General stigma, defined as “a set of negative and unfair beliefs that society or a group of people have about something,” is everywhere. You may have heard it in regards to mental health (e.g., “You can’t be sad since your life is going so well right now”), menstrual health (e.g., “Periods are disgusting and embarrassing”), and physical ability (e.g., “Only elderly folks need hearing aids”). These examples only scratch the surface of how far stigma reaches and what it can look like.

Another one of those many, many examples that we don’t talk about enough is weight stigma, aka weight bias, weight-based discrimination, or “fat phobia.” And considering the emotional and physical ramifications, we need to talk about it more.

Indeed, according to a May 2021 study in the International Journal of Obesity¹, 42 percent of people have experienced weight stigma. That number is close to—and by some estimations higher than—the rates of other serious forms of discrimination, such as racism and sexism.

What is weight stigma?

“Weight stigma, also referred to as sizeism, is negative beliefs as well as discrimination toward people specifically because of their body weight,” explains Maya Feller, RD, a registered dietitian nutritionist of Brooklyn-based Maya Feller Nutrition and author of Eating from Our Roots: 80+ Healthy Home-Cooked Favorites from Cultures Around the World. “This stigma is disproportionately directed at people who live in larger bodies.”

Even worse, weight stigma has inherent and horribleroots in racism and other forms of oppression. Feller points to the book Fearing the Black Body: The Racial Origins of Fat Phobia, in which sociologist Sabrina Strings writes about the conflation of body weight and size of Black people—particularly women—with inferiority and lack of intellect. “Black and brown people in larger bodies experience a double social burden, and women and femmes of color experience triple burdens,” she adds.

That discrimination is still rampant today. “When being Black is criminalized and weight is weaponized, fat bias and weight stigma become the social norm in the same way that the transatlantic crossing and racism were normalized and became socially acceptable,” Feller says.

The effects of weight stigma are real and far-reaching (more on this below). For example, if a person doesn’t fit within culture norms based on their body shape and size, it can lead others to view them as lazy or unmotivated, and as a result, face discrimination, says Jessica Barth Nesbitt, RD, a regional nutrition director at Eating Recovery Center.

Society’s perception that a thin body is the ideal body is what ultimately drives weight stigma, Nesbitt explains. This message is ubiquitous, from health care settings to social media to the grocery store. There’s also a major push for weight-loss drugs from companies who want money, and social media influencers promoting unhealthy dieting practices. These examples only scratch the surface. 

“All of these factors drive the narrative that thin is the only acceptable body standard and anything else is considered undesirable and unhealthy,” Nesbitt says. 

But in reality, weight is not a sole determinant of health. According to a July 2023 study in PLOS One, older adults with a body mass index (BMI) of 22.5 to 34.9 had no significant increase in mortality. This suggests that having an “overweight” BMI isn’t an accurate indicator of your mortality risk and further illustrates that the BMI scale is deeply flawed.

What weight stigma looks like in everyday life

Weight stigma manifests in various ways and settings; it’s not just someone suggesting what foods to eat and what types of exercises to do. Knowing what weight stigma looks like can help you identify it when it happens and learn how to cope. 

In places of work and education

People with a higher BMI were less likely to be hired even though they are qualified for the job, according to a March 2010 study in Obesity Facts. Even just interacting or being next to someone who is living with obesity can have detrimental consequences. In a 2003 study in Personality and Social Psychology Bulletin, a male applicant was rated more negatively when he was seen seated next to a female categorized as obese or overweight versus a “normal-weight” woman. 

In schools, teachers have lower expectations for fat students than they do for thin students, as shown in a September 2012 study in Obesity, says Serena Nangia, a marketing manager for Project HEAL, weight expert, and a self-identified Fat person.

In relationships

Making fun of, shaming, blaming, or speaking in disparaging ways about a person’s size—and how this is socially acceptable—is a key example of how weight stigma has infiltrated our society. That judgment may be unspoken, but it’s still there and noticeable. 

Think about the friend who talks about how “horrible” a celebrity looks after gaining weight. What does that say about how they view friends with similar body sizes?

In the media

The examples are endless here, too. There are Disney villains who are always the bigger characters, the articles about how much “better” celebrities look after taking weight-loss drugs, and headlines that suggest being fat is the worst thing you can be. There are also social media influencers who don’t take rest days, and TV episodes where fat suits are the butt of the joke. This is only a start.

