December 21st, 2024

The Globalization of Anti-Fat Bias: Social Justice, Decolonization, and Transformative Pedagogy

By Jenna Ann Broderick

 

Link to the JSE December 2024 CECR Issue Table of Contents

Broderick JSE Dec 2024 CECR Issue PDF

 

Abstract: This paper examines the history and globalization of anti-fat bias and diet culture, highlighting how these ideologies have been perpetuated by both governmental and non-governmental actors, beginning with white European colonizers. Throughout history, fat bodies have been commodified, stigmatized, and pathologized, with the rise of global media and public health campaigns further reinforcing these harmful narratives. The paper explores how anti-fat bias has been entrenched within biomedical and mental health fields and examines the far-reaching consequences on individuals and societies. Additionally, it provides actionable steps for mental health professionals, educators, and policymakers to address these injustices through social justice frameworks, counselor self-reflection, and inclusive pedagogical practices. Ultimately, the paper calls for systemic change to confront weight-based discrimination and promote body diversity as an essential component of health and equity.

Keywords: anti-fat bias, diet culture, fatphobia, social justice, decolonization, body diversity, sustainability education, weight stigma

 

Positionality Statement

I acknowledge that my positionality, shaped by my identity as a cis-gender, queer, North American, small-fat, white woman with mental health lived experience, significantly influences my academic and advocacy work, as well as my research. My lived and embodied experiences, coupled with the privilege of critically studying mental health and higher education at the graduate level, provide a unique perspective that both informs and challenges the traditional narratives within mental health discourse.

Through intentional reflection and community-supported research, I strive to navigate the complex intersections of power, privilege, and oppression inherent in the systems in which we study. My work is guided by a commitment to honoring these intersections while actively exploring and challenging how my positionality may perpetuate or disrupt existing power dynamics. By bringing lived experience into the academic space, I aim to contribute to a more inclusive and socially just framework for understanding mental health, one that recognizes the value of diverse perspectives and the importance of community collaboration in transforming awareness and relevance within the institution (Hawke et al., 2022).

 

How and when did “fat” become synonymous with fear and disease, and how did it go global? Throughout this paper, I will trace the history and ultimate globalization of anti-fat bias and diet culture. The critical actors in this process started with early white European colonizers and have been perpetuated by significant non-governmental and governmental actors throughout history. Despite the rise in body acceptance, positivity, liberation, and neutrality movements, fat bodies remain monetized, demonized, stigmatized, medicalized, and ultimately weaponized within national and global media outlets, biomedical and mental health fields, and government agencies. I will also examine steps to address these injustices through liberatory and social justice work. The globalization of “the war on obesity,” anti-fat bias, fat-phobia, and diet culture must be addressed and seen as critical liberatory and social justice work.

In addition to the historical and cultural impacts of fatphobia, it is crucial to acknowledge how anti-fat bias intersects with other systems of oppression, such as racism, sexism, and ableism. This intersectionality, where other forms of marginalization compound the impacts of fatphobia, must be considered in the creation of inclusive educational and mental health frameworks. As Amin (2022) notes, an intersectional approach is essential to fully understand how these biases manifest and affect individuals, particularly marginalized communities. This perspective will be explored further in terms of how educators and professionals can be trained to recognize and challenge these layered oppressions.

This paper addresses the history and globalization of anti-fat bias and proposes actionable solutions that actively engage marginalized communities, healthcare professionals, and educators. By collaborating with community organizations that support fat individuals, especially those from marginalized racial and cultural backgrounds, this research aims to promote body autonomy and create inclusive spaces through grassroots initiatives and collaborative action (Harvey, 2023; Kinavey & Cool, 2019)

Reclaiming the Word “Fat”

History and Current Shifts

First, the word “fat” and living in a fat body are acceptable in body neutrality and body liberation communities (Kinavey & Cool, 2019; Matz, 2022). Society has stigmatized the word fat and left it offensive and oppressive. Forth (2012) traced some of our earliest white Eurocentric anti-fat biases back to the late eighteenth century. The author shared that a growing number of authors noted that several non-Western cultures deeply admire fatness and would, given the opportunity, purposely want to fatten themselves as much as possible. Nevertheless, discussions of such body fattening often included east-west comparisons and contrasts, as well as contemptuous accounts of how one non-Western culture or another perversely admired things that, they reasoned, any self-respecting European would dismiss as unhealthy, unattractive, and quite frankly disgusting (Forth, 2012). They continued that these looseness, greasiness, and sensuality reflected Western-conceived puritanical moral flaws attributed to Eastern peoples, such as sensuality, laziness, and indolence. This belief served as a warning for Western elites in this way, especially concerning the beauty and purity of women (Forth, 2012).

While the word ‘fat’ has historically been stigmatized and used as an insult, there has been a growing movement, especially within body liberation and fat acceptance communities, to reclaim ‘fat’ as a neutral or even positive descriptor. This reclamation challenges the negative connotations that have been deeply ingrained in society and reframes fatness as a legitimate and valid identity, not a source of shame (Tracy, 2021; Matz, 2022). The significance of this reclamation will be explored further as I examine how fatphobia intersects with other systems of oppression and its global implications for body autonomy.

