Weight stigma is stressful. A review of evidence for the Cyclic Obesity/Weight-Based Stigma model
Open accessAbstract
Weight stigma is highly pervasive, but its consequences are understudied. This review draws from theory in social psychology, health psychology, and neuroendocrinology to construct an original, generative model called the cyclic obesity/weight-based stigma (COBWEBS) model. This model characterizes weight stigma as a "vicious cycle" - a positive feedback loop wherein weight stigma begets weight gain. This happens through increased eating behavior and increased cortisol secretion governed by behavioral, emotional, and physiological mechanisms, which are theorized to ultimately result in weight gain and difficulty of weight loss. The purpose of this review is to evaluate the existing literature for evidence supporting such a model, propose ways in which individuals enter, fight against, and exit the cycle, and conclude by outlining fruitful future directions in this nascent yet important area of research.
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Together, the cognitive and emotional effects of weight stigma weaken efforts to manage weight.
“The suite of cognitive and affective factors resulting from weight stigma collectively undermines weight management efforts (e.g., dysregulated eating, weight cycling, and sedentary behaviors; Puhl et al., 2016, 2022; Tomiyama, 2014)”
From A Randomized Controlled Trial of an Acceptance and Commitment Therapy-Informed Diabetes Prevention Program Reduces Body Shame and Distress. (2025) · cites this paper as Tomiyama, 2014
The Introduction says weight stigma may undermine weight-loss attempts through interacting behavioral and emotional mechanisms. The Eating behavior mechanisms and Fighting against the cycle sections discuss impaired self-regulation, increased eating, and possible exercise avoidance. The paper discusses repeated failed weight-loss attempts, but the cited passages do not establish weight cycling as a resulting behavior; the sentence also states the overall effect more firmly than the review does. (LLM, conf=0.82)
Experimental — accuracy not yet measuredThe experience of stigmatization increases cortisol, which may drive food consumption by sensitizing the reward system.
“Similar to dieting, the experience of stigmatization increases cortisol, which may drive food consumption by sensitizing the reward system [203].”
From Food Addiction and Psychosocial Adversity: Biological Embedding, Contextual Factors, and Public Health Implications (2020) · cites this paper as [203]
Weight stigma begets weight gain.
“Weight stigma has been described as a “vicious cycle” where weight stigma begets weight gain [203].”
From Food Addiction and Psychosocial Adversity: Biological Embedding, Contextual Factors, and Public Health Implications (2020) · cites this paper as [203]
The majority of health-related stigma frameworks explore psychological pathways at the individual level, focusing on individuals experiencing stigma, those perpetuating stigma, or both.
“The majority of health-related stigma frameworks explore psychological pathways at the individual level, focusing either on the individuals experiencing stigma [10, 11, 14–16, 30, 31], those perpetuating stigma [21, 26], or both [20, 24, 32].”
Existing stigma frameworks typically focus on one health condition in isolation and often concentrate on psychological pathways occurring among individuals.
“Existing stigma frameworks typically focus on one health condition in isolation and often concentrate on the psychological pathways occurring among individuals.”
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- Authors
- Tomiyama, A. J.
- Affiliations
- University of California, Los Angeles (US)
- Corresponding author
- Tomiyama, A. Janet
- ORCID
- Tomiyama, A. Janet
- Venue
- Appetite
- Publisher
- Elsevier BV
- Published
- 2014-11
- Volume
- 82
- Pages
- 8-15
- ISSN
- 0195-6663 (ISSN-L)
- OpenAlex
- W2138305066
- Cited by
- 690
- References
- 110
- Citations by year
- 2026: 58 · 2025: 80 · 2024: 73 · 2023: 73 · 2022: 68 · 2021: 92 · 2020: 55 · 2019: 48 · 2018: 54 · 2017: 37 · 2016: 33 · 2015: 17 · 2014: 2
- FWCI
- 5.82
- Type
- journal article
- Language
- en
- Open access
- green
- www.escholarship.org
- Locations
- Appetite (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- 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 stigma, obesity, vicious circle, positive feedback loop, weight gain, cortisol, dietary habits, stress, neuroendocrinology
- MeSH terms
- Feeding Behavior, Humans, Obesity, Stress, Psychological, Weight Gain, Weight Loss, Randomized Controlled Trials as Topic, Social Stigma
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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