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While most recognize that weight-based bias exists in America, researchers recently quantified just how commonplace it is.

new study conducted at Duke University found that children from ages 9 to 11 showed implicit bias against overweight children at a level similar to implicit racial bias among adults.  Science and nutrition writer Jane E. Brody points out in “Fat Bias Starts Early and Takes a Serious Toll” that very young children can hold the same weight-related biases that are often present in older adults.

While many of us witness explicit bias against overweight and obese people, implicit bias operates subconsciously, influencing behavior unknown to the offender. Both explicit and implicit fat bias negatively affect people who are overweight or trying to lose weight. Implicit bias, however, can be more difficult to identify and change.

Besides the inherent malevolence of prejudiced beliefs, discrimination resulting from fat bias deters people from losing weight. A study released in March found that people’s chances of maintaining weight loss dropped by 28% for every extra unit of internalized weight stigma they held. This effect was independent of demographics, perceived stress, physical health, and weight-loss behaviors. Research from 2009 found that overweight and obese adults who had been subjected to more fat bias had greater caloric intake, lower energy expenditure and exercise, and less weight loss than individuals who had been subjected to less bias. Weight-based bias, Brody notes, is highly counterproductive.

So how can fat bias be addressed? New York, Main, and New Hampshire have anti-bullying laws regarding weight discrimination among kids. The Americans with Disabilities Act also protects people with severe obesity against certain types of employment discrimination. Unfortunately, fat bias is difficult to change. Brody suggests greater intervention and prevention of weight-related bullying in schools and “positive self-talk” on an individual level to combat negative messages in the media.

Hopefully, greater awareness of weight-based bias will translate to diabetes. The negative effects of stigma surrounding type 2 diabetes and prediabetes are too great to ignore.