Note: this article will discuss bigoted ideas about weight and mortality. If you’re feeling sensitive today, it might not be the right time to read this article. Just in case you still want the big takeaway (without the triggers) it’s this: according to research, just being in a bigger body is not the problem; discrimination is. Any claims that higher weight people are just “less healthy” don’t take into account the deleterious health effects of ongoing social stigma.
One of the most triggering things you’ll hear in the ongoing national conversation about weight is that being fat is tantamount to decreased life expectancy. According to a 2015 paper, however, health/life expectancy disparities that do exist between fat and thin people may actually be a product of discrimination - not weight itself.
Let’s break this abstract down:
1: “Discrimination based on weight is a stressful social experience linked to declines in physical and mental health.”
This opener indicates that the way that fat people are treated and seen in society leads to stress. In scientific research, “stress” isn’t just a casual reference to a hard day. Stress refers to consistently being in fight-or-flight mode, evidenced by the production of cortisol. This is the kind of stress that people in stigmatized groups (including BIPOC, queer and trans people and higher weight people) experience. For sexual minority groups, chronically high levels of stress have been correlated with increased rates of mood and anxiety disorders and substance use. In general, this type of stress is really hard on the body and it’s really hard on the mind and the spirit.
2: “We examined whether this harmful association extends to risk of mortality.”
The researchers were interested in figuring out if that chronically high level of stress didn’t just lead to physical and mental health declines, but also potentially shortened a person’s life.
3: “Participants in the Health and Retirement Study (HRS; N = 13,692) and the Midlife in the United States Study (MIDUS; N = 5,079) reported on perceived discriminatory experiences and attributed those experiences to a number of personal characteristics, including weight.”
Note the large sample sizes: 13,692 and 5,079. These are large studies, meaning that the results from this research can’t just be disregarded as outliers or flukes. Participants were asked to share times they'd experienced discrimination and the reasons they felt the experiences were happening. Yes, these reports are subjective, but what matters when it comes to stress is the perception that the discrimination is happening because of a characteristic. This subjective report is typically based on previous life experience and social attitudes that have been internalized.
4: “Weight discrimination was associated with an increase in mortality risk of nearly 60% in both HRS participants (hazard ratio = 1.57, 95% confidence interval = [1.34, 1.84]) and MIDUS participants (hazard ratio = 1.59, 95% confidence interval = [1.09, 2.31]). This increased risk was not accounted for by common physical and psychological risk factors.”
These hazard ratios and confidence intervals mean that we can be confident that this finding is accurate for the population that was studied. So what does the 60% increase in mortality risk mean? It means that of the people who died between the time when the study was initially done and the follow-up (ranging between 1 month and 84 months from the initial study), that the people who reported that they experienced weight discrimination were 60% likelier to be among those people who had died. The researchers accounted for behavioral and clinical risk factors, and were able to isolate weight discrimination (not weight itself) as the true mortality risk.
5: “The association between mortality and weight discrimination was generally stronger than that between mortality and other attributions for discrimination. In addition to its association with poor health outcomes, weight discrimination may shorten life expectancy.”
The researchers looked at other forms of discrimination that participants experienced - not just weight-based - including discrimination based on race, ethnicity, sex, age, appearance, physical disability, and sexual orientation. Mortality risk was highest for people who experienced weight-based discrimination and ableism. And finally, weight discrimination didn’t just lead to worse physical and mental health, the researchers believe there’s a correlation between weight discrimination and living a shorter life.
“Many of the diseases associated with obesity (e.g., hypertension, diabetes) are stress-related diseases that may develop, in part, from the stress of discrimination (Muennig, 2008).”
So, why does this matter?
What this paper shows is that higher weight people may, in fact, live shorter lives - not because of our bodies, but because of how we are treated in society. This finding shows us that when people express concern over fat people being fat, that the best thing we can respond with is, “Doing your part to end systemic fatphobia is the best thing you can do for my health.”