Sources of Weight Bias

Bon Bon Fatty Girl: A Qualitative Study of Weight Bon Bon Fatty Girl: A Qualitative Study of Weight Bias in SingaporeBias in Singapore

Patti Lou WatkinsPatti Lou Watkins(based on a thesis by Maho Isono)(based on a thesis by Maho Isono)

Oregon State University Oregon State University

Sources of Weight BiasSources of Weight Bias

Media MessagesMedia Messages• AdvertisementsAdvertisements

ProductsProducts Partners (HWP)Partners (HWP)

• TV & MoviesTV & Movies• Music VideosMusic Videos• BooksBooks• NewspapersNewspapers• CartoonsCartoons

Personal RelationshipsPersonal Relationships• FamilyFamily

ParentsParents SiblingsSiblings Other RelativesOther Relatives

• PeersPeers• PartnersPartners• Teachers/CoachesTeachers/Coaches• StrangersStrangers

SingaporeSingapore Southeast AsiaSoutheast Asia

• Smallest countrySmallest country• Densely populatedDensely populated• 4.68 million people4.68 million people

British Rule 1945British Rule 1945 Independence 1965Independence 1965

• Rapid economic developmentRapid economic development• Top 20 wealthiest nations in Top 20 wealthiest nations in

20072007• Continued economic growth Continued economic growth

expectedexpected

SingaporeSingapore DemographicsDemographics

• Chinese = 75.2%Chinese = 75.2%• Malay = 13.6%Malay = 13.6%• Indians = 8.8%Indians = 8.8%• Eurasians = 2.4%Eurasians = 2.4%

LanguageLanguage• National language is National language is

MalayMalay• Official languages are Official languages are

English, Malay, English, Malay, Mandarin, and TamilMandarin, and Tamil

• English is primary English is primary language of education, language of education, government, etc.government, etc.

Singapore’s “Progress”Singapore’s “Progress”

Once a poor country, body fat was Once a poor country, body fat was celebratedcelebrated

Now a wealthy country, body fat is Now a wealthy country, body fat is abhorredabhorred

Desire for thinness related to preference for Desire for thinness related to preference for English language (Wang et al., 1999)English language (Wang et al., 1999)

““Not more than a few decades ago, the Not more than a few decades ago, the concept of beauty was a lady who would concept of beauty was a lady who would be, by today’s anorexic standards, an be, by today’s anorexic standards, an overweight woman averaging more than 70 overweight woman averaging more than 70 kgs. These days, women weighing more kgs. These days, women weighing more than 40 kgs may be considered too big” than 40 kgs may be considered too big” (Fung, 2004).(Fung, 2004).

Singapore’s Slimming Centers Singapore’s Slimming Centers & Products& Products

Chinese Caterpillar Fungus And Glossy Ganoderma

AT LAST A SLIMMING PILL THAT ACTUALLY WORKS

F-Cell - Reducing LotionA lotion with a reducing, lipolytic and stimulating action. Grapefruit and pineapple extracts, together with caffeine's stimulating effect, help

reduce fat deposits.

Singapore Experiences an Singapore Experiences an Increase in Eating DisordersIncrease in Eating Disorders

Two cases reports published in 1982Two cases reports published in 1982• Kua, Lee, & Chee, 1982; Ong, Tsoi, & Cheah, 1982Kua, Lee, & Chee, 1982; Ong, Tsoi, & Cheah, 1982

Eating Disorders Clinic established in 1995Eating Disorders Clinic established in 1995 Six-fold rise in documented cases between 1994 & Six-fold rise in documented cases between 1994 &

20022002• Ung, 2005Ung, 2005

Most clinical presentations of eating disorders were Most clinical presentations of eating disorders were females (91.3%) who were teenagers at time of females (91.3%) who were teenagers at time of onsetonset• Lee et al., 2005Lee et al., 2005

Prevalence of females at risk for eating disorders is Prevalence of females at risk for eating disorders is 7.4%7.4%• Ho et al., 2006Ho et al., 2006

Investigation of Factors Related to Investigation of Factors Related to Eating Disorders in SingaporeEating Disorders in Singapore

Ethnographic studyEthnographic study• Provides an “insider’s perspective”Provides an “insider’s perspective”

Researcher lived in SingaporeResearcher lived in Singapore• Three monthsThree months

Recruited participants through the Recruited participants through the Institute of Mental Health Institute of Mental Health • Eating Disorders ClinicEating Disorders Clinic

Qualitative InterviewsQualitative Interviews• 60-90 minutes60-90 minutes

Investigation of Factors Related to Investigation of Factors Related to Eating Disorders in SingaporeEating Disorders in Singapore

Informant CharacteristicsInformant Characteristics• Target Group (Target Group (nn = 16) = 16)

95% female95% female Average age = 20 years; Range = 15-26 yearsAverage age = 20 years; Range = 15-26 years 81% of Chinese descent81% of Chinese descent Diagnosed with anorexia nervosa, bulimia nervosa, or Diagnosed with anorexia nervosa, bulimia nervosa, or

eating disorder non-specified typeeating disorder non-specified type• Control Group (Control Group (nn = 8) = 8)

Similar demographic characteristicsSimilar demographic characteristics No diagnosed eating disordersNo diagnosed eating disorders

• Additional informants included teachers and Additional informants included teachers and parents who were in a position to reflect on parents who were in a position to reflect on reports of weight biasreports of weight bias

ResultsResults Both groups reported similar experiences…Both groups reported similar experiences…

• SourcesSources FamilyFamily Friends & PartnersFriends & Partners School PersonnelSchool Personnel Strangers (least often reported)Strangers (least often reported)

• FormsForms TeasingTeasing AdviceAdvice Casual RemarksCasual Remarks Outright CensureOutright Censure

• Remarks elicited distressRemarks elicited distress• Remarks accepted passivelyRemarks accepted passively

Weight biased remarks perceived as normal in Singaporean Weight biased remarks perceived as normal in Singaporean societysociety

Weight biased remarks perceived as Weight biased remarks perceived as deserveddeserved• Remarks elicited eating disordered behaviorRemarks elicited eating disordered behavior

Weight Bias by StrangersWeight Bias by Strangers

At the public swimming At the public swimming pool…pool…• Target informant recalled Target informant recalled

“frightening” event from “frightening” event from primary schoolprimary school

• Upon weighing self, a man Upon weighing self, a man in line behind her in line behind her exclaimed, “Your weight is exclaimed, “Your weight is so heavy! You need to slim so heavy! You need to slim down!”down!”

