Weight Bias: Nature, Consequences, and Remedies

By Weiss, Fran | American Journal of Psychotherapy, January 1, 2007 | Go to article overview

Weight Bias: Nature, Consequences, and Remedies


Weiss, Fran, American Journal of Psychotherapy


K.D. BROWNELL, R.M. PUHL, M.B. SCHWARTZ, L. RUDD, (eds): Weight Bias: Nature, Consequences, and Remedies. The Guilford Press: New York. 2005, 320 pp., $35.00, ISBN 1593851995

Weight Bias focuses on what the authors suggest is the last accepted arena of discrimination, obesity. The field of obesity research has come a long way since Theodore B. Van Itallie produced his original research on metabolism and Albert Stunkard's oriented the profession, as well as the public, to the unspoken emotional pain of the obese in the Pain of Obesity. These historic giants in the field laid the groundwork for the present-day centers of excellence in the field of obesity research. With Weight Bias, Brownell et al have taken on the enormous challenge of producing a substantial work on the stigma and bias surrounding obesity. The book successfully demonstrates that although overweight and obesity are linked to a long list of diseases, what is generally not recognized is the extent to which stigma, bias, and discrimination affect the health of obese individuals. This is an important book. It's wide scope, which provides a history of the field of obesity research from the 1960s to the present, may be its weakness as well as its strength. That being said, it is a thought-provoking work, which will inform the public as well as anyone working in this field.

The twenty-two chapters in the book are divided into four Parts: "The Nature and Extent of Weight Bias"; "Origins, Explanations and Measurements"; "Consequences of Weight Bias"; and "Remedies". Part I demonstrates the prevalence of weight bias in employment, health care settings, the media, and among children and teens. Janna Fikkan and Esther Rothblum supply ample evidence of weight bias in hiring, pay equity, and other work-related areas, and the book provides an extensive examination of the legal ramifications of making "excess fat" a legal disability. In a discussion of health care workers in health care settings, Anthony Fabricatore, Thomas Wadden, and Gary Foster describe the inadvertent, insidious collaboration between patient and physician surrounding weight loss issues, which occurs in the transference and countertransference of the relationship. The suggested scenario goes something like this: A patient is told to lose weight. When the patient does not follow through, the health care provider becomes less invested in the patient, who in turn becomes discouraged. Fabricatore & Wadden emphasize that it is inappropriate and inaccurate to assume that obese individuals must also have some form of psychopathology, raising the age-old question: Is obesity a psychosomatic illness? They argue that top experts in the obesity field deem genetic, rather than psychological factors, and lack of physical activity to be the primary causes of obesity. The latter chapters of Part I grapple with the emotional fallout of obesity in children and teens in a society where thinness is cherished.

Part II is a rather lackluster, if informative, examination of the origins of the stigma in obesity. …

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