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Health-related outcomes associated with weight discrimination[edit | edit source]
In adulthood, individuals who experience weight discrimination are more likely to identify themselves as overweight regardless of their actual weight status. The experience of weight stigma can function as motivation to avoid stigmatizing environments, and although it may motivate one to escape stigma through weight loss, it undermines one's capacity to do so. Researchers have linked weight stigma to decreases in physical activity, decreases in seeking health care and increases in maladaptive eating patterns such as binge eating. In addition, those who have experienced weight stigma have shown altered cardiovascular reactivity, increased cortisol level, oxidative stress, and inflammation.

People who expect to be fat-shamed by healthcare providers are less likely to seek care for medical issues or for weight loss, even if the weight gain is caused by medical problems. Common medical issues that cause weight gain include type 2 diabetes, polycystic ovarian syndrome, hypothyroidism, and the side effects of some medications.

In terms of psychological health, researchers found that obese individuals demonstrated a lower sense of well-being relative to non-obese individuals if they had perceived weight stigmatization even after controlling for other demographic factors such as age and sex. Overweight and obese individuals report experiencing forms of internalized stigma such as body dissatisfaction as well as decreased social support and feelings of loneliness. In addition, similar to findings in adolescence, weight stigma in adulthood is associated with lower self-esteem, higher rates of depression, anxiety, and substance abuse.

In both adults and children with overweight and obesity, several reviews of the literature have found that across a variety of studies, there is a consistent relationship between experiencing weight stigma and many negative mental and physical health outcomes. These will be discussed separately in the sections below, although physical and mental health consequences are often intertwined, in particular those related to eating disorders.

Papadopoulos and Brennan (2015) recently found that across many reviewed studies of weight loss treatment seeking adults, relationships emerged between experiencing weight stigma and both BMI and difficulty losing weight. However the findings are somewhat mixed. They also report evidence that experiencing weight stigma is related to poor medication adherence. Among weight loss treatment-seeking adults, experiencing weight stigma might exacerbate weight- and health-related quality of life issues. This review along with reviews by Vartanian and Smyth (2013) and Puhl and Suh (2015) have also found that across several studies and in both adults and children, experiencing weight stigma is related to decreased exercise behavior overall, as well as decreased motivation to exercise, decreased exercise self-efficacy, and increased food craving and tendency to overeat. It is important to note that these effects of weight stigma on exercise and physical activity emerge independent of Body Mass Index, suggesting that weight stigma becomes a unique barrier to physical activity outside of barriers that may be associated with overweight and obesity in particular. Finally, across many studies, Puhl and Suh (2015) also found that experiencing weight stigma is related to many physiological consequences as well, including increased blood pressure, augmented cortisol reactivity, elevated oxidative stress, impaired glycemic control/elevated HbA1c, and increased systemic inflammation, all of which have notable consequences for physical health and disease.

Mental health and psychological consequences[edit | edit source]

Broadly speaking, experiencing weight stigma is associated with psychological distress. There are many negative effects connected to anti-fat bias, the most prominent being that societal bias against fat is ineffective at treating obesity, and leads to long-lasting body image issues, eating disorders, suicide, and depression.

Papadopoulos's 2015 review of the literature found that across several studies, this distress can manifest in anxiety, depression, lowered self-esteem, and substance use disorders, both in weight loss treatment seeking individuals as well as community samples. Many empirical reviews have found that weight stigma has clear consequences for individuals suffering from eating and weight disorders (including Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder), as it plays a unique role, over and above other risk factors, in perpetuating disordered eating psychopathology. These results have emerged in both adult and adolescent, as well as in male and female samples. Notably, the studies included in these reviews reported their results emerging over and above the degree of overweight/obesity in their respective subjects, suggesting that weight stigma, in particular, and not just being overweight or obese, precipitates these negative outcomes.

One prominent argument against anti-fat bias is that it doesn't treat the underlying causes of obesity, especially the emotional issues faced by overweight children. Another argument is that you can't tell if someone has food addiction just by looking at them, as obesity is not the same thing as an eating disorder, and someone might be considered healthy even if they don't fit society's standards for what appears healthy. Fighters of anti-fat bias claim that health should not be connected to weight, as a person's weight isn't the only indicator of health. They also say that society promotes the opinion that fat bodies can't be attractive.

Association between weight stigma and non-clinical disordered eating[edit | edit source]

Weight stigma may be exaggerated or heightened in individuals with disordered eating patterns and behaviours, even at the non-clinical level. Sub-clinical levels of disordered eating behaviours are less studied than eating disorders, but are potentially more prevalent in society, notably in young adult populations. Non-clinical disordered eating includes engaging in behaviors or thoughts that are similar to symptoms of clinical eating disorders, but at a lesser frequency or lower level of severity. Examples of disordered eating behaviors can include food restriction, binge eating, purging or obsessive calorie counting. Examples of disordered eating thoughts include body dissatisfaction, perceiving oneself as overweight despite being of normal or low weight, as well as anxiety about certain foods or food groups.

As well, although symptom severity levels fall short of the diagnostic criteria for a clinical disorder, sub-clinical disordered eating patterns remain an important source of distress and can significantly interfere with an individual’s daily functioning. Researchers have highlighted the importance of early detection as one of the most effective prevention strategies against the onset of clinical eating disorders and assessing sub-clinical disordered eating symptoms as important risk markers can be a critical tool.

Researchers have investigated whether self-reported weight stigma was related to sub-clinical disordered eating and observed that individuals displaying either binge-purge behaviours, or only binge behaviours, scored higher in self-reported weight stigma than individuals not displaying disordered eating patterns. Other groups have examined potential factors underpinning this association and have observed that weight bias internalization and psychological distress might factor into the relationship between weight stigma and disordered eating. Thus, a relation seems to exist between self-reported weight stigma and sub-clinical disordered eating levels, and many other factors may play a role in intensifying the association.