Family & FriendsFamily & FriendsFamily

“Your size is so huge. Your buttocks are getting bigger You need to watch what you eat!”

Friends“She has so much fat on her stomach!”

Friends“Why do you even introduce those girls to us? They are not even pretty”

Friends“Bon, bon fatty girl!” You look like a hamburger!”

,

Family“You are getting bigger! You are getting rounder

now!”

PartnersPartners

“He did not say that I must lose weight, but I remember that he told me that girls

should be below 50 kg. I think part of me

started dieting because of him.”

JenniferTreated for anorexia and bulimia nervosa

Multiple Sources of Weight BiasMultiple Sources of Weight Bias

“I met so many people who teased

me about my body. I hate my childhood

because of it.”

School PersonnelSchool Personnel

“You are stupid, clumsy, and fat!”

“You are so fat and lazy! You are doing nothing to help yourself!”

The Mandatory School Weigh-In

Why don’t recipients of weight-biased Why don’t recipients of weight-biased remarks assert themselves?!remarks assert themselves?!

• Such remarks are “normative”Such remarks are “normative”• Such remarks are “deserved”Such remarks are “deserved”

“My cousin teased me about my body in a very

funny way. I had no choice except laughing even though I was upset.”

“I thought it was my fault for being teased.

Something was wrong with me.”

The Trim & Fit ProgramThe Trim & Fit Program

Government-mandated school “health-Government-mandated school “health-promotion” program for all children deemed to be promotion” program for all children deemed to be overweight (primary-secondary school)overweight (primary-secondary school)• Began in 1992Began in 1992• Rationale: obesity rates in children increased from 5.4% Rationale: obesity rates in children increased from 5.4%

in 1980 to 15.1% in 1991in 1980 to 15.1% in 1991• Overweight children segregated from “normal” weight Overweight children segregated from “normal” weight

childrenchildren• Restrictive dieting & regimented exercise Restrictive dieting & regimented exercise • Schools rewarded for decreasing percentage of Schools rewarded for decreasing percentage of

overweight childrenoverweight children• TAF deemed a “success” in that childhood obesity rates TAF deemed a “success” in that childhood obesity rates

declined to 10% in 2004 and to 9.5% in 2006.declined to 10% in 2004 and to 9.5% in 2006. However…However…

Study Revealed Weight Bias Study Revealed Weight Bias Towards TAF ParticipantsTowards TAF Participants

“Students did not want to be involved in the Trim and Fit

Program. It was very embarrassing. It affected my bulimia because it made me

very body conscious.”

“It was humiliating because it singled

out obese students. I was told

by my instructor that ‘You would

look better if you cut that weight.’”

Study Revealed Weight Bias Study Revealed Weight Bias Towards TAF ParticipantsTowards TAF Participants

“The staff told me, ‘if you lose all that weight, you will be

very pretty. If you don’t lose weight, you cannot wear any kinds of clothes.’ I did not feel

good at all.”

“TAF hurt me.”

Study Revealed Weight Bias Study Revealed Weight Bias Towards TAF ParticipantsTowards TAF Participants

“Girls are made to feel in a way it’s a sin to be fat. Fat

girls are rounded up to do sit ups and so on before school starts, at recess, and after school. She is dieting and

skips meals to try to stay out of the TAF program.”

“It was very painful for me to see. Kids would cry. They don’t know how active a student is. Kids might be born with a bigger figure

than others.”

TAF Student’s Mother Teacher

Trim & Fit Program Trim & Fit Program Follow-UpFollow-Up

Discontinued in March 2007Discontinued in March 2007• Due to reports of stigmatization Due to reports of stigmatization

and emotional harm caused by the and emotional harm caused by the program!program!

• http://youtube.com/watch?v=-2PY_7DJphttp://youtube.com/watch?v=-2PY_7DJpSc&watch_responseSc&watch_response

ConclusionsConclusions

Weight bias may be more harmful than Weight bias may be more harmful than weight itselfweight itself

Forced and stigmatizing “health promotion” Forced and stigmatizing “health promotion” programs may be counterproductive programs may be counterproductive andand unethicalunethical

Einstein’s definition of insanity…Einstein’s definition of insanity…• Doing the same thing over and over again and Doing the same thing over and over again and

expecting different resultsexpecting different results Credit Sandy Szwarc, Junkfood ScienceCredit Sandy Szwarc, Junkfood Science http://junkfoodscience.blogspot.com/2007/03/definition-of-insanity.htmlhttp://junkfoodscience.blogspot.com/2007/03/definition-of-insanity.html

Contact InformationContact Information

Dr. Patti WatkinsDr. Patti Watkins

Women Studies ProgramWomen Studies Program

200 Gilkey Hall200 Gilkey Hall

Oregon State UniversityOregon State University

Corvallis, OR 97330-6208Corvallis, OR 97330-6208

(541) 737-6135(541) 737-6135

[email protected]@oregonstate.edu