Latest news with #weightstigma
Forbes
12-07-2025
- Business
- Forbes
The Psychological Cost Of The Plus-Size Retail Collapse
'Sorry, we're closed' sign close up Plus-Size Scarcity: 'I Don't Think People Realize How Precarious The Plus-Size Fashion Industry Really Is' A few years ago, I was in New York ahead of Fashion Week having lunch with the CEO of a major online plus-size retailer. She frowned a little as I told her about all the reasons she should feel hopeful about the fight to end weight stigma, on the clothing front and beyond. 'I need to hear this good news,' she said, unconvinced. Her next words landed like a premonition: 'I don't think people realize how precarious the plus-size fashion industry really is." Today, as I witness one plus-size business shutter or downsize after another, I can't help but think back on what she said. Despite the optimism I'd displayed at lunch, my private purchasing habits as a plus-size woman told the story of someone who knew that precarity intimately. At the time of that meeting, we were still in the middle of a proliferation of plus-size options never before seen. Before the plus-size revolution began, I hadn't realized how many things I'd given up on ever having the opportunity to wear – a bikini, a beautiful wedding dress, a cute pair of jeans, anything made of linen, a matching bra and panty set that fit, a comfortable pair of pajamas, a business suit I liked, and the list goes on. As more and more businesses proclaimed their newfound commitment to clothing for all bodies, I reveled publicly and hoarded privately. Even though plus-size customers make up the majority of the American customer base, the fashion industry has long treated us as an inconvenient minority. As much as I wanted to believe that these options were indeed here to stay, deep down I couldn't ever fully fight the feeling that I had a limited window of opportunity to assemble the wardrobe I'd always wanted. I even bought clothes I knew I'd likely never wear, just to remind myself – in case it all went away – that there was a time when I could get a plus-size three-piece see-through bright pink mesh outfit lined with faux fur. My closet began to overflow because I was unwilling to let go of any of my newly acquired, actually fashionable clothes. This scarcity mentality compelled me to keep buying before it was too late. I knew these fears and impulses were borne from the trauma of navigating a fashion landscape that seemed to indicate at every turn that I was unworthy of dressing. I wanted to be wrong, but that lunch meeting had foretold something I think I'd already accepted deep down. "Before the plus-size revolution began, I hadn't realized how many things I'd given up on ever ... More having the opportunity to wear – a bikini, a beautiful wedding dress, a cute pair of jeans, anything made of linen, a matching bra and panty set that fit, a comfortable pair of pajamas, and the list goes on." Plus-Size Retail Collapse: 'You Are Not Meant To Be Here' As we witness the dismantling of a plus-size fashion revolution that changed history, it's important to name that this is a grave loss for everyone, but especially plus-size people. I spoke with London-based fashion psychologist Jennifer Heinen about the emotional and psychological cost of the plus-size retail collapse. For over a decade, Heinen worked inside the fashion industry as a designer and bespoke tailor. Now her work focuses on how clothing shapes emotional well-being, self-concept, and resilience. She sees fashion as a part of self-expression, but also emotional self-regulation. Heinen says that watching this collapse can feel like being silently — but persistently — pushed out of public space. 'It doesn't happen all at once,' shared Heinen. 'It's death by a thousand cuts – fewer racks, smaller size ranges, trend items missing, and online-only (options). Each moment on its own might be tolerable, but collectively, they tell plus-size shoppers: You are not meant to be here.' 