Women who are overweight and obese are likely to experience frequent, daily insults and humiliation from strangers, family and friends, according to a new study.
Fifty overweight and obese women kept week-long diaries that reported a total of 1,077 "weight-stigmatizing" events, with an average of three negative events per individual over seven days.
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"Obesity is connected to numerous social stereotypes in our society: having less stamina and drive, being less competent, and seeming less likable," said Jason Seacat, lead author of the study and associate professor of psychology at Western New England University, in Springfield, Massachusetts. "The heavier an individual, the more stigma they face."
Diary entries from the women showed several common types of weight stigmatization: physical barriers (84 percent), nasty comments from others (74 percent), being stared at (72 percent) and "others making negative assumptions" (72 percent).
One participant noted in her diary: "Boyfriend's mother denied me access to food; also stated that I was so fat because I was lazy."
Another wrote: "With friends at a baby shower. Went to McDonald's first so people wouldn't look at me eating more than I should."
Seacat, who previously focused on the stigma associated with HIV and Aids, first became interested in studying stigmatization and obesity while he was working out at the gym one day. He noticed a 300-pound woman come into the gym, and then saw a group of teenagers pointing and laughing at her. The woman immediately walked out.
"I thought it was sad that we have well-intentioned people who want to do the things that are healthy, and people are making that difficult," Seacat remembered.
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Immediately visible to others
It's a plight faced by many. More than two-thirds of Americans are overweight or obese, according to the U.S. Centres for Disease Control and Prevention.
The challenge for overweight people is that their problem is immediately visible to others. "Most everybody struggles with some kind of health issue but obesity is something you wear on the outside," said Ted Kyle, advocacy advisor for the Obesity Society.
The study authors noted that while healthful activities such as maintaining a healthy diet and exercising are challenging for most people, when weight stigmatization is added to the picture, such goals may become impossible.
Kyle said he was recently in an elevator on Capitol Hill when an obese person in an apparent hurry to see a senator rushed in. Someone in the elevator told the individual that the stairs would be a healthier option. "For many overweight people, life is a series of small but cumulative insults like that," Kyle said.
Why are people sometimes rude to those who are overweight? Kyle said they often have a misguided notion that they're helping someone by addressing the problem. "People feel they have permission – and some feel they have an obligation – to offer unsolicited comments or advice."
For the study, the researchers recruited 50 women through weight-related discussion websites and forums. Most of the women were white, and their average age was 38. The women were told the purpose of the study was to collect information about daily experiences with weight-related stigma and discrimination.
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Through an Internet survey, the women gave basic information such as age, educational level, marital status, racial/ethnic identity, height and weight, and exercise patterns. They also chronicled their daily activities. Participants noted whether or not several different types of stigmatizing events occurred. For example: "A child made fun of you because your weight," or "A spouse or partner called you names," or "Strangers suggested a diet to you."
Stigma was defined as any form of negative treatment or evaluation that had occurred on that day that participants felt happened because of their weight.
The researchers found that body mass index – BMI, a ratio of weight to height – was the most significant factor associated with all forms of stigma except that caused by interpersonal relationships. They also learned that women tended to report more stigmatisation when they were more frequently involved in activities with other people.
Kyle noted the study, which was recently published in the Journal of Health Psychology, was somewhat limited because it was small, included only women, and was limited to mostly white women.
As for what needs to be done to reduce stigmatisation of those who are overweight, Seacat said they need to be empowered. "We need to give them the skills and the courage to face those daily barriers they encounter and keep going."