The Western world has a new export: fat stigma.
"These really negative ideas, these moralizing ideas about what it means to be fat seem to have spread very quickly," study researcher Alexandra Brewis, an anthropologist at the University of Arizona, told LiveScience. "It's this moral judgment that creates prejudice and discrimination."
From the thin ideal to fat-hating
Researchers have noticed for years that societies that once welcomed larger bodies increasingly idealize thinness. The most famous example is the South Pacific island of Fiji. Anthropologists who visited the island in the 1980s found that fatness was celebrated. But the advent of television on the island in 1995 rapidly changed all that: Fijian teenage girls began to compare themselves with the stars of "Melrose Place" and "Beverly Hills 90210." By 1998, 15 percent of girls surveyed said they'd induced vomiting to control their weight, compared with 3 percent in 1995. Post-TV, 74 percent of girls said they were too fat, researchers reported in the journal Culture, Medicine and Society in 2004.
But wanting to be thin isn't the same thing as stigmatizing fat, Brewis said. In the Western world, people associate fat with laziness and a lack of self-control, she said. That wasn't necessarily the case in traditionally fat-friendly countries.
"Even though the body ideals were shifting, there weren't all these negative ideas attached to being large," she said.
Brewis and her colleagues surveyed city-dwellers in the Western countries of the United States, England and Iceland as well as American Samoa, Argentina, Mexico, Paraguay, Puerto Rico and Tanzania. The surveys asked about people's attitudes on fat, including whether or not they agreed with statements such as "people are overweight because they are lazy." Originally, Brewis said, she was looking for a spot where fat people were present but not stigmatized, because she wanted to study the effect of obesity in the absence of discrimination.
A recent study found that the stigma and discrimination associated with being obese may make the health effects of extra weight worse. In that research, obese people who reported discrimination showed greater physical decline over time.
To Brewis' surprise, fat-friendly spots had all disappeared. Places like Puerto Rico and American Samoa that once valued bigger bodies now associate fat with laziness, Brewis found. The only place that could be classified as fat-neutral — if not fat-positive — was Tanzania.
"We discovered that the situation appears to have changed very rapidly," Brewis said.
The researchers developed a scale of fat stigma based on respondents' answers, spanning from 0 (least stigmatizing) to 25 (most stigmatizing). Tanzania scored a 10, while the most stigmatizing nation, Paraguay, scored a 15.
The other countries studied fell in between these two extremes, and their rates of stigma were not statistically significant from one another, Brewis said. The U.S. scored about a 12.5 on the scale.
Tanzania may be relatively accepting of fat because sub-Saharan Africa has the lowest rate of obesity worldwide, Brewis said. And the area's associations of skinniness with HIV might also influence public opinion, she said.
Fat stigma is likely spreading along with Western ideas and media, Brewis said.
"I think this is definitely an export situation in the sense that we know these ideas have real cultural depths in Western thinking," she said. "They really pervade public health, they pervade medicine, they pervade public thinking about obesity, they're pervasive in the media. As all these processes globalize, we assume a lot of these negative messages are traveling with those."
Brewis said it was surprising to see that middle-income developing countries such as Paraguay look down on fat more than the Western industrialized countries where obesity stigma originates. It's possible that these areas aren't really more stigmatizing, she added — just that they're more willing to say so.
"In the West, there's a lot more notion of political correctness now, so people are less likely to state the most judgmental ideas about fat even if they think them," Brewis said. "So it might not be that people in the West are less stigmatizing, it might just be that they mellow how they talk about it."