Have you ever been judged by others for your weight, and/or for your bariatric surgery? If so, you know firsthand the negative and harmful effects of weight stigma and bias.
The World of Obesity Federation defines weight stigma as “the discriminatory acts and ideologies targeted towards individuals because of their weight and size. Weight stigma is a result of weight bias. Weight bias refers to the negative ideologies associated with obesity.”
Weight stigma can result in devastating emotional responses such as depression, low self-esteem and anxiety, which can lead to even more potential consequences. However, weight stigma can affect more than the emotional health, but also on social and physical health. Some individuals have reported to intentionally avoid social gatherings or settings in order to remain isolated away from fear of being criticized.
Effects of Stigma on Physical Health
We know some of the emotional effects stigma can cause, but what about physical health?
- Treatment: Some might avoid medical care for problems they are experiencing. This will cause barriers to the treatment and strategic prevention of obesity for the patient.
- Eating Behaviors: According to Canadian Medical Association (CMA), weight stigma and shaming can actually cause eating disorders, such as binge eating, emotional eating, restrictive eating, weight cycling, and eating anxiety.1
- Stress: It has been studied and shown by the research of the American Psychological Association (APA) that stigma correlates with increased stress hormone levels. Stress, long-term or chronic, can have serious effects on our bodies, including the musculoskeletal, respiratory, cardiovascular, endocrine, gastrointestinal, nervous, and even the reproductive systems.2
- Self-Harm or Suicide: In some instances, weight stigma is so severe that it has led to self-harm or suicidal ideations and acts. Although no studies to date have investigated the topic of body weight and suicide ideation, the prevalence of both obesity and suicide ideation has risen in the last several decades suggesting that obesity may increase the risk of suicide ideation.3
Places Stigma Can Take Place
The environment can also play a part in weight stigma—the chairs at the movie theaters, restaurants, and airlines are not designed to accommodate people with obesity. Medical tables and gowns are also sometimes unable to accommodate patients with obesity.
- Schools and Educational Environments: According to Obesity Action Coalition (OAC), bullying has become an epidemic. In a national survey of overweight sixth-graders, 24% of the boys and 30% of the girls experienced daily teasing, bullying or rejection because of their size.4 But not only are students victimized, teachers can also commonly be victimized by their peers. For more information on bullying, please visit the following web sites:
- Workplace: It has been shown that employees who are obese or who carry excess weight are frequently treated poor or unfairly in the workplace.5 This can include unfair hiring practices, lower wages (women affected by obesity earn 6% lesser, and men earn 3% lesser, for work identically performed), harsher discipline from employees, wrongful termination, and negative stereotypes (for example: laziness, less competent, undisciplined, less ambitious, less productive).The article continues with some employers beginning to impose financial penalties, such as charging employees who are obese more in healthcare costs until they are able to reduce their body mass index (BMI).
- Personal Relationships: This topic could by far be argued to be the most harmful to people affected by obesity. Being criticized by spouses/partners, parents, siblings and children, are the most common source of stigma comments, and can be the most damaging comments made, intentionally or not.
- Healthcare and Medical Settings: Research done with support from the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) have shown that many healthcare providers strongly regard people with obesity with negative attitudes and stereotypes.6 This way of thinking can influence judgment, interpersonal behavior and decision-making, as well as person perceptions, and can then impact the care they provide to patients with obesity. Some healthcare providers can view obesity as an avoidable risk factor that hinders their ability to treat and prevent disease.
- Social Media: Weight discrimination has increased significantly in the United States, as much as 66% between 1995 and 2006, and 71% of adolescents reported being bullied about their weight in the past year.7 Social media, such as Facebook, Instagram, Tik Tok, or Twitter could have both negative and positive influences on weight stigma. It has a potentially notorious role in both worsening and reducing weight stigma. In a study of college-age women at Utah State University, exposure to “thin-ideal” magazines and sites provoked higher body dissatisfaction, negative effect, eating disorder symptoms, and decreased self-esteem.8
Combating Weight Bias
Tackling weight stigma and bias requires a united effort from everyone. There are many ways to help prevent bias and get involved with the movement. This can be done starting with individual actions in your daily life, and ranges all the way down to speaking out for those who might think their voice doesn’t matter, or are being bullied or teased.