History of Anti-fat Bias

Colonialism and Early Medicalization of Fatness

The illustrations above are also some of the earliest examples of blame misattributed to fat bodies and misidentified as health problems through a patriarchal white bias. To appreciate or seek fat, in the opinion of these white European elite men, was to diverge from the virtue, harmony, and proportion strongly associated with the classical heritage, hence the essential principles of Western civilization (Forth, 2012). This outlook is steeped in Eurocentric standards of beauty and morality. Examples of ‘European’ or ‘Western’ fatness and intentional fattening, which seemed to rise as the century went on, could be separated from any deep cultural acceptance of fat among ‘civilized’ people through such a lens, a tactic that appears to have been inextricably linked to the colonial imagination. This ethnomedical discourse claimed that, while innate variables could play a role in the etiology of corpulence, Europeans’ tendency to gain weight was due to uncontrollable causes (such as climate or inheritance) or failings in self-control (such as overindulgence) (Forth, 2012).

In pre-colonial cultures, fatness was often seen as a symbol of wealth, fertility, and beauty. For example, Forth (2012) shared that larger bodies were celebrated and associated with higher status and prosperity in Polynesian cultures. The author also shared that in some African communities, particularly among the Maasai, fatness in women was seen as an ideal, a sign of health, and the ability to produce strong offspring. These cultural norms were drastically altered with the onset of European colonialism, which imposed Western ideals of slimness and ‘civilized’ beauty standards, leading to the stigmatization of fat bodies in many regions (Forth, 2012).

The so-called ‘civilized’ conversation is saturated with racism and bias and continues through history. In the 1900s, archeologists equated finding artifacts of fat bodies with living primitively and proof of decadence and degeneration (Forth, 2012). The researcher posited that the anti-fat bias telegraph to colonizers encouraged white elites to see “fatness as evidence of ‘primitive’ impulses more appropriate to ‘savage’ than ‘civilized’ individuals” (p. 25). These constructs of fat phobia continue to work alongside racial prejudice, and several fat activists have likened size discrimination to racism. Due to its frequent use as a derogatory epithet, “fat” continues to cause discomfort. “Fat” has been reclaimed for those who are the targets of anti-fat bigotry, like many other disparaging labels applied to oppressed bodies. More people now identify “fat” as a substantial social identity justified by patterns of experiences, such as discrimination, beyond simple description (Tracy, 2021).

The Globalization of Anti-fat Bias

Historical, Cultural, and Medical Perspectives

The colonial history of anti-fat bias and fatphobia laid the groundwork for the later medicalization of fatness, particularly with the rise of the ‘obesity epidemic’ in the 1990s. During this period, fat bodies became pathologized, and the public health narrative framed them as both a societal burden and a health crisis (Lawson, 2022). This shift marked a transition from cultural stigma to institutionalized discrimination, where neoliberal values tied personal responsibility for weight to individual morality and health (Harvey, 2023). Consequently, fatphobia became embedded in policies, healthcare systems, and education, making it imperative to rethink these approaches through an intersectional lens. Fat activism, particularly from marginalized groups, began to challenge these views, advocating for body autonomy and the dismantling of systemic weight-based discrimination (Johansson, 2021).

Following the colonial period, the pathologization of fatness evolved as Western medical and racial ideologies began to converge. In the late 19th and early 20th centuries, eugenicists linked slimness to racial purity and health, reinforcing the view that fatness was a marker of moral and racial inferiority (Mulder, 2021). These views were influenced by colonial narratives that depicted larger bodies as ‘primitive’ and contrasted them with the ‘civilized’ slimness of European bodies (Forth, 2012). By the mid-20th century, these racial and moral frameworks evolved into the medicalization of fatness, culminating in the rise of the ‘obesity epidemic’ narrative in the 1990s. The colonial roots of fatphobia paved the way for the modern-day pathologization of fatness, setting the stage for the rise of the ‘obesity epidemic’ narrative in the late 20th century. This shift framed fatness as a health crisis, tying individual responsibility for weight loss to broader health outcomes and cementing the stigmatization of fat bodies in public health discourse (Benson & Rosen, 2023).

In addition to the historical and cultural impacts of fatphobia, it is crucial to acknowledge how anti-fat bias intersects with other systems of oppression, such as racism, sexism, and ableism. As Strings (2019) argued in Fearing the Black Body, the racial origins of fatphobia are deeply embedded in Western society, where fatness has been used to marginalize and racialize Black bodies. Fatness was historically linked to Blackness, framing it as ‘primitive’ and inferior, which compounded the experience of oppression for Black individuals (Strings, 2019). The author highlighted how this intersectional lens broadens our understanding of how weight-based discrimination disproportionately affects Black individuals and highlights the need for a more inclusive approach to anti-fat bias.

War on Obesity: From Pathologization to Public Health Crisis

With the rise of global public health initiatives, particularly in the late 20th century, fatness was increasingly framed as a medical issue rather than a cultural one. This shift from societal perspectives to a focus on ‘obesity’ as a health crisis marked the beginning of the so-called ‘War on Obesity,’ a global phenomenon that further entrenched fatphobia in both medical and public health frameworks (Jenkins, 2022; Benson & Rosen, 2023). Since the early 1990s, a fevered effort has been made to curb “obesity” globally. The World Health Organization (WHO) created the globalized, politicized, and moralized term “globesity” (a portmanteau for global obesity) to wage the “War on Obesity” or the “Obesity Epidemic” (Jenkins, 2022, p. 10).

