Fat Stigma Can Cause Physical Harm, Says New Study

Sabrina Rojas Weiss
Overweight people who internalize the stigma of their size are at a higher risk of developing metabolic syndrome. (Photo: Getty Images)
Overweight people who internalize the stigma of their size are at a higher risk of developing metabolic syndrome. (Photo: Getty Images)

We know the obvious reasons why fat-shaming isn’t good. It’s demoralizing, bullying, mean, and a whole lot of other adjectives you can apply to the impact that such words have on their target’s emotional state.

But it may also do physical harm, as an increasing body of research has shown. A study published last week in Obesity indicates that overweight people who internalize the stigma of their size are at a higher risk of developing metabolic syndrome, a cluster of risk factors including high triglycerides, blood pressure, blood glucose, and waist circumference.

“We were looking at [the effect of] weight bias internalization, which happens when people who are overweight or obese are aware of the negative stereotypes that are pervasive in our society, they agree with them, and they apply them to themselves, so they’re self-stigmatizing,” University of Pennsylvania professor Rebecca L. Pearl, the lead author of the study, tells Yahoo Beauty.

In the study, 159 patients who were already enrolled in a separate weight-loss study were given questionnaires about weight-bias internalization (WBI) and health, as well as a medical examination. Those who scored high on the WBI scale were statistically much more likely to be among the 32 percent who had metabolic syndrome when controlled for body mass index and symptoms of depression. Pearl acknowledges that this was a limited sample (most participants were black and female), and this study could not to determine causality, so it could even be the case that the symptoms of metabolic syndrome lead to high WBI scores instead of the other way around. But she is certain that the results point to a need for further research.

Marie Denee, founder of the Curvy Fashionista blog and a proponent of body positivity, welcomes this concrete evidence of the physical damage that stereotypes can do.

“People ask, ‘Have you ever thought if you lost weight that maybe you’ll be able to’ — whether it’s ‘get a boyfriend,’ or ‘be happier’ or ‘look prettier,'” Denee said. “Those type of qualifiers, those types of comments, when you hear them enough, can have a toll on someone’s internal perception of their own worth or beauty. Words do hurt.”

Kelsey Miller, an editor for Refinery29 and author of Big Girl: How I Gave Up Dieting and Got a Life, points out how body-shaming has become part of even the most polite conversation.

“Even if we don’t criticize people openly based on their appearance, we compliment them based on their appearance,” she told Yahoo. “When we notice somebody has lost weight, the polite thing to do … is to say, ‘You look great!’ Similarly, if somebody is complaining of having gained weight, or if they’re pregnant or had a baby, we’re supposed to comment on how thin they appear.”

Pearl and her colleagues have a couple of hypotheses about what WBI does to people. For one, the stress of being criticized and stigmatized can trigger a physiological response, which includes inflammation, higher blood pressure, and increased cortisol release, which in turn causes increased appetite. Another factor might be the way in which believing a negative stereotype about oneself, such as “Fat people are lazy,” can be a self-fulfilling prophecy.

“If people believe that they’re lazy, they might be less likely to go for that walk that they were planning,” Pearl said. “It could be that people are coping with this stigma by engaging in unhealthy behaviors.”

Denee believes that internalizing bias leads to low self-esteem, making goals unattainable. “It doesn’t matter if you get that lost weight, if you don’t love yourself, if you don’t feel good about yourself, you’re always going to be chasing the ghost. That relationship with your body is never going to be enough. … When you love yourself, you’ll make the changes you need for you, not for what someone else says, not for what someone else believes.”

Encouraging people to feel good about their bodies is one solid step, but society as a whole has a role in stopping this cycle, Pearl says.

“Generally, we don’t need to comment about other people’s bodies,” she said. “A person’s weight does not give you a lot of information about their health behaviors or their health status. We know that there are plenty of people who have higher body weights who eat healthfully, who do exercise, whose cardiometabolic rates might not be that great — just as how there are people who are thinner who don’t eat well and don’t exercise.”

Miller has a solution that may require everyone to think more before they talk to each other. “My utopian vision would be that everybody speaks about their own body and other people’s bodies in a neutral way,” she said. “We can appreciate things that we find attractive and beautiful, but we do so in a way that does not assign a value judgment.”

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