'Fashion isn't just aesthetic," says Heinen, 'It's psychological scaffolding. When that scaffolding is absent — when someone walks into a store and sees nothing made for their body — it creates more than inconvenience. It creates emotional erosion. And over time, that erosion leaves a trace in how people speak about themselves, in how they show up socially, and in how much space they allow themselves to take up.' Heinen sees clothing as a form of narrative. We dress ourselves into who we are and who we want to become. When plus-size options are stripped away it disrupts that ability to create a narrative. It sends a message that if you're plus-size, your story isn't worth writing. "That message isn't abstract. It lands in the body. It lands in the mirror. It lands in the quiet resignation that builds when shoppers stop expecting joy or creativity," says Heinen. Heinen described four psychological phenomena that can deeply negatively impact plus-size shoppers: learned helplessness, symbolic annihilation, identity suppression, and body image destabilization. Jennifer Heinen is a London-based fashion psychologist who says that fashion helps people express ... More themselves and emotionally self-regulate Learned Helplessness: 'Why Bother Looking? Nothing Ever Fits.' 'Nothing ever fits.' 'Why bother looking?' 'It's just going to be disappointing again.' These are phrases that are commonly expressed among plus-size shoppers, and Heinen says this is part of a psychological state known as learned helplessness. 'It's what happens when people are met with chronic rejection," says Heinen. 'They stop trying, not because they don't want to succeed, but because they've learned it won't matter.' The process begins with inconvenience and disappointment that morphs into shame, grief, and sometimes withdrawal or resignation. That resignation erodes agency, reinforces shame, and strips people of the hope that they'll ever be seen or celebrated as they are. She says this isn't just a consumer issue, it's a public mental health concern. Heinen recalls shopping for a formal event and standing in a plus-size section full of greys, blacks, and outdated cuts. 'I knew that if I wanted to be included, I'd have to dim myself." That moment stayed with her. 'I hear this over and over, from friends, clients, and people online. We don't want more basics. We want more belonging. When that's missing, the psychological impact isn't subtle. It shapes how people see themselves in the mirror and in the world.' 'When a group is consistently excluded from self-expression, their emotional regulation suffers," ... More says Jennifer Heinen, fashion psychologist. Symbolic Annihilation: 'You Shouldn't Exist At All' Symbolic annihilation is a theory that describes what happens when certain identities are made invisible, mocked, or only selectively included. 'In fashion, it manifests through disappearing racks, hidden plus-size sections, and a total absence of larger bodies in visual campaigns," says Heinen. 'It's not just exclusion, it's instruction. It teaches all of us who deserves visibility and who doesn't. To plus-size shoppers, the message is clear: You're not profitable enough to be seen. To straight-size shoppers, the message is more insidious: This is the 'normal' body. This is who fashion is for." Heinen says that for plus-size consumers, this erasure doesn't just communicate the message that we don't belong in retail spaces, it often implies we shouldn't exist at all. For straight-size consumers, Heinen says this exclusion reinforces the illusion of neutrality. 'If the only bodies on display are thin, then thinness is seen as normal, desirable, default. This not only perpetuates anti-fat bias, it stokes quiet fear. The fear of being excluded next. When fashion limits its definition of beauty, it doesn't just hurt those excluded. It creates a system where everyone is watching their reflection with scrutiny.' When retailers stop making clothes for plus-size shoppers, it sends a clear message: you don't ... More belong here. Identity Suppression: 'The World Won't Let Me Be Who I Am." Alienation doesn't always show up in obvious ways, says Heinen. 'Sometimes, it's skipping the mall. Sometimes, it's declining an invitation to a wedding because nothing fits, or because what fits doesn't feel like you. Sometimes it's declining a job interview because your professional wardrobe doesn't include your current body. It's subtle avoidance layered over years of exclusion.' From a psychological lens, this is identity suppression: when external structures, like limited fashion access, constrain someone's ability to express their internal identity. When someone enters a store and realizes they can't participate in trends it reinforces a the message that the world won't let me be who I am. 