79 The Professional Counselor | Volume 13, Issue 2 health care). Allen et al. found that alliance around the tasks/goals of therapy had long-term benefits, while an initial therapeutic bond was only associated with activation at the beginning of therapy. These findings suggest that despite client bias, a strong alliance may still form if there is a connection between counselor and client on their treatment goals and plan. Despite a client and counselor’s mutual investment in a counseling relationship, research about weight bias in counseling has focused solely on counselors’ perceptions of clients’ weight and its influence on the therapeutic alliance (Kinavey & Cool, 2019; McHugh & Kasardo, 2012; Puhl et al., 2014). Thus, research has insufficiently examined how a counselor’s weight may hinder this alliance (Moller & Tischner, 2019). This gap is further concerning given that researchers have found that professionals in other disciplines identified as overweight or underweight face discrimination in the workplace (Beggan & DeAngelis, 2015; Hutson, 2013). Overweight Bias Toward Counselors Researchers have found that counselors are subject to weight bias from clients. Moller and Tischner (2019) examined client perceptions of counselors by specifically examining counselor weight. They conducted a qualitative story completion task with students from Great Britain aged 15–24 (N = 203) and found that participants perceived overweight counselors as incompetent. Counselors’ competence came into question because of the perception that being overweight implies a lack of emotional stability, personal discipline, and mental stability (Moller & Tischner, 2019). Participants also reported perceiving overweight counselors as distracting because of their physical appearance. Additionally, participants viewed an overweight counselor as having poor psychological health. Some participants noted that being overweight suggested an eating disorder (ED), such as bulimia or binge eating disorder. Furthermore, responses indicated that weight bias would impact the therapeutic relationship, and many participants would not want to work with an overweight counselor (Moller & Tischner, 2019). These results are striking, and further research is needed to corroborate their value, as they point to a high level of bias toward overweight counselors. These types of inaccuracies can perpetuate prejudice and discrimination that may also hurt potential clients who would otherwise not have access to a counselor. Stereotypes and biases impact those who choose to work in this profession and could struggle to feel they belong in the helping professions. Underweight Bias Research geared toward overweight bias is well established in the health professions; however, evidence suggests that underweight health professionals also experience bias and discrimination (Allison & Lee, 2015; Beggan & DeAngelis, 2015; Davies et al., 2020a, 2020b). Researchers have noted stereotypes suggesting that extreme thinness may indicate a lack of wellness or the presence of a mental health issue like anorexia (Davies et al., 2020a). Furthermore, implicit bias toward underweight people may also come from the survival instinct that hunger, poverty, and war create underfed people, and we want to be with those who can help us survive (Marini, 2017). Interestingly, scholars have noted that if being underweight is not perceived as stemming from health issues or an ED, people possess more favoritism toward underweight persons, limiting institutional discrimination toward them (Allison & Lee, 2015; Beggan & DeAngelis, 2015). In some social settings, a slender appearance of health follows socially accepted norms and may supersede the importance of actual health (Moller & Tischner, 2019). This leads to what is known as thin privilege; hence the possibility that there is enough benefit to being thin that it negates any negative attitudes or behaviors by others.
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