Latest news with #weightstigma
CNN
4 days ago
- Health
- CNN
Weight stigma isn't just cruel — it makes losing weight harder
Maybe you have decided that the voice inside your head judging yourself or others for body size can be pretty mean, but at least it's encouraging weight loss, right? No, it's not, experts say. 'There has long been a misunderstanding … that if you shame people about their weight, then that will lead them to eat less or to eat more healthfully or to exercise more in order to lose weight,' said Dr. Rebecca Pearl, associate professor of clinical and health psychology at the University of Florida. 'What the research, though, has shown over and over again is that that is not true,' Pearl said. 'It actually has the opposite effect.' Stigma around weight and body size is everywhere: in US culture, messages from people around you and even at your doctor's office, Pearl said. One study found that after bariatric surgery, experiencing continued weight stigma was associated with higher risks of depression, anxiety and disordered eating such as binge eating. Those who experienced less weight stigma were more likely to continue losing weight and maintain weight loss, according to the study published Thursday in the journal Health Psychology. And not only are biases around weight damaging to mental health, they also are counterproductive if people want to lose weight or engage in more health-promoting behaviors, said first study author Dr. Larissa McGarrity, clinical psychologist in physical medicine and rehabilitation at University of Utah Health. Weight stigma centers around a pervasive public misconception: that what a person weighs is entirely within a person's control. 'As a result of that, people should just be able to eat healthy on their own, to lose weight on their own, to be physically active –– that's their personal responsibility to do that,' said Pearl, who was not involved in the study. When a person doesn't lose weight or comes up against barriers to that thin body ideal –– such as lack of access to nutritious and affordable foods, no place for physical activity, or their genetics –– the misconception says their body shape is a sign of a moral failing, said Dr. Alexis Conason, a psychologist and certified eating disorder specialist in New York City who also did not participate in the new research. Messages saying that a person has a responsibility to lose weight and is a worse person if they do not can come from images or storylines in television and social media, direct comments from people you know, and bullying or discrimination, Pearl said. It gets worse when a person absorbs those derogatory remarks from others about their body weight and applies it to themselves. 'Experiencing stigma from other people is harmful,' Pearl said. 'But for the individuals who really internalize that, that seems to be a really strong predictor of these negative eating and physical activity outcomes, but also kind of broader mental and physical health outcomes.' Physical activity is so important to many aspects of health, including healthy aging, management of depression, better sleep and lower cancer risk. People often have a hard time going to the gym or getting outside for exercise, because it can feel intimidating or overwhelming, said Dr. A. Janet Tomiyama, professor of psychology at the University of California Los Angeles who was not involved in the study. It is particularly hard if you know you will get comments, judgment or even just extra attention because of your weight, Conason added. Research has linked experiencing and internalizing weight stigma to less motivation and enjoyment of physical activity, less confidence about exercising, and less time spent exercising, Pearl said. 'A gym is a location where a lot of weight stigma and fat shaming can happen,' said Tomiyama. 'If you've been stigmatized for the way you look, the last thing you want to do is put on some tight clothes and go to a gym.' Being judged for your body can be distressing, which can impact food choices. 'When someone is teased or criticized, or even just feels like they're getting negative looks from other people around them, that is stressful,' Pearl said. 'We know that one of the very common ways that everybody copes with stress is by eating more and eating more unhealthy kinds of foods.' Stress eating isn't a behavior we need to shake our finger and shame people out of either, Tomiyama said. It is in our own biology as well as that of other animals, she added. Physical or psychological stress signals your body to release the hormone cortisol, Tomiyama said. 'One of the things that cortisol does, is it works on our brain to really activate reward processes that make high-sugar, high-salt, high-calorie food taste really, really good,' she added. 