For Mental Health After Metabolic Surgery, Less Stigma Is Key
Mental health often, but not always, improves after metabolic and bariatric surgery. But new research tells us that this is not really a direct consequence of weight reduction. Instead, it seems that better mental health very likely comes from the reduction in experiences of weight stigma. In fact, Larissa McGarrity and colleagues found that the best predictor of better mental health after metabolic surgery was a reduction in experiences of weight stigma. Not the amount of weight a person loses. They write:
“Weight stigma experienced by patients improves after undergoing bariatric surgery, contributing to better mental health, improved eating behaviors, and lower weight. However, ongoing stigma remains a significant risk for some patients, highlighting the need for considering the role of weight stigma even years after surgery and to develop interventions to enhance quality of life and long-term outcomes.”
Follow-up 1.5 to 3 Years Later
McGarrity et al collected complete data for psychological evaluations both before and after surgery in 148 patients undergoing metabolic surgery. They followed up with additional assessments between 1.5 and 3 years later. They found a clear association between weight loss and a reduction in experiences of weight stigma. And less stigma had a robust association with better mental health. But they did not find such an association between weight loss and improved mental health.
This is what leads them to believe it is the stigma that weighs on a person’s mental health – not the excess weight itself.
Internal Stigma
Rebecca Pearl, a weight stigma scholar who was not involved with this study, reminds us that the effects of stigma become worse when a person internalizes it:
“Experiencing stigma from other people is harmful. 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.”
This is just one more reason: When treating obesity, we need to focus on much more than just weight.
Click here for the new study, here, here, and here for more perspective.
A Red Skirt, painting by Pablo Picasso / WikiArt
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June 7, 2025