'I've seen this manifest as wardrobe apathy, performative neutrality ('I'll just wear black'), or style silence — people dressing only for invisibility. That's not minimalism. That's trauma management,' says Heinen. Body Image Destabilization: 'This Isn't Just Disconnection From Fashion. It's Disconnection From Self.' Body image destabilization occurs when the world keeps signaling that your body is a problem to be fixed. 'When options vanish from stores, when models in your size disappear from campaigns, when 'plus-size' becomes a whispered afterthought, your sense of worth becomes conditional. The result isn't just disconnection from fashion. It's disconnection from self," says Heinen. People begin shrinking their style, avoiding mirrors, and dressing to camouflage rather than for expression. "It breeds mistrust of the body, often leading to mood instability, hypervigilance, or avoidance behaviors that bleed into other areas of life." Navigating the plus-size retail collapse means learning new strategies and tools. Six Tips For Combatting The Negative Psychological Costs Of The Plus-Size Retail Collapse Heinen has a lot of advice for plus-size people who are experiencing things like learned helplessness and body image destabilization: 1. Reclaim your narrative through micro-expression. When mainstream fashion doesn't reflect you, start with small style choices that feel true to who you are. This might include a favorite texture, bold glasses, a scent that anchors you, or a piece of jewelry that reminds you of your strength. 'These are not superficial details. They are micro-acts of identity,' says Heinen. 'In fashion psychology, we call this symbolic self-completion, using external signals to affirm internal identity. These choices help regulate emotion and assert agency.' 2. Take power back through tailoring. If the clothes don't fit, change them, not you. 'There is radical self-compassion in altering a blazer instead of blaming your arms, or hemming trousers instead of shrinking your thighs,' says Heinen. 'Fashion taught us for too long that we must mold ourselves to the industry. Alteration is adaptation — and adaptation is power.' 3. Reframe beliefs: Your body is not the problem. The exclusion is. Heinen encourages something called cognitive reappraisal, which is the process of changing how we interpret a situation to reduce emotional distress. When clothes don't fit or options vanish, the instinct is often self-blame. Heinen points out that self-blame is commonly expressed through the impulse to lose weight. She encourages shoppers to reframe this: 'This brand wasn't designed with me in mind. That's their failure, not mine. This shift is not denial. It's clarity." 4. Use style rituals as grounding techniques. In psychology, rituals are known to reduce anxiety and reinforce identity, especially during change. Even simple acts, like choosing jewelry that makes you feel powerful, or laying out your clothes the night before can function as emotional regulation tools. 'These moments help you return to yourself, especially in a system that keeps pushing you away,' says Heinen. 5. Normalize grief. It's okay to mourn what's missing. Grief is a valid emotional response to exclusion. 'In trauma-informed psychology, we recognize that not being able to dress joyfully or be included in trends is a type of loss. You don't need to minimize it. Grieve the options that never included you. That grief is not indulgent. It's part of healing.' 6. Use 'if–then' coping plans to reduce avoidance. Heinen suggests making simple mental plans for when you hit roadblocks. For example, if nothing fits in the store, your plan can be to take a deep breath, remind yourself it's not you, and plan to check your favorite online creators for inspiration instead. 'This reduces emotional spiral and builds self-trust,' says Heinen. Simple rituals like brushing your hair, wearing soft fabrics that comfort you, and choosing colors that make you feel positive are micro-practices of self-respect. 'You don't need to love your body to honor it,' shares Heinen.
CNN
24-06-2025
- 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 ResourcesThe 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.
