Health Consequences of Weight Stigma: Implications for Obesity Prevention and Treatment
- 3.1k Downloads
Despite decades of research documenting consistent stigma and discrimination against individuals with obesity, weight stigma is rarely considered in obesity prevention and treatment efforts. In recent years, evidence has examined weight stigmatization as a unique contributor to negative health outcomes and behaviors that can promote and exacerbate obesity. This review summarizes findings from published studies within the past 4 years examining the relationship between weight stigma and maladaptive eating behaviors (binge eating and increased food consumption), physical activity, weight status (weight gain and loss and development of obesity), and physiological stress responses. Research evaluating the effects of weight stigma present in obesity-related public health campaigns is also highlighted. Evidence collectively demonstrates negative implications of stigmatization for weight-related health correlates and behaviors and suggests that addressing weight stigma in obesity prevention and treatment is warranted. Key questions for future research to further delineate the health effects of weight stigmatization are summarized.
KeywordsObesity Stigma Discrimination Health Health behaviors
The authors gratefully acknowledge support for this research from the Rudd Foundation.
Compliance with Ethics Guidelines
Conflict of Interest
Rebecca Puhl and Young Suh declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance
- 4.Bradshaw CP, Waasdorp TE, O’Brennan LM, Gulemetova M. Teachers’ and education support professionals’ perspectives on bullying and prevention: findings from a national education association study. Sch Psychol Rev. 2013;42(3):280–97.Google Scholar
- 5.Puhl RM, Luedicke J, DePierre JA. Parental concerns about weight-based victimization in youth. Childhood Obes. 2013;9(6):540–8.Google Scholar
- 8.Hilbert A, Pike K, Goldschmidt A, Wilfley D, Fairburn C, Dohm F-A, et al. Risk factors across the eating disorders. Psychiatry Research. 2014.Google Scholar
- 9.•Almeida L, Savoy S, Boxer P. The role of weight stigmatization in cumulative risk for binge eating. J Clin Psychol. 2011;67(3):278–92. This study considers the influence of weight stigmatization on binge eating alongside other individual-level and environmental risk factors and presents clear evidence for weight stigmatization as a unique predictor of binge eating.CrossRefPubMedGoogle Scholar
- 22.•Durso LE, Latner JD, White MA, Masheb RM, Blomquist KK, Morgan PT, et al. Internalized weight bias in obese patients with binge eating disorder: associations with eating disturbances and psychological functioning. Int J Eat Disord. 2012;45(3):423–7. This study highlights the important role of internalization of weight bias as a contributor to maladaptive eating behaviors and emotional well-being. CrossRefPubMedCentralPubMedGoogle Scholar
- 24.Rudolph A, Hilbert A. A novel measure to assess self-discrimination in binge eating disorder and obesity. International Journal of Obesity. 2014.Google Scholar
- 27.•Major B, Hunger JM, Bunyan DP, Miller CT. The ironic effects of weight stigma. J Exp Soc Psychol. 2014;51:74–80. This is the most recent experiment conducted in a laboratory setting documenting the direct effects of weight stigma on greater caloric intake and poorer dietary control only among women with overweight. CrossRefGoogle Scholar
- 28.Brochu PM, Dovidio JF. Would you like fries (380 cal) with that? Menu labeling mitigates the impact of weight-based stereotype threat on food choice. Social Psychol Personal| Sci. 2013.Google Scholar
- 33.Peters DM, Jones RJA. Future sport, exercise and physical education professionals’ perceptions of the physical self of obese children. Kinesiology. 2010;42(1):36–43.Google Scholar
- 35.Li BJ, Lwin MO, Jung Y. Wii, myself, and size: the influence of proteus effect and stereotype threat on overweight children’s exercise motivation and behavior in exergames. GAMES FOR HEALTH. Res, Deve, Clin Appl. 2014;3(1):40–8.Google Scholar
- 42.Pearl RL, Puhl RM, Dovidio JF. Differential effects of weight bias experiences and internalization on exercise among women with overweight and obesity. J Health Psychol. 2014. doi: 10.1177/1359105313520338
- 43.Jackson SE, Beeken RJ, Wardle J. Perceived weight discrimination and changes in weight, waist circumference, and weight status. Obesity (Silver Spring). 2014;22:2485–8. doi: 10.1002/oby.20891.
- 44.•Sutin AR, Terracciano A. Perceived weight discrimination and obesity. PLoS ONE Vol 8(7), Jul 2013, ArtID e70048. 2013;8(7). This four-year, longitudinal study provides strong support that experiences of weight discrimination (but not other forms of discrimination) greatly increases the risk for becoming and remaining obese among adults.Google Scholar
- 51.•Gudzune KA, Bennett WL, Cooper LA, Bleich SN. Perceived judgment about weight can negatively influence weight loss: a cross-sectional study of overweight and obese patients. Prev Med. 2014;62:103–7. This study is the first to document that experiences of weight stigma in health care may undermine patients’ efforts for weight loss. CrossRefPubMedCentralPubMedGoogle Scholar
- 57.Wagner J, Lampert R, Tennen H, Feinn R. Exposure to discrimination and heart rate variability reactivity to acute stress among women with diabetes. Stress Health. 2013. doi: 10.1002/smi.2542
- 61.Rosenthal L, Earnshaw VA, Carroll-Scott A, Henderson KE, Peters SM, McCaslin C, et al. Weight- and race-based bullying: health associations among urban adolescents. J Health Psychol. 2013.Google Scholar
- 70.•Puhl R, Luedicke J, Peterson JL. Public reactions to obesity-related health campaigns: a randomized controlled trial. Am J Prev Med. 2013;45(1):36–48. The counter-productive effect of weight stigma in obesity prevention media campaigns addresses the need for empirical testing of obesity health messages prior to public dissemination. CrossRefPubMedGoogle Scholar