During a routine appointment, Linda Ayrapetov peeked at her physician’s notes and saw that in the exercise category, the doctor had written “sedentary.”
“She never asked me what my exercise level was. She looked at me and decided I don’t work out,” the Jamaica Plain resident, 30, recalled. “I actually over-exercised at the time ... but that was not something she would have ever asked, because I look the way that I look.”
Constance Smith, a plus-size model, has had awkward interactions with co-workers at photo shoots.
“People talk to you like, ‘Oh, you model? Oh, I thought you were, like, the help. I thought you were makeup or nails,’ ” said the 30-year-old Mattapan resident. “It’s like, ‘No. You see my picture on the board. I’m here to model.’ ”
When Rachel Estapa was 15, the Catholic school she attended took her class on an Ipswich River canoe trip, but when she went to get a boat, a worker was reluctant to let her have it.
“Just the comment that, ‘Oh no, you’re going to sink or tip the canoe,’ — I didn’t go on a canoe until like last year,” said Estapa, 38, of Somerville.
Massachusetts residents like those three women could demand better treatment in medical settings, the workplace, and recreational areas under a bill before the state Legislature that would ban discrimination based on weight or height — a proposal that may have fresh momentum after a similar measure passed the New York City Council this month.
The Massachusetts bill was sent to the Judiciary Committee in mid-February, and the panel has not yet scheduled a hearing. Proponents hope the overwhelming approval in New York City will help buoy the bill here. Similar statewide measures are under consideration this year in Vermont, New Jersey, and New York.
Only one state — Michigan — has a law specifically banning size discrimination. The Washington state Supreme Court ruled in 2019 that a law banning discrimination against people with disabilities applies to those perceived to be obese — a term many self-identified fat people find offensive. A handful of US cities, including Binghamton, N.Y.; San Francisco; and Washington, D.C., also offer protections.
Tigress Osborn, chair of the National Association to Advance Fat Acceptance, said that 54 years after her organization was founded, American society is finally starting to understand that weight isn’t just a matter of willpower and that people of all sizes deserve to be treated with dignity.
“There is so much reason for hope,” said Osborn, 48, a 1996 Smith College graduate who lives in her native Arizona. “We are seeing more investment in the fat liberation movement. ... We’re seeing more attention to the voices of fat and fat-positive people.”
Decades of stereotypical depictions in popular culture have given way to a generation of performers who are sharing authentic experiences, Osborn said, from rapper/singer Lizzo, to entertainers like Dulcé Sloan on “The Daily Show,” Jana Schmieding in “Rutherford Falls,” and Harvey Guillén in “What We Do in the Shadows.”
Despite the increasing visibility, weight stigma remains “pervasive throughout society,” and causes stress that can lead to “binge eating, increased caloric consumption, maladaptive weight control, disordered eating, lower motivation for exercise, and then subsequently less physical activity,” said Dr. Fatima Cody Stanford, an obesity medicine physician scientist at Massachusetts General Hospital.
“All of this subsequently leads to weight gain,” she said.
When people encounter bias in medical settings, it can discourage them from seeking care, according to Amanda Raffoul, a faculty member in the Strategic Training Initiative for the Prevention of Eating Disorders at the Harvard T.H. Chan School of Public Health and Boston Children’s Hospital.
Now, some researchers “are taking a look at how health care avoidance because of weight discrimination might actually partially explain some of the negative health outcomes that we see among people with higher body weights,” Raffoul said.
In short, it might not be the fat making people sick, but the discrimination, she said.
Almost three-quarters of American adults are considered fat based on their body mass index, a controversial tool that measures the ratio of height to weight. About 42 percent are classified as obese and another 32 percent as overweight, according to the US Centers for Disease Control and Prevention.
Massachusetts lawmakers have been proposing to ban size discrimination since at least 1995, when then-state Representative Byron Rushing introduced a bill. Rushing refiled versions of the bill session after session until he lost his seat in 2018, and state Senator Rebecca Rausch and Representative Tram Nguyen took the baton.
The bill would add the phrase “height or weight” to the state’s existing nondiscrimination laws, with some exemptions for existing safety standards. It would bar discrimination in many areas, including education, jobs, insurance, and real estate transactions, as well as hospitals, stores, and restaurants.
The bill appears to have no organized opposition. Associated Industries of Massachusetts, which represents 3,400 businesses across 150 industries statewide, has taken no position, a spokeswoman said.
Rausch said the amusement park industry initially expressed concern about potential safety issues, but that has been addressed and, “I have not heard from any vocal opponents in a while.”
“Consistently, the thing that business owners are telling me is .... among the top challenges that they’re facing now is hiring workers,” Rausch said. “And workers, we know from statistics, are leaving the state in pretty significant numbers. Passing a law to protect workers and protect people as they seek health care, and education, and other opportunities ... is certainly a step in the right direction.”
Nguyen said size discrimination “has a disproportionate impact on women in the workplace, gives rise to bullying in schools, and often leads to eating disorders.”
“As a society, we need to change how we treat people based on their appearance, which can negatively impact their mental and physical well-being,” she said in a statement.
In the meantime, Ayrapetov will go on hosting her podcast, “Plus 1,” about being young, single, and plus-size; Smith continues her modeling career; and Estapa is teaching yoga to people of all sizes at More to Love Yoga in Cambridge.
Estapa, who testified in support of the bill last year, said it “is much more about sending a message” than about trying to punish wrongdoers.
“This is just as much aspirational, and I think ... we need those focal points,” she said, adding that an anti-discrimination law would help encourage people with larger bodies to seek medical care and to live fuller lives, knowing they can go to a restaurant and expect a seat that fits them.
Throughout her life, Smith said, she has dealt with people projecting their weight issues onto her and giving her bad advice, whether it was the high school nurse who recommended skipping meals or the college teaching assistant who advised her to start smoking cigarettes and drinking coffee. Now she wants to set a better example for young girls.
“You have to believe in yourself, because no one else is going to, ultimately,” she said.
Ayrapetov hopes to see changes in the law and in societal acceptance for fat people, but she isn’t waiting for anyone else’s approval. For her, finding happiness began with loving herself and understanding her body, instead of judging it.
“As soon as I kind of got my life together and realized, you know what, I’m great, I look great, everything’s fine, I stopped judging other people too,” she said. “I was able to actually change my mind about the way that I saw myself as beautiful, and therefore see other people as beautiful.”