'And so, at a brain level, it's making these potentially health harming foods way harder to resist.' Cortisol also blocks the parts of your brain that help you make decisions that benefit you in the long term, Tomiyama said. Research has linked exposure to weight stigma and unhealthy, disordered eating behaviors such as binge eating, purging and unhealthy restriction –– all of which undermine health, Pearl said. Eating Disorder Resources US: National Eating Disorder Association The NEDA has a confidential, toll free helpline at 800-931-2237 as well as an online click-to-chat service. For 24/7 crisis support, text 'NEDA' to 741-741. The NEDA also has a list of recommended websites and free or low-cost resources. ANAD runs a helpline at 888-375-7767 from 9 a.m. to 9 p.m. CT and provides links to support groups and treatment providers. A call center at 800-334-673 and online chat run by the Butterfly Foundation is open 8 a.m. to midnight AET every day except public holidays. Helplines for England, Scotland, Wales and Northern Ireland are open 9 a.m. to midnight weekdays and 4 p.m. to midnight weekends, every day of the year. Unfortunately, weight stigma is pervasive, and it isn't something you can snap your fingers and rid yourself of, Conason said. One step the medical field can take is to de-emphasize body mass index, or BMI, as an important marker of health, especially because it often classifies healthy people as unhealthy and those with health issues as falling into a healthy weight class, Tomiyama said. When working with clients, Conason also focuses on creating resiliency, she said. 'We may not be able to change the entire culture, but we can try to understand that the problem is the culture, not our bodies,' Conason said. 'That can provide resiliency around moving through the world and experiencing weight stigma and trying not to internalize the stigma.' Conason does this by helping clients build greater self-compassion, educating them on the ways in which a culture of weight stigma has influenced them, and encouraging the practice of acceptance. If you notice an internalized weight stigma is affecting your behavior, contacting a disordered eating mental health counselor or a weight-inclusive dietitian may be a helpful first step.
CNN
4 days ago
- Health
- CNN
Weight stigma isn't just cruel — it makes losing weight harder
Maybe you have decided that the voice inside your head judging yourself or others for body size can be pretty mean, but at least it's encouraging weight loss, right? No, it's not, experts say. 'There has long been a misunderstanding … that if you shame people about their weight, then that will lead them to eat less or to eat more healthfully or to exercise more in order to lose weight,' said Dr. Rebecca Pearl, associate professor of clinical and health psychology at the University of Florida. 'What the research, though, has shown over and over again is that that is not true,' Pearl said. 'It actually has the opposite effect.' Stigma around weight and body size is everywhere: in US culture, messages from people around you and even at your doctor's office, Pearl said. One study found that after bariatric surgery, experiencing continued weight stigma was associated with higher risks of depression, anxiety and disordered eating such as binge eating. Those who experienced less weight stigma were more likely to continue losing weight and maintain weight loss, according to the study published Thursday in the journal Health Psychology. And not only are biases around weight damaging to mental health, they also are counterproductive if people want to lose weight or engage in more health-promoting behaviors, said first study author Dr. Larissa McGarrity, clinical psychologist in physical medicine and rehabilitation at University of Utah Health. Weight stigma centers around a pervasive public misconception: that what a person weighs is entirely within a person's control. 'As a result of that, people should just be able to eat healthy on their own, to lose weight on their own, to be physically active –– that's their personal responsibility to do that,' said Pearl, who was not involved in the study. When a person doesn't lose weight or comes up against barriers to that thin body ideal –– such as lack of access to nutritious and affordable foods, no place for physical activity, or their genetics –– the misconception says their body shape is a sign of a moral failing, said Dr. Alexis Conason, a psychologist and certified eating disorder specialist in New York City who also did not participate in the new research. Messages saying that a person has a responsibility to lose weight and is a worse person if they do not can come from images or storylines in television and social media, direct comments from people you know, and bullying or discrimination, Pearl said. It gets worse when a person absorbs those derogatory remarks from others about their body weight and applies it to themselves. 'Experiencing stigma from other people is harmful,' Pearl said. 'But for the individuals who really internalize that, that seems to be a really strong predictor of these negative eating and physical activity outcomes, but also kind of broader mental and physical health outcomes.' Physical activity is so important to many aspects of health, including healthy aging, management of depression, better sleep and lower cancer risk. People often have a hard time going to the gym or getting outside for exercise, because it can feel intimidating or overwhelming, said Dr. A. Janet Tomiyama, professor of psychology at the University of California Los Angeles who was not involved in the study. It is particularly hard if you know you will get comments, judgment or even just extra attention because of your weight, Conason added. Research has linked experiencing and internalizing weight stigma to less motivation and enjoyment of physical activity, less confidence about exercising, and less time spent exercising, Pearl said. 