ABC News
24-06-2025
- Health
- ABC News
The maternity care that took Tara's BMI out of the equation
Early in her pregnancy, Tara Sawyer was told the local hospital would not be able to accommodate her. "Because of my higher BMI, you automatically have to go to Box Hill rather than Angliss Hospital," says the 29-year-old from Emerald/land of the Bunurong and Wurundjeri peoples in Victoria. "Initially I was quite upset about that because I'm a teacher, I work full-time, and it meant all my appointments had to be an hour away, so I had to take a whole day off work to have an appointment. "It led to stress in my job, which was not ideal." Tara says she also felt ashamed to tell people why she had to travel to a different hospital. "My husband and I talk about weight all the time, but even just to tell him I can't go to this hospital because I'm overweight, was quite embarrassing." Recent research from Monash University has found reducing women's experiences of weight stigma should lead to better care and better pregnancy outcomes for larger-bodied women. It shows larger-bodied women are sometimes automatically treated as high-risk, which the authors write is "problematic because it focuses on body size rather than health". BMI is a method used to sort patients by weight into four categories from underweight to obese. Its appropriateness as a measure of healthy weight for individuals has long been contested. For Tara, the redirection to a hospital further away ended up being a "blessing in disguise", thanks to a program dedicated to maternity care for women with a high BMI. "It meant that I could opt to not be weighed at each appointment, not be told about my weight, or be told only if I wanted," Tara says. We spoke to Tara about her pregnancy journey, and how, for the first time, her weight meant she received more care, rather than less. These are her words. I had been on a health journey for about 10 years prior to being pregnant, with what I assumed was an autoimmune disease. I really struggled to get care early on. The default response from most doctors about my symptoms was to exercise more and lose weight. I was aware of my weight, but struggled to lose any, and suspected whatever else condition I had was contributing to that. I also have anxiety, and at one point I was having some internal bleeding investigated. When they didn't find a cause, I had a specialist gastroenterologist tell me what it was probably just anxiety causing those symptoms. After about three years of fighting to have my voice heard, I was finally referred to a rheumatologist who has taken my condition seriously. I also found a fantastic GP who has listened to my fear of being dismissed because of my weight, and made sure unless my bloods indicated it was a problem, or I came in concerned about my weight, it would not be factored into my care and treatment. I actually fall into the catchment of Angliss Hospital, but due to having a suspected autoimmune condition, borderline high hypertension, and a high BMI, I was told I had to present to Box Hill and receive care there. I was quite frustrated and embarrassed I had to do that. But it did work out for the best. I was told about the PEARL (Pregnancy Elevated BMI Antenatal Risk reduction and Lifestyle) program. It's run by this beautiful midwife Maddy (Madeline Hawke). She was concerned about weight stigma with pregnancy and how many women deal with a lot of weight conversations in pregnancy that are not necessarily important to that pregnancy. I saw Maddy and the same obstetrician throughout my pregnancy. We didn't really discuss weight. At one point I raised concerns about how much I was putting on, but I was assured it was in the normal range for women with my BMI. There was also an honest conversation about why it's sometimes recommended women with high BMI be induced, but it was presented to me as research and fact, rather than pressure or opinion to sway me one way or the other. I kind of got the "royal treatment". I met another woman in the program and she said to me, "It's like the first time that being overweight has been a positive in my life". I felt the same way. Despite the great care, I had such an awful pregnancy with pain and pre-natal depression. It was a really hard time. But I would give birth every day of the week. I loved it. It was such a positive experience. The midwives and team were amazing. I put that down to all the research I did. Familiarising myself with hospital policies on what I could and couldn't push back on. Having a thorough birth plan. I learnt that I was always entitled to ask for a second opinion, and ask for a second doctor if I wasn't happy with my care. It's your right to ask for that. And I know it's really hard; as women we are seen as being rude and up-front when advocating for ourselves. But pregnancy is one of the most vulnerable times in your life, you want to make sure the people in the room have your best interests at heart, and don't look down on you because of your weight.
