Internalized Weight Stigma and Eating Disorders (Part 1): An overview of the research

by Emily Presseller and Natalie Papini

Emily Presseller (@EmilyPresseller) is a 2022 CEED Summer Fellow. Her research interests include understanding factors that influence the maintenance of and recovery from eating disorders.

Natalie Papini (@nataliep310) is a 2022 CEED Summer Fellow. One of her research interests includes the intersection of eating disorders, weight stigma, and internalized weight stigma.

Societal attitudes and beliefs can change throughout different cultures and different time periods. Research in the U.S. shows that societal attitudes around sexual orientation, race, and skin tone have become more accepting while other attitudes around age and disability have remained unchanged over the course of the past decade.1 Only one societal attitude seemed to worsen between the years of 2004 and 2016—attitudes toward body weight. Weight stigma is defined as mistreatment from others and societal disapproval based on weight.2,3 Weight stigma is communicated and expressed in several domains of life, including: the workplace, healthcare, education and schools, mass media, and interpersonal relationships.2-10 For example, weight stigma in the form of interpersonal relationships could be a relative suggesting weight loss to a family member in a larger body.11 In the job market, carrying excess weight could prevent a person from getting a job. In fact, Michigan is the only state in the U.S. that explicitly outlaws discrimination based on weight.12,13

What is Internalized Weight Stigma (IWS)?

Separate from the stigma people experience from others about their body shape and size, IWS involves how a person feels about themselves as a person as a result of believing negative attitudes about their size or shape.14 There are four steps to developing IWS: 1. A person becomes aware of overweight and obesity stereotypes; 2. The person believes those stereotypes; 3. They apply those stereotypes to themselves; and 4. They begin to devalue themselves as a result of identifying with the stereotypes.14 For example, a person may begin to think of themselves as “lazy” or lacking will power as a result of negative stereotypes associated with their size.

Impact of IWS

People who perceive themselves to have overweight or obesity report higher IWS than people who perceive themselves to be normal weight.15 People who experience or feel as if they are being stigmatized by others because of their weight are more likely to internalize that stigma, and this can lead to negative health outcomes (including disordered eating and body dissatisfaction16). IWS is associated with poor physical and mental health, including high blood pressure,17 increased stress responses,18,19 and inflammation (which can lead to even more health problems20). People with higher IWS may avoid healthcare services for fear of further stigmatization or traumatization, which can further contribute to poor health.3 IWS is also linked with poorer mental health, including depression,21-25 low self-esteem,21,22 body image concerns,22,25-28 psychological stress,29-30 and increased substance use.22

In Part 2 of this post (coming soon), read more about the impact of IWS on eating disorders and next steps we need to take to reduce weight stigma in our society.


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