Weight Stigma
Weight stigma is the negative attitudes, beliefs, and behaviors directed towards individuals based on their weight. It encompasses a range of experiences, from subtle microaggressions to overt discrimination, and can have profound consequences for the physical, mental, and social well-being of those affected.
Understanding weight stigma is crucial for addressing its harmful effects on individuals and society as a whole. It is essential for creating a more supportive and inclusive environment for individuals of all sizes, promoting healthy behaviors through non-stigmatizing approaches, and conducting research that is sensitive to the complex relationship between weight and health.
Critical Review Questions
1. Define weight stigma and discuss its various forms.
What are the different forms of weight stigma, including microaggressions, overt discrimination, and internalized stigma?
How does weight stigma manifest in different settings, such as healthcare (e.g. Remmert et al, 2019; Puhl et al, 2021), education, the workplace, and interpersonal relationships?
What other types of stigma exist in health and what can we learn from these cases? (e.g. Bayer et al, 2008; Puhl & Heuer, 2011)
2. Describe the prevalence and impact of weight stigma.
How widespread is weight stigma in society, and how does it affect individuals of different ages, genders, and socioeconomic backgrounds?
What are the physical, mental, and social consequences of weight stigma for individuals and society as a whole? (e.g. Puhl & King, 2013)
How might weight stigma be driving obesity levels? (e.g. Tomiyama et al, 2018)
3. Analyze the factors that contribute to weight stigma.
What are the historical and cultural roots of weight stigma, and how have societal attitudes toward weight changed over time?
How do media portrayals, social norms, and individual biases contribute to weight stigma?
4. Evaluate the effectiveness of different approaches to addressing weight stigma.
What are the strengths and limitations of various intervention strategies aimed at reducing weight stigma, such as education, policy changes, and community-based initiatives?
How can we ensure that interventions to combat weight stigma are culturally sensitive and inclusive?
5. Discuss the role of public health in addressing weight stigma.
What are the responsibilities of public health professionals in addressing weight stigma and promoting body acceptance?
How can public health initiatives integrate weight stigma reduction into broader efforts to promote health equity and well-being?
Recommended Reading
If you only read one paper, try...
Brown, A., Flint, S. W., & Batterham, R. L. (2022). Pervasiveness, impact and implications of weight stigma. EClinicalMedicine, 47. https://doi.org/10.1016/j.eclinm.2022.101408
Westbury, S., Oyebode, O., Van Rens, T., & Barber, T. M. (2023). Obesity stigma: causes, consequences, and potential solutions. Current Obesity Reports, 12(1), 10-23. https://doi.org/10.1007/s13679-023-00495-3
Much more...
Argüelles, D., Pérez-Samaniego, V., & López-Cañada, E. (2022). “Do you find it normal to be so fat?” Weight stigma in obese gym users. International Review for the Sociology of Sport, 57(7), 1095-1116. https://doi.org/10.1177/10126902211056867
Baker, P., Brookes, G., Atanasova, D., & Flint, S. W. (2020). Changing frames of obesity in the UK press 2008–2017. Social science & medicine, 264, 113403. https://doi.org/10.1016/j.socscimed.2020.113403
Bayer, R. (2008). Stigma and the ethics of public health: not can we but should we. Social science & medicine, 67(3), 463-472. https://doi.org/10.1016/j.socscimed.2008.03.017
Hill, B., Bergmeier, H., Incollingo Rodriguez, A. C., Barlow, F. K., Chung, A., Ramachandran, D., ... & Skouteris, H. (2021). Weight stigma and obesity‐related policies: a systematic review of the state of the literature. Obesity Reviews, 22(11), e13333. https://doi.org/10.1111/obr.13333
Brewis, A. A. (2014). Stigma and the perpetuation of obesity. Social science & medicine, 118, 152-158. https://doi.org/10.1016/j.socscimed.2014.08.003
Brookes, G. (2021). Empowering people to make healthier choices: a critical discourse analysis of the tackling obesity policy. Qualitative Health Research, 31(12), 2211-2229. https://doi.org/10.1177/10497323211027536
Eberhardt, J. L. (2020). Biased: Uncovering the hidden prejudice that shapes what we see, think, and do. Penguin.
