Internalizing Weight Bias Can Be Detrimental to Health

People who internalize weight bias, such as fat-shaming and discrimination, are more likely to have risk factors for heart disease and diabetes, according to a new study published in the February issue of Obesity, the scientific journal of The Obesity Society. The stares and the sideways glances, the hurled insults and the unsolicited advice that people struggling with obesity endure daily add up to a pernicious culture of weight bias that many people internalize, which can be making them less healthy.

For the first time, researchers studied the relationships between self-directed weight stigma and higher risks of cardiometabolic disease. The results showed that higher levels of weight bias internalization were associated with greater odds of having metabolic syndrome, which is a cluster of risk factors associated with heart disease, type 2 diabetes, and other obesity-related health problems.

"When people with obesity internalize weight bias, they start believing that negative stereotypes apply to themselves," says Ted Kyle, RpH, MBA, spokesperson for The Obesity Society. "Not only is this an unfair generalization, it can actually harm the mental and physical health of people with obesity."

The research team studied 159 research participants, and 51 participants met the criteria for metabolic syndrome. Weight bias internalization was associated with increased odds of having metabolic syndrome, although the effects were no longer significant when controlling for participant demographics. However, when participants were divided into categories of high vs low weight bias internalization, the participants with high internalization had three times greater odds of having metabolic syndrome, and six times greater odds of having high triglycerides than participants with low internalization. These findings were significant after controlling for BMI, depression, and demographics. The majority of the study participants were African American women, a group typically underrepresented in weight bias research.

"When people with obesity internalize the weight-based stigma that they frequently encounter in our society, it can negatively affect their mental health and lead to unhealthy behaviors like overeating," says lead researcher Rebecca L. Pearl, PhD, an assistant professor of psychology in the department of psychiatry in the Perelman School of Medicine at the University of Pennsylvania in Philadelphia. "In this study, we found evidence that weight bias internalization may also be associated with poorer physical health. These initial findings emphasize that blaming and shaming people with obesity does not help them to improve their health, and in fact may make the problem worse."

In an accompanying editorial published in Obesity, Scott Kahan, MD, and Rebecca M. Puhl, PhD, discuss the weight-based shaming that has become commonplace in our culture and expound on research showing that when people internalize these negative messages, it's damaging to health and well-being. They point out that while more research is needed on this topic, obesity treatment must go beyond weight loss "to address the mental and physical effects of living a life with obesity, including shame and stigma reduction."

— Source: The Obesity Society