In advance of Weight Stigma Awareness Week (September 21-25), Stacey Cahn, PhD, associate professor of clinical psychology at Philadelphia College of Osteopathic Medicine, recently offered her perspectives concerning the causes and consequences of weight stigma in a press release.
Stigma related to obesity is a pervasive and negative perception directed to people who are obese or overweight. Obesity is a serious social problem with a rising trend. In the United States between 1995 and 2005, the prevalence of discrimination related to weight increased to 66%, a rate identical to the rates of racial discrimination.
Weight stigma can lead to bullying or weight-based victimization. Since obesity or being overweight affects 2 in every 3 Americans, this type of discrimination can affect millions of people. It is especially concerning in the context of bullying in children.
In comparison to their peers, individuals of all ages with obesity who face weight discrimination have reported less success in finding romantic relationships, and have fewer friends. Findings from a recent social experiment conducted by Dr. Natasha Schvey and colleagues revealed that stigma related to being overweight even influences jurors’ determination of guilt, while individuals with obesity are less likely to be promoted or hired and earn less. However, under US laws, it is within the law for a company to fire someone solely on the basis of weight.
With these issues in mind, Dr. Cahn aims to address the question: does weight stigma or “fat shaming” help motivate people to lose weight?
Weight stigma does not help motivate people to lose weight. Results from a recent study conducted in more than 2,000 obese adults showed that 79% managed their stress related to weight stigma by eating. These individuals are also more likely to experience depression, anxiety and suicide behaviors in order to avoid facing stigma. Studies have also shown that 2 in every 3 overweight individuals face weight stigma from their healthcare providers, and importantly they are misdiagnosed because physicians often consider their symptoms to be associated with their obese status. In light of this situation, many patients avoid future visits to their doctors just to avoid being stigmatized.
Findings from studies have also shown that stress related to weight stigma increased the levels of cortisol in overweight as well as thin women. Heightened cortisol reactivity incites appetite, diminishes satiety cues, prepares the body to store fat, and heightens preference for highly palatable foods.
Weight stigma is a social construct based on the thinness social ideal and in obesity misperceptions. However, currently held social beliefs about obesity being a personal choice are often overrated, as body weight involves a complex interplay of biological, genetic, environmental, and behavioral factors. In fact, according to the American Medical Association, obesity is a disease, and evidence is clear in showing that it is a chronic disease not easily treated by lifestyle changes alone. Research has shown that 97% of obese people who lose weight through exercise and diet actually regain their weight in the future.
Weight Stigma Awareness Week is a weight awareness campaign that aims to educate the public on weight stigma. The non-profit Rudd Center has been active in campaigning against weight stigma, producing some promising results related to policy recommendations on this issue.
The National Science Foundation is currently supporting a five-year investigation aiming to examine the extent and consequences of stigma related to weight. The researchers are planning to gather real-time information using mobile texting to assay the theory about a vicious cycle where people with obesity cope with the stress of weight stigma by eating. This in turn causes them to gain more weight, which leads them to experience greater weight stigma.
The obesity epidemic is a worldwide problem, and weight stigma remains one of the most pervasive and socially acceptable forms of discrimination and bias. According to Stacey Cahn, society needs to attack the problem of obesity, not the people with obesity.