This propagandized warfare encouraged moralized panic language toward fat, which has resulted in decades of sensationalism in global headlines in print publications and now multiple online forums. Multiple governments added obesity to lists of threats to public health that also included terrorism, war, floods, and disease pandemics that warrant government-wide initiatives (Jenkins, 2022). The globalization of anti-fat bias and weight stigma in institutions, private spaces, and media spread like wildfire.

The False Narrative of the “Obesity Epidemic”

The so-called “obesity epidemic” has caused a great deal of harm to fat people. The medical sector itself declared obesity an “epidemic,” similar to a communicable disease, which sparked a global fatphobia panic and was conducted under false pretenses (Benson & Rosen, 2023). In 1999, the Journal of the American Medical Association released an entire special-themed issue on “obesity,” which included incorrectly reported claims that “obesity” was responsible for 300,000 fatalities annually. The findings were not, in fact, causation but correlation (Benson & Rosen, 2023). Rosen pointed out that since such a novice mistake was being represented by “respected” scholars in a respected journal, no one questioned the research mistake nor demanded it was retracted publicly (2023).

Again, in 2004, similar, flawed, and problematic research was replicated by Mokdad et al., who incorrectly asserted that “obesity” caused early mortality to 400,000 deaths in the year 2000 (Benson & Rosen, 2023). Benson and Rosen once more clarified that, irrespective of its methodology, this study received substantial funding from the US government, the NIH, and the CDC. They also pointed out that the media significantly increased anti-fat prejudice in the general public on a globalized scale by widely disseminating the findings to the public through the CDC’s website (2023).

Threats to the War on Obesity

Flegal et al. conducted a new study in 2005 using the proper research approach (Benson & Rosen, 2023). They discovered that those in the “overweight” category of BMI had lower mortality rates than people in the “normal” weight category after correcting the sample issues from the earlier research and adjusting for gender, age, and smoking. In other words, “overweight” persons lived longer than “normal” weight people. The authors also argued that contrary to what Mokdad et al. had incorrectly claimed, the combined effects of “obesity” and “overweight” status only likely contributed to 26,000 fatalities in 2000.

Unfortunately, the “war on obesity,” which financially supported much research, was perceived as threatened by Flegal’s findings (Benson & Rosen, 2023). The CDC discreetly revised its conclusions, changing the 400,000 figure online to 26 thousand. However, as the researchers emphasized, the damage had already been done regarding anti-fat bias, and the globalized fatphobia panic had already been legitimized. The medical industry was financially benefiting from the rise in interest in funding research to treat a disease they had created. The “war on obesity” had also been encouraged by sensational media (Jenkins, 2022; Benson & Rosen, 2023).

The Reciprocated Monetization of Globalized Fat-phobia

Globalizing Western anti-fat biases and diet culture brought and continues to bring funding in full circle for several actors. The framing of fatness as a global epidemic created a lucrative ecosystem by sustaining funding for organizations like the WHO, supporting public health research initiatives, generating profits for the $50-billion diet industry, and fueling demand for bariatric surgery and prescription weight-loss drugs (Lawson, 2022). The researchers continued that journalists and media figures manufactured endless ominous headlines to relay to an increasingly worried population. Lawson also stated that it ensures profits for a $50 billion diet industry that works to fund medical research and campaigns and its market for prescription weight loss drugs (2022). The researcher posited that this relationship is mainly bought genesis and dangerous because “. . . anti-obesity campaigns, according to one public health law professor, should be “recast[ed] as unsexy and uncool . . . The younger fat-shaming begins, the better] (Lawson, 2022, p. 3).

This financial reciprocity led to the diet industry’s value of over $192 billion in 2019. That figure is projected to reach over $295 billion by 2027 (Benson & Rosen, 2023). However, Benson and Rosen (2023) noted that because of the physiological, hormonal, and metabolic alterations caused by calorie restriction, diets do not, in the long run, result in sustainable weight loss. According to O’Hara and Taylor (2018), the majority of people who attempt to lose weight through dieting end up gaining it back due to “weight cycling”. The authors discussed that between one-third and two-thirds of individuals who lose substantial amounts of weight on a dietary-based weight loss program will regain all the lost weight and more within five years (p. 12).

Other studies also demonstrate that dieting can have adverse long-term effects including weight cycling, psychological distress, and an increased risk of eating disorders (Matz, 2022). Furthermore, fat studies scholarship by Gillon and Pausé (2022) critiqued the failure of traditional weight loss methods, showing that dieting often leads to harmful physical and mental health outcomes. These findings underline the need to rethink the efficacy of dieting practices and their long-term consequences on health.

