. 

Weight stigma prevents people from exercising when they want to, encourages more negative body image thoughts, and encourages disordered eating. Unfortunately, this is why our government’s “obesity strategies”, including listing calories on menu’s is sadly only creating more of a problem. The more society stigmatises weight, the more eating disorders, body image issues and mental health problems people have.

The discrimination people in larger bodies have to deal with can be traumatic. The Equality Act 2010 doesn’t cover size, so it’s not illegal to discriminate against people in larger bodies. It’s also very “normal” for people to comment on other people’s bodies and give weight loss tips and advice. Even well-meaning advice can be part of weight stigma, from people saying they are concerned for people’s “health”. Nobody else has the right to comment on your body or tell you what to do with it or how to eat. We are all responsible for our own bodies, and what’s right for you might not be right for someone else.


Fatphobia refers to a fear of being fat. In a world that tells us that fat is one of the worst things we can be, and young children are scared of being fat, fatphobic views are widespread. This means that medical professionals, and other professionals such as counsellors and people working in eating disorder services, may also hold these views, albeit unintentionally.

If you’re a person in a larger body, Regan Chastain has some resources on how to advocate for yourself when seeing health professionals, as well as other helpful ways to deal with fatphobia.

If you’re not in a larger body, exploring fatphobia is still important as it affects most people with body image/food issues. A fear of fatness can be one of the main drivers for people who diet, have body image concerns or struggle with eating disorders. This fear of fatness may be keeping you in cycles of body shame and stopping you from being able to accept and respect your body. 

Everyone of every size deserves respect, whether they are “healthy” or not. Health is an individual factor that is nobody else’s business but yours. Being concerned for someone’s health because they’re in a larger body isn’t helpful as it will only increase stigma and shame. The only way you can have respect for yourself and find comfort in your body, whatever size, is by understanding the complex influences upon you and understanding the impact of fatphobia.

If you’re a person in a larger body who has been shamed for your size or told to lose weight, you might be more likely to feel hurt, ashamed or angry. Feeling like this likely doesn’t promote wanting to look after yourself, so it keeps many people in unhelpful cycles of thinking and behaviour. Please know that you don’t owe anyone attractiveness, thinness or health. It’s your body and you can make your own decisions.

Implicit bias

Most people have grown up in a society of weight stigma and fatphobia, so we all have these “implicit biases”, meaning we don’t recognise them – they’re subconscious. We also “internalise” our fatphobia, which means we have turned that bias in on ourselves after so long of believing it.

However, thoughts can be unlearned. Our brains are adaptable (they have “plasticity”) and we are constantly learning, growing and adapting. Sometimes, things we learnt growing up aren’t correct, or no longer serve us. We need to be able to recognise and challenge the things we think we know in order to build our self-awareness and self-worth.

Fat people can have anorexia too

Tess Holliday is a plus-size model who spoke out about having anorexia. She received a backlash and trolling on social media for speaking out as a larger person as she didn’t fit the image of what people thought anorexia looked like. 

For many of us, we associate anorexia with thin girls. This is likely what we’ve seen in the media. It means that people in larger bodies are doubted, disbelieved, bullied, trolled, abused and discredited when they speak out. Eating disorders can affect anyone of any size – that includes any eating disorder and anyone of any size. Eating disorders are mental health disorders and are to do with thoughts, feelings and behaviours, not body size. We might feel some uncertainty, resistance, or even anger when something strongly contradicts what we thought. In the case of Tess Holliday, many people were very angry and simply couldn’t comprehend a large person limiting their food. This only shows the importance of needing to push back against these harmful stereotypes and challenge our own perceptions.

Challenging our own biases

To help both people in larger bodies and those who aren’t, we all need to consider our own perceptions and biases. Sometimes that means questioning a dominant way of thinking in the world. Many things are deemed “normal” in our society, but we need to question why that is and where it comes from, because “normal” isn’t always right for us. But we can shift our perception of things – it starts with awareness.

Here are some questions you might like to reflect on or write about in your journal. These prompts can be considered no matter what your size, as we can all experience internalised fatphobia, but please do take a break or come back to it later if you need to.

  • What thoughts and feelings occur when you think about fat people who say they have restrictive eating disorders, such as anorexia?
  • What do you think/how do you feel when you see a fat person exercising? 
  • Have you ever made assumptions about the way a person eats based on them being in a larger body?
  • How would you react to someone sharing a fat joke or meme? 
  • Have you even said, “you’re not fat, you’re beautiful!”
  • How do you feel if you see a fat person wearing a crop top?

In noticing our reactions, we need to be very honest with ourselves. You might feel quite defensive, but that’s okay. The word “fat” might be difficult for you as it can be a trigger for many people who have been teased or bullied about their weight. Many body acceptance advocates are now using “fat” to reclaim the word and take back the power.

If you have negative thoughts about people in larger bodies (and yourself if you’re in a larger body), acknowledging this as fatphobia doesn’t make you a bad person, it means you’re able to see how our society has created these biases. It’s not your fault and you don’t need to give yourself a hard time about it. By bringing biases into consciousness, we can reflect on them and where they came from, and change our perceptions.

It might be that you feel sadness or compassion for people in larger bodies, which is understandable as weight discrimination is so hurtful. It’s important to remember that losing weight isn’t the way to deal with weight stigma, but rather we all have a part to play in encouraging body acceptance and reducing weight stigma and fatphobia, for ourselves and others.

If you spend time on social media, how might it be for you to follow more people in larger bodies on social media? Diversifying our social media feeds can change our sense of what is “normal”. We’ve mostly grown up seeing young, slim people in the media, so changing to your social media to include fat, body accepting people can be a positive move to help our own body acceptance. Through understanding and bringing awareness to weight stigma and fatphobia, we don’t just help people in larger bodies, we help everyone.

People can be healthy at any size. If you’re struggling with negative thoughts about fatness it might be helpful for you to read the section in our body image resources about Health at Every Size for some myth-busting, plus Lindo Bacon’s books (Health at every Size and Body Respect). Aubrey Gordon (aka Your Fat Friend) has blogs, a podcast and a book that may also be helpful, and also Christy Harrison, who has a podcast called Food Psych and a book called Anti-Diet.

Contributed by Mel Ciavucco,
Assessor and Project Lead for First Steps ED

To read more from Mel, visit her blog