Understanding weight stigma: how it impacts mental health and weight loss

Around 800 million of us are living with obesity, with millions more at risk. We know the causes  of obesity are complex and multifactorial, and the effects of weight stigma can be detrimental to an individual’s mental and physical health. It is important for healthcare providers to be aware of this issue and take steps to overcome it.

Defining weight stigma

Weight stigma can be defined as negative attitudes, stereotypes, and discrimination towards people who are perceived to have a higher body weight. It can result in bullying, teasing, and discrimination in various settings. Weight stigma assumes that individuals with higher body weight lack self-control and are less healthy.

However, body weight is complex and multifactorial. Weight stigma can lead to negative impacts on mental and physical health, such as decreased self-esteem, body dissatisfaction, disordered eating, and increased risk of chronic health conditions. It’s crucial to address weight stigma and promote body positivity and acceptance for individuals of all body sizes.

Understanding weight stigma and its implications

Weight stigma is a common phenomenon, and can include body shaming, fatphobia, and weight bias. Negative attitudes towards individuals based on their weight can have far-reaching consequences, including impacting their mental health and making it more difficult to make positive changes to their lifestyle. 

Despite efforts to increase awareness of the impact of weight stigma, people living with overweight and obesity are often automatically portrayed negatively in the media. For example, popular media outlets often include depersonalised images of overweight torsos without heads. Weight stigma has a far-reaching impact, and seemingly is present across all areas of modern life.

What causes weight stigma?

Weight stigma is often described as a product of societal attitudes towards body diversity, diet culture, and the medicalisation of weight. Individuals who experience weight stigma may also face discrimination in the workplace and in healthcare settings.

Healthcare settings can be stigmatising places for individuals who live with overweight and obesity. There are various factors that can contribute to this stigma, including unsuitable waiting area chairs, blood pressure cuffs that do not fit, language use, and the actual care provided. 

Unfortunately, biases held by healthcare professionals can contribute to weight stigma in these settings, causing affected individuals to experience profound discomfort, an unwelcoming atmosphere, heightened distress, and even discontinuation of essential healthcare visits.

Weight stigma amongst healthcare professionals is a widespread issue, as highlighted by a survey conducted by the World Obesity Federation which found that 54% of people living with obesity in the United Kingdom reported experiencing weight stigma from healthcare professionals, such as doctors, nurses, and dietitians. This survey included responses from over 2,000 people with obesity from 11 countries, indicating the global prevalence of the problem.

What are the consequences of weight stigma?

The impact of weight stigma is far-reaching. It has both immediate and long-term effects on individuals. People living with overweight and obesity can feel immediate distress and be hyper-vigilant about their surroundings. They may feel like people are avoiding them, and their size is not accommodated in public spaces. Weight stigma can also be explicit, such as name-calling and street harassment.

Both implicit and explicit stigma can lead to internalisation of negative beliefs, and people may begin to believe that they are at fault for their weight. It can lead to low self-esteem, depression, anxiety, and other mental health issues, which in turn can make it harder for individuals to lose weight and maintain a healthy lifestyle.

Fix-It mentality

Weight stigma can lead to people developing a “fix-it” mentality, which can hinder their ability to make changes. Internalised weight stigma can lead people to believe that if they change their weight, everything else will be okay. They may delay going to the gym, swimming pool, or participating in other activities because they fear judgement from others. People may avoid seeking medical care altogether because of weight stigma. This avoidance can lead to delayed diagnoses, untreated health problems, and can cause further health problems in the long term. 

How can we combat weight stigma?

Healthcare professionals can play a critical role in reducing weight stigma by providing compassionate care and avoiding weight-based stereotypes.

Using adjectives like “obese” to describe someone can be stigmatising as it implies a negative judgement on a person’s body size. Additionally, prescribing weight loss as the primary solution for any health issue without considering a person’s overall wellbeing can perpetuate the idea that thinness equates to health, and that larger bodies are inherently unhealthy. 

It is important for healthcare professionals to understand the impact of weight stigma on their patients and to actively work towards creating inclusive and non-judgmental environments for people of all body sizes.

Improving culture and training to overcome weight stigma

Training is a critical component of overcoming weight stigma in healthcare settings. Healthcare providers need to be aware of weight stigma; the subject of weight stigma should be part of the core training that healthcare providers receive.

Creating a culture of inclusivity and respect within healthcare teams is essential in reducing weight stigma. Healthcare professionals have a responsibility to challenge all forms of discrimination and stigma, including weight stigma. Encouraging positive and empowering feedback, as well as providing constructive criticism, can be effective in helping patients feel confident and motivated in achieving their health goals. By promoting a culture that values every patient’s individual journey, healthcare professionals can create a safe and supportive environment that promotes positive health outcomes for all.

Individual responsibility

Healthcare professionals need to maintain reflective practice to consider their actions and the care they provide for those living with overweight and obesity. It is essential to keep patients’ individuality in mind, as each person has different needs and requires individual conversations and approaches.

Assuming that most  individuals living with overweight and obesity will have unfortunately  experienced weight stigma is a critical starting point in providing compassionate and person-centred care.

Conclusion

Weight stigma is a pervasive issue that impacts individuals and society as a whole. The healthcare industry has a crucial role to play in avoiding weight stigma and creating a less stigmatising environment for people living with obesity. Through person-centred approaches, healthcare professionals can help people with obesity feel welcome, accepted, and supported in healthcare settings. By creating a culture of compassion, the industry can provide patients with the encouragement and support they need to make positive changes in their lives.