Is media coverage in Scotland reinforcing weight stigma?

Weight stigma encompasses the negative attitudes, stereotypes, prejudice. and discrimination towards people because of their body weight. It can occur in interpersonal relationships, social settings, workplaces, and schools, and is reinforced culturally through the media. According to research, being exposed to weight stigma and negative attitudes in the media can have a detrimental effect on a person's self-esteem and body image, as well as their health behaviours and outcomes.¹

This short study aims to provide a snapshot of the prevalence of weight stigma in Scottish newspapers based on content features such as language and imagery.

What is weight stigma?

Weight stigma is when the actions or vocabulary used by a person or group is hurtful towards individuals due to their weight, creating or fuelling negative stereotypes regarding people with overweight and obesity.² Stereotypes portrayed via the published media often associate higher weight with negative traits such as laziness, bad personal hygiene, or general unattractiveness. By perpetuating this image, the media can encourage the general public to develop stigmatising beliefs which in turn can result in real world negative outcomes.

Weight stigma can also occur in treatment settings where people should feel most safe and able to ask for help. Often, people affected by overweight and obesity have found they are less likely to receive respect or time from a GP when in need of medical advice.² Research has found that 69% of adults with obesity in Europe have reported experiencing weight stigma or bias when contacting a health worker.²

Newspapers and the wider media regularly use content that could be seen as harmful towards people with higher weight, often in order to market their version of events and grab the attention of the public. Stigmatising language tends to focus on placing sole responsibility for obesity on a person’s actions and lifestyle. This ignores other significant contributing factors such as the obesogenic environment that constantly encourages people to buy cheap, energy dense, and nutritionally poor foods.² Placing blame on the individual has been shown to increase risk of developing poor mental health, low self-worth, and even maladaptive eating in people with overweight and obesity.³

This review investigated the content of newspapers and magazines commonly available in Scotland to sample their approach to stories relating to overweight and obesity and assess biases that would encourage weight stigma

What we did

Using the Public Health Scotland Challenging weight stigma learning hub,2 [a recognised assessment framework] definitions were agreed to establish foundational knowledge and gain better understanding of how obesity can be stigmatised. An analysis was undertaken on a selection of newspaper clippings from 2021 to identify instances of weight stigma in language and imagery used.

We conducted an analysis of clippings from Scottish newspapers issued between January 2021 to October 2021 which covered the topics of obesity, weight and/or diet. We read through each newspaper clipping to identify language and imagery that could contribute to weight stigma.

Language, within the context of the story, was classified into two categories: words and phrases with overtly stigmatising or insulting connotations, and less obvious instances such as framing issues (the way information is written or conveyed). The latter includes failure to use person-first language, which is viewed as a crucial component in addressing weight stigma by obesity patient and advocacy groups. Framing of public health issues has been shown to be important in terms of addressing stigma and influencing levels of public understanding. This review also considers evidence⁴ on obesity problem framing to identify additional content that can contribute to weight stigma.

Images were categorised as stigmatising if they had traits commonly used to demean people with obesity, such as the use of unflattering angles or showing no face in frame.

The Public Health Scotland learning hub2 contains examples that reflect the types of stigmatising language identified throughout the review. Below are the definitions established by this resource to categorise relevant terms:

Weight Bias – Refers to negative attitudes towards others because of their weight.

Weight Stigma – Refers to stereotypes and labels publications may assign to people who have a higher weight.

Weight Discrimination – Refers to actions against people who have a higher weight that can cause social exclusion and inequalities.

It is important to note that this snapshot survey included a relatively small sample size of media articles over a set period and is mainly intended to test prevailing attitudes. It serves as a valuable starting point for further monitoring of media practices.

What we found

Of 98 articles reviewed that met the inclusion criteria, there were 28 different newspaper titles including national papers and local papers. The range of newspaper outlets gives an initial snapshot of what the media environment looks like in Scotland and how weight stigma is conveyed.

Language

When comparing instances of stigmatising language between outlets, it is important to consider the frequency of reporting. For example, some outlets only published one article included in this analysis while others published more than ten. The greater the number of articles per outlet, the more we might infer about their individual reporting practices.