'A gym is a location where a lot of weight stigma and fat shaming can happen,' said Tomiyama. 'If you've been stigmatized for the way you look, the last thing you want to do is put on some tight clothes and go to a gym.' Being judged for your body can be distressing, which can impact food choices. 'When someone is teased or criticized, or even just feels like they're getting negative looks from other people around them, that is stressful,' Pearl said. 'We know that one of the very common ways that everybody copes with stress is by eating more and eating more unhealthy kinds of foods.' Stress eating isn't a behavior we need to shake our finger and shame people out of either, Tomiyama said. It is in our own biology as well as that of other animals, she added. Physical or psychological stress signals your body to release the hormone cortisol, Tomiyama said. 'One of the things that cortisol does, is it works on our brain to really activate reward processes that make high-sugar, high-salt, high-calorie food taste really, really good,' she added. 'And so, at a brain level, it's making these potentially health harming foods way harder to resist.' Cortisol also blocks the parts of your brain that help you make decisions that benefit you in the long term, Tomiyama said. Research has linked exposure to weight stigma and unhealthy, disordered eating behaviors such as binge eating, purging and unhealthy restriction –– all of which undermine health, Pearl said. Eating Disorder Resources US: National Eating Disorder Association The NEDA has a confidential, toll free helpline at 800-931-2237 as well as an online click-to-chat service. For 24/7 crisis support, text 'NEDA' to 741-741. The NEDA also has a list of recommended websites and free or low-cost resources. ANAD runs a helpline at 888-375-7767 from 9 a.m. to 9 p.m. CT and provides links to support groups and treatment providers. A call center at 800-334-673 and online chat run by the Butterfly Foundation is open 8 a.m. to midnight AET every day except public holidays. Helplines for England, Scotland, Wales and Northern Ireland are open 9 a.m. to midnight weekdays and 4 p.m. to midnight weekends, every day of the year. Unfortunately, weight stigma is pervasive, and it isn't something you can snap your fingers and rid yourself of, Conason said. One step the medical field can take is to de-emphasize body mass index, or BMI, as an important marker of health, especially because it often classifies healthy people as unhealthy and those with health issues as falling into a healthy weight class, Tomiyama said. When working with clients, Conason also focuses on creating resiliency, she said. 'We may not be able to change the entire culture, but we can try to understand that the problem is the culture, not our bodies,' Conason said. 'That can provide resiliency around moving through the world and experiencing weight stigma and trying not to internalize the stigma.' Conason does this by helping clients build greater self-compassion, educating them on the ways in which a culture of weight stigma has influenced them, and encouraging the practice of acceptance. If you notice an internalized weight stigma is affecting your behavior, contacting a disordered eating mental health counselor or a weight-inclusive dietitian may be a helpful first step.
CNN
4 days ago
- Health
- CNN
Weight stigma isn't just cruel — it makes losing weight harder
Maybe you have decided that the voice inside your head judging yourself or others for body size can be pretty mean, but at least it's encouraging weight loss, right? No, it's not, experts say. 'There has long been a misunderstanding … that if you shame people about their weight, then that will lead them to eat less or to eat more healthfully or to exercise more in order to lose weight,' said Dr. Rebecca Pearl, associate professor of clinical and health psychology at the University of Florida. 'What the research, though, has shown over and over again is that that is not true,' Pearl said. 'It actually has the opposite effect.' Stigma around weight and body size is everywhere: in US culture, messages from people around you and even at your doctor's office, Pearl said. One study found that after bariatric surgery, experiencing continued weight stigma was associated with higher risks of depression, anxiety and disordered eating such as binge eating. Those who experienced less weight stigma were more likely to continue losing weight and maintain weight loss, according to the study published Thursday in the journal Health Psychology. And not only are biases around weight damaging to mental health, they also are counterproductive if people want to lose weight or engage in more health-promoting behaviors, said first study author Dr. Larissa McGarrity, clinical psychologist in physical medicine and rehabilitation at University of Utah Health. Weight stigma centers around a pervasive public misconception: that what a person weighs is entirely within a person's control. 