October is National Bullying Prevention Month, which provides the opportunity to trace familiar steps over a well-worn path to the top of my soap box to deliver an address about a topic important to me: the fact that people with obesity are the last group in our country against whom we allow discrimination. The twin factors of public tolerance and the physical nature of the disease lead to those with obesity being victimized at higher rates than bullying due to race, religion or disability.

I’m a therapist who’s had the privilege of working exclusively with obese adolescents for the last decade. I distinctly remember a conversation I had with a woman about 4 years into my work. We discussed the public perception of people with obesity, and lamented the misconceptions, judgments, and assumptions surrounding them. This woman, who was sympathetic but not obese herself, said something like “…those poor kids. The bullying they must endure. You must hear about it constantly.”

I thought long and hard, doubted myself, thought long and hard again, then finally responded, “You know, I actually don’t hear about it that often.” I was as surprised by my words as she was. How could this be? By this time I’d been through thousands of hours of individual therapy with these young people. We discussed divorce, trauma, anxiety, fears, love, hopes, and dreams. We covered the full array of human experience, but I couldn’t remember any substantive conversations about bullying or its impact.

I concluded that in the larger scheme of things, my clients didn’t want to waste energy discussing what others thought about them. When it came time to do therapeutic work on themselves, they preferred to focus on their own experiences and what they thought of themselves. But in my mind, this phenomenon begged another question: how were they able to set bullying aside in a time when the intensity and prevalence of bullying had increased?

Concern crept in. We discussed all the coexisting markers of bullying, such as depression, anxiety, poor self-image, and in increasing cases, even suicidal thoughts. It’s not difficult to imagine the type of teasing and ridicule these kids experience on a regular basis. The tragic nature of the default cultural attitude towards obesity has two parts: first, discrimination against people with obesity is accepted; second, the physical characteristics of the disease are never inconspicuous. You can gather fifty people off the street and try to guess who has Crones, lymphoma, depression, or addiction, and you’ll never be one hundred percent accurate. For people with obesity, there’s no anonymity and no reprieve. There is never a point when you can blend in and not feel judged. As Andie Mitchell, author of the obesity memoir It Was Me All Along, wrote:

“…it’s impossible to imagine what goes through a fat person’s mind in every single interaction in life. Everything is colored by your size. There’s some concern that every single person you come across will be inconvenienced or offended by your fatness.”

Had these kids built a tolerance to bullying? Did the bullying, over time, have a progressively smaller effect on them? A tolerance to bullying sounds preferable for the victim, until we take a deeper look at the word itself and understand the totality of its definition. Tolerance can mean all the following: 

  • The capacity to endure mental or emotional pain and hardship
  • The act of allowing something to happen
  • The capacity of the body to endure or become less responsive

Notice the word endure shows up twice. That a tolerance would have these kids enduring ridicule, judgment, or harsh treatment should be neither acceptable nor preferable – to anyone. The last definition mentions “the capacity of the body to endure or become less responsive”. In the case of prolonged bulling, I fear it’s the child’s spirit that becomes less responsive.

Another hypothesis occurred to me that I found far more disturbing. Had the judgment, comments, stares, and ridicule done the damage already? Had the victims internalized all this? Had acceptance – and tolerance – allowed bullying words to become part of their vision of themselves? Did the taunts and jeers fall on the ears of someone who thought very differently of themselves than what was being said, or did the taunts echo what they were already saying to themselves?

Had the bully’s script become their script?

This can happen. It works in an extremely potent power of suggestion sort of way, much like brainwashing. The negative messages are so constant and pervasive the victim begins to believe them, against all tangible evidence and contrary to their own beliefs. I once literally had to convince a 15 year-old girl she wasn’t a binge eater because there was no physical or behavioral evidence that supported her belief. She’d been accused so often due to her weight that she adopted the belief, and accepted it so deeply it had to be metaphorically pried from her fingers.

What’s astonishing is that the basis for this type of bullying is someone’s physical appearance and characteristics. And what’s even more astonishing is that bullies victimize people for having something defined by the American Medical Association as a disease. There’s no other disease where this is the case. Take cancer, AIDS, or Alzheimer’s – bullying victims of those diseases would be unacceptable even in the lowliest of circles.

In the spirit of National Bullying Prevention Month, it’s important to recognize not only the immediate impact, but the long-term, residual effects of bullying a person with a disease such as obesity. With eighty percent or more of obese adolescents becoming obese adults, the impact of adolescent bullying can last a lifetime. Emotional scars remain far after someone has successfully managed their condition and achieved a healthy weight.

There’s a common belief that you shouldn’t react outwardly when you’re bullied, because it gives the bully power. While that may be true, we’d be remiss not to consider where those bullying words or actions go. We need to ask how they’re processed and explore effective ways to keep them from becoming internal beliefs. If we truly seek to protect the victim, these questions need to be answered with empathy, care, and compassion. So if you hear a child recounting a time they were bullied and they say “it doesn’t bother me,” don’t necessarily be relieved.

That may be the end of one conversation, but it should be the beginning of another.