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How and why weight stigma drives the obesity ‘epidemic’ and harms health

Bibliographic Data

ID23364348
AuthorsA Janet Tomiyama (0000-0002-2152-5813, University of California, Los Angeles, corresponding author), Deborah Carr (0000-0002-8175-5303, Boston University), Ellen M Granberg (Clemson University), Brenda Major (0000-0002-2688-9464, University of California, Santa Barbara), Eric Robinson (0000-0003-3586-5533, University of Liverpool), Angelina R Sutin (0000-0002-1824-8974, Florida State University), Alexandra Brewis (0000-0003-3769-4205, Arizona State University)
Year2018
Volume16
Issue1
Pages123-123
Publication date2018-12-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueBMC Medicine (JOURNAL)
Journal identifiersISSN: 1741-7015 • E-ISSN: 1741-7015
PublisherSpringer Science and Business Media LLC (PUBLISHER)
DOI10.1186/s12916-018-1116-5
PMID30107800
OpenAlexW2884991139
LanguageEN
Citations received130
References cited67

BACKGROUND: In an era when obesity prevalence is high throughout much of the world, there is a correspondingly pervasive and strong culture of weight stigma. For example, representative studies show that some forms of weight discrimination are more prevalent even than discrimination based on race or ethnicity. DISCUSSION: In this Opinion article, we review compelling evidence that weight stigma is harmful to health, over and above objective body mass index. Weight stigma is prospectively related to heightened mortality and other chronic diseases and conditions. Most ironically, it actually begets heightened risk of obesity through multiple obesogenic pathways. Weight stigma is particularly prevalent and detrimental in healthcare settings, with documented high levels of 'anti-fat' bias in healthcare providers, patients with obesity receiving poorer care and having worse outcomes, and medical students with obesity reporting high levels of alcohol and substance use to cope with internalized weight stigma. In terms of solutions, the most effective and ethical approaches should be aimed at changing the behaviors and attitudes of those who stigmatize, rather than towards the targets of weight stigma. Medical training must address weight bias, training healthcare professionals about how it is perpetuated and on its potentially harmful effects on their patients. CONCLUSION: Weight stigma is likely to drive weight gain and poor health and thus should be eradicated. This effort can begin by training compassionate and knowledgeable healthcare providers who will deliver better care and ultimately lessen the negative effects of weight stigma.

Body mass index · Body weight · Environmental health · Ethnic group · Family medicine · Health care · Obesity · Overweight · Prejudice (legal term) · Psychiatry · Social stigma · Stigma (botany) · Weight gain · Weight loss · Weight stigma · Bariatric Surgery and Outcomes · Eating Disorders and Behaviors · Medicine · Obesity and Health Practices · Psychology · Social Psychology · Gerontology

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    Open Access•Timothy J Williamson, Jamie S Ostroff et al.•Stigma and Health•2020

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    Seryan Atasoy, Hamimatunnisa Johar et al.•Psychosomatic Medicine•2022

  • A Randomized Controlled Trial of a Combined Physical Activity and Attitude Education Intervention on Weight Stigma and Health Outcomes

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  • Elucidating knowledge and beliefs about obesity and eating disorders among key stakeholders

    Open Access•Bianca Bullivant, Aaron R Denham et al.•BMC Public Health•2019

  • Public beliefs about the consequences of living with obesity in the Republic of Ireland and Northern Ireland

    Open Access•Eleni Spyreli, Laura McGowan et al.•BMC Public Health•2022

  • Is It Time to Say Goodbye to BMI? A Commentary

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    Open Access•Kamila R Irvine, Josie A Binder et al.•Critical Public Health•2026

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    Open Access•Alexander Wilhelm Gorny, Mui Cheng Low et al.•BMC Public Health•2021

  • Dismantling weight stigma in eating disorder treatment

    Open Access•Mindy L McEntee, Samantha R Philip et al.•Frontiers in Psychiatry•2023

  • Weight stigma in adolescents

    Open Access•Vivi Just-Nørregaard, Per Buch Andreasen et al.•BMC Public Health•2025