Global Anti-fat Bias

Western Media Ideals in the Non-Western World

Jensen and Arnett (2012) shared several research findings where Western media had negatively impacted adolescent girls’ body image in non-Western nations. Comparing themselves to Western physical appearance, they began to determine that their local standards of physical appearance were outdated and began to imitate the Western image they either found more appealing or were told was more appealing by media, portrayed by Western models in advertising, and actors in TV and movies (Jensen & Arnett, 2012). For example, in a study conducted by Bhugra et al. (2003), 68% of adolescent girls interviewed on the Caribbean islands of Trinidad and Barbados expressed acute anxiety about gaining weight. Bhugra et al. concluded that this anxiety was driven by the girls’ desire to conform to Western standards of thinness. Similarly, Jensen and Arnett (2012) noted that such pressures to embody Western ideals were widespread and influenced cultural perceptions of body image among these girls. A similar, more recent study by Zainal et al. (2020) shared that Western media ideals are attributed to body dissatisfaction, the internalization of the anti-fat bias, thin-ideal, and eating pathology in Kuwaiti adult women.

Gillion and Pausé (2022) shared their research in fat studies, where they work to counteract the effects of colonization and globalized anti-fat bias. The researchers stated that white Euro-western ideologies of health and wellness and ideal body shape do not acknowledge the vitality and health of their Indigenous Māori people. The WHO campaigns and Western diet culture embraced Westernized neoliberal frameworks of health, both of which Gillion and Pause’s fat studies and Kaupapa Māori reject (2022). The researchers are also taking back social media to raise awareness to reject deficit framing, the pathologizing of Māori and fat people, and critical awareness around who defines health from what position, for whom, and for what purpose. Both viewpoints shed light on how we may develop more inclusive conceptions of health and offer obese people access to health (Gillion & Pausé, 2022).

Impact on Biomedical and Mental Health Treatment

Biomedical Treatment

Stoll (2019) explored the background of the medicalization of obesity and posed the question, “What happens when a condition is medicalized?” (p. 426). The researcher’s question responded to the injustice and dangers of medicalizing human bodies under the guise of calling it a medical condition. The medicalization of bodies established and validated a power differential between medical professionals and those who are marginalized by asserting that a condition can only be treated through a biological model and that only medical professionals possess the knowledge and experience to speak authoritatively about it (Stoll, 2019). Furthermore, the “fat as uncivilized” narrative that puritanical white European men constructed has evolved into the moralized “fat is a choice” narrative and is perpetuated in doctor’s offices and through public health initiatives (Harvey, 2023).

Doctors often prescribe weight loss as treatment rather than treating the actual medical issue (Ramos Salas et al., 2019). As such anti-fat bias causes major injustices and discriminatory treatment in biomedical and mental health practices. Examples include seeing the client’s body rather than their surrounding systems as the problem, causing fat patients to receive different treatment and care than thin patients with the same symptoms (Tomiyama et al., 2018, as cited in Oliver, 2022). Tomiyama et al., 2018 stated that through this practice, weight loss becomes the first line of treatment, and practitioners refuse any further line of inquiry or discussion (as cited in Oliver, 2022). This hyperfixation of weight, body size, and first-line recommendations for weight loss can cause delayed or harmful treatments and cause disordered eating (Harvey, 2023). Harvey (2023) also noted startling issues, schisms, and family shaming when women who are primary caretakers and food preparers are often prescribed more significant medical neoliberal pressure. The author shared that the standard that mothers and caretakers are held to, the “healthy” range that the BMI defines, is arbitrary at best.

Mental Health Treatment

Kinavey and Cool (2019) stated, “As [mental health] professionals, it is our ethical duty to unpack and address this prejudice and to shift our focus and commitment to the human being who inhabits the body” (p. 5). In the therapeutic context, anti-fat bias should be regarded as microaggressions, and body acceptance/neutrality should be considered a form of body autonomy (Kinavey & Cool, 2019). While there should be no limits to accepting another human being’s body, “obesity” is unjustly included in the American Psychiatric Association’s (APA) fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) (Blanchette, 2019). Diagnoses in the DSM are also often “grounded in the social discourse of immorality that pathologizes difference from white heteronormative cis-gendered colonial ideals” (Blanchette, 2019, p. 87).

Moreover, while the DSM-V quickly labels fat as deviant and pathological, Blanchette (2019) emphasized the need to review all mental health states through a socio-political lens. Researchers and advocates may disagree that fatness belongs in the DSM-V, but the essential issue with its inclusion is that the BMI classifies the body, and the DSM classifies the mind. “Inclusion of obesity in the DSM-V marks an attempt to solidify a biomedical relationship between obesity and mental illness, such that fat embodiment is surveilled and punished as physical and mental deviance” (Blanchette, 2019, p. 79). Further, obesity is the only condition listed in the DSM-V that does not “pertain to behavior or trauma, but to physicality and appearance, suggesting it is the only embodiment that can be directly linked with mental illness” (Blanchette, 2019, p. 81).

Understanding Internalized Weight Stigma in Society and Counseling

Internalized weight stigma is not a phenomenon that spontaneously arises within an individual. For many, living in a fat body means internalizing society’s fat-phobic messages and enduring social stigmatization in a culture that equates fatness with negative social connotations (Kerl-McClain et al., 2022; Harvey, 2023). Society, through the diet industry and the medical establishment, perpetuates neoliberal narratives that portray fatness as a personal failure requiring correction (Harvey, 2023). In this context, the individual is blamed for failing to achieve a “healthy” weight, often in the absence of consideration for the broader social determinants of health (Afful & Ricciardelli, 2015, as cited in Harvey, 2023).

