The Weight of Stigma

Weight stigma is an interesting area of research at the moment.

Weight stigma is the negative weight-related beliefs, attitudes, judgments and behaviours toward people based on their weight. (Sometimes called weight bias).

It is sometimes claimed that weight stigma produces positive behaviour changes that result in weight loss, however this claim has been debunked by recent research, with data indicating that stigma actually has a paradoxical impact.

Weight stigma causes:

  • Low self-esteem, self-worth and self-confidence.

  • Depression and anxiety.

  • Emotional eating.

  • Avoidance of eating in public.

  • Secret eating.

  • Avoidance of healthcare settings and reluctance to seek help.

  • Social isolation.

  • Difficulties forming and maintaining relationships.

Some key points on weight stigma:

Weight stigma can affect people of all weights.

Those in larger bodies are at risk of greater levels of stigma, and experience significantly more environmental stigma (E.G. not being able to but clothes in every shop or not being able to use certain seating). However, perceived stigma also has an affect on health. Nolan and Eshleman (2016) found that perceived weight predicted increased eating and less self-control when eating, something associated with binge eating.

Weight stigma does not encourage weight loss.

There is an old fashioned notion that if we tell people that fat bodies are bad, those people will be motivated to lose weight. This notion has never been backed up and in fact the evidence indicates that the opposite is true. When individuals are stigmatized due to their weight, they are less likely to lose weight. Weight stigma tends to be associated with increased binge eating behaviour and predicts likelihood of becoming or staying obese.

Weight stigma perpetuates the notion that weight is associated with morality.

We can't seem to shake the notion that fat bodies are wrong and bad. This adds to feelings of guilt and low self-esteem, leading to social isolation. Therefore it is unsurprising that individuals who perceive weight stigma are more likely to avoid social situations. All this combines to contribute to loneliness and disconnection from society.

Weight stigma impacts people's sense of identity.

There are many stereotypes given to fat bodies, and these are felt by people. Lewis et al. (2011) found that their participants felt that they were prescribed an identity because of their weight. They felt people assumed they were lazy and gluttonous, and some female participants even noted assumptions regarding their ability to be a mother because of their weight.

Healthcare is negatively impacted by weight stigma.

Some research suggests that negative assumptions are made by medical professionals regarding fat patients. Phelan et al. (2015) found that healthcare providers commonly perceived "obese" patients as lazy, undisciplined and weak-willed, they had less respect for patients who were in larger bodies, spent less time educating these patients on health, were more likely to rate the visit as a "waste of time" compared to non-obese patient visits AND over-attribute symptoms and problems to obesity, often failing to refer patients for further testing, instead recommending weight loss. These stigmatizing opinions and behaviours can be picked up by patients, meaning that fat patients are more likely to avoid healthcare settings. Avoidance results in fat patients presenting with more advanced conditions-> can't necessarily say "fat people have worse outcomes of X illness because of their size", as it may be more to do with avoidance of healthcare until illness is no longer manageable. Additionally, fat patients frequently report feeling worried or stressed during healthcare visits and as such are more likely to fail to engage in the visit. This can impact ability to recall advice fully and therefore lead to poor adherence to treatment.

Our environment contributes to weight stigma.

If you are straight-sized, you may not have realised that our world is not always suited to different body sizes. But think about it- does your favourite clothes shop stock a range of sizes that suit all bodies? Does your gym contain equipment that could be used by a larger body? Does the seating in your office etc. allow any body to sit comfortably? Probably not. When the world seems to not facilitate your body, it leads to a feeling that your body is not socially accepted or valued by society. I.E. our environment is stigmatizing in and of itself.

An interesting study on stigma:

A research team recruited students- all wore a tracksuit, but half wore a fat suit under their tracksuit. They then had the students walk around the university campus. Those who wore the fat suit reported increased feelings of anger, anxiety, depressed mood and lowered self-esteem. They also consumed more crisps and chocolate than the students not wearing a fat suit (around 200kcals more).

The interesting thing about this research is that although the participants perceived stigma that they had not perceived without the fat suit, there were no significant change in anti-fat attitudes of participants.

So, these students felt the stigma, noted it's impact on their mood, but once the fat suit came off, they still held beliefs that fat bodies are wrong.

This is only a small amount of information on weight stigma, but I'm sure you can begin to see the significance of it's impact.

If we all "check our stigma", it could make a huge difference. Just ask yourself, do I hold beliefs about larger bodies? Are those beliefs based on fact? Are those beliefs potentially harming people? Am I contributing to weight stigma? If the answer is yes, start to challenge stigmatizing thoughts that come up and reframe those thoughts when possible. If you need help with this, reach out!

Next week, I have a post coming on weight stigma in childhood so stay tuned!

Lots of love,

Little O x

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