Adding Stigma to Obesity and Heart Disease

These are three problems that often travel together. But each one by itself is a problem – stigma, obesity, and heart disease. Now, a new study from the University of Connecticut gives us some of the best empiric evidence yet for the distinct harm that weight stigma adds to obesity and heart disease.

Randomized and Controlled

For the most part, prior evidence for the health harm of weight stigma, though persuasive, was observational. Persons with a history of exposure to stigmatizing experiences are more likely to have poor health outcomes. Persons who feel stigmatized because of their weight are more likely to have persistent or progressive obesity.

So this new research is important because it brings the first experimental evidence that stigmatizing experiences directly cause a worsening of heart disease symptoms in persons with obesity.

It was a randomized controlled trial in women with obesity and normal (n=24) or high (n=25) blood pressure. Each of those women, on separate occasions, had exposures to neutral or stigmatizing video content.

What they found was that the stigmatizing content caused an increase in blood pressure for the women with high blood pressure, but not for those with normal blood pressure. That rise in blood pressure persisted well after the exposures. During sleep hours afterward, those women had both elevated blood pressure and heart rate. The authors sum it up quite clearly:

“To our knowledge, this is the first rigorously designed, controlled study to test whether an acute weight stigma exposure compared to a neutral exposure leads to heightened cardiovascular reactivity among women with obesity with elevated versus normal BP.

“These findings suggest the need for health care providers to be educated on the harmful effects of weight stigma on patients’ cardiovascular health.”

Three Distinct Problems

This research reminds us that we have three distinct problems, often in the same patients, each of which harms health – obesity, cardiovascular disease, and weight stigma. These problems aren’t in some sort of perverse competition, though some HAES advocates suggest otherwise. They say the health harms of obesity don’t hold up when one accounts for the harm of weight stigma. However sincere their feelings about this might be, these claims are neither true nor helpful.

Heart disease is a problem, with or without obesity. Obesity causes harm all by itself and through a large number of other diseases that result from it. On top of that, weight stigma causes further harm.

With every day that passes, we have better medical options for treating obesity and heart disease. The stigma that people perpetuate, intentionally or not, is a tougher nut to crack.

Click here for the new study from Gregory Panza, Rebecca Puhl, and a host of other talented researchers. For more on strategies to end weight stigma in healthcare, click here.

The Heart of the Rose, painting by Margaret Macdonald / WikiArt

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January 24, 2023