- Overweight women who believe negative messages about their bodies are at higher risk for diabetes and heart disease, finds a new study.
- Weight bias and stigma can negatively affect physical and mental health.
- Negative messages can make a person avoid exercise and consume more calories to cope with stress.
Overweight and obese women are stereotyped as lazy, incompetent, unattractive, lacking willpower, and they are blamed for their excess weight. Body shaming is a practice of humiliating someone by making critical comments about their body shape and size. Body shaming is found in cyberbullying, critiques of celebrities', at school, work and public places.
A new study has found that body shaming can take a toll on health and increase the risk of cardiovascular and metabolic disease. The study published in Obesity
, the journal of The Obesity Society found that weight bias was associated with increased risk of heart disease and diabetes.
‘When people feel shamed because of their weight, they are more likely to avoid exercise and consume more calories to cope with this stress.’
A research team from the Perelman School of Medicine at the University of Pennsylvania conducted the study. The study found that above and beyond the effects of body mass index (BMI) and depression, higher levels of weight bias internalization increased the risk of cardiovascular and metabolic disease.
Lead author Rebecca Pearl, PhD, an assistant professor of Psychology in Psychiatry and colleagues from Penn's Center for Weight and Eating Disorders, said, "There is a common misconception that stigma might help motivate individuals with obesity to lose weight and improve their health."
"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."
Body Shaming Linked to Poor Health Outcomes
The research team examined 159 obese adults who were enrolled in a larger clinical trial testing the effects of weight loss medication. The majority of the participants were African American women. The participants completed baseline questionnaires measuring depression and weight bias internalization before any intervention was given.
Weight bias internalization occurs when people apply negative weight stereotypes to themselves, such as believing they are lazy, unattractive and devalue themselves because of their weight.
The participants underwent medical examinations to check for metabolic syndrome, risk factors, high triglycerides, blood pressure, and waist circumference which are associated with heart disease, type 2 diabetes, and other obesity-related health problems.
No relationship was observed between weight bias internalization and metabolic syndrome when controlling for participant demographics, such as age, gender, and race. However, when patients were stratified into two groups, "high" and "low" levels of weight bias internalization, those with high internalization were three times more likely to have metabolic syndrome, and six times more likely to have high triglycerides as compared to participants with low internalization.
"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," said co-author Tom Wadden, PhD, a professor of Psychology in Psychiatry and director of Penn's Center for Weight and Eating Disorders.
"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."
Previous studies have shown that exposure to weight bias and stigma can have a negative impact on mental and physical health. Weight bias and stigma can lead to a physiological stress response such as increased inflammation and cortisol levels and can escalate unhealthy behaviors such as overeating and avoiding physical activity.
Additional research, specifically larger, longer-term studies, are needed to explore further the possible biological responses and behaviors that may explain why individuals with obesity who internalize weight bias might be at greater risk for cardio-metabolic disease.
"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," added 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."
- Rebecca L. Pearl, Thomas A. Wadden, Christina M. Hopkins, Jena A. Shaw, Matthew R. Hayes, Zayna M. Bakizada, Nasreen Alfaris, Ariana M. Chao, Emilie Pinkasavage, Robert I. Berkowitz, Naji Alamuddin. Association between weight bias internalization and metabolic syndrome among treatment-seeking individuals with obesity. Obesity, (2017) DOI: 10.1002/oby.21716