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ABC News
Health
the Specialist Reporting Team's Gemma Breen and national medical reporter Sophie Scott 

Have you experienced weight stigma? Body shame and blame highlights a problem in our health system

Evie has always felt judgement and discrimination from others, simply because of the way she looks.

Her mum is a doctor and took care of Evie's health needs when she was young.

It wasn't until she was an adult that she booked a standard check-up with a GP to discuss fatigue.

Before even asking Evie why she'd made the appointment, the doctor asked her to stand on the scales. Her blood pressure was tested, and it was high.

Evie was told the solution was to lose weight.

"I was shocked by the amount of body shame I felt," the 26-year-old says.

She didn't have a chance to discuss her symptoms because the doctor had already decided her health issues were linked to her body size.

Evie didn't agree. Instead of going on a diet, she decided to tackle her stress levels by finding a new job, taking care of her mental health and moving her body in ways that felt good.

Her blood pressure dropped back to a healthy level.

"I'm not here to subscribe to standards of beauty or health. [I'm] looking after my body in a way that's not about how it looks, but about how it feels," she explains.

Evie confronted "one of the few remaining socially acceptable forms of stigmatisation" — weight stigma — and according to recently published research, it's damaging our health.

So what is weight stigma, and why should we care?

Weight stigma, or weight bias, is when we're devalued or discriminated against based on our body size.

Two thirds of Australians are classified as being overweight or living with obesity — widely accepted as a key risk factor in heart disease and other life-threatening conditions.

But it's a complex issue and a research paper released this month says we've failed to consider the multifaceted nature of what makes a human healthy.

Lead author Blake Lawrence, from Curtin’s School of Population Health, has experienced weight stigma.

While he acknowledges diet and exercise is a part of a healthy lifestyle, he says ignoring the genetic, psychological, environmental, economic and social causes of obesity is "glossing over how complicated this is".

"It's one of the only remaining forms of stigma that's socially acceptable, because it's so ingrained in our culture that your body weight is tied to your own choices."

Dr Lawrence says weight stigma has the unintended consequence of damaging our health by lowering our motivation to exercise, increasing our chance of binge eating and forcing us to "avoid healthcare altogether".

"It's about approaching this with greater empathy for the individual. It's important to reflect that this isn't just about people eating too much junk food," he says.

"People who haven't been struggling with weight have no idea what it's like. It's so easy to make judgements."

Changing the narrative: Where to from here?

The message from public health experts is clear – the decades-old "move more, eat less" narrative hasn't worked.

And as the number of Australians living with obesity increases year on year, experts agree body shaming and discrimination is causing Australians more harm. 

Have you experienced weight stigma? Share your story with us. 

Dr Georgia Rigas, a Sydney-based GP with a specific interest in obesity management, has seen first-hand how people can be discriminated against or made to feel ashamed of themselves. 

"It's this perception that people are lazy and that doesn't sit right with me," she says. 

She says doctors have a duty of care to tell patients their weight is affecting their health and to intervene early when a patient is seeking treatment for obesity.

But for some, weight loss is only part of the solution and she says doctors should talk to their patients "less about kilograms or dress size and more about health improvements".

She says health professionals need to be careful with the language they use when treating patients — no matter their body size or weight.

"It's inviting [my patients] to start the dialogue. But it's how you raise it and link it to the problem they came to see you about," she says.

Tiffany Petre is the director of The Obesity Collective — the peak body for obesity prevention in Australia — and agrees. She says the health system has spent too long telling people that "if you're fat, it's your fault".

Weight stigma, Ms Petre says, can have a greater impact on people with a disability, who for a range of reasons, already find the health system difficult to access and navigate.

And when considering higher rates of obesity in regional and remote areas, Indigenous communities and for people trying to make ends meet, she says it's clear there are other factors at play. 

"Some of the people who would particularly benefit from treatment to help manage obesity and health may be least able to afford weight management support," she says.

"Of course, we all have a major role to play in our own health and wellbeing, but we have set people up to fail and then blamed them for it."

No matter your size, eating healthy food, managing stress, getting enough sleep and keeping active by doing something you love are key factors for long-term health, she adds.

Want to get in touch? Email us at weightstigma@abc.net.au.

Evie prioritises movement that makes her feel good, which include Pilates and walking. She strives to eat healthier meals that appeal to her taste buds.

And for her, it's also about having safe and open conversations with medical professionals by setting boundaries.

If they insist on weighing her, she doesn't want to know the number on the scales.

Her focus is on living a healthy life.

"When you're bombarded with messages from all sorts of places that it's not okay to be in a larger body, you're not going to wake up one day and accept yourself," she says.

"I want people to know that I still struggle — and it's okay to struggle."

We want to hear from you. Please fill out the form below and tell us your story. 

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