The United Nations Declaration of Human Rights, for instance, does not recognize weight or body size as protected grounds (Moore, 2021). Despite evidence suggesting that weight-discrimination laws may help reduce weight stigma, fat people continue to lack legal protections in many North American contexts, particularly in the workplace (Shinall, 2016, as cited in Harvey, 2023). This legal and social invisibility contributes to ongoing weight-based discrimination and the reinforcement of harmful fatphobic beliefs.

Professional counselors and counselors-in-training (CITs) are well-suited to be agents of change in this arena. Kerl-McClain et al. (2022) assert that counselors, grounded in fat studies, the ACA Code of Ethics (2014), and decolonization work, must commit to the uncomfortable but necessary work of unpacking their own anti-fat biases. Counselors and CITs should also examine how these biases intersect with racism, classism, and sexism (Kinavey & Cool, 2019).

Moreover, counselors must create inclusive environments that accommodate the needs of clients of all body sizes. A few practical strategies include offering a variety of seating options, such as armless chairs or couches that are not too low to the ground, ensuring that all body types feel welcome in the therapeutic space (Kinavey & Cool, 2019). Counselors can also advocate for the dismantling of the financial support that the diet industry receives and demand that public spaces become more equitable for individuals with larger bodies (Kase & Mohr, 2022, as cited in Kerl-McClain et al., 2022).

At the heart of combating internalized weight stigma is centering the voices of fat individuals, particularly those from marginalized racial and cultural communities. Community storytelling is an essential tool in this process, as it amplifies the lived experiences of weight-based discrimination and highlights how these experiences intersect with other forms of oppression. Through these stories, we gain a more nuanced understanding of how internalized stigma manifests differently across communities. Collaborating with community leaders and activists is critical to shifting the narrative around fatness and fostering more inclusive spaces that support body autonomy (Kerl-McClain et al., 2022; Mulder, 2021).

The Role of Fatphobia as a Social Control Mechanism

Anti-fat bias, particularly as it manifests in medical and educational systems, can be understood not just as a cultural issue but as a tool of social control. Michel Foucault’s concept of “biopower” helps us understand how fatness has been pathologized and policed. Foucault (1975) argued that modern institutions, including healthcare and education, exert control over individuals’ bodies through surveillance and regulation. In the case of fat bodies, this surveillance manifests in the way fatness is treated as a medical condition to be “corrected.” The medicalization of fatness ties into the broader societal pressure to conform to idealized body size, positioning fat bodies as sites of failure and disorder.

In this context, education and counseling are pivotal in reinforcing these norms. By failing to address the systemic causes of weight stigma and not adequately training educators and counselors on the negative impacts of anti-fat bias, these institutions inadvertently uphold the larger societal power structures that seek to regulate fat bodies. Foucault’s idea of “discipline,” how institutions impose normative behaviors and appearances on individuals, can be applied to how education and counseling subtly, and sometimes overtly, enforce conformity to body ideals. The body, in this case, becomes a site of both individual and institutional control, where fatness is treated as something to be fixed or eliminated.

Connecting Fatphobia with Western Cultural Narratives
The cultural narratives surrounding fatness, particularly in the West, have been deeply shaped by the work of feminist scholars like Bordo. Bordo’s (1993) seminal work Unbearable Weight examines how cultural anxieties about women’s bodies are often projected onto fatness. In their analysis, Bordo explains that fatness is seen as a failure of self-discipline and personal control. These cultural assumptions have filtered into education and counseling, where fat individuals, particularly women, are often subjected to the belief that they are inherently flawed or lacking in willpower. Bordo’s analysis helps us understand that fatphobia is not just a personal prejudice but is tied to broader cultural fears about gender, power, and control (1993). The ‘war on obesity’ rhetoric perpetuates these ideas, framing fatness as a moral failure, something that must be “fixed” through individual responsibility. This narrative is often embraced by counselors and educators who are socialized into these cultural assumptions and fail to see fatness through a more critical, systemic lens.

John Berger’s Ways of Seeing (1972) also provides a crucial framework for understanding the visual stigma attached to fatness. Berger focused on how bodies are seen and how societal structures shape those perceptions. In the case of fatness, the portrayal of fat bodies in media and education often reinforces negative stereotypes, making fat individuals feel objectified and dehumanized. This visual stigma extends into educational settings, where fat students may feel invisible or alienated, as their bodies do not fit the dominant ideals of what is considered “normal” or “desirable” (Berger, 1972).

The Role of Counseling and Education in Perpetuating Anti-Fat Bias

Counseling and education are not neutral spaces; they are shaped by societal norms, including those around body size (Kinavey & Cool, 2019); Puhl & Latner, (2007). Research such as Kerl-McClain et al. (2022) consistently shows that both counselors and educators may unintentionally perpetuate anti-fat bias, which affects their ability to effectively support fat clients and students. Kerl-McClain et al. (2022) highlighted that many counselors-in-training are unaware of their implicit anti-fat biases, contributing to harm when fat clients are not given adequate or appropriate care. For example, a counselor working with a fat client seeking help for anxiety may, without recognizing their own bias, immediately suggest weight loss as a solution. This response reinforces the idea that fatness is inherently linked to mental distress, while overlooking broader psychosocial factors at play.

