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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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In the citing paper
“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
Experimental — accuracy not yet measuredIn the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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].”
In the citing paper
“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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“Some human data also indicate that stress-induced eating functions to dampen psychological (Finch & Tomiyama 2015) and physiological stress (Tomiyama et al. 2011, Tryon et al. 2013, van Strien et al. 2013).”
BackgroundWu, Y., & Berry, D. C. (2018) · Journal of Advanced Nursing · doi:10.1111/jan.13511 · Cited by 536
Healthy Weight and Obesity Prevention
Lavie, C. J., Laddu, D., Arena, R. A., Ortega, F. B., Alpert, M., & Kushner, R. F. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.08.1037 · Cited by 480
Weight stigma as a psychosocial contributor to obesity.
Puhl, R. M., Himmelstein, M. S., & Pearl, R. L. (2020) · American Psychologist · doi:10.1037/amp0000538 · Cited by 452
Metadata
- 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 › Medicine › Public Health, Environmental and Occupational Health › 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
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