Women who are obese experience many more incidents of stigmatization because of their weight — an average of three incidents a day — than previous research has reported, according to a study published in the Feb. issue of the Journal of Health Psychology.

Past research has tended to suggest that people who are overweight or obese experience negative weight-related stigmatization only a few times during their entire lives.

Those studies relied, however, on asking people to recall any past experiences with weight-related stigmatization. This new study had women keep contemporaneous diaries.

As background information in the current study explains, the stigmatization of overweight people has increased significantly over the past two decades. These negative attitudes have disproportionally been aimed at women, even though the rates of obesity are similar for both men and women.

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Weight-related stigmatization can take many forms, such as interpersonal (being ridiculed or shamed for your size), institutional (not getting a job or promotion because of your size), or physical barriers (not being able to find clothes that fit or chairs in theaters or restaurants that can accommodate your body). Such stigmatization has been linked to low self-esteem and increased rates of depression, but it can also have physical and health consequences. People who report weight-related stigmatization are more likely, for example, to become binge eaters and to avoid exercise and other healthful habits.

For these reasons, say the current study’s authors, it’s important to get a better understanding of both the frequency and nature of this particular social stigma.

Study details

The study was led by Jason Seacat, an associate professor of psychology at Western New England University who researches social stigma. He and his colleagues recruited 50 overweight and obese women from weight-related websites. Their average age was 38, and their average body mass index was 42.5. (A BMI of 30 or higher falls under the category of “obese.”) More than 40 percent of the participants were married, more than a third had a college education, and almost all (90 percent) were white.

The women were asked to make entries in a diary each night before going to bed for seven straight days. They recorded their daily activities, both within and outside of their home. They also recorded any experiences of weight-related stigmatization.

A long list of possible stigmatizing experiences was provided, such as “a spouse or partner called you names because of your weight” or “strangers suggested a diet to you” or “you were not able to fit in seats at restaurants, theaters and other public places.” Space was also provided for the women to describe incidents of stigmatization that weren’t on the list, although these entries were not included in the study’s final statistical analysis.

Key findings

The 50 women cited a total of 1,077 stigmatizing experiences during that single week — an average of three a day for each woman. The most common experiences involved “physical barriers” (84%), “nasty comments from others” (74%), “being stared at” (72%) and “others making negative assumptions” (72%). Experiences least frequently reported included “job discrimination” (22%), “comments from doctors” (16%) and “being physically attacked”(12%).

The most frequent sources of the nasty comments, by the way, were spouses, friends and family members.

A further crunching of the data revealed that the higher a woman’s BMI, the more likely she was to report all forms of weight-related stigma. Women who were older or who had lower levels of education also tended to record more stigmatizing experiences.

Healthful behaviors were less common among the women who reported higher numbers of stigmatizing events, a finding that is consistent with other evidence linking weight-related stigmatization to avoidance of exercise and to unhealthful eating habits.

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“Healthful activities such as maintaining a diet and exercise regimen are already challenging for most individuals, but when the additional burden of weight stigmatization is added to daily life, these goals may become unattainable,” write Seacat and his co-authors.

Insightful examples

The open-ended entries in the diary offer some insight into what daily life is often like for people who are obese:

“With friends at a baby shower. Went to McDonald’s first so people wouldn’t look at me eating more than I should.” “Teenagers made animal sounds [moo] outside of a store I was in.” “I was told what a bad mother I am because I can’t set limits as to what my son or his friends eat during sleepovers, because I can’t even control myself.” “Boyfriend’s mother denied me access to food, also stated that I was so fat because I was lazy.”

Not all the entries were negative, however. Some provided examples of positive experiences — including the experience of being in the study:

Positive thing today — just moved from Canada to the UK and found out that I fit into a standard size that many stores carry here — in North America, I always have to shop at specialized “plus sized” stores. I have a beautiful new red raincoat in a trendy style. Yay! Thank you for allowing me to be a part of this research study. I hope that your research reveals answers that you were looking for. I am pleased to say that since 5/15, the start of my healthy lifestyle change; I have lost 2.5 lbs and with the exception of the last two days, am working out. I am taking my health more seriously. I feel your study has contributed to helping me make these changes. Article continues after advertisement

A need for greater understanding

This study, like all studies, has several important limitations. Most notably, it involved a relatively small number of participants who were all women and almost all white. The study’s findings, therefore, may not reflect the experiences of other populations, particularly men and people from other ethnic and racial groups.

Still, Seacat and his colleagues say they hope that their findings will “help broaden the scientific understanding of factors that may serve to exacerbate and/or alleviate weight stigma.”

“As the obesity epidemic intensifies and public attention to this issue increases, weight stigmatization will likely persist and may even intensify,” they add. “It is therefore important that researchers continue investigating all aspects of this important phenomenon. Future interventions to reduce stigma and better equip overweight/obese individuals for their encounters with stigmatization should be based upon solid empirical and ecologically valid research.”

FMI: You’ll find an abstract of the study on the website on the Journal of Health Psychology, but the full study is, unfortunately, behind a paywall. An online version of the study was published in 2014; this latest version is considered the “version of record.”