Weight stigma is a form of discrimination based on a person's body weight. It is the social rejection and devaluation that people face when they do not conform to society's expectations of acceptable body weight and shape. Weight stigma can have serious consequences for both physical and mental health, leading to increased stress, unhealthy coping mechanisms, and avoidance of healthcare settings.
Studies have shown that weight stigma can trigger changes in the body, such as increased cortisol levels, which can lead to poor metabolic health and increased weight gain. People who experience weight stigma may cope by engaging in unhealthy behaviors, such as:
Increasing alcohol and substance use
Overeating to deal with negative emotions
Avoiding healthcare settings or social encounters
The negative health outcomes resulting from weight discrimination can be severe, with studies finding a 60% increased risk of death, even when controlling for body mass index (BMI).
To address weight stigma, we must first acknowledge its existence. We can then take steps to change the way we think and speak about people with excess weight, such as:
Using person-first language: Say "person with obesity" instead of "obese person"
Recognizing that obesity is a disease, not a personal failing
Avoiding assumptions about a person's eating habits or physical activity levels based on their weight
Weight stigma is particularly prevalent in healthcare settings, leading to reduced quality of care for patients with overweight or obesity. Physicians have been shown to exhibit strong anti-fat bias, which can result in poor health outcomes for their patients.
To combat weight stigma in healthcare settings, clinicians should:
Use person-first language in speech and medical documentation
Avoid cookie-cutter advice to eat less and exercise more, and instead consider the various environmental, genetic, and physiological factors contributing to obesity
Believe patients' reports of dietary intake and physical activity levels
Focus on gathering information and understanding each patient's unique situation
Refer patients to obesity specialists when necessary
Patients with obesity should seek care from compassionate and knowledgeable healthcare providers to optimize the quality of their care and reduce the negative effects of weight bias.
Several organizations offer valuable information and resources for patients and healthcare providers to learn more about obesity and how to combat weight stigma:
Obesity Action Coalition: Helps individuals with obesity improve their health through education, advocacy, awareness, and support
Obesity Medicine Association: Provides a search tool to find board-certified obesity medicine clinicians in specific geographic areas
American Society for Metabolic and Bariatric Surgery: Offers information for those with severe obesity or milder obesity with other medical complications who are interested in bariatric surgery
By understanding the harmful effects of weight stigma and taking steps to address it in our daily lives and healthcare settings, we can create a more inclusive and supportive environment for people of all body sizes and shapes.
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