Obesity is one of the most pervasive and serious health risks we face today. Being obese or overweight saddles you with greatly increased chances of contracting a suite of different maladies, including heart disease, high blood pressure, stroke, Diabetes, metabolic syndrome, cancer, osteoarthritis, sleep apnea, reproductive problems, gallstones and many more. And according to new science, obesity’s health risks are compounded by “fat shaming,” a popular colloquial term that refers to the social stigma associated with being overweight.
The study, conducted by the Perelman School of Medicine at the University of Pennsylvania and published in the journal The Obesity Society, suggests that this stigma comes with its own high price tag. According to the lead researcher, Rebecca Pearl, PhD, shame around weight exacerbates an obese person’s risk of cardiovascular and metabolic disease.
“There is a common misconception that stigma might help motivate individuals with obesity to lose weight and improve their health,” says Pearl. “We are finding it has quite the opposite effect. When people feel shamed because of their weight, they are more likely to avoid exercise and consume more calories to cope with this stress. In this study, we identified a significant relationship between the internalization of weight bias and having a diagnosis of metabolic syndrome, which is a marker of poor health.”
The study examined data collected on 159 adult participants in a larger weight loss medication trial conducted by Eisai Pharmaceutical Co. Most of the subjects were African-American women, who filled out questionnaires that measured depression and “weight bias internalization.”
Weight bias internalization refers to the acceptance of negative self-image as influenced by social pressure, i.e. they accept the verdict that they’re overweight because they’re lazy or worthless.
The researchers ultimately concluded that participants with a high level of weight bias internalization were 300% more prone to have metabolic syndrome and 600% more likely to have a high triglyceride count, as compared with participants who expressed low weight bias internalization.
Tom Wadden, PhD, one of the study’s co-authors, said of the results, “Health care providers, the media, and the general public should be aware that blaming and shaming patients with obesity is not an effective tool for promoting weight loss, and it may in fact contribute to poor health if patients internalize these prejudicial messages. Providers can play a critical role in decreasing this internalization by treating patients with respect, discussing weight with sensitivity and without judgment, and giving support and encouragement to patients who struggle with weight management — behaviors everyone should display when interacting with people with obesity.”
The study corroborates previous findings that suggest stigma has a negative impact on mental and physical health indices. Being shamed for weight can trigger a stress response that leads to inflammation and boosted cortisol levels. It can also lead people to go on eating binges and avoid exercise.
“Disparagement of others due to their weight and messages that perpetuate blame and shame, if internalized, can cause harm to the physical and mental health of individuals with obesity,” says Rebecca Pearl. “As health care practitioners, we can help challenge negative, internalized stereotypes by educating patients about the complex biological and environmental factors that contribute to obesity, while providing concrete strategies to help patients manage their weight and improve their health.”
The study was funded by Eisai Pharmaceutical Co.