The damaging effects of weight bias internalization

Kahan, Scott; Puhl, Rebecca M.

doi:10.1002/oby.21772

Cited by 65Obesity and Health PracticesEating Disorders and BehaviorsObesity, Physical Activity, Diet

The damaging effects of weight bias internalization

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Kahan, Scott, Puhl, Rebecca M.·2017·Obesity

DOI 10.1002/oby.21772

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Abstract

Prejudice, explicit bigotry, and implicit bias have become regular topics of national discourse in our current social and political environments.These discussions have included highly publicized examples of weight-based shaming (1), an unfortunate and frequent symptom of systemic weight stigmatization and discrimination in the United States.Despite increased public attention to weight stigma, few appreciate its extent and damaging impact on health.Weight-based stigmatization is a pervasive yet under-recognized health issue prevalent even in close interpersonal relationships, including parents, spouses, friends, teachers, and healthcare providers (2).Stemming in part from oversimplified and inaccurate beliefs about weight and obesity, weight stigma leads to societal devaluation, discrimination, and rejection of individuals with obesity and excess weight.In addition to damaging consequences for the mental health of those targeted, weight stigma adds insult to the direct injury of obesity, causing physiological stress, weight gain, disordered eating, and other maladaptive behaviors, and may increase mortality (3,4).There is likely a bidirectional relationship between obesity and weight stigma; discrimination is a prominent consequence of living with obesity, and, paradoxically to some, experiencing weight stigma can contribute to further progression of obesity.Weight stigma may mediate relationships between excess weight and a range of negative health outcomes attributed to obesity, including decreased quality of life.

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Self-blame is associated with numerous negative health outcomes.
“(which itself is associated with numerous negative health outcomes85)”
From Maintenance of Lost Weight and Long-Term Management of Obesity (2018) · cites this paper as [85]
The paper’s Abstract links weight bias internalization—self-directed, weight-related shaming and negative attitudes—to several adverse health outcomes, including poorer self-reported health, binge eating, and maladaptive health behaviors. It does not establish the same association for self-blame generally, without the weight-related qualifier. (LLM, conf=0.85)
Experimental — accuracy not yet measured
Excessive discrepancies between expectations and actual outcomes would be demoralizing and increase negative thoughts and self-blame, and may diminish long-term persistence for behavioral change and weight loss maintenance.
“it stands to reason that excessive discrepancies between expectations and actual outcomes would be demoralizing and increase negative thoughts and self-blame (which itself is associated with numerous negative health outcomes85), and may diminish long term persistence for continued behavioral change and weight loss maintenance.”
From Maintenance of Lost Weight and Long-Term Management of Obesity (2018) · cites this paper as [85]

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Authors: Kahan, S., & Puhl, R. M.
Affiliations: Johns Hopkins University (US)
University of Connecticut (US)
Corresponding author: Kahan, Scott
ORCID: Kahan, Scott
Puhl, Rebecca M.
Venue: Obesity
Publisher: Wiley
Published: 2017-01-26
Volume: 25
Issue: 2
Pages: 280-281
ISSN: 1930-7381 (ISSN-L)
1930-739X
DOI: 10.1002/oby.21772
OpenAlex: W2580947255
Semantic Scholar: e2a99f9f8845d97afade5941a78c33394bdfd914
Cited by: 65
References: 6
Citations by year: 2026: 2 · 2025: 5 · 2024: 3 · 2023: 8 · 2022: 9 · 2021: 14 · 2020: 7 · 2019: 5 · 2018: 8 · 2017: 3
FWCI: 13.58
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Obesity (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords: weight bias internalization, weight stigma, weight discrimination, mental health, disordered eating, physiological stress, quality of life, interpersonal relationships, health care discrimination
MeSH terms: Body Image, Body Weight, Defense Mechanisms, Humans, Obesity, Overweight

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The damaging effects of weight bias internalization

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