Distressing Levels of Weight Stigma in Six Countries

Weight stigma is not just a U.S. problem. A whole series of new studies – two of them coming out just today – tell us that weight stigma is common across six countries. Not only do people find it in personal relationships, but they even find it common in healthcare. In fact, two thirds of people in these six countries who experience weight stigma find it in their visits with doctors.

These studies arose from a collaborative effort between leading weight stigma researchers and behavioral scientists at WW International. All of these countries –  Australia, Canada, France, Germany, U.K., and U.S. – have a problem. This stigma harms health. People with obesity avoid healthcare, have less confidence in self-care, and adopt less healthy habits because of stigma.

In sum, stigmatizing obesity harms the health of people all around the world.

Weight Stigma in Healthcare

In PLOS One today, Rebecca Puhl and colleagues report on a study of weight stigma in healthcare. They surveyed 13,996 adults in six countries about experiences of weight stigma in healthcare. These persons were actively engaged in a weight management program. Puhl et al found that weight stigma was common in healthcare in all of the countries studied.

However, in this study Germany stood out. Weight stigma from doctors was more common in Germany than in any other country except the U.S. Among respondents in Germany, 74 percent reported experiences of stigma from a doctor. The U.S. was close, with 70 percent reporting it, and that number was not significantly lower than the number in Germany.

Internalized Weight Bias

The problem with experiencing stigma is that it becomes internalized. People start believing they are less capable and less worthy of self-care. Rebecca Pearl et al reported on internalized weight bias across these six countries earlier this year.

Again, this was common in all six countries. The highest scores for internalized weight bias came from the U.K., Australia, and France. But the real importance is the harm this causes. With internalized stigma, people experienced lower quality of life related to both physical and mental health. They had more stress, ate more to cope, and avoided fitness activities more. Their body image was more negative and they had less confidence in their skills for healthy eating and active living.

Prevalent in All Six Countries

In the International Journal of Obesity, Puhl et al nicely summarize this body of research:

“Weight stigma is prevalent for adults actively engaged in weight management across different Western countries. There were more similarities than differences in the nature, frequency, and interpersonal sources of people’s experiences of weight stigma across the six countries in this study. Findings underscore the need for multinational initiatives to address weight stigma and interventions to support individuals engaged in weight management who experience weight mistreatment.”

Weight stigma interacts with local cultures around the world. It’s not precisely the same everywhere. But it is a problem for people living with obesity, wherever they might live.

Click here, here, here, and here for papers from this series of reports on weight stigma in six countries around the world.

International Hygiene Exhibition 1911 in Dresden, Poster by Franz Stuck / WikiArt

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June 1, 2021