  • Psychosocial Variables Related to Weight-Related Self-Stigma in Physical Activity among Young Adults across Weight Status

    Open Access•Xavier C C Fung, Amir H Pakpour et al.•International Journal of…•2019

  • Chutes and ladders

    Open Access•Craig Tomlinson, Chioma N Tomlinson et al.•Frontiers in Psychiatry•2025

  • Long-lasting effects of the Covid-19 pandemic on lifestyle and body weight

    Open Access•Hans Hauner, Carmen P S Blanken et al.•BMC Public Health•2024

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    Open Access•Yi-Ching Lin, Chung-Ying Lin et al.•BMC Psychology•2023

  • Attitudes and beliefs of healthcare workers towards obese persons in occupied Palestinian territories

    Open Access•Sana Al-Aqqad, Nihal Natour et al.•BMC Public Health•2026

  • Then and Now

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    Open Access•Kelly Moes•Frontiers in Psychiatry•2026

  • Binge Eating Disorder Is a Social Justice Issue

    Open Access•Brenna Bray, Chris Bray et al.•International Journal of…•2022

  • Do Registered Dietitians, Nutrition Students, and Laypeople Perceive Individuals with Obesity Differently

    Open Access•Giovana Santarosa Cassiano, Joana Pereira de Carvalho-Ferreira et al.•International Journal of…•2021

  • Enrolment of families with overweight children into a program aimed at reducing childhood obesity with and without a weight criterion

    Open Access•Emma K Esdaile, Emely Hernandez et al.•BMC Public Health•2019

  • A “messy ball of wool”

    Open Access•Kathryn Ogden, J Barr et al.•BMC Psychology•2020

  • Australian School Stakeholders’ Perceived Strategies for Preventing Adolescent Obesity

    Open Access•Kakale Buru, Theophilus I Emeto et al.•International Journal of…•2021

  • Internalized Sexual Stigma among Lesbian, Gay, and Bisexual Individuals in Taiwan

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  • Exercise-based obesity simulation reduces weight bias and improves clinical decision-making in health professions students

    Open Access•Gregory N Ruegsegger, Ricky L Lopez et al.•BMC Medical Education•2026

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  • The ethics of wegovy for children

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    Open Access•Kathryn A Hicks•American Journal of Human Biology•2020

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    Open Access•Sophie B To, Alexandra Brewis et al.•American Journal of Human Biology•2020

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    Open Access•Amanda Raffoul, Sharon I Kirkpatrick•Social Science & Medicine•2026

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    Open Access•Natasha Clarke, Emily Pechey et al.•Appetite•2020

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    Open Access•The GBD Obesity Collaborators•New England Journal of Medicine•2017

  • Perceived Weight Discrimination and Obesity

    Open Access•Angelina R Sutin, Antonio Terracciano et al.•PLoS ONE•2013

  • Perceptions of weight discrimination

    Open Access•Rebecca M Puhl, Tatiana Andreyeva et al.•International Journal of Obesity•2008

  • Health Consequences of Weight Stigma

    Open Access•Rebecca M Puhl, Rebecca Puhl et al.•Current Obesity Reports•2015

  • Obesity and discrimination – a systematic review and meta‐analysis of observational studies

    Open Access•J Spahlholz, N Baer et al.•Obesity Reviews•2016

  • Changes in Perceived Weight Discrimination Among Americans, 1995–1996 Through 2004–2006

    Open Access•Tatiana Andreyeva, Rebecca M Puhl et al.•Obesity•2008

  • The Weight-Inclusive versus Weight-Normative Approach to Health

    Open Access•Tracy L Tylka, Rachel A Annunziato et al.•Journal of Obesity•2014

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    Katherine M Flegal, Brian K Kit et al.•JAMA•2013

  • Misclassification of cardiometabolic health when using body mass index categories in NHANES 2005–2012

    Open Access•A Janet Tomiyama, Jeffrey M Hunger et al.•International Journal of Obesity•2016

