Impact of weight stigma on physiological and psychological health outcomes for overweight and obese adults: A systematic review

Cummings

et al. 2020

Nat Med

701

605

People with obesity commonly face a pervasive, resilient form of social stigma. They are often subject to discrimination in the workplace as well as in educational and healthcare settings. Research indicates that weight stigma can cause physical and psychological harm, and that affected individuals are less likely to receive adequate care. For these reasons, weight stigma damages health, undermines human and social rights, and is unacceptable in modern societies. To inform healthcare professionals, policymakers, and the public about this issue, a multidisciplinary group of international experts, including representatives of scientific organizations, reviewed available evidence on the causes and harms of weight stigma and, using a modified Delphi process, developed a joint consensus statement with recommendations to eliminate weight bias. Academic institutions, professional organizations, media, public-health authorities, and governments should encourage education about weight stigma to facilitate a new public narrative about obesity, coherent with modern scientific knowledge.

Section: Summary Of Evidencementioning

confidence: 99%

Joint international consensus statement for ending stigma of obesity

Rubino

Cummings

et al. 2020

Nat Med

701

605

“…Because obesity is such a highly stigmatized condition, people with higher weight are vulnerable to weight‐based prejudice, victimization and discrimination . These experiences contribute to harmful health consequences for targets of weight stigma and can impair both psychological wellbeing and physical health . Studies further indicate that healthcare providers' use of stigmatizing communication about body weight can exacerbate this problem in the medical setting and undermine delivery of health care for patients with high body weight .…”

Section: Introductionmentioning

confidence: 99%

What words should we use to talk about weight? A systematic review of quantitative and qualitative studies examining preferences for weight‐related terminology

2020

Obesity Reviews

110

Evidence of weight stigma and its harmful consequences have led to increased attention to the words that are used to talk about obesity and body weight, including calls for efforts to carefully consider weight-related terminology and promote respectful language in the obesity and medical fields. Despite increased research studies examining people's preferences for specific words that describe body weight, there has been no systematic review to synthesize existing evidence on perceptions of and preferences for weight-related terminology. To address this gap, the current systematic review identified 33 studies (23 quantitative, 10 qualitative) that examined people's preferences for weight-related terminology in the current research literature (from 1999 to 2019). Across studies, findings generally suggest that neutral terminology (eg, "weight" or "unhealthy weight") is preferred and that words like "obese" and "fat" are least acceptable, particularly in provider-patient conversations about weight.However, individual variation in language preferences is evident across demographic characteristics like race/ethnicity, gender, and weight status. Of priority is future research that can improve upon the limited diversity of the existing literature, both with respect to sample diversity and the use of culturally relevant weight-related terminology, which is currently lacking in measurement. Implications for patientprovider communication and public health communication are discussed. K E Y W O R D S language, obesity, terminology, weight stigma 1 | INTRODUCTION Discourse about obesity and weight control remains prominent in public health initiatives, medical care and health-related media campaigns. As body weight is entangled with societal and cultural meanings that infer evaluative dimensions of one's identity, 1,2 it can be a complex and emotionally charged topic to communicate about. The words used to refer to people's body weight can affect their self-perceptions, attitudes and behaviours. Experimental research shows that even a brief exposure to body-related words can induce automatic evaluations and judgements of body shape and weight, and trigger negative affective responses. 3 These negative, and often implicit, associations 4,5 are a symptom of broader societal weight stigma, so pervasive that recent evidence points to the globalization and presence of weight stigma in both developed and developing countries around the world. 6Because obesity is such a highly stigmatized condition, people with higher weight are vulnerable to weight-based prejudice, victimization and discrimination. 7,8 These experiences contribute to harmful health consequences for targets of weight stigma and can impair both psychological wellbeing and physical health. 9-11 Studies further indicate that healthcare providers' use of stigmatizing communication in consultation with a science literature librarian at the author's institution. Data extraction and synthesis were conducted in accordance with Preferred Reporting Items for Systematic Revie...

“…Prospective studies have shown that experiencing weight stigma predicts weight gain and obesity over time, controlling for demographic characteristics and baseline body weight (15). Research has suggested that weight stigma contributes to weight gain through a range of behavioral and psychological mechanisms, such as maladaptive eating behaviors like binge eating and unhealthy weight control practices (16), increased physiological stress (17), and poor psychological health (18). This evidence demonstrates weight stigma Original Article EPIDEMIOLOGY/GENETICS to be a key psychosocial contributor to obesity and poor weightrelated health (19).…”

Section: Introductionmentioning

confidence: 99%

Weight Stigma Among Sexual Minority Adults: Findings from a Matched Sample of Adults Engaged in Weight Management

Himmelstein

Pearl

et al. 2019

Obesity

Objective Despite elevated rates of obesity among some groups of sexual minority (SM) adults, research examining weight stigma in this population is scarce. Methods Weight stigma and weight‐related health correlates were assessed in SM adults (N = 658) versus heterosexual adults (N = 658) matched on sex, race/ethnicity, age, education, and BMI. Adults enrolled in WW (formerly Weight Watchers) completed digital questionnaires assessing experienced weight stigma, weight bias internalization (WBI), weight cycling, eating self‐efficacy, eating to cope, physical activity, and health‐related quality of life (HRQOL). Results Survey response rates ranged from 0.8% to 3.5%. There were no differences in experienced weight stigma between SM and heterosexual participants; more than two‐thirds experienced weight stigma, and more than 50% reported stigma from family, health care providers, teachers and classmates, and community members. Gay men endorsed higher WBI than heterosexual men (β = 0.22, P < 0.001). Regardless of sexual orientation, WBI was associated with poorer mental HRQOL, lower eating self‐efficacy, and increased eating to cope, controlling for demographics and BMI. Conclusions Experiencing weight stigma is as common for SM adults as heterosexual adults engaged in weight management, and WBI is associated with maladaptive eating behaviors and poor mental HRQOL. Increased attention to weight stigma and its health implications in SM populations is warranted.