'As a result of that, people should just be able to eat healthy on their own, to lose weight on their own, to be physically active –– that's their personal responsibility to do that,' said Pearl, who was not involved in the study. When a person doesn't lose weight or comes up against barriers to that thin body ideal –– such as lack of access to nutritious and affordable foods, no place for physical activity, or their genetics –– the misconception says their body shape is a sign of a moral failing, said Dr. Alexis Conason, a psychologist and certified eating disorder specialist in New York City who also did not participate in the new research. Messages saying that a person has a responsibility to lose weight and is a worse person if they do not can come from images or storylines in television and social media, direct comments from people you know, and bullying or discrimination, Pearl said. It gets worse when a person absorbs those derogatory remarks from others about their body weight and applies it to themselves. 'Experiencing stigma from other people is harmful,' Pearl said. 'But for the individuals who really internalize that, that seems to be a really strong predictor of these negative eating and physical activity outcomes, but also kind of broader mental and physical health outcomes.' Physical activity is so important to many aspects of health, including healthy aging, management of depression, better sleep and lower cancer risk. People often have a hard time going to the gym or getting outside for exercise, because it can feel intimidating or overwhelming, said Dr. A. Janet Tomiyama, professor of psychology at the University of California Los Angeles who was not involved in the study. It is particularly hard if you know you will get comments, judgment or even just extra attention because of your weight, Conason added. Research has linked experiencing and internalizing weight stigma to less motivation and enjoyment of physical activity, less confidence about exercising, and less time spent exercising, Pearl said. 'A gym is a location where a lot of weight stigma and fat shaming can happen,' said Tomiyama. 'If you've been stigmatized for the way you look, the last thing you want to do is put on some tight clothes and go to a gym.' Being judged for your body can be distressing, which can impact food choices. 'When someone is teased or criticized, or even just feels like they're getting negative looks from other people around them, that is stressful,' Pearl said. 'We know that one of the very common ways that everybody copes with stress is by eating more and eating more unhealthy kinds of foods.' Stress eating isn't a behavior we need to shake our finger and shame people out of either, Tomiyama said. It is in our own biology as well as that of other animals, she added. Physical or psychological stress signals your body to release the hormone cortisol, Tomiyama said. 'One of the things that cortisol does, is it works on our brain to really activate reward processes that make high-sugar, high-salt, high-calorie food taste really, really good,' she added. 'And so, at a brain level, it's making these potentially health harming foods way harder to resist.' Cortisol also blocks the parts of your brain that help you make decisions that benefit you in the long term, Tomiyama said. Research has linked exposure to weight stigma and unhealthy, disordered eating behaviors such as binge eating, purging and unhealthy restriction –– all of which undermine health, Pearl said. Eating Disorder Resources US: National Eating Disorder Association The NEDA has a confidential, toll free helpline at 800-931-2237 as well as an online click-to-chat service. For 24/7 crisis support, text 'NEDA' to 741-741. The NEDA also has a list of recommended websites and free or low-cost resources. ANAD runs a helpline at 888-375-7767 from 9 a.m. to 9 p.m. CT and provides links to support groups and treatment providers. A call center at 800-334-673 and online chat run by the Butterfly Foundation is open 8 a.m. to midnight AET every day except public holidays. Helplines for England, Scotland, Wales and Northern Ireland are open 9 a.m. to midnight weekdays and 4 p.m. to midnight weekends, every day of the year. Unfortunately, weight stigma is pervasive, and it isn't something you can snap your fingers and rid yourself of, Conason said. One step the medical field can take is to de-emphasize body mass index, or BMI, as an important marker of health, especially because it often classifies healthy people as unhealthy and those with health issues as falling into a healthy weight class, Tomiyama said. When working with clients, Conason also focuses on creating resiliency, she said. 'We may not be able to change the entire culture, but we can try to understand that the problem is the culture, not our bodies,' Conason said. 'That can provide resiliency around moving through the world and experiencing weight stigma and trying not to internalize the stigma.' Conason does this by helping clients build greater self-compassion, educating them on the ways in which a culture of weight stigma has influenced them, and encouraging the practice of acceptance. If you notice an internalized weight stigma is affecting your behavior, contacting a disordered eating mental health counselor or a weight-inclusive dietitian may be a helpful first step.
