What is Weight Stigma? | Impacts of Bias and How to Cope
Almost half of all adults in the U.S. have experienced weight stigma at some point in their lives, and yet it is a term that is still not commonly known and understood.
This lack of awareness and understanding of weight stigma, weight bias, and internalized weight bias and their serious consequences only allows these issues to continue to exist and impact the lives of so many people, regardless of body size.
While it’s important to raise public awareness about these issues to challenge weight stigma and make a positive change, it’s also crucial to know how to cope if you find yourself going through these experiences.
What is Weight Stigma?
Weight stigma is the discrimination people experience as a result of their body size, most commonly experienced by people in larger bodies.
Weight stigma is caused by weight bias, which are the negative attitudes and beliefs people have about others based on their weight. Weight bias can also be commonly referred to as weight discrimination or ‘fatphobia’.
Weight stigma and weight bias can be obvious, or it can be subtle, and it can happen in pretty much any setting.
In this blog, we’ll focus on the healthcare setting, because many people don’t seek the proper healthcare they need as a result of weight stigma, which has a major impact on the health of people in larger bodies.
Examples of Weight Stigma:
Negative comments about one’s weight or unsolicited advice on eating habits or exercise
Teasing or bullying
Lack of representation and negative portrayals in the media of people with larger bodies as lazy, unattractive, lacking willpower, or having poor hygiene, which reinforce negative stereotypes and weight bias
Receiving poor care or treatment, lack of accessibility, and providers making assumptions about health issues solely based on weight in healthcare settings
Experiencing discrimination in the workplace, being perceived as unmotivated or unprofessional, or receiving fewer job opportunities because of one’s weight
How Common is Weight Discrimination?
A study conducted by researchers at Yale University sought to find out how often adults in the United States experience weight discrimination, and how those rates compare to other types of discrimination like race, gender, and age.
They surveyed a nationally representative sample of adults and found that weight discrimination is not only common, but it affects women and people with larger bodies at especially high rates. Here’s what they found:
About 5 out of every 100 men said they've been discriminated against because of their weight.
About 10 out of every 100 women reported experiencing weight discrimination.
40% of those with a Body Mass Index (BMI) of 35 or higher reported experiencing weight discrimination.
Women with a BMI of 30–35 were three times more likely to report weight discrimination compared to men of similar weight.
For all adults, weight discrimination is the fourth most common form of discrimination, coming in after age, gender, and race.
For women, weight discrimination is the third most common form of discrimination—after gender and age.
Many people reported experiencing weight discrimination institutionally (such as a workplace) as well as personal mistreatment by others, making it very common. In some cases, the rates of weight discrimination were higher than gender or race discrimination.
What Causes Weight Stigma?
As we mentioned, weight stigma is caused by weight bias. The causes of weight bias, leading to weight stigma, are very complex.
Diet culture is a major culprit of both weight stigma and bias, because it has ingrained in us the ways we perceive ourselves and others regarding weight. Diet culture is a set of ideals that believe that our worth and value are tied to our appearance. It ultimately prioritizes thinness over everything else, including our mental and physical health.
When diet culture influences society to believe that smaller bodies are better than larger bodies, and oversimplify weight issues by encouraging people to “just lose weight”, and shaming those who don’t, weight bias is formed.
A common misconception is that body size determines the quality of one’s health, when in fact, it does not. This misconception leads people to believe that those with larger bodies are experiencing poor health, which isn’t always the case. This also leads to healthcare providers reducing all health issues down to being caused by one's weight, when it’s likely that there are other factors at play.
The Impacts of Weight Stigma
Weight stigma doesn’t just impact the way people feel about themselves– it has lasting effects on people’s physical and mental health, and quality of life. Being repeatedly exposed to discrimination, judgement, and shame because of body size takes a serious toll on one’s overall well-being.
Mental Health
Research has shown that weight stigma can cause an increased risk of anxiety, depression, low self-esteem, substance abuse, and suicidal thoughts. Individuals experiencing weight stigma are also more likely to engage in disordered eating behaviors or develop eating disorders due to having a poor body image.
Being treated as less than due to one’s body size can create internalized weight bias, which is when someone who experiences weight bias begins to believe the negative messages they are told about themselves and their weight.
Over time this chips away at their self worth, which can lead to poor body image, then disordered eating habits, potentially leading to an eating disorder and other mental health issues.
Poor Body Image
Body image is more than just what we see when we look in the mirror– it’s the way we think and feel about our bodies. The thoughts and feelings we have about our bodies then drive how we treat them.
Many factors can influence our body image to be positive or negative. Our family and friends, past experiences, media messages we’re exposed to, and the culture we are raised in all play a major role in shaping how we think and feel about ourselves.
Having a positive body image not only decreases the risk of developing an eating disorder, but it also leads to having a higher self-esteem, lower levels of anxiety and depression, increased likelihood of having a healthier relationship with food and engaging in joyful movement, and generally being more happy overall.