  • BMI-related errors in the measurement of obesity

    Open Access•Kenneth J Rothman•International Journal of Obesity•2008

  • Weight stigmatization and bias reduction

    Rebecca M Puhl, Corinne A Moss-Racusin et al.•Health Education Research•2007

  • Weight Discrimination and Risk of Mortality

    Open Access•Angelina R Sutin, Yannick Stephan et al.•Psychological Science•2015

  • Increasing socioeconomic disparities in adolescent obesity

    Open Access•Carl B Frederick, Kaisa Snellman et al.•Proceedings of the National…•2014

  • Impact of weight bias and stigma on quality of care and outcomes for patients with obesity

    Open Access•Sean M Phelan, Darren J Burgess et al.•Obesity Reviews•2015

  • The Impact of Weight Stigma on Caloric Consumption

    Open Access•Natasha A Schvey, Rebecca M Puhl et al.•Obesity•2011

  • Weight Science

    Open Access•Linda Bacon, Lucy Aphramor•Nutrition Journal•2011

  • The Stigma of Obesity

    Open Access•Rebecca M Puhl, Chelsea A Heuer•Obesity•2009

  • Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016

    Open Access•Leandra Abarca-Gómez, Ziad Abdeen et al.•The Lancet•2017

  • Obesity

    Open Access•Daniel Callahan•The Hastings Center Report•2013

  • Experiences of weight stigma in everyday life

    Lenny R Vartanian, Rebecca T Pinkus et al.•Stigma and Health•2016

  • The phenomenology of weight stigma in everyday life

    Open Access•Lenny R Vartanian, Rebecca T Pinkus et al.•Journal of Contextual Behavioral…•2014

  • It’s not your fault

    Open Access•Dina Eliezer, Brenda Major•Group Processes & Intergroup…•2012

  • Is Fat a Feminist Issue? Exploring the Gendered Nature of Weight Bias

    Open Access•Janna Fikkan, Janna L Fikkan et al.•Sex Roles•2011

  • The Stigma of Obesity

    Open Access•M H Schafer, Kenneth F Ferraro•Social Psychology Quarterly•2011

  • The ironic effects of weight stigma

    Brenda Major, Jeffrey M Hunger et al.•Journal of Experimental Social…•2013

  • That swimsuit becomes you

    Barbara L Fredrickson, Tomi-Ann Roberts et al.•Journal of Personality and Social…•1998

  • On the malleability of automatic attitudes

    Nilanjana Dasgupta, Anthony G Greenwald•Journal of Personality and Social…•2001

  • Obesity Stigma

    Rebecca M Puhl, Chelsea A Heuer•American Journal of Public Health•2010

  • Weight Bias and Stigma

    Open Access•Rebecca L Pearl•Social Issues and Policy Review•2018

  • Cultural Uniformity in Reaction to Physical Disabilities

    Stephen A Richardson, Norman Goodman et al.•American Sociological Review•1961

  • A daily diary assessment of female weight stigmatization

    Open Access•Jason D Seacat, Sarah C Dougal et al.•Journal of Health Psychology•2016

  • Weight-related stigma is a significant psychosocial stressor in developing countries

    Open Access•Joseph V Hackman, Joseph Hackman et al.•Social Science & Medicine•2016

  • Effects of Weight Stigma on Exercise Motivation and Behavior

    Open Access•Lenny R Vartanian, Jacqueline G Shaprow•Journal of Health Psychology•2008

  • Is Obesity Stigmatizing? Body Weight, Perceived Discrimination, and Psychological Well-Being in the United States

    Open Access•Deborah Carr, Michael A Friedman et al.•Journal of Health and Social…•2005

  • The Stigma of Obesity

    Open Access•Werner J Cahnman•Sociological Quarterly•1968

  • Body Norms and Fat Stigma in Global Perspective

    Alexandra Brewis, Alexandra A Brewis et al.•Current Anthropology•2011

Unique citing works130
Citations per year18,57
Citation span2019 - 2026 (8)
Citation velocitycurrent
Highly citedYes
Citation typesNeutral: 114

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