Body weight and the credibility of psychologists

A recent survey of over 2000 UK adults found that only 9 per cent would take advice on diet and exercise from an overweight GP (Royal Society for Public Health: see tinyurl.com/kuk3msb). Does weight similarly impact the credibility of psychologists?

A flippant response might be that this may only be an issue for the fat psychologists. However, while it may not be possible to know what percentage of psychologists are overweight, in England in 2012 it was estimated that 66.6 per cent of men and 57.2 per cent of women were overweight or obese (Health and Social Care Information Centre: see tinyurl.com/nse94pl). If in the UK being fat is now the norm, it is logical to consider that for psychologists too the issue of how their weight and body size is read by others may be becoming increasingly – ahem – weighty.

I wrote a paper on the topic of weight stigma in therapy for the December 2014 issue of the BACP magazine Therapy Today; like obesity, fat stigma is increasing globally, in fact research suggests that in the US it is increasing even faster than obesity, up from 7 per cent in 1996 to 12 per cent in 2006 (Andreyeva et al., 2008). The purpose of this letter is to ask what others think about one of the issues I raised – What might fat stigma mean for overweight practitioners?

There is a small theoretical as well as case study literature which argues that the body shape/weight of a therapist does matter to clients (e.g. Gubb, 2013). There is also a tiny research base focused on the impact of therapist weight/shape on eating disorder clients which provides evidence that therapist weight/shape is important for clients.

Online discussion of one of these papers provides further anecdotal evidence: 'This was a major issue with all of my therapists and many times we (patients) spent time talking to each other about our therapists' weight/size and feeling uncomfortable with their advice because of it.'

However, we do not properly know how a therapist being overweight impacts therapeutic interactions as research is lacking. One can, however, extrapolate from all the research on fat stigma that being a fat therapist is likely to evoke fat stigma in at least some clients, which in turn may impact therapeutic alliance, a robust predictor of client outcome.

Currently colleagues and I are analysing data from over 200 young adults (aged 16–24) who responded to a story completion task about a fat therapist. The study aim was to try and understand how a group that is particularly prone to body pressures might make sense of fatness in the counselling room. Preliminary findings are that many stories link therapist excess weight with emotional eating, which in turn is read as the therapist not coping with their life. Fatness thus becomes a signifier of mental instability, which given the professional context is fatally discrediting. In the words of one participant: 'How could that help me?'

Thoughts?

If you are a practitioner psychologist who has worked with fat clients, would you like to take part in a research project? It is an online survey and totally anonymous, it will take only 10–20 minutes of your time.
Naomi Moller
The Open University

References
Andreyeva, T., Puhl, R.M. & Brownell, K.D. (2008). Changes in perceived weight discrimination among Americans: 1995–1996 through 2004–2006. Obesity, 16, 1129–1134.
Gubb, K. (2013). Re-embodying the analyst. Psycho-