Weightism and Diabetesism

We all know that those of us who have diabetes, particularly when we are also overweight, have serious health problems to manage. And almost all people with diabetes are overweight.

But we often overlook the social problems that accompany these issues. They can be as serious and can make our physical problems even worse, according to provocative new research.

Discrimination is the root cause of these social problems. Although during the past century our country has made — and continues to make — enormous strides to end overt discrimination, covert discrimination still festers in the hearts of many Americans. We are cleaning up our act, but not our hearts.

Almost all of us are simultaneously perps and victims. Who doesn’t believe that“the other,” whoever this may be, is inferior? Who doesn’t suffer the sting of the other’s beliefs that their type of person is better than another type of person?

We face discrimination for having diabetes. This is diabetesism.

A good friend of mine who has type 1 diabetes felt he had to close down his outstanding diabetes blog this month because he is looking for a job. Some employers won’t hire people who have diabetes, although they would tell you otherwise.

If you are overweight, it’s even worse. In fact, perceived discrimination for being overweight often leads to a vicious cycle of even more weight. That’s the surprising and sad conclusion of this new research.

Weightism is discrimination against people who are overweight or obese. The study found a surprising and strong feedback loop that increases our risk for becoming and staying obese.

Today two researchers from Florida State University College of Medicine published their study, “Perceived Weight Discrimination and Obesity” inPLOS ONE. A few days ago I obtained an embargoed copy of the study from a representative of this professional journal.

A total of 6,157 people formed the basis of the study. They were those who answered the questions about discrimination and provided weight and height information in the Health and Retirement Study, which is representative of people who live at home in the United States. The study is longitudinal, which means that it involves repeated observations of the same variables over a long period of time. In this case it compared them in 2006 and 2010.

For me the shocking finding is that people in the study who experienced weight discrimination were about 2.5 times more likely to become obese by the end of the study. Those who were already obese at the start of the study were three times more likely to remain obese at the end of it than those who hadn’t experienced discrimination.

The new study puts it bluntly. “Like other forms of discrimination, body weight is a highly visible, personal characteristic that can evoke strong stereotypes and strong reactions from others,” the authors write.

American society has a pervasive stereotype about obesity: People are obese because they are lazy, unsuccessful, and weak-willed. Typical responses to such discrimination included coping behaviors like problematic eating and avoiding physical activity. This is a vicious cycle.

I can’t prove it, but I suspect that the reason why I was fired many years ago was because at that time I was fat. I know that it wasn’t because of a lack of competence, because I had always got the highest ratings. It wasn’t because of my Hispanic surname, because the owner of the small business where I worked was Hispanic himself. He had just brought in consultants to advise him on insurance costs. My weight was a potential liability, although in fact I have been remarkably healthy, especially after I subsequently got diabetes, which served me well as a wakeup call to taking better care of my body.

Discrimination by others leads to self-discrimination. While the study did not explicitly deal with self-discrimination, anyone who has ever been fat knows the self-loathing that we experience when our clothes no longer fit. First, we loosen a waist button and eventually give in to buying larger sizes in those stores that cater to big men and women. When we perceive the dislike that others show us for being fat, it’s easy to accept their judgement.

In the immediate future, the way out of this trap is to know discrimination when we see it and to accept it. This is the heart of heart of successful 12-step programs. This is what the fat acceptance movement is about. Denial doesn’t work.

In the long run, I feel sure that weight discrimination will go the way of discrimination based on sex, race, and sexual preference. It’s contrary to the American Creed.

I have known this all my adult life. In college I read An American Dilemma, which Gunnar Myrdal wrote in 1944 about our race relations. The dilemma refers to our shared cognitive dissonance between our liberal ideals and our gradual ending practices of discrimination.

The ideals of equality embodied in the Declaration of Independence and our Constitution on one hand and pervasive beliefs that people who are different from us are inferior can’t be reconciled. Our ideals are steadily winning and our beliefs are changing. While the changes sometimes seems glacial to those afflicted by discrimination, when we look at them through the long lens of history, the pace has been remarkably quick.

This article is based on an earlier version of my article published by HealthCentral.

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  • Helen O'Neill at

    Hi David – sad but true. I have the feeling also and wonder if you do – that doctors also discriminate against the obese – case in point: a cardiologist and
    my pcp both want to put me on a statin without even a suggestion or hint that perhaps exercise and weight loss would help the problem immensely. It’s discouraging. Aren’t they reading the same things I am about statins?

    • David Mendosa at

      Dear Helen,

      I am afraid that almost all medical professionals feel that they have to do the standard thing and don’t dare make independent judgements. Statins have so many negative consequences that they continue to ignore. I am glad that I am able to avoid them now.