The Role of Stigma in Weight Loss Maintenance Among U.S. Adults

  • Rebecca M. Puhl
  • Diane M. Quinn
  • Bradley M. Weisz
  • Young J. Suh
Original Article

DOI: 10.1007/s12160-017-9898-9

Cite this article as:
Puhl, R.M., Quinn, D.M., Weisz, B.M. et al. ann. behav. med. (2017). doi:10.1007/s12160-017-9898-9



Challenges of maintaining long-term weight loss are well-established and present significant obstacles in obesity prevention and treatment. A neglected but potentially important barrier to weight-loss maintenance is weight stigmatization.


We examined the role of weight stigma—experienced and internalized—as a contributor to weight-loss maintenance and weight regain in adults.


A diverse, national sample of 2702 American adults completed an online battery of questionnaires assessing demographics, weight-loss history, subjective weight category, experienced and internalized weight stigma, weight-monitoring behaviors, physical activity, perceived stress, and physical health. Analyses focused exclusively on participants who indicated that their body weight a year ago was at least 10% less than their highest weight ever (excluding pregnancy), the weight loss was intentional, and that attempts to lose or maintain weight occurred during the past year (n = 549). Participants were further classified as weight regainers (n = 235) or weight-loss maintainers (n = 314) based on subsequent weight loss/gain. Data were collected in 2015 and analyzed in 2016.


Hierarchical logistic regression models showed that internalized weight stigma and subjective weight category made significant individual contributions to prediction of weight-loss maintenance, even after accounting for demographics, perceived stress, experienced stigma, physical health, and weight-loss behaviors. For every one-unit increase in internalized weight stigma, the odds of maintaining weight loss decreased by 28% (95% CI: 14–40%, p < .001).


Findings provide initial evidence that overlooked psychosocial factors, like weight stigma, may hinder weight-loss maintenance. Implications for addressing stigma in obesity-focused clinical interventions are highlighted.


Stigma Bias Obesity Weight loss maintenance Internalization 

Copyright information

© The Society of Behavioral Medicine 2017

Authors and Affiliations

  • Rebecca M. Puhl
    • 1
  • Diane M. Quinn
    • 2
  • Bradley M. Weisz
    • 2
  • Young J. Suh
    • 3
  1. 1.Department of Human Development and Family Studies, Rudd Center for Food Policy and ObesityUniversity of ConnecticutHartfordUSA
  2. 2.Department of Psychological SciencesUniversity of ConnecticutStorrsUSA
  3. 3.University of Massachusetts Medical SchoolWorscesterUSA