In health care spaces

At the doctor’s office—or better yet, the hospital—having the right materials is more important than ever. And yet, weight discrimination is present even in those settings. For example, Nangia shares a September 2012 study in Obesity² that says 90 percent of emergency departments don’t have certain types of equipment, such as CT and MRI, for people who weigh more than 450 pounds. She also points to September 2012 review in Obesity³ that found that physicians spent less time with patients with obesity than their thin counterparts, even when they came in with the same ailment. 

Here are some red flags that your doctor has weight bias. For example, they assume how much you eat or exercise, ignore a history of disordered eating, and encourage weight loss (especially in the presence of healthy vitals and lab results).

Weight stigma extends to insurance, too. Feller explains that some companies design premiums based on BMI (which, again, is an inaccurate and racist measurement), in which people with higher BMIs may not be eligible for some types of premium or select life insurance.

In transportation

Have you ever gone to a cycling class and felt uncomfortable after sitting on such a tiny seat? Or maybe while on a rollercoaster or plane, you felt smushed? “Cars, buses, trains, airplanes, and bikes are designed for people in smaller bodies and tight spaces,” Feller says. 

This is one of many instances in which we see capitalism (like wanting to sell as many tickets as possible, with no respect for consumers) intersecting with weight bias.

In fashion

From school uniforms to theater costumes and group shirts, there’s a lack of inclusive clothing sizing, well, everywhere, Nangia says. This also includes sports uniforms, as discussed in Virginia Sole-Smith’s book Fat Talk: Parenting in the Age of Diet Culture.

“The messaging here is that these spaces are not for larger bodies,” Feller says.

And that’s only a start.

Along these lines, a quick FYI: Red flags indicating your doctor might hold weight bias include assuming how much you eat or exercise, ignoring a history of disordered eating, and encouraging weight loss (especially in the presence of healthy vitals and lab results).

“The messaging here is that these spaces are not for larger bodies,” Feller says.

The effects of weight stigma

Bias against a person’s weight—whether implicit or explicit—has harmful effects. “They [people in larger bodies] are subject to micro and macro aggressions,” Feller says. “It can have a negative impact on mental health and the provision of quality care.”

To sum up how weight stigma affects people, Nangia suggests remembering “the four Is:” ideologically, institutionally, interpersonally, and internally. Weight stigma is about how our society sees and treats thin people better on levels both big and small.

“Privilege gives permission and reinforcement for individual members of the dominant group to personally disrespect and mistreat individuals in the oppressed group,” she says.

Here are just some examples of the negative impact weight stigma has on people with larger bodies.

1. Mental health conditions

There are multiple studies exploring some of the mental health effects of weight stigma, such as an increased risk for substance use⁴ and suicidal ideation⁵, increased stress⁶, and poorer cognitive performance⁷, to name a few.

Unfortunately, that’s understandable. Weight stigma affects all areas of a person’s livelihood, and that can easily discourage someone. “Because of the societal, implicit weight bias [and] discriminatory practices against [people in larger bodies], such as denial of jobs, assumptions about intelligence and general ability, substandard medical care, public humiliation, and more become the norm,” Feller says. “This is traumatic. And we know that trauma has a negative impact on mental health, substance use and misuse, self-perception, and more.”

2. Being in abusive or toxic relationships

Nesbitt has found the same—and more—to be true. “Weight stigma can lead to negative impacts to an individual’s mental health, self-esteem, relationships, and body image,” she says.

Individuals who experience weight stigma “can experience increased symptoms of depression and anxiety in addition to impacts on their self-esteem and perceived self-worth,” she continues. So someone who feels unworthy of a respectful partner could easily end up in a relationship with someone who treats them poorly.

3. Eating disorders

Nangia shares an August 2018 study in the Journal of General Internal Medicine⁸ that shows that the intersection of living in a larger body and having an eating disorder is higher than you might realize—largely thanks to the weight stigma ingrained in many doctors.

“High-weight peoplewith eating disorders are exponentially more likely to be encouraged to engage in eating disorder behaviors (restriction, over-exercise, etc) in order to lose weight than to be screened for an eating disorder by their doctors,” she says.

Some doctors basically encourage eating disorder behaviors, which are harmful and unsafe regardless of body size. “People in larger bodies are often encouraged by their doctors to lose weight by any means necessary, including engaging in eating disorder behaviors, like restriction, over-exercise, dieting, etc.,” she continues. This often leads to weight cycling, which she notes has increased rates of mortality.