Eisenberg, M. E., Carlson‐McGuire, A., Gollust, S. E., & Neumark‐Sztainer, D. (2015). A content analysis of weight stigmatization in popular television programming for adolescents. International Journal of Eating Disorders, 48(6), 759-766. https://doi.org/10.1002/eat.22348
Flint, S. W. (2019). Weight stigma and discrimination: Time for change! Nutrition Bulletin https://doi.org/10.1111/nbu.12398
Flint, S. W. (2019). Addressing weight stigma: a timely call. The Lancet Public Health, 4(7), e322. https://doi.org/10.1016/S2468-2667(19)30083-0
Flint, S. W. (2020). The NHS long-term plan: a comparison of the narrative used for cancer and obesity. The Lancet Diabetes & Endocrinology, 8(5), 355-357. https://doi.org/10.1016/S2213-8587(20)30072-3
Flint, S. W., Leaver, M., Griffiths, A., & Kaykanloo, M. (2021). Disparate healthcare experiences of people living with overweight or obesity in England. EClinicalMedicine, 41. https://doi.org/10.1016/j.eclinm.2021.101140
Flint, S. W., & Snook, J. (2014). Obesity and discrimination: the next ‘big issue’?. International Journal of Discrimination and the Law, 14(3), 183-193. https://doi.org/10.1177/1358229114534550
Hart, L. M., Ferreira, K. B., Ambwani, S., Gibson, E. B., & Austin, S. B. (2021). Developing expert consensus on how to address weight stigma in public health research and practice: A Delphi study. Stigma and Health, 6(1), 79. https://psycnet.apa.org/doi/10.1037/sah0000273
Hatzenbuehler, M. L., Phelan, J. C., & Link, B. G. (2013). Stigma as a fundamental cause of population health inequalities. American journal of public health, 103(5), 813-821. https://doi.org/10.2105/AJPH.2012.301069
Luck-Sikorski, C., Riedel-Heller, S. G., & Phelan, J. C. (2017). Changing attitudes towards obesity–results from a survey experiment. BMC Public Health, 17(1), 1-13. https://doi.org/10.1186/s12889-017-4275-y
Theis, D. R., & White, M. (2021). Is obesity policy in England fit for purpose? Analysis of government strategies and policies, 1992–2020. The Milbank Quarterly, 99(1), 126-170. https://doi.org/10.1111/1468-0009.12498
Pomeranz, J. L. (2008). A historical analysis of public health, the law, and stigmatized social groups: the need for both obesity and weight bias legislation. Obesity, 16(S2), S93-S103. https://doi.org/10.1038/oby.2008.452
Puhl, R. M., Himmelstein, M. S., & Pearl, R. L. (2020). Weight stigma as a psychosocial contributor to obesity. American Psychologist, 75(2), 274. https://psycnet.apa.org/doi/10.1037/amp0000538
Puhl, R. M., & Heuer, C. A. (2010). Obesity stigma: important considerations for public health. American journal of public health, 100(6), 1019-1028. https://doi.org/10.2105/ajph.2009.159491
Puhl, R. M., & King, K. M. (2013). Weight discrimination and bullying. Best practice & research Clinical endocrinology & metabolism, 27(2), 117-127. https://doi.org/10.1016/j.beem.2012.12.002
Puhl, R. M., & Lessard, L. M. (2020). Weight stigma in youth: prevalence, consequences, and considerations for clinical practice. Current Obesity Reports, 9, 402-411. https://doi.org/10.1007/s13679-020-00408-8
Puhl, R. M., Lessard, L. M., Himmelstein, M. S., & Foster, G. D. (2021). The roles of experienced and internalized weight stigma in healthcare experiences: Perspectives of adults engaged in weight management across six countries. PLoS One, 16(6), e0251566. https://doi.org/10.1371/journal.pone.0251566
Puhl, R. M., Lessard, L. M., Pearl, R. L., Himmelstein, M. S., & Foster, G. D. (2021). International comparisons of weight stigma: addressing a void in the field. International Journal of Obesity, 45(9), 1976-1985. https://doi.org/10.1038/s41366-021-00860-z
