For many people, preparing for a workout involves simple steps like pulling on stretchy workout clothes, tying the laces on a pair of running shoes, filling up a water bottle and tuning in to a playlist of high-energy music.

When an individual is overweight or obese, getting ready for physical activity can be a bit more complicated. For these people, exercise or visiting a gym is often accompanied by anxiety that is rooted in weight bias—both their own internalization of negative beliefs and the perception, or reality, that others view them negatively.

Herein lies the conundrum: We all need physical activity to have healthy bodies, but individuals with overweight or obesity often avoid exercise because of how they might be perceived.

Paul Rukavina, PhD, professor of health and sport sciences, Ruth S. Ammon College of Education and Health Sciences, has studied the effects of weight bias since working toward his 2003 doctoral degree, and he continues to pursue research that explores its implications. His article “Inclusion of Individuals With Overweight/Obesity in Physical Activity Settings,” which was recently published in the journal Kinesiology Review, highlights the deleterious effects of weight bias in physical activity spaces and examines the psychological underpinnings of the feelings that prevent people from taking steps to improve their health.

Avoiding the Gym

Though exercise is an important strategy to reduce the health risks of overweight and obesity, for many it can trigger recollections of stigma previously experienced across a lifetime. Dr. Rukavina’s study cites a vicious cycle of psychological and emotional damage, internalization of weight-based stigma, maladaptive coping and additional weight gain.

“Individuals who are overweight and obese are constantly reminded that they do not fit the norm. It starts in youth and just continues,” Dr. Rukavina said. “Stigma comes in many forms, from media messaging promoting thin and muscular ideals, to exercise equipment that is not designed for all body shapes, to lesser availability of flattering athletic leisure clothes that fit people with larger bodies. Why are there beautiful clothes for thinner bodies and not larger bodies?”

Dr. Rukavina says that constant reminders like these reinforce a negative self-narrative, and describes the most insidious aspect of weight bias as the internalization and application of these negative stereotypes by those who are overweight or obese themselves. In his article, he shares that those who carry these feelings of stigmatization also spend a lot of mental energy on fear or worrying about others’ thoughts and reactions, and how they could respond to negativity.

Stigmatization and resultant discrimination can occur because people have been socialized to believe it is a person’s individual responsibility to achieve a thin or muscular ideal, which leads to judgment for health-related choices—and feelings of guilt and shame on the part of the overweight or obese individual for not conforming to society’s expectations.

The Roots of the Trauma

In this article, Dr. Rukavina focused on the experiences of both youth and adults to depict how one impacts the other. He says that both voices corroborate a similar theme—youth report the stigmatization, and adults carry with them the vivid memories.

“I think once you experience trauma, it is not easy to let that go,” said Dr. Rukavina. “The stigmatization could be the trigger that starts a vicious cycle of maladaptive coping and further weight gain, and then wanting to avoid physical activity spaces altogether. And this vicious cycle continues indefinitely until individuals learn how to cope with this stress.”

People who are overweight or obese often report very different experiences in physical education and physical activity than their fellow students for whom weight is not a concern. While some share positive feelings about sports and activities, as well as their physical education teachers, others report negative experiences like weight-related teasing from their peers, negative assumptions about their skill levels, exclusion from social groups and even physical violence. At times, their stories place the onus on their physical education teacher, saying that tasks were too competitive or developmentally inappropriate—sometimes even recalling jokes or teasing from teachers themselves. This negativity often spreads beyond the gymnasium, into all corners of school, and, for many, becomes an indelible mark on their psyche that continues into adulthood.

Teaching Our Future Teachers

Dr. Rukavina says that creating reflective leaders in physical education is about empowering them by fostering professional and empathetic dispositions, instilling the belief that all students can learn, and helping them to discover pedogogical strategies that level the playing field for individuals who are overweight or obese.

“The experienced physical education teachers I’ve encountered through my research understand where their students are coming from and are willing and able to ‘bridge the gap’ to create safe and motivating learning environments,” he said.

In training students to become effective physical education teachers, Adelphi’s health and sport sciences faculty help them become cognizant of how their beliefs and value orientations might affect their pedagogical choices, and the importance of including all children. Throughout the program, faculty members teach ways to create safe and welcoming environments and develop inclusive instruction.

Fueling Inclusion

To build environments that welcome people of all shapes and sizes, Dr. Rukavina says it is less about the structure of the space and more about the messaging and making activities developmentally appropriate.

“When it comes to encouraging people with overweight or obesity who are averse to the gym, it is less about ‘buzzwords’ and more about having equipment designed for all, imagery that doesn’t promote a specific body type, and a culture and instructors that are welcoming,” Dr. Rukavina said.

However, it’s not as simple as “if you build it, they will come.” Dr. Rukavina shares that the difficulty of convincing people they are worthy of opportunities for physical activity is that their self-narrative is very rational and logical. He says it is only when the narrative does not seem logical that people can let go of these feelings.

Instead, he recommends an attempt at reversing the cycle that brought people with overweight and obesity to avoid exercise in the first place.

“A more effective intervention is to create a focus on becoming metabolically healthy so individuals have the cognitive resources to deal with stressors,” he said. “Rather than trying to convince people of their self-worth, it is more productive to help them become more metabolically healthy by getting enough sleep, exercising, eating nutritiously and taking breaks. When you have enough cognitive resources to deal with stressors, you are less likely to grab onto negative societal narratives, their effect will be diminished, and it becomes easier to feel worthy.”

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