The impacts of having a poor body image are the opposite. Some of these impacts include an increased risk for:
Eating disorders or disordered eating habits
Self-harm
Risky sexual behaviors
Substance abuse
Mental health issues like anxiety and depression
Social/relationship issues
This is why recognizing weight stigma’s impact on body image is so important– having a positive or negative body image has a major impact on overall quality of life.
Physical Health
If someone develops poor body image due to weight stigma and eventually develops an eating disorder, there are many possible physical consequences that can occur such as heart problems, gastrointestinal issues, hormonal imbalances, low bone density, neurological problems, and more. Other physical health impacts can include:
Developing binge eating habits and exercise avoidance due to stress, which can result in gaining weight
Increased risk of chronic health problems such as metabolic syndrome
Poor quality of healthcare as a result of bias from healthcare professionals
Decrease in overall health from healthcare avoidance
Aside from eating disorders and disordered eating, the other major factor that causes negative impacts to physical health is due to weight stigma in healthcare settings. When people experience weight stigma when seeking healthcare they become more likely to not receive the care they need by avoiding it all together, leaving their medical issues untreated.
Avoiding Medical Care Due to Weight Stigma
Health professionals, sometimes unknowingly, often reduce the health issues patients in larger bodies are experiencing to being issues tied directly to their weight without digging any deeper to identify what is truly causing their health issues. This happens because of weight bias.
Some examples of experiencing weight stigma and bias in healthcare settings include:
A patient goes to their doctor because they are experiencing knee pain. Their doctor only recommends to them that they lose weight without looking into any other possible causes.
Patients in larger bodies are told they have to lose weight before they can receive diagnostic testing or procedures, even if they have nothing to do with weight.
A doctor withholds treatment or referrals until a patient loses a certain amount of weight, delaying their care.
A healthcare provider assumes a patient is inactive or overeats based only on their body size without considering their actual habits and lifestyle.
Patients getting less time with their doctors because they are viewed as non-compliant as a result of their weight.
Experiencing weight stigma and bias is extremely uncomfortable and it happens far too often. One study of almost 14,000 individuals found that at least 66% of those who experienced weight stigma encountered it from their healthcare providers.
When patients have these experiences, they will often avoid trying to continue to seek the treatment and preventative care they need so they don’t have to go through it again with their healthcare providers.
Even if they do push to get the care they need, medical professionals engaging in weight bias provide poorer quality of care because of their inability to offer support and empathy to their patients.
Avoiding healthcare over time increases patients' medical risks and even the cost of future healthcare, if their health problems worsen. According to a study by Fulton, Dadana, and Srinivasan:
“Weight-based discrimination and stigmatization are linked to lipid and metabolic dysregulation, glucose metabolism issues, and elevated markers of inflammation, leading to an elevated 10-year cardiometabolic risk and increased morbidity. One study even suggests that weight-based discrimination might result in a 60% increase in mortality among individuals, although the exact mechanism is unclear.”
People in larger bodies feeling ashamed and embarrassed to get the medical care they need is not only leading to heart disease and even death, it prevents people from being diagnosed with things like cancer because they aren’t being screened properly for these issues.
Paradox of Encouraging Weight Loss
A common belief among healthcare providers is that labeling patients as “obese” will motivate them to lose weight. Contrary to this belief, research has shown that encouraging weight loss can actually cause weight gain due to the effects of weight stigma.
As we mentioned previously, having repeated experiences in personal, professional, and medical situations where people in larger bodies are made to feel less than for the way their bodies look can lead to internalized weight bias. When people begin to believe these negative messages they are told, they end up losing confidence in themselves and their ability to lose weight.
Additionally, weight stigma negatively impacts individuals' eating patterns, with some studies showing that those who experience weight stigma increased the amounts of food they ate as a way to cope with stress.
In fact, one study of nearly 2,500 women found that 79% of the participants reported using food to cope with weight stigma on multiple occasions, and 90% reported using food to cope with weight bias at least once in their lives.
This data, and much more from other research, shows that even when health professionals have good intentions, those who engage in weight bias and encourage their patients in larger bodies to lose weight actually have the opposite effect and negatively impact their overall health.
BMI Doesn't Measure Health
Body Mass Index (BMI) is a measurement of one's height and weight to determine the amount of body fat, and is commonly used to measure health or the risks of health problems in those who are “under or overweight” based on the number.
In 1832, a Belgian scientist named Lambert Adolphe Jacques Quetelet sought to develop a formula that defined what the “average” man looked like. This measurement he created became known as the Quetelet Index.
It wasn’t until 1972 that a physiologist named Ancel Keys renamed the measurement to Body Mass Index, or BMI, and went on to emphasize BMI’s usefulness in analyzing data involving entire populations. Over time, BMI has become a widely used tool to assess health and determine risk for disease.
When BMI was designed and created, it was not done so with the intention of using it for medical purposes. It is not able to tell the difference between muscle mass, bone mass, and fat. It also does not consider how fat is distributed in the body, which is important when determining health risks.
