Weight Stigma: Health Implications

Rebecca M. Puhl, PhD

Weight Stigma and Stereotypes

Stigma and prejudice toward obese persons occur frequently in our society. Several decades of research have identified many negative weight-based stereotypes, including opinions that obese individuals are lazy, unintelligent, unsuccessful, lacking in willpower and self-discipline, and noncompliant with treatment.^[1] Unfortunately, these pervasive stereotypes contribute to prejudice and discrimination in many areas of daily life, such as employment, healthcare, education, and the media.^[2] Unlike other forms of social bias, weight-based stigmatization is largely acceptable in our culture, and no federal law prohibits weight discrimination. Thus, perhaps not surprisingly, reports of weight discrimination are increasing. Recent estimates show that the prevalence of weight discrimination has increased by 66% over the past decade^[3] and is now on par with prevalence rates of racial discrimination in the United States.^[4]

Although weight discrimination is often framed and discussed as an issue of social injustice, it is equally important to understand and address this form of discrimination as a public health problem.^[5] Unfortunately, despite consensus that disease stigma undermines public health, this principle has not been applied to the obesity epidemic, and instead the stigma of obesity has been largely ignored in the context of public health. There is even a public perception that stigma might serve as an incentive to motivate obese persons to adopt healthier lifestyle behaviors. This is concerning, given evidence that stigmatization of obese individuals poses serious risks to their psychological and physical health, generates health disparities, and interferes with implementation of effective strategies to address obesity. Let's look at these issues more closely.