There were many instances of language identified which could be perceived as harmful or stigmatising to people with a higher weight. One example of this included an article stating "a quarter of adults are grossly overweight" when covering proposals to make calorie labelling mandatory on alcoholic products. Describing people as having a ‘gross’ bodyweight compounds harmful narratives that people with higher weights are not as valuable and should be criticised. Another news item, discussing the effectiveness of BMI as a measurement of healthy weight, used language to mock by describing people with overweight as “people who carry a spare tyre”. Again, such statements may ingrain the idea that people with higher weights should be made fun of.

The analysis revealed a wide range of other stigmatising content, from jokes at the expense of people (e.g. ‘fat lot of good’, ‘tubby taunting’) to use of demeaning descriptions (e.g. ‘slobs’, ‘love handles’, ‘excess flab’). The most frequently appearing words that would be characterised as stigmatising were “obese” and “fat”, delivered as blunt descriptions. In this context, these terms are deemed stigmatising as they reduce individuals to their weight, solely defining them by their weight, and don’t use person first language. Referring to people as “obese” or “fat” was also commonly followed by discussion centred around consuming “too much” food, which fuels the narrative of individual blame often associated with obesity.

In terms of language framing that can contribute to weight stigma, multiple news items also included statements that significantly oversimplify potential ways to reduce overweight and obesity at the individual level. An opinion column in one national newspaper criticised public health efforts to address childhood obesity and suggested society was avoiding the real problem by being “too scared to tell them (children) to stop eating junk”. A different article quotes an expert on Alzheimer’s disease saying that people need to “swap the biscuits for a piece of fruit” to improve their long-term health prospects. These are commonly cited solutions in today’s public discourse on obesity which typically omit the context of the significant structural barriers which prevent people from easily carrying out health promoting behaviours. This absence of context can exacerbate weight stigma as people are told that it is simple to achieve a healthy weight and that doing so is completely within their own power.

The results showed that regional publishers tend to publish fewer articles covering the overall subject of obesity. The articles they did publish showed very limited use of negative language. This finding may be because smaller publishers did not alter the stories they covered with stigmatising editing, or simply did not produce as many topic-relevant articles over the reviewed period compared to larger titles.

Imagery

*For various reasons we are unable to publish the examples of images in this article.

In line with the findings on language, stigmatising imagery is also a widespread issue. Within this analysis,. The most common instances of stigmatising imagery in the analysis were uncomplimentary photographs of people who have a higher weight, usually with no face in frame, either measuring their waist circumference or performing/dressed to perform some kind of physical activity (e.g. swimming). The use of images showing individuals with no face in shot or focusing on the torso area encourages the idea that living with obesity or other weight issues is shameful and implies that those people are in a separate group compared to everyone else. Not including faces in images is also a way of dehumanising individuals who have obesity and reduces them to their weight, disregarding all other characteristics.

Parallel to the language results, local papers repeatedly published little to no images that could be considered stigmatising.

Conclusion

Overall, this snapshot review of media cuttings from Scottish newspapers published between January and October 2021 has shown that stigmatising language and imagery in the industry is commonplace, with similar opinions and narratives playing out across different news outlets. The narratives and biases created by such harmful content encourages society to judge and demean people who live with overweight and obesity rather than treat them as individuals who face unique circumstances and experiences. Stigmatising imagery, another form of negative stereotyping, was also found to be frequently used. Furthermore, media coverage that stigmatises does little to communicate and reflect wider evidence on the multiple and complex factors that contribute to obesity at the population level.

Read more about weight stigma and communication resources to help reduce it on our website.

References

1) Addressing weight stigma and misconceptions about obesity in Europe: Considerations for policymakers. World Obesity.

2) Challenging Weight Stigma Learning Hub (2022). Public Health Scotland.

3) World Obesity, (2018). Weight Stigma. World Obesity Federation.

4) Health first: Communicating about health and obesity in Scotland (2023). Public Health Scotland.

With thanks to previous OAS student placements Louise Johnston and Fatema Abualqassim for their valuable contributions.