We Have To Talk About Thin Privilege.

I have thin privilege. A lot of my fellow dietitians and other health care providers also have thin privilege. It’s essential that we have discussions around thin privilege, because if we don’t recognize it for what it is, we won’t recognize weight stigma. And if we want to promote well-being and true health, we all need to be working hard to dismantle weight stigma every day.

For some, acknowledging privileges that aren’t earned may feel uncomfortable. Arguably, this makes it even more important to address. We might not see the privileges we have unless we are intentional in our choice to learn about them. I've written about thin privilege before, but I was recently inspired to bring it back after hearing the wonderful dietitians Aaron Flores and Glenys Oyston discuss thin privilege on their podcast. They had the opportunity to speak to a group of future dietitians and discuss the concept of thin privilege. Unfortunately, this conversation was met with some negative feedback and it seems as if there were misconceptions around what thin privilege actually means. As Aaron mentioned on the podcast, "this is a consciousness we need to include in our work." I couldn’t agree more.

thin privilege exists because of weight stigma

So, what is thin privilege? Thin privilege acknowledges that my body size has protected me from weight stigma and to a certain degree, diet culture. It’s important to explicitly acknowledge that having thin privilege doesn't entirely protect a person from body image concerns and eating disorders, or even lead to full immunity from diet culture. Absolutely not. In fact, the reality is that having thin privilege often means your eating disorder is more likely to be diagnosed. For those in larger bodies, disordered eating behaviors may be praised and wrongly misinterpreted as being health promoting, or a reflection of one’s ‘dedication.'

It's important to recognize thin privilege, because doing so acknowledges the reality that people in smaller bodies haven't had exposure to the stigmatizing experiences that are all too common for people in larger bodies. We are all exposed to diet culture in different degrees, but thin privilege is often present when a person has been protected from diet culture and it’s harms. As helping professionals, it's important to practice with empathy, compassion and an understanding of the cultural norms that cause harm. We can't dismantle what we don't see, so it's important to recognize that thin privilege and weight stigma are in fact, real.

Certain experiences can indicate thin privilege - thin privilege is seeing representation of bodies that look like yours on TV, being able to find all types of clothing in your size while shopping, never giving a second thought to the size or sturdiness of a chair, and not worrying about a booth vs. table at a restaurant. Thin privilege is never having received unsolicited suggestions to lose weight when seeking medical care (especially if you have been seeking treatment for an entirely unrelated ailment, like a sinus infection). It’s the absence of assumptions based on body size alone, like the presumption that a person is 'unhealthy' or ‘lazy’ because of their body. Thin privilege allows me to share a wide variety of food photos without critical judgments about how eating a certain food is ‘bad for my health.’ Thin privilege can also protect a person from harmful diet talk - especially when a person young and vulnerable, it can serve as a buffer from diet culture. Thin privilege is one of the reasons many people learn about intuitive eating and say ‘well, that works for you, but it wouldn’t work for me.’ Spoiler: intuitive eating is for everyone.

Why is this important to talk about? Because, if we are going to examine our own biases and work toward reducing weight stigma (and therefore increasing health), we have to recognize our privileges. I didn't consider my own body privilege when I was studying to become a dietitian. Unfortunately, I wasn’t encouraged to do so, but I hope that this will be standard practice one day. I was young and naive and had vague beliefs about body size and health behaviors. When I started counseling (aka, listening) and heard the injustice my clients in larger bodies experienced, I started to consider this from a different lens. Listening to the experiences of others helped me to learn about weight stigma and better understand what it’s like to be mistreated because of body size. Biases around weight and size contribute to discrimination. The research echoes the lived experience of others, suggesting that weight stigma is very real, and very problematic. Allostatic load is real, and glorifying the thin ideal hurts everyone. Unconscious bias within the medical field is harmful and must change. If we hope to do no harm, it’s necessary we acknowledge these topics. And, it's one of the reasons I've been so driven to practice with a weight-inclusive approach. I certainly can’t speak to the experiences of those in a larger body, but I can use my thin privilege to bring attention to these injustices.

Another reason why this has to be acknowledged? Most dietetic classrooms across the country look incredibly similar. We have very little body diversity (or diversity in general, which is why Diversify Dietetics is SO important). This lack of body diversity is problematic for many reasons, but it also subtly reinforces the idea that there's ONE way to be ‘healthy' and that ‘healthy eating’ is associated with a certain body type. It's also interesting to notice that some of the people who are most resistant to the Health at Every Size approach have a fair amount of thin privilege.

As dietitians and health providers, we are often touted as the ‘experts.’ When many of the experts also have a certain amount of bodily privilege, this is easily misinterpreted by our diet culture to falsely suggest that size is directly related to health and wellbeing. By not acknowledging thin privilege and failing to work to dismantle weight stigma, we won’t encourage body diversity among dietitians, and we will continue to contribute to a culture that associates body size with health status and worthiness.

We need to do better to make health inclusive, and we need to have hard conversations. I also want to say that I am by no means an expert here - I am still learning, but I am open to learning and listening, and I invite you to do the same. How can you work to explore your privileges and your biases? If you're comfortable sharing, I would love to hear your thoughts.

Some Resources Referenced or Worth Reading:

Dietitians Unplugged Podcast

Weight Science: Evaluating the Evidence for a Paradigm Shift

Weight Bias in Dietetics Education

Diversify Dietetics

Fat Bias and Thin Privilege TEDx Talk

Ragen Chastain's What to Say at the Doctor's Office Melissa Fabello's Article on Skinny Shaming

Meredith Noble's Grieving the Thin Ideal

Linda Bacon on Thin Privilege

Implicit Weight Bias Test