The Real-World Impact of Weight Stigma and What It Looks Like in Everyday Life

Another one of those many, many examples that we don’t talk about enough is weight stigma. And considering the emotional and physical ramifications, we need to talk about it more.

What is weight stigma?

“Weight stigma, also referred to as sizeism, is negative beliefs, as well as discrimination toward, people specifically because of their body weight,” explains Maya Feller, MS, RD, CDN, a registered dietitian nutritionist of Brooklyn-based Maya Feller Nutrition and author of Eating from Our Roots: 80+ Healthy Home-Cooked Favorites from Cultures Around the World. “This stigma is disproportionately directed at people who live in larger bodies.”

Even worse, weight stigma has inherent and horrible roots in racism and other forms of oppression. “This assumption can lead to discrimination and viewing an individual as lazy or unmotivated if they don’t fit within culture norms based on their body shape and size," says Jessica Barth Nesbitt, RD, LD, CEDRD, a regional nutrition director at Eating Recovery Center.

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What weight stigma looks like in everyday life

Weight stigma is pervasive. According to a 2021 study in the International Journal of Obesity¹, 42 percent of the over 2,000 people polled said they'd experienced it.

Weight stigma especially impacts people who also face racism, misogyny, and other forms of oppression, too. “Black and Brown people in larger bodies experience a double social burden, and women and femmes of color experience triple burdens,” Feller says.

She lists some specific examples of what weight stigma can look like:

• Making fun of, shaming, blaming, or speaking in disparaging ways about a person’s size (and how this is socially acceptable).
• The way cars, buses, trains, airplanes, and bikes are designed for people in smaller bodies with small seats and tight spaces
• Insurance companies designing premiums based on BMI (which is an inaccurate and racist measurement) in which people with higher BMIs may not be eligible for some types of premium or select life insurance
• People who are categorized as “obese” may be less likely to be hired, according to a 2016 study in Frontiers in Psychology². They're also more likely to be paid less, according to a 2019 study in the International Journal of Environmental Research and Public Health³.

Serena Nangia, an advocate for eating disorder recovery, marketing manager for Project HEAL, a nonprofit focused on equitable treatment access for eating disorders, and a self-identified fat person, agrees that weight stigma and its effects are rampant in health care, education, and many other spaces. Nangia, who leads workshops on fatphobia and weight stigma, cites the following research as just a few of the many ways weight stigma impacts people in bigger bodies:

• A national survey published in Obesity⁴ found that 90 percent of emergency departments don’t have certain types of equipment, such as scanners, for people over 450 pounds.
• An updated review in Obesity⁵ found that doctor’s visits for patients in larger bodies lasted a shorter amount of time than that of their thin counterparts, regardless of coming in with the same ailment.
• A lack of inclusive clothing sizing, as seen in school uniforms, theater costumes, group shirts, and more
• Teachers have lower expectations for fat students than they do for thin students, according to an Obesity study⁶.

And that’s only a start.

Along these lines, a quick FYI: Red flags indicating your doctor might hold weight bias include assuming how much you eat or exercise, ignoring a history of disordered eating, and encouraging weight loss (especially in the presence of healthy vitals and lab results).

“The messaging here is that these spaces are not for larger bodies,” Feller says.

The effects of weight stigma

Bias against a person’s weight—whether implicit or explicit—has harmful consequences. “They're subject to micro and macro aggressions,” Feller says. “It can have a negative impact on mental health and the provision of quality care.”

She points to an American Psychological Association article linking to multiple studies that share some of those effects, such as an increased risk for substance use⁷ and suicidal ideation⁸, decreased physical activity and interactions with health-care systems⁹, and poorer cognitive performance¹⁰, to name a few.

Nesbitt has found the same—and more—to be true. “Weight stigma can lead to negative impacts on an individual’s mental health, self-esteem, relationships, and body image,” she says. “It can also support and reinforce the engagement of disorder[ed] eating behaviors.”

On that note, Nangia cites a 2018 study in the Journal of General Internal Medicine¹¹ with similar findings. “High-weight people with eating disorders are exponentially more likely to be encouraged to engage in eating disorder behaviors—restriction, over-exercise, etc.—to lose weight than to be screened for an eating disorder by their doctors,” she says.

To sum up how weight stigma affects people, Nangia suggests remembering “the four Is”: ideologically, institutionally, interpersonally, and internally. Weight stigma is about how our society sees and treats thin people better on levels both big and small.

“Privilege gives permission and reinforcement for individual members of the dominant group to personally disrespect and mistreat individuals in the oppressed group,” she says.

Further, the stereotypes and stigma surrounding fat bodies are not only hurtful, but also unnecessary, inapplicable, and untrue. “People often feel that ‘health’ is a valid reason to tell a fat person that their body is bad, ugly, or disgusting—all words my body has been called,” she adds. “Despite people’s dedication to strangers’ health, the truth is that health cannot be determined by someone’s size, aka Health at Every Size, and being healthy is not a moral obligation.”