Sticks and stones: the association between weight discrimination and mental and physical well-being

Abstract

Obese individuals face increasing levels of prejudice and discrimination. In addition, some individuals internalise society’s anti-fat attitudes and stereotypes. Both internalised and societal stigmas have been associated with poorer health outcomes, independent of BMI.

In this online study, 379 overweight or obese adults (88% female, average age 37.6 years, average BMI 36.8) from social media sites related to health, fitness, weight-loss, and plus-size fashion completed online questionnaires about stigma and health outcomes.

Nasty comments from family, friends, co-workers or total strangers were the most common form of stigma, but over 80% had received inappropriate comments from doctors, and over one in four had experienced weight-based discrimination in an employment setting. More than one in ten had been physically attacked because of their weight, some more than once. Women experienced significantly more stigma than men, even after controlling for BMI. Both experienced and internalised stigma were associated with more disordered eating behaviours, poorer self-esteem, worse body image, and a greater restriction on public activities such as exercising: however, the effects of internalisation appear to be even greater than those of actual stigma experiences.

Focusing future interventions on reducing internalisation of ubiquitous anti-fat messages may improve health outcomes in overweight individuals.