Weight And Its Associated Stigma

  • Amika PatelMSc. in Mathematical Modelling (Biology and Medicine), University of Exeter, UK

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Introduction

Weight is a complex topic to discuss. It stirs up a plethora of emotions in us: the good, the bad, and everything in between. Moreover, there is a wealth of information out there regarding the potential health implications of being above or below a specific weight range and the impact of cultural and upbringing factors on our mental perception of weight. All this adds to the complexity of the topic. 

The following question arises: must we consistently view someone’s weight as a direct indicator of their health? As a society, we tend to overlook the fact that not all aspects of weight are within our control. While lifestyle choices and some environmental factors are variables we can influence, other elements like genetics, inherited characteristics, or even gender play a significant role, too.1 Although a challenging concept to grasp at times, it is entirely plausible for an individual not to lie in a supposedly healthy weight bracket while still maintaining good health.

All these notions that we have just discussed are manifestations of weight stigma. The World Obesity Organisation has defined weight stigma as “the discriminatory acts and ideologies targeted towards individuals because of their weight and size”. While the organisation views “weight stigma” and “weight bias” as separate terms, weight stigma is still commonly interchanged with “weight bias,” among other terms like “weight discrimination” or “weight prejudice”.2 

In this article, we look to further elaborate on weight stigma, as well as some of the consequences it may have on an individual’s life. 

Understanding weight

Definition of weight

Before we venture any further into the realm of weight-based stigma, we first want to understand this concept called “weight”. What is it? In physics or even engineering terms, weight is a vector quantity, a force acting on an object due to gravity. Using simpler terms, more relevant to the medical basis here, weight is how heavy an object is. A person’s body weight can be measured in pounds or kilograms.

Body Mass Index (BMI) is a common metric to measure weight in relation to height, and it is calculated by dividing the square of height (h) by the weight (w) i.e., w / h2. While BMI is useful in assessing weight categories (underweight, healthy weight, overweight, and obesity) that could potentially lead to health problems, it does not directly measure body fat and should not be used as a sole indicator of health. 

For example, BMI may not be a good assessor of an athlete’s weight, as they may have a high BMI and be considered overweight despite having higher muscle mass than body fat. Therefore, more relevant health tests need to be carried out by a trained health professional to ascertain an individual’s health status. 

Factors influencing weight 

Below, we look at factors affecting body weight in different individuals: 

  • Genetic makeup: While genetics can't solely determine our weight, they play a role in how our bodies handle appetite, energy expenditure, and fat storage. For example, some genetic variations can make it harder for people to feel full after eating, potentially leading to overeating and weight gain.
  • Gender: Gender also plays a role. People assigned male or female at birth have different body compositions and metabolic rates. For instance, people with AMAB tend to have more muscle mass, which can boost their calorie-burning capacity even at rest.
  • Age: As we age, our metabolism tends to slow down, and we may lose muscle mass, making weight management more challenging. Hormonal changes, such as decreasing oestrogen levels in people with AFAB, can further impact body weight.
  • Level of physical activity: Regular physical activity is essential for maintaining a healthy weight. Exercise not only burns calories but also helps build muscle, contributing to a balanced physique and overall well-being by reducing the risk of chronic diseases, such as heart disease and diabetes.
  • Diet: A well-balanced diet rich in fruits, vegetables, whole grains, and lean protein supports healthy weight maintenance. Conversely, a diet high in calories, saturated fat, and added sugars can lead to weight gain. Factors like portion control, dining out frequency, and snacking habits also affect diet and, consequently, body weight.
  • Environmental and social factors: Access to nutritious food options, socioeconomic status, and cultural norms can shape our dietary choices and physical activity levels. For instance, limited access to healthy foods in certain areas may lead to a calorie-rich but nutrient-poor diet. Cultural ideals around body size can influence how individuals perceive their own weight and their behaviours related to diet and physical activity.1

Factors contributing to weight stigma 

There has been an increase in the prevalence of weight stigma in society, and it is a concerning issue for individuals of all ages, backgrounds, and body sizes. It has been noted that at least 40% of the adult population in the U.S., with varying body sizes, have faced weight stigma at some point in their lives. This could be in a school setting, in romantic relationships, or even at the doctor’s office. In fact, a major reason why children are bullied in school is because of their body size.3 

Here are some key factors that influence weight stigma’s prevalence in society:

Media and advertising

Statistics show that more than 3.6 billion people have social media accounts, with this number further being projected to increase to 4.41 billion by 2025. With such a high population connected worldwide, there is easier access to information as well as exposure to content that can affect our perception of various topics. Such content could increasingly idealise a slim body to be the ultimate body figure to strive for. Furthermore, recent research shows that social media posts on platforms like Instagram and X (formerly Twitter) have consistently exposed members to stigmatising posts about weight gain during the pandemic.2

Advertisements by beauty companies, fashion brands, or even those based on diets also have the potential to add to this stigma and lead to low self-esteem and poor body image when they promote images of unattainable body sizes.3 People AFAB, as well as individuals with other stigmatised identities like those part of the LGBTQ community, are more likely to have weight-based discrimination directed at them than people AMAB.3,4