Additionally, BMI does not consider the differences in people of different genders, races, or age groups. Not taking all of these factors into account means that BMI is not a reliable measure of individual health or risk for disease.
With critique of the use of BMI on the rise, more accurate measurements of health are being explored including waist-to-hip ratio, waist-to-height ratio, and neck circumference. These measurements may more accurately reflect health risks, especially those that are related to fat distribution in the body.
In the meantime, it’s best to use metabolic markers to assess one’s health such as liver function, blood pressure, blood sugar levels, and cholesterol levels, because these measurements more accurately reflect the quality of people’s overall health.
BMI can be a useful tool, but the problem is that it has become normalized to use it in a way that it wasn’t intended to be used. It is one piece of a bigger puzzle, but too often it is viewed as a sole indicator of health, and it reinforces the misconception that body size is tied directly to the quality of one’s health.
Challenging Weight Stigma in Healthcare
As we’ve explored, there are serious long-term consequences of weight stigma, with healthcare providers being a major contributor. Recognizing this, healthcare professionals have a pivotal role in making a change to challenge weight stigma and make their patients feel supported and properly cared for.
The STRIPED Roadmap, developed through expert consensus, offers actionable steps for healthcare providers to address weight stigma. The following are just a few that the roadmap offers:
Shift the Focus to Health Behaviors and Biomarkers: Encourage practices that promote overall well-being, such as balanced nutrition and regular physical activity, rather than emphasizing weight loss. Shift the focus of health being tied to body size to actual markers of health such as blood pressure, cholesterol, and blood sugar levels.
Avoid Stigmatizing Language: Use respectful and person-centered language that does not reinforce negative stereotypes about body size.
Ensure Inclusive Care: Provide medical equipment and facilities that accommodate diverse body sizes, ensuring all patients receive equitable care.
Engage Patients in Their Care: Involve individuals in decision-making processes, respecting their experiences and perspectives.
By implementing these strategies, and the many more provided in the roadmap, healthcare providers can foster a more inclusive environment and avoid the harm that weight stigma and bias causes.
How to Take Care of Yourself in the Face of Weight Stigma & Bias
Experiencing weight stigma and bias is far from easy. It becomes even more difficult if you find yourself facing internalized weight bias. While dealing with this is challenging, know that you are not alone in these struggles.
While there are things you can do to help cope and take care of yourself, it’s important to remember that these suggestions are not about fixing yourself, because you are not wrong as you are now. They are about building resilience and compassion for yourself when faced with unfair bias.
Call it Out
Recognizing that what you’re experiencing is weight stigma, not a personal failure, is important. When other people, society, healthcare systems, or even your inner voice are treating you unfairly because of your body size, calling it out to yourself can help you separate your worth from the judgement. You are not the problem, the bias and discrimination is.
Practice Self-Compassion
When faced with weight stigma, it can be easy to internalize the negativity and turn it on yourself. In times like these it’s important to practice self-compassion by speaking to yourself in the same way you would to a loved one. Remind yourself that your worth is not tied to your appearance, your feelings are valid, and that you deserve love, care, and respect exactly as you are.
Clean Up Your Social Media Feed
Social media can have a strong influence on how we see ourselves. If you see that your feed is sharing messages that promote unrealistic body standards, diet culture, or shame-fueled messaging, it’s time for a clean up. Find and follow accounts that celebrate body diversity, self-love, and support positive mental health.
Find Support
Weight stigma can have a lot of negative impacts on a person, and you don’t have to navigate them alone. If you’re struggling, find support from loved ones, a mental health professional, or even support groups.
Advocate for Yourself
Advocating for yourself means to stand up for your needs and rights when weight stigma shows up, like at the doctor's office, at work, or even when you’re with family and friends. It’s okay to ask for respectful treatment, to request healthcare that focuses on behaviors rather than weight, or to speak up when harmful assumptions are made about your body. Your voice matters and it deserves to be heard.
Rest and Heal
Healing takes time and is an ongoing process, so it’s good to remind yourself that it’s okay to take breaks and rest along the way. Experiencing discrimination and bias can be both physically and emotionally exhausting, especially when you’re also working on learning new ways to take good care of yourself. Prioritize doing things that nourish your mind and body, like spending time in nature, journaling, or simply just taking breaks when needed.
Building a Better Future
Weight stigma is a very real and impactful challenge so many people face, but it doesn’t have to be this way and we are not powerless against it.
Raising awareness and educating people about these issues and the reality of their impacts is the best way to make the public aware about others' lived experiences, challenge weight stigma, and make a positive change.
If you’re interested in diving even deeper into weight stigma and weight bias, want to learn about ways you can challenge weight stigma, or would like additional resources and support, check out UConn Rudd Center for Food Policy and Health. Their website provides research, resources, and educational materials aimed at understanding, addressing, and reducing weight bias and stigma across various settings, including healthcare, education, and media.
If you are experiencing eating disorder or body image issues and are in need of support, please visit our Helplines and Resources page.