Yahoo
20-06-2025
- Health
- Yahoo
The American Diabetes Association Demonstrates Its Commitment to Curbing the Obesity Epidemic with Obesity Standards of Care
Symposium previews new content for Standards of Care in Overweight and Obesity, designed to improve patient care and outcomes CHICAGO, June 20, 2025 /PRNewswire/ -- Recent developments for the new Standards of Care in Overweight and Obesity guidelines, the first clinical guidance of its kind, were presented during the Standards of Care in Overweight and Obesity 2025 Updates symposium at the 85th Scientific Sessions of the American Diabetes Association® (ADA) in Chicago. The Obesity Association™, a division of the ADA, recently announced the publication of Weight Stigma and Bias: Standards of Care in Overweight and Obesity—2025, along with the Introduction & Methodology section in BMJ Open Diabetes Research & Care. This comes at a time when about 110 million American adults are impacted by obesity. Further, up to (53%) of new cases of type 2 diabetes are attributed to obesity every year, demonstrating the need for comprehensive, evidence-based guidelines to inform care. The symposium highlighted key insights on physician guidelines for weight stigma and bias, including training for health care professionals, creating inclusive clinical environments, person-centered communication, shared decision making, and evidence-based interventions. Additionally, researchers highlighted what is next for the clinical guidelines, including a potential section for pharmacologic treatment and a preview of what is going to be covered in that section. The Standards of Care in Overweight and Obesity 2025 Updates symposium is one of many obesity-related symposia and abstracts at the 85th Scientific Sessions, spanning basic through clinical and implementation science. Additional studies highlighting groundbreaking developments obesity treatment and care to be presented at ADA's annual meeting include: Once-Monthly MariTide for the Treatment of Obesity in People with or without Type 2 Diabetes—A 52-Week Phase 2 Study ADJUnct Semaglutide Treatment in Type 1 Diabetes (ADJUST-T1D) Trial Outcomes Can We Improve the Quality of Weight Loss by Augmenting Fat Mass Loss while Preserving Lean Mass? The BELIEVE Study of Bimagrumab + Semaglutide PATHWEIGH Trial—Building the Highway for Weight Management in Primary Care First Report of a Phase 3 RCT of Orforglipron, a Small Nonpeptide GLP-1RA, as Monotherapy in Drug-Naïve Type 2 Diabetes with Inadequate Glycemic Control—The ACHIEVE-1 Trial Efficacy and Safety of CagriSema 2.4mg/2.4mg in Adults with Overweight/Obesity—The REDEFINE 1 and REDEFINE 2 Clinical Trials "The ADA's Standards of Care in Diabetes guideline is the gold standard for diabetes care and management," said Raveendhara Bannuru, MD, PhD, the ADA's vice president, medical affairs and lead author of the guidelines. "The new Standards of Care in Overweight and Obesity guidelines stand to yield significant impact and progress in patient care, and it's only just the beginning." As part of the ADA's ongoing commitment to combating obesity, new clinical practice guidelines and initiatives are continually being developed to advance the quality of care. Research presentation details:Dr. Bannuru and other Professional Practice Committee members will present these findings at the symposium: Standards of Care in Overweight and Obesity 2025 Updates Friday, June 20 from 12:45–1:45 p.m. About the ADA's Scientific SessionsThe ADA's 85th Scientific Sessions, the world's largest scientific meeting focused on diabetes research, prevention, and care, will be held in Chicago, IL, on June 20–23. Thousands of leading physicians, scientists, and health care professionals from around the world are expected to convene both in person and virtually to unveil cutting-edge research, treatment recommendations, and advances toward a cure for diabetes. Attendees will receive exclusive access to thousands of original research presentations and take part in provocative and engaging exchanges with leading diabetes experts. Join the Scientific Sessions conversation on social media using #ADASciSessions. About the Obesity Association Obesity is an epidemic that demands both attention and action. The Obesity Association, a division of the American Diabetes Association, is dedicated to reducing the prevalence of obesity and improving health outcomes. Through a focus on education, action, and evidence-based support, we strive to create a world where people affected by obesity can thrive. About the American Diabetes AssociationThe American Diabetes Association (ADA) is the nation's leading voluntary health organization fighting to end diabetes and helping people thrive. This year, the ADA celebrates 85 years of driving discovery and research to prevent, manage, treat, and ultimately cure—and we're not stopping. There are 136 million Americans living with diabetes or prediabetes. Through advocacy, program development, and education, we're fighting for them all. To learn more or to get involved, visit us at or call 1-800-DIABETES (800-342-2383). Join us in the fight on Facebook (American Diabetes Association), Spanish Facebook (Asociación Americana de la Diabetes), LinkedIn (American Diabetes Association), and Instagram (@AmDiabetesAssn). To learn more about how we are advocating for everyone affected by diabetes, visit us on X (@AmDiabetesAssn). Media Contact: Mimi Carmody, MCarmody@ View original content to download multimedia: SOURCE American Diabetes Association Sign in to access your portfolio
CNN
06-06-2025
- 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.