Use respectful language when talking to or about people affected by obesity. “Fat jokes” and certain vocabulary words are harmful and support society’s stigma. Modeling respectful language is a way to influence others to do the same.
Educate yourself and others to help understand that obesity is a disease with compound causes. This can also help harmful weight-based stereotypes and bullying in any setting.
The Obesity Action Coalition (OAC) have a Weight Bias Task Force that will take on any social media platform which displays weight stigma and bias in the media. You can contact them if you see any examples of weight-based stereotypes by going here.
We here at Rocky Mountain Associated Physicians (RMAP) encourage you to get involved, become educated, and help to make a difference in lessening weight stigma and bias. Use your voice, stand up for others, and help reduce the negative stigma associated with the disease of obesity.
If you or someone you know needs help, please contact the 988 Suicide and Crisis Lifeline. If you are experiencing mental health-related distress or are worried about a loved one who may need crisis support, please don’t wait or hesitate to reach out.
- Call or text 988
- Chat at 988lifeline.org
Links to related articles:
The Real Deal on Obesity, Part 1
The Real Deal on Obesity, Part 2
Bariatric Surgery as a Benefit of Diabetes
The Power of Self-Acknowledgement
Preparing Emotionally for Bariatric Surgery
- Lauren Vogel, “Fat Shaming is Making People Sicker and Heavier”, Canadian Medical Association, v.191 (23); 2019 Jun 10, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6565398/
- William Shaw, PhD; Susan Labott-Smith, PhD, ABPP; Matthew M. Burg, PhD; Camelia Hostinar, PhD; Nicholas Alen, BA; Miranda A.L. van Tilburg, PhD; Gary G. Berntson, PhD; Steven M. Tovian, PhD, ABPP, FAClinP, FAClinHP; and Malina Spirito, PsyD, Med, “Stress Effects on the Body”, American Psychological Associated (APA), https://www.apa.org/topics/stress/body
- Carlyn Graham, Michelle Frisco, “The Relationship Between Obesity and Suicide Ideation Among Young Adults in the United States”, SSM Popul Health, 2022, Jun, 18: 101106, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9079098/#:~:text=Obesity%20is%20highly%20stigmatized%20in,suicide%20ideation%20among%20young%20adults
- JoAnn Stevelos, MS, MPH, “Bullying, Bullycide and Childhood Obesity”, Obesity Action Coalition, Winter 2011, https://www.obesityaction.org/resources/bullying-bullycide-and-childhood-obesity/
- “Weight Bias in the Workplace”, Obesity Action Coalition, 2015, https://www.obesityaction.org/wp-content/uploads/Weight-Bias-in-the-Workplace.pdf
- SM Phelan, DJ Burgess, MW Yeazel, WL Hellerstedt, JM Griffin, M van Ryn, “Impact of Weight Bias and Stigma on Quality of Care and Outcomes for Patients with Obesity”, National Institute of Diabetes and Digestive and Kidney Disease (NIDDK), 2015 Apr; 16(4): 319-326, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4381543/
- Olivia Clark, Matthew M. Lee, Muksha Luxmi Jingree, Erin O’Dwyer, Yiyang Yue, Abrania Marrero, Martha Tamez, Shilpa N. Bhupathiraju, Josiemer Mattei, “Weight Stigma and Social Media: Evidence and Public Health Solutions”, 2021 Nov 12; 8: 739056, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8632711/
- Nicole Hawkins, P Scott Richards, H Mac Granley, David M Stein, “The Impact of Exposure to the Thin-Deal Media Image on Women”, 2004 Spring; 12(1):35-50, https://pubmed.ncbi.nlm.nih.gov/16864303/