The issue of anti-fat bias extends beyond counseling to education as well. In schools, fat students often face discrimination that hinders their academic and emotional development. Puhl and Latner (2007) found that fat students are frequently subjected to bullying and have their abilities underestimated, as teachers and administrators may unknowingly prioritize thinness and physical appearance over qualities like intelligence, creativity, and resilience. Without proper training in body acceptance and the harms of weight stigma, educational environments can become hostile for fat students, leading to lower academic expectations and poorer mental health outcomes (Puhl & Latner, 2007).

Manifestations of Anti-Fat Bias in Counseling and Counselor Education

Anti-fat bias can manifest in various ways in both counseling and counselor education, undermining therapeutic effectiveness and perpetuating harmful weight-based stigma. Kinavey and Cool (2019) explained that in counseling settings, counselors, whether consciously or unconsciously, may attribute clients’ psychological and emotional issues to their body size, reinforcing weight bias and potentially leading to harmful interventions. For instance, counselors may suggest weight loss as the first line of treatment for mental health struggles, such as anxiety or stress, without considering underlying psychological or social factors (Kinavey & Cool, 2019). This approach oversimplifies clients’ concerns, perpetuates the stereotype that fatness is inherently linked to mental health problems, and dismisses other important dimensions of mental well-being.

Similarly, anti-fat bias is prevalent in counselor education, where training programs often fail to adequately address or challenge biases regarding body size. Kerl-McClain et al. (2022) noted that counselor education programs frequently overlook how biases about body size can impact therapeutic practice. Counselors-in-training who harbor implicit anti-fat biases may unintentionally perpetuate these biases when working with fat clients, furthering a cycle of discrimination. These biases can undermine the therapeutic relationship, making it difficult for fat clients to feel safe and supported.

A common manifestation of this bias is the tendency of counselors to make weight loss the central focus of therapy, even when the client’s concerns may not be related to their body size. This reinforces the idea that fatness must be “fixed,” which can alienate clients and discourage them from returning to therapy (Kerl-McClain et al., 2022). In addition, microaggressions such as using weight-focused language or making assumptions about a client’s lifestyle can create an unwelcoming and harmful therapeutic environment for fat clients. These microaggressions not only harm individual clients but also reflect broader systemic issues within counseling and mental health education (Kerl-McClain et al., 2022).

A specific example comes from Matz (2022), who described a situation in which a counselor assumed that a fat client’s trauma history was linked to emotional eating, neglecting the broader context of the client’s experiences. This weight-centric approach ignored the complexity of the client’s trauma and inadvertently retraumatized the individual. This case underscores the need for a more comprehensive, non-judgmental therapeutic approach that addresses the full spectrum of a client’s experiences and avoids pathologizing body size (Matz, 2022).

Finally, counselor education programs often fail to adequately prepare future therapists to recognize and confront their biases related to body size. While some programs may briefly touch on weight stigma, they often do not engage deeply with how these biases can impact the therapeutic process. Kerl-McClain et al. (2022) recommended that counselor training programs include more thorough discussions about body size, foster critical self-reflection, and actively challenge implicit weight biases. By promoting a body-neutral and inclusive perspective, counselor education can better equip future therapists to provide equitable care to clients of all body sizes.

Practical Applications and Capacity Building

The globalization of anti-fat bias and diet culture not only reflects a deeply entrenched system of oppression but also presents an opportunity for significant change within educational and policy frameworks. The findings of the aforementioned research offer vital insights that can be translated into practical, actionable interventions designed to dismantle these harmful biases and foster more inclusive and equitable environments. This section explores several pathways for applying the research in educational and policy settings, mainly through training mental health professionals, educators, and policymakers to recognize and address anti-fat bias.

Training Mental Health Professionals

Mental health professionals, particularly counselors and therapists, are often on the front lines of addressing body image issues and the effects of weight stigma (Kerl-McClain et al., 2022). However, many practitioners may unknowingly perpetuate anti-fat bias through their clinical practices. To address this, educational institutions and professional organizations must develop comprehensive training programs focusing on the following key areas: recognizing anti-fat bias in therapeutic settings, developing culturally responsive approaches, and promoting body autonomy in therapy (Kerl-McClain et al., 2022; Kinavey & Cool, 2019).

Recognizing Anti-Fat Bias in Therapeutic Settings

Training programs should equip mental health professionals with the tools to recognize and dismantle the pervasive anti-fat bias that can influence diagnosis and treatment. This involves critically examining their own biases, as well as addressing systemic issues within the mental health field that pathologize fat bodies (Kinavey & Cool, 2019). For example, practitioners could be trained to identify and challenge their assumptions about weight and health, ensuring that treatment plans focus on holistic well-being rather than solely promoting weight loss (Stoll, 2019).

Developing Culturally Responsive Approaches

To create a more inclusive mental health care system, professionals must be trained in culturally responsive approaches that honor body diversity and respect clients’ lived experiences. This involves rejecting a one-size-fits-all approach to health and wellness and embracing frameworks that recognize the social, cultural, and historical factors contributing to anti-fat bias (Kinavey & Cool, 2019). Counselors’ training programs should incorporate practical workshops on cultural humility, body neutrality, and size acceptance (Harvey, 2023).