Cultural and societal norms

Different cultures have different norms of what a body should look like. For example, it is believed by many in Africa that slim people symbolise ill health and poverty, while mothers should be well-fed for their own well-being and that of their young ones after giving birth.5 Polynesian societies also view plumpness as a sign of well-being and fertility. On the other hand, Westerners idealise a slim body, with this idealisation now spreading to societies that did not conventionally view oversized bodies negatively. From these examples, we see that the size of a human body, not the health of the individual, plays a more important role in how you are viewed in society.6

Consequences of weight stigma

  • Psychological consequences: There is an increase in emotional distress faced by the individual as well as feelings of depression, anxiety, and chances of psychopathology (e.g., eating disorders or unhealthy eating habits).6,3 Other consequences also include substance abuse and suicidal feelings in extreme situations.3
  • Physical health consequences: Weight stigma leads to higher cortisol levels (a hormone that is linked to stress) due to the emotional toll of discrimination. Constant elevation of these hormone levels can lead to adverse health effects like high-fat deposition and other chronic health problems like hypertension (high blood pressure) and osteoporosis (weak bones and muscles).3
  • Social consequences: Discrimination is a significant social consequence, where individuals may face bias in education, employment, healthcare, and other areas based on their weight. Moreover, it is the people closest to us that can be the most stigmatising.3 It could lead to social isolation, whereby individuals withdraw from social activities and even relationships to avoid the potential negative judgements or interactions that can arise.

Combating weight stigma

Promoting body positivity and self-acceptance

It is vital to encourage individuals to embrace their bodies, regardless of size and shape, but this is not as easy as just telling someone to do so. One way to get the message through would be through popular ways we consume content, the same platforms that intensify the experiences of stigma: media and adverts.2,4

The Body Positive Movement is an example of a movement causing waves on social media to help reduce the stigma surrounding weight.2 Popular beauty product companies like Dove Real Beauty have created adverts to help promote more body positivity.4  Such stances from platforms that can reach millions of populations have the ability to empower individuals to foster self-acceptance and even to focus more on their overall well-being.

Education and awareness campaigns

Public awareness campaigns can also be powerful in dispelling common misconceptions and stereotypes revolving around weight, as well as educating the public about the harmful effects of weight stigma on physical and mental health. An example of such a campaign that was recently launched in 2020 in an effort to combat weight stigma is the ‘Stand up to Weight Campaign’. 

Furthermore, educating children in school could also be very beneficial as it is a crucial step in promoting a more inclusive and empathetic society, especially given that body weight is one of the top reasons why children are bullied in school. 

Summary

Through this article, we have delved into the complex emotions and societal influences surrounding body weight while questioning the common perception that weight directly correlates with health. Beyond the obvious factors we can control in regards to weight, like diet, there are those we can’t control, like age and genetics. Prevalence of weight stigma has detrimental consequences on psychological and physical health, and we, as a society, still have much work to do to continue to provide an inclusive environment for all body sizes, be it in a school setting or even in healthcare. 

References

  1. Management I of M (US) S on MW. Factors that influence body weight. In: Weight Management: State of the Science and Opportunities for Military Programs [Internet]. National Academies Press (US); 2004 [cited 2023 Sep 30]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK221834/
  2. Clark O, Lee MM, Jingree ML, O’Dwyer E, Yue Y, Marrero A, et al. Weight stigma and social media: evidence and public health solutions. Frontiers in Nutrition [Internet]. 2021 [cited 2023 Sep 30];8. Available from: https://www.frontiersin.org/articles/10.3389/fnut.2021.739056
  3. Abrams Z. The burden of weight stigma. Monitor on Psychology [Internet]. 2022 Mar 1 [cited 2023 Sep 30];53(2). Available from: https://www.apa.org/monitor/2022/03/news-weight-stigma
  4. Selensky JC, Carels RA. Weight stigma and media: An examination of the effect of advertising campaigns on weight bias, internalized weight bias, self-esteem, body image, and affect. Body Image [Internet]. 2021 Mar 1 [cited 2023 Sep 30];36:95–106. Available from: https://www.sciencedirect.com/science/article/pii/S1740144520304198
  5. Manafe M, Chelule PK, Madiba S. The perception of overweight and obesity among South African adults: implications for intervention strategies. Int J Environ Res Public Health [Internet]. 2022 Sep 28 [cited 2023 Sep 30];19(19):12335. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9564787/
  6. Schrimpf A, McGarvey S, Haun D, Kube J, Villringer A, Gaebler M. Socio-cultural norms of body size in Westerners and Polynesians affect heart rate variability and emotion during social interactions. Cult Brain [Internet]. 2019 Jun 1 [cited 2023 Sep 30];7(1):26–56. Available from: https://doi.org/10.1007/s40167-018-0071-5

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Amika Patel

MSc. in Mathematical Modelling (Biology and Medicine), University of Exeter

Amika balances her family business commitments in Kenya with a burgeoning portfolio of medical research and data science projects. Her passion for aiding those in need fuels her ambition to make a difference in Africa's healthcare sector. She aspires to contribute to breakthroughs in combating infectious diseases like Malaria, which continues to affect large populations across Africa, while also actively promoting health education in society.

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