How to deal with weight stigma

Weight stigma may affect you, and it definitely affects other people. In a way, it affects us all, especially if and when our bodies change. So, how can we cope and make the world better? Do the following.

1. Increase awareness 

Feller believes we need to address the origins of weight bias (like racism) and increase awareness about them. This way, people will hopefully realize the harms of weight stigma and how it’s not rooted in truth.

As a starting point, she recommends taking Harvard’s Implicit Association Test and reflecting on the results. What biases do you hold without even realizing?

2. Connect with HAES providers and promoters

Health at Every Size (HAES) is a framework that believes health care for people of all body sizes is a human right. It also promotes compassionate care, bodily autonomy, informed consent, addressing anti-fat bias, and more.

Nesbitt recommends finding HAES-informed health care providers (or weight-inclusive/weight-neutral ones), which you can find through the Association for Size Diversity and Health’s database. You can also diversify your social media feed with influencers who talk about being fit and curvy.

3. Talk about it with trusted support people

In particular, Nangia suggests people who understand what you’re going through firsthand. “While anyone can provide an empathetic listening ear, other people in larger bodies, especially in bodies similar to yours, might be the best sounding boards, as you’re more likely to have things in common,” she says. 

If you don’t know any of those individuals—or don’t feel close enough to open up—she encourages following fat creators and community members. Facebook groups, subreddits, and Instagram accounts can be helpful places to go.

“Talking about weight stigma can be scary, but it gets easier with time (depending on what experiences you’re talking about),” she adds.

4. Trust yourself

It’s understandable you may begin to question weight stigma and whether it’s really “real” when it’s so insidious. Nangia urges you to not let those thoughts win. “When a pattern occurs and you’re stared at every time you eat in public, that’s real,” she affirms. “That’s weight stigma. And it’s harmful and degrading.”

5. Set boundaries

Know you are more than allowed to say what is and isn’t okay with you. “Take this as your permission to not let anyone talk down to you, to ask to change the subject if you’re not interested in using language or on topics rooted in weight stigma, to leave a conversation in the middle of it if your boundaries are broken, to use the block button fearlessly and without reproach, to cut ties or change relationships as necessary, and to set boundaries with yourself and the language you use about yourself,” Nangia says. “You are worthy of love, respect, and kindness, no matter your size.”

How to inspire change

Thinking about the complete overhaul our society needs when it comes to weight stigma can feel exhausting. At the same time, the more we do our part, the more we can prevent the trauma that comes with weight bias.

Health care settings

A big focus here is separating weight and health since the two aren’t synonymous. Many factors determine a person’s health, including environment, SES, discrimination, early childhood development, and more.

One crucial step to making this change is waving goodbye to BMI. “Moving away from using BMI as a metric for health would be one step away from pathologizing body weight,” Feller says. “There also needs to be clear public health messaging separating weight loss and health.”

That public health messaging—and further, action from insurance companies regarding it—is crucial, too. “Proper coverage and benefits for metabolic conditions, such as diabetes, high blood pressure, and high cholesterol, would allow us to recenter health care away from weight loss and focus on metabolic health,” Feller adds.

Society’s understanding of dieting and weight loss drugs

Nesbitt pushes for increased awareness and education around the harmful effects of dieting practices and weight-loss aids. For example, yo-yo dieting can lead to diabetes, an unhealthy relationship with food, muscle loss, and insulin resistance. Weight loss drugs and diet pills can increase the risk of gastrointestinal issues and heart problems.

Representation

From entertainment to news to social media, we need to see more diverse bodies being accepted and appreciated, Nesbitt says. One recent example is a piece of Penelope’s storyline in season three of “Bridgerton.”

Last but not least, if you want to learn more or get help, check out these expert-backed resources:

• Harvard’s Implicit Association Test
• Health at Every Size Health Sheets
• Fearing the Black Body: The Racial Origins of Fat Phobia by Sabrina Strings
• Food Psych Podcast by Christy Harrison, MPH, RD, CEDS
• Body Kindness podcast and book by Rebecca Scritchfield, RD
• The Association for Size Diversity and Health
• Fat Talk: Parenting in the Age of Diet Culture by Virginia Sole-Smith
• Fat Girl Book Club Podcast
• You Have the Right to Remain Fat by Virgie Tovar
• Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness by Da’Shaun Harrison
• What We Don’t Talk About When We Talk About Fat by Aubrey Gordon

Nangia shares some great Instagram accounts to follow, too: