rebecca puhl, Other, 07:32PM Jul 24, 2013
A new study published today in PLoS One1, is one of the first longitudinal studies to demonstrate that weight discrimination is associated with becoming obese. The study, conducted by Sutin and Terraccinao at Florida State University College of Medicine, followed 6,157 adults over 4 years. They found that adults who reported experiencing weight discrimination were 2.5 times more likely to be obese four years later than those who did not report weight discrimination. Importantly, respondents were asked about their experiences of different forms of discrimination (e.g., race, sex, age, sexual orientation, etc.), but it was only weight discrimination that increased risk of obesity. Moreover, those who reported experiencing weight discrimination were more over 3 times more likely to remain obese during the four-year period of the study compared to individuals who did not experience weight discrimination.
Previous research has demonstrated that experiencing weight stigmatization is associated with negative health consequences, including behaviors that may impair weight loss or contribute to weight gain, such as binge-eating, unhealthy weight control behaviors, increased food consumption, and avoidance of physical activity. The findings of this new study go one step further, documenting the effects of weight discrimination over time, and isolate weight discrimination specifically as a potential contributor to obesity.
As Sutin and Terraccinao assert, there may be several mechanisms that contribute to the relationship between weight discrimination and obesity. Discrimination can be considered a form of stress, and for many obese individuals this is a chronic (and often daily) form of stress. Eating food is a common coping strategy that people turn to in an attempt to temporarily relieve symptoms of distress. As an example, in one of our own studies in which we surveyed 2400 overweight and obese women, 79% of women reported that they turned to food as a coping mechanism to deal with stigmatizing experiences related to their weight.2 In a more recent experimental study, overweight women ate 3 times more calories after being exposed to weight stigma compared to women who were exposed to neutral stimuli.3 Other research has also demonstrated that many people internalize negative weight-based stereotypes and blame themselves for weight stigma, which in turn is associated with binge-eating.4-5 Physiological mechanisms may also play a role, where the psychological stress of being stigmatized may increase cortisol reactivity, which in turn is associated with increased food intake.
These new findings indicate that weight discrimination may pose considerable challenges and barriers in efforts to effectively prevent weight gain or lose excess weight. Although weight discrimination is often discussed in the context of being a social injustice, this study underscores the importance of recognizing that weight discrimination is also a public health priority, and should be prioritized on the agenda of efforts to prevent and treat obesity.
1 Sutin AR, Terracciano A. Perceived weight discrimination and obesity. PLoS One, 2013; 8(7). e70048. dpi:10.1371/journal.pone.0070048.
2 Puhl R, Brownell, KD. Confronting and coping with weight stigma: An investigation of overweight and obese individuals. Obesity, 2006; 14:1802-1815.
3 Schvey N, Puhl RM, Brownell KD. The impact of weight stigma on caloric consumption. Obesity, 2011; 19:1957-1962.
4 Puhl R, Moss-Racusin C, Schwartz MB. Internalization of Weight Bias: Implications for Binge Eating and Emotional Wellbeing. Obesity, 2007;15 (1): 19-23.
5 Ashmore JA, Friedman KE, Reichmann SK, Musante GJ. Weight-based stigmatization, psychological distress, & binge-eating behavior among obese treatment-seeking adults. Eat Behav. 2008; 9: 203-209.