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What Is the Impact of Weight Stigma?

Learn more about the specific impact of weight stigma in obese and overweight individuals.

Weight stigma and the fear of stigma can affect emotional, physical, and social well-being in individuals who are overweight or obese.

Emotional

People experiencing weight stigma have markedly increased psychological stress, depression, and anxiety as well as low self-esteem. Many people can internalise the weight bias directed toward them, blaming and devaluing themselves because of their weight. Those most prone to this tend to be younger, female, have a higher body mass index, and an earlier onset of their weight struggle5.

Research has shown that individuals who have greater weight bias internalisation have poorer mental health6. Weight stigma is also associated with increased caloric consumption, maladaptive eating behaviours, and binge eating which can lead to further weight gain. Thus weight stigma creates a substantial barrier to effective obesity treatment.

Physical

Obesity is linked to a number of serious medical conditions. However, more recent scientific evidence indicates that weight stigma itself plays a key role in the development of some of these conditions. For example, it has been found that weight stigma, independent of adiposity, positively correlates with higher stress hormone levels and other biological markers of poorer health. Recognition of chronic stress is important as it has been found to negatively influence multiple areas of health such as blood pressure, cardiac health, visceral fat levels, and insulin resistance.

Social

Weight stigma can weaken social relationships while avoidance of social situations because of the fear of weight stigma can lead to social isolation and loneliness, further increasing the risk of various physical and mental health conditions.

Weight stigma can negatively impact health care:7

  • Quality of health care given by health professionals – such as less time in appointments, less education, and fewer diagnostic tests.
  • Patients’ engagement with treatment – Fear of stigma can lead patients to avoid seeking medical care while patients who perceive negative attitudes about their weight from their health professionals are less likely to trust and engage with them, adopt positive health behaviours, and be motivated to act.

The following flow chart synthesises some of the relationships between weight stigma and health impacts (Modified from Puhl at al 2016)8

Weight stigma -> Stress and Health Care Quality (Poorer treatment adherence, less trust of health providers, avoidance of follow up care, delay in preventative health screenings, poor communication). Stress -> Eating and physical activity behaviours (Binge eating, increased caloric consumption, maladaptive weight control, disordered eating, lower motivation for exercise, less physical activity) and physiological reactivity (Increased levels of cortisol, C-reactive protein, HbA1C, and elevated blood pressure) -> Weight gain-> Psychological distress (depression, anxiety, low self esteem, poor body image, substance abuse) and Physiological Health (Poor glycaemic control, less effective chronic disease management, more advanced and poorly controlled chronic disease, lower quality of life)

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EduWeight: Weight Management for Adult Patients with Chronic Disease

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