Remmert, J. E., Convertino, A. D., Roberts, S. R., Godfrey, K. M., & Butryn, M. L. (2019). Stigmatizing weight experiences in health care: Associations with BMI and eating behaviours. Obesity Science & Practice, 5(6), 555-563. https://doi.org/10.1002/osp4.379
Robinson, E., Haynes, A., Sutin, A. R., & Daly, M. (2017). Telling people they are overweight: helpful, harmful or beside the point?. International Journal of Obesity, 41(8), 1160-1161. https://doi.org/10.1038/ijo.2017.85
Rubino, F., Puhl, R. M., Cummings, D. E., Eckel, R. H., Ryan, D. H., Mechanick, J. I., ... & Dixon, J. B. (2020). Joint international consensus statement for ending stigma of obesity. Nature medicine, 26(4), 485-497. https://doi.org/10.1038/s41591-020-0803-x
Ryan, L., Coyne, R., Heary, C., Birney, S., Crotty, M., Dunne, R., ... & Walsh, J. C. (2023). Weight stigma experienced by patients with obesity in healthcare settings: A qualitative evidence synthesis. Obesity Reviews, 24(10), e13606. https://doi.org/10.1111/obr.13606
Schvey, N. A., Sbrocco, T., Bakalar, J. L., Ress, R., Barmine, M., Gorlick, J., ... & Tanofsky-Kraff, M. (2017). The experience of weight stigma among gym members with overweight and obesity. Stigma and Health, 2(4), 292. https://psycnet.apa.org/doi/10.1037/sah0000062
Spahlholz, J., Baer, N., König, H. H., Riedel‐Heller, S. G., & Luck‐Sikorski, C. (2016). Obesity and discrimination–a systematic review and meta‐analysis of observational studies. Obesity reviews, 17(1), 43-55. https://doi.org/10.1111/obr.12343
Talumaa, B., Brown, A., Batterham, R. L., & Kalea, A. Z. (2022). Effective strategies in ending weight stigma in healthcare. Obesity Reviews, 23(10), e13494. https://doi.org/10.1111%2Fobr.13494
Thedinga, H. K., Zehl, R., & Thiel, A. (2021). Weight stigma experiences and self-exclusion from sport and exercise settings among people with obesity. BMC public health, 21, 1-18. https://doi.org/10.1186/s12889-021-10565-7
Tomiyama, A. J., Carr, D., Granberg, E. M., Major, B., Robinson, E., Sutin, A. R., & Brewis, A. (2018). How and why weight stigma drives the obesity ‘epidemic’and harms health. BMC medicine, 16(1), 1-6. https://doi.org/10.1186/s12916-018-1116-5
Westbury, S., Oyebode, O., Van Rens, T., & Barber, T. M. (2023). Obesity stigma: causes, consequences, and potential solutions. Current Obesity Reports, 12(1), 10-23. https://doi.org/10.1007/s13679-023-00495-3
Williams, O., & Annandale, E. (2019). Weight bias internalization as an embodied process: understanding how obesity stigma gets under the skin. Frontiers in psychology, 10, 953. https://doi.org/10.3389/fpsyg.2019.00953
Watch a lecture/presentation on the topic
Further Resources
Food Active: Weight Stigma Resource Hub - https://foodactive.org.uk/weight-stigma-resource-hub/
Public Health Scotland: Challenging weight stigma learning hub - https://learning.publichealthscotland.scot/course/view.php?id=622
Plymouth City Council - A compassionate approach to working with families - https://www.plymouth.gov.uk/compassionate-approach-working-families
Obesity UK - Language Matters: Obesity - https://static1.squarespace.com/static/5bc74880ab1a6217704d23ca/t/612e32f5d423b36012a1bb16/1630417666068/FINAL_Obesity_UK_Language_Matters_2020.pdf
Impact on Urban health - Reframing how we talk about children’s health and food: Interactive Toolkit - https://urbanhealth.org.uk/our-work/childrens-health-and-food/framing-toolkit-talking-about-childhood-obesity
World Obesity - Image Bank Guidelines - https://www.worldobesity.org/resources/image-bank/image-bank-guidelines
Doncaster's Compassionate Approach to Weight - https://www.doncaster.gov.uk/services/health-wellbeing/doncaster-s-compassionate-approach-to-weight
Fitness Professionals Against Weight Stigma - Free Course: Weight stigma - the basics https://www.againstweightstigma.com/weight-stigma-the-basics