Weight stigma comes in so many forms, from so many sources. It is prevalent in media and entertainment, in school and work, and even in healthcare, where providers fat-shame patients in the “name of health”.
But more and more evidence shows that obese people are not only emotionally harmful, it can make people gain even more weight. And women can be particularly susceptible.
ONE small new study, recently presented at an annual American Heart Association conference, found that women were more likely than men to say they feel stigmatized over their abdominal fat, no matter what they actually weigh. The internalized weight stigma was associated with further weight gain.
“Some people who struggle to control their weight may devalue themselves based on external messages from society that tell them they are unattractive, self-indulgent or weak-willed because they weigh more,” says lead author Natalie Keirns, a doctoral candidate in clinical psychology at Oklahoma State University, said in a statement. “When these ‘anti-fat’ messages are internalized, people often feel ashamed, which in turn can make them vulnerable to weight gain.”
The pitfalls of fat-shaming
The new research has limitations, including its small size (only 70 participants) and the fact that it was a cross-sectional study, so it was based on data from a time point and could not determine cause and effect.
Still, the researchers believe that it raises a lot of interesting questions about how weight stigma and weight gain are related. One hypothesis is that people who have been ashamed of what they weigh may be less likely to seek medical attention – especially if they have had health professionals make them feel bad about their weight before. They may also be more likely to turn to unhealthy behaviors to cope with that kind of stigma.
There may also be an underlying physiological link between weight stigma and weight gain.
“Shame, specifically as an emotion, is related to human stress response,” Keirns said. “When we feel ashamed, our cortisol production increases, which can lead to the accumulation of visceral fat.”
Rethink weight as a measure of health
Keirns and her co-researchers believe their study is the first to draw a link between internalized weight stigma and specifically visceral fat. Visceral fat is a special type of deeper belly fat that surrounds a person’s organs and has been associated with serious health outcomes such as diabetes, heart disease and high blood pressure. For years, many experts have warned that this type of belly fat is special “dangerous.”
But at the same time, doctors and researchers are reconsidering the relationship between weight and health, or at least arguing that it is much more nuanced than many of us have been led to believe.
Using a person’s body mass index or BMI as a measure of health has been criticized not only for being overly simplistic, but also for being inherently racist and sexist. Research also shows that focusing too much on weight really misses the point.
A recent scientific review found that physical activity is much more important in predicting whether a person will live a long and healthy life than what they weigh. As one of the researchers behind this study said, “We want people to know that fat can fit and that healthy and wholesome bodies come in all shapes and sizes.”
The researchers behind the new study say they really hope doctors will take note of their findings and focus much more on promoting healthy behaviors than emphasizing. “Healthy” behaviors can include get more physical activity (things like gardening, brisk walking and yoga all count), eating more fruits and vegetables, or even just establishing a heart-healthy bedtime.
“Among healthcare professionals, we need to be more aware of our assumptions and how weight disorders can negatively affect our patients,” Keirns said.