Medscape
20-05-2025
- Health
- Medscape
Obesity Association Publishes Weight Stigma, Bias Standards
New standards on weight stigma and bias in overweight and obesity were published recently the Obesity Association, a division of the American Diabetes Association (ADA). The recommendations, developed by the Obesity Association's Professional Practice Committee, make up the first of several chapters to be published as part of the organization's Standards of Care in Overweight and Obesity. The introduction and methodology sections of the standards were published as well. The ADA brought together 'an interdisciplinary panel of experts — spanning obesity medicine specialists, primary care, endocrinology, cardiology, nephrology, hepatology, surgery, pediatrics, emergency medicine, and more — to create authoritative guidance,' Nuha El Sayed, MD, the ADA's senior vice president of healthcare improvement told Medscape Medical News . The new standards 'build on a legacy of professional practice guidelines previously developed by expert organizations,' and so should not create confusion, she said. To ensure the recommendations reflect consensus across the field, collaborating organizations include the American Board of Obesity Medicine Foundation, Obesity Medicine Association, Obesity Action Coalition, The Obesity Society, and the American Society for Metabolic and Bariatric Surgery. The new standards will include updates to previous topics, while creating recommendations to guide new topics related to screening, diagnostic, and therapeutic interventions that affect the health outcomes of people living with obesity. Furthermore, she said, 'they will address the prevention, screening, diagnosis, and management of weight-related complications.' Key Recommendations Key recommendations from the new standards include: Training: Healthcare professionals and staff should receive ongoing education on weight bias and stigma beginning in early career and continuing throughout their careers. Inclusive clinical environments: Clinics should be equipped with appropriate furniture, equipment, and private accommodations that support people of all sizes. Person-centered communication: Healthcare professionals are urged to use respectful, non-judgmental language and to ask permission before discussing weight-related issues. Shared decision-making: Healthcare professionals are encouraged to align care goals with a patient's values, recognizing health outcomes beyond just weight loss. Evidence-based interventions: The guidelines support multicomponent strategies, such as role-play, self-reflection, and patient engagement, to reduce implicit and explicit bias effectively. 'Individuals with obesity should feel comfortable in healthcare settings,' El Sayed said. 'This guidance represents a call to action to eliminate the stigmatizing practices that still persist across healthcare systems.' To help raise awareness, ADA is providing continuing medical education on reducing weight bias and stigma in obesity care. The Standards of Care in Overweight and Obesity is funded by ADA general revenue. No expert panel members were employees of any pharmaceutical or medical device company during the development of the 2025 Standards of Care. Members of the PPC, subject matter experts, their employers, and their disclosed potential dualities of interest are listed in each section manuscript.
Medscape
14-05-2025
- Health
- Medscape
Use Patient-Centered Language in Discussions About Weight
Pediatric primary care providers need more training and support in respectfully addressing weight issues with families while avoiding inadvertently stigmatizing terms, suggest findings from a qualitative study presented at Pediatric Academic Societies (PAS) 2025 Meeting. An estimated 1 in 3 US children aged 2-18 years have overweight or obesity, so this issue is one that all primary care pediatricians inevitably must address on a regular basis with their patients and their caregivers. At the same time, extensive research has revealed the harms of fat bias in healthcare and the ways in which weight stigma increases unhealthy behaviors and even the risk for mortality. The American Academy of Pediatrics therefore recommends non-stigmatizing and person-first language (eg, person with obesity) in discussing weight. While many of the providers interviewed for the study were aware of the importance of using respectful, responsive language, the research also revealed more work needs to be done to support pediatric providers 'in delivering patient-centered, non-stigmatizing care for overweight and obesity,' concluded Katrina B. Dietsche, Yale School of Medicine, Yale University, New Haven, Connecticut, and her colleagues in their poster. Dietsche told Medscape Medical News she was impressed with how often providers used preferred terms, but she was also a little surprised at how little person-first language was used, perhaps because it's a newer recommendation. 'While this study explored how clinicians talk to researchers about weight, I think it's very possible the way we talk about weight when we're not talking to patients reveals some of the biases we all have. I also think it's easy to slip up and accidentally use stigmatizing language with patients if it's not something we're consistent about outside of visits.' But she said it was very clear that clinicians want well-defined language to use with patients in these discussions, and Dietsche hopes that one result of her research will be to design scripts to help better prepare clinicians for these conversations. 