Promoting Body Autonomy in Therapy

Mental health professionals can also be taught to promote body autonomy in therapy, empowering clients to decide about their bodies free from societal pressures related to weight and appearance. This could include teaching techniques such as body positivity, body neutrality, and fat liberation within therapeutic contexts (Kerl-McClain et al., 2022). Promoting body autonomy ensures that mental health care fosters a sense of agency and self-determination for all individuals, regardless of body size.

Practical applications of this research include community-based initiatives like fat-positive workshops in schools, counseling services, and healthcare institutions. These workshops should aim to educate educators, healthcare providers, and counselors about the harm of weight stigma and the importance of creating inclusive, body-positive spaces (Kinavey & Cool, 2019). By engaging community leaders, healthcare professionals, and educators, these initiatives can foster systemic change at the institutional level. Furthermore, policy changes must be advocated for to address weight bias in public health, education, and workplace settings. These efforts should be grounded in collaboration with grassroots organizations to dismantle weight stigma and promote body autonomy (Matz, 2022).

Curriculum and Professional Development for Educators

Pedagogy and Training

Educators are vital in shaping societal attitudes toward body size and health. Anti-fat bias, which has deep historical and cultural roots, continues to pervade educational settings, from K-12 schools to universities (Forth, 2012). To address this issue, educators must have the tools to foster inclusive and equitable learning environments. Schools and universities should incorporate curricula that challenge the dominant narratives of diet culture and anti-fat bias, promoting body diversity as a core component of health and wellness education (Blanchette, 2019).

Curriculum Development

Curricula should be redesigned to avoid the traditional focus on weight management and instead emphasize overall physical, emotional, and mental well-being, regardless of body size. For example, health and physical education programs can explore the history of anti-fat bias, tracing its colonial roots and critiquing how Eurocentric ideals have shaped global perceptions of health and beauty (Forth, 2012; Kinavey & Cool, 2019). By integrating courses that challenge dominant narratives of diet culture, such as those outlined in this research, schools can promote body diversity as a core component of health and wellness education (Blanchette, 2019). Activities that encourage students to critically analyze media representations of fatness and public health campaigns will foster a deeper understanding of how these narratives perpetuate stigma (Jensen & Arnett, 2012; Benson & Rosen, 2023).

Professional Development for Educators

Educators play a crucial role in shaping social attitudes toward body image, which is why they need to be equipped to recognize and challenge anti-fat bias in their teaching methods. Anti-fat bias can manifest in various ways within educational settings, such as biased curriculum materials that emphasize thinness, classroom debates that perpetuate harmful stereotypes about larger bodies, and interactions where students with different body sizes are marginalized or ridiculed. According to Kinavey and Cool (2019), anti-fat bias in psychotherapy, for example, has been shown to impact relationships negatively, and similar biases in the classroom can hinder effective teaching and learning. To address these challenges, professional development programs are essential for helping educators recognize weight stigma and develop strategies to challenge it in their teaching practices. These programs should promote body diversity, challenge stereotypes, and create a more inclusive classroom environment.

As noted by Gillon and Pausé (2022), such initiatives can help educators design curricula and foster more equitable interactions, encouraging all students, regardless of body size, to engage fully. Jensen and Arnett (2012) further support the importance of providing educators with tools to recognize and address body image issues in ways that support students’ self-esteem and learning. Through these targeted professional development efforts, educators can actively create an inclusive and equitable learning environment where all students feel valued and respected.

Workshops on Inclusivity and Body Autonomy

Effective professional development programs should include comprehensive training on body autonomy, diversity, and the consequences of promoting weight stigma in the classroom (Kinavey & Cool, 2019). These courses should help educators understand the systemic basis of anti-fat bias and how it links with other types of oppression, including racism, sexism, and ableism. By equipping educators with the knowledge to recognize both explicit and implicit types of bias, they may foster more supportive settings in which all students, including those with larger bodies, feel valued and respected.

Addressing Microaggressions and Implicit Bias

According to Harvey (2023), anti-fat bias frequently presents itself in the form of microaggressions, which are subtle but destructive words or acts that perpetuate stereotypes and marginalize students. These microaggressions can harm a student’s self-esteem, mental health, and academic performance. As a result, professional development should focus on assisting educators in identifying and challenging microaggressions and cultivating a classroom culture that values body diversity.

Reflexive Practices for Educators

As Stoll (2019) addressed, professional development programs should emphasize the value of reflexive behaviors. Reflexivity helps educators to question their views, assumptions, and biases regarding body size and health. This self-awareness is essential for breaking down negative preconceptions and developing lesson plans and curricula demonstrating a commitment to diversity (Stoll, 2019). Educators who engage in reflexive practices can better create a school atmosphere that respects and values all body shapes.

Developing Inclusive Teaching Strategies

Furthermore, educators must understand how to incorporate size-inclusive teaching practices into instructional resources. This could entail scrutinizing textbooks and teaching materials for fatphobic content and ensuring that classroom discussions do not perpetuate negative stereotypes (Kerl-McClain et al., 2022). Educators should be educated to enable discussions that challenge cultural norms about body size and promote critical thinking about media portrayals of health and beauty standards.