'This study highlights a crucial, often overlooked aspect of obesity care — how we talk to patients and families about what it means to live in a larger body,' Alaina Vidmar, MD, the medical director of the Obesity Medicine and Bariatric Surgery Program at Children's Hospital Los Angeles, Los Angeles, told Medscape Medical News . 'Communication has a profound impact on trust, engagement, and outcomes. As we work to address the obesity epidemic in children, aligning our language with empathy and evidence-based guidance is just as important as the treatment itself,' said Vidmar, who was not involved in the research. The researchers conducted a qualitative study with primary care practices in three US health systems in the Northeast, Midwest, and South. Through semi-structured interviews, the researchers explored how primary care providers manage overweight and obesity in their clinical practice. Before the interviews, a content analysis of words from a literature review in PubMed identified preferred and stigmatizing terms related to weight. Preferred terms included body mass index (BMI), weight, and overweight, while potentially stigmatizing terms included obesity, large, heavy, and morbidly obese. The 21 interviewees were mostly female (81%) attending physicians (90%) who had been in practice more than 10 years (86%). When discussing weight, 29% used a mix of nonperson first ('obese patient') and person-first ('patient with obesity') language, while 33% used person-first language only and 33% used nonperson first language only. The most used terms by providers were BMI and weight, each used by 20 of the interviewees, and obesity, used by 19 of them. Overweight was used by 14, while three or fewer used large, heavy, or morbidly obese. 'There was a wide spectrum as to how primary care clinicians discussed weight, but it was mainly along a spectrum of 'weight focused' or 'lifestyle/health focused,'' Dietsche said. 'A common way to introduce the conversation about weight was to use the growth chart, which then helped give patients a visual.' One physician who used the growth chart strategy would then say something such as ''Your 6-year-old weighs like a 12-year-old' because I think that opens their eyes a little bit more.' Overall, four strategies emerged for how the providers discuss weight. One focuses specifically on the weight/BMI itself, such as drawing attention to where a child falls on the growth chart or comparing them with children of other ages. A second strategy avoids discussion of weight and focuses on health and lifestyle, such as how patients are eating and how much exercise they're getting. 'I'll say, 'I'm not so much interested in the total number of the weight. I'm interested in how healthy your body is,'' one provider said. That approach 'is instructive for identifying weight as a problem and linking it to health,' Dietsche said. 'One clinician used a very poetic metaphor about patients' growing bodies like growing a garden,' Dietsche said. 'They talked about how important nourishing foods were to grow a garden and related it to how we need to feed, water, and exercise our own bodies.' A third approach centers on respect for patient values, preferences, and context, including asking permission from the family to discuss it. The fourth strategy involves being attuned to emotions and cues from the patient and family and following their lead. 'Then the discussion is very sensitive to whatever signals you're getting as feedback from what you're saying,' one physician who uses this approach said. Mahnoosh Sharifi, MD, MPH, an associate professor of pediatrics at Yale and the senior author on the study, noted that they intentionally used the term 'potentially stigmatizing' when assessing the terms used 'to avoid placing a definitive value judgement on whether it is appropriate or not to use terms like 'obesity.'' What's key, Sharifi said, is preserving trust with patients and remaining patient-centered in communication. 'It is important to balance a focus on health and well-being with communication that obesity is a chronic disease that is not a patient's fault,' Sharifi told Medscape Medical News . 'Using the word 'obesity' may not be helpful and could be unnecessarily experienced as stigmatizing in counseling a parent of a toddler whose BMI is just over the threshold of obesity, but discussing the diagnosis of obesity and using the term may be very helpful in communicating about the condition and treatment options such as medication and bariatric surgery for an adolescent with severe obesity and early-onset diabetes and high blood pressure,' she said. So while using the term 'obesity' has a role in describing a medical condition with patients, 'we should take care to center the patient's and family's needs, values, and preferences,' she said. The research was funded by the National Institute on Minority Health and Health Disparities. The authors reported having no disclosures. Vidmar reported having no disclosures.