Long-term Benefits of Professional Development

Educators participating in ongoing professional development addressing anti-fat bias can advance significantly toward fostering inclusive and equitable learning environments. These initiatives assist students in bigger groups and contribute to a broader culture of inclusion and diversity, allowing all students to prosper intellectually and personally in a supportive educational environment.

Integration of Social Justice Frameworks

Institutions must implement transformational and inclusive pedagogical approaches based on social justice frameworks to address anti-fat bias in educational settings. Drawing on decolonizing strategies, educational approaches should actively reject colonial narratives that pathologize fat bodies in favor of celebrating body diversity (Tuck & Yang, 2021). This decolonizing viewpoint acknowledges that Western ideals of beauty and health, which criticize fatness, are forms of cultural erasure and ongoing colonialism.

Furthermore, an intersectional approach is essential in training educators to understand how fatphobia intersects with other systems of oppression, such as racism, sexism, and ableism (Amin, 2022). Educators should be trained to apply inclusive practices that center the voices of fat individuals, particularly those from marginalized communities, to create genuinely equitable learning environments. This aligns with the broader goals of social justice education, which seeks to dismantle systemic barriers and foster solidarity among diverse student populations.

Lastly, adopting a horizontalist framework in educational spaces empowers students and educators alike to participate in collective decision-making processes that challenge traditional power hierarchies (Sitrin, 2012). By incorporating peer-based learning models and creating opportunities for students to co-create curricula, institutions can foster a more inclusive and participatory educational environment where all bodies are valued.

Policy Implications and Advocacy

The findings of this research have important implications for public policy and advocacy efforts aimed at dismantling systemic anti-fat bias. Local, national, and international policymakers must be encouraged to consider weight discrimination’s role in shaping health care, education, and employment outcomes for individuals in larger bodies (Harvey, 2023); Kinavey & Cool, 2019; Oliver, 2022). Critical examination is needed within anti-discrimination legislation and public health campaigns.

Anti-Discrimination Legislation

One practical application of this research is promoting anti-discrimination legislation that explicitly protects individuals from weight-based discrimination in the workplace, schools, and healthcare settings. By advocating for the inclusion of weight as a protected category under existing anti-discrimination laws, policymakers can take concrete steps toward reducing the pervasive impact of anti-fat bias on people’s lives (Oliver, 2022). This may include advocating for policy changes that hold employers, educators, and healthcare providers accountable for discriminatory practices based on body size.

Public Health Campaigns

Public health campaigns can also play a critical role in addressing anti-fat bias at a societal level. Rather than focusing on weight loss as a public health goal, campaigns should shift towards promoting body diversity and health at every size (HAES) approach (Kinavey & Cool, 2019). These campaigns could educate the public about the harmful effects of weight stigma and challenge the pervasive myths that equate thinness with health (Harvey, 2023). Advocating for using inclusive and non-stigmatizing language in public health messaging could help reduce the negative impact of anti-fat bias on individual and community health.

Conclusion

Our work in mental health and education is not to help people adjust to oppression but to actively challenge the structures that sustain it. This paper argues that the fight against anti-fat bias requires a theoretical shift and actionable change rooted in community engagement. By working with community-based organizations, healthcare providers, and educators, we can begin to dismantle the systemic weight stigma that pervades our institutions. A decolonizing approach that centers the voices and experiences of marginalized fat individuals, especially Black, Indigenous, and People of Color (BIPOC), is necessary for creating a genuinely inclusive and body-positive society. This research calls for collaboration and collective action to transform institutional policies and social norms around body size.

Recognizing how anti-fat bias manifests in our environments and the lives of mental health clients and students is a crucial step toward fostering a liberatory consciousness (Kinavey & Cool, 2019). To effectively combat the harm caused by anti-fat bias, we must resist the ideological framework that pathologizes fatness and denies fat people their expertise and agency over their own experiences. As author and fat activist Gordon (2020) asks, “What would become of us if we sat quietly with our misconceptions, examined them, and looked at the effects they created? What if, for once, we spoke with fat people instead of about fat people?” (as cited in Tracy, 2021, p. 4).

This paper underscores the urgent need for systemic change to confront the globalization of anti-fat bias and diet culture. By applying these findings within educational and policy frameworks, we can empower mental health professionals, educators, and policymakers to dismantle anti-fat bias and foster more inclusive, equitable environments. These efforts must be grounded in a commitment to social justice, body autonomy, and the liberation of marginalized communities from harmful societal norms related to body size. Through this approach, we can create tangible, lasting change that supports personal and collective well-being in a world where body diversity is embraced rather than pathologized.

While this paper does not present original empirical data, it aims to contribute to the ongoing dialogue surrounding anti-fat bias and its global implications. By synthesizing existing research and exploring the intersections of fatphobia with other systems of oppression, this paper offers actionable recommendations for educators, mental health professionals, and policymakers to create inclusive environments and challenge anti-fat bias at a systemic level. On a global scale, confronting anti-fat bias is a matter of individual transformation and systemic change. The globalization of anti-fat bias, fueled by diet culture, the medical industry, and media narratives, continues to perpetuate harmful stereotypes and exclusionary practices. Therefore, it is imperative that we advocate for policies and practices that recognize the dignity of all bodies, regardless of size, and work towards a more inclusive, equitable society. By dismantling these biases at every level, we can create a world that embraces body diversity as an integral part of global health and well-being.

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