Associations among enacted weight stigma, weight self-stigma, and multiple physical health outcomes, healthcare utilization, and selected health behaviors
Abstract
Background This study examined the relationship among enacted weight stigma, weight self-stigma, and multiple health outcomes. Weight stigma, a stressor experienced across all body sizes, may contribute to poorer physical health outcomes by activating the nervous and endocrine system or by triggering counterproductive health behaviors like lower physical activity, maladaptive eating patterns, and delayed health care, as well as provider bias that may cause a medical concern to be discounted. While associations of weight stigma with mental health issues are well documented, less is known about its association with physical health. Methods We enrolled 3821 adults who completed an online survey assessing enacted weight stigma, weight self-stigma, multiple self-reported physical health outcomes, healthcare utilization, and selected health behaviors. Results After controlling for BMI, health care delay or avoidance, sedentary behavior, and selected demographic characteristics, enacted weight stigma, significantly increased the odds of six physical health problems including hypertension (OR 1.36; CI 1.08, 1.72), hyperglycemia (OR 1.73; CI 1.29, 2.31), thyroid disorder, (OR 1.65; CI 1.27, 2.13), any arthritis (OR 1.70; CI 1.27, 2.26), non-arthritic chronic pain (OR 1.76; CI 1.4, 2.29), and infertility (OR 1.53; CI 1.14, 2.05). Weight self-stigma significantly increased the odds for three physical health problems including hypertension (OR 1.43; CI 1.16, 1.76), hyperglycemia (OR 1.37…
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Weight stigma and body shame also obstruct use of health care, especially for people with higher body weight, prediabetes, or type 2 diabetes.
“Weight stigma and body shame are also barriers to health care utilization (Mensinger et al., 2018; Phelan et al., 2022; Prunty et al., 2023), particularly among those with higher body weight (Curran et al., 2024), prediabetes (Salvia et al., 2023), and T2D (Himmelstein & Puhl, 2021; Svenningsson et al., 2011).”
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 Prunty et al., 2023
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“Weight stigma and body shame are also barriers to health care utilization (Mensinger et al., 2018; Phelan et al., 2022; Prunty et al., 2023), particularly among those with higher body weight (Curran et al., 2024), prediabetes (Salvia et al., 2023), and T2D (Himmelstein & Puhl, 2021; Svenningsson et…”
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- Authors
- Prunty, A., Hahn, A., O’Shea, A., Edmonds, S., & Clark, M. K.
- Affiliations
- University of Iowa (US)
- Corresponding author
- Prunty, April
- Venue
- International Journal of Obesity
- Published
- 2022-11-04
- Volume
- 47
- Issue
- 1
- Pages
- 33-38
- ISSN
- 0307-0565 (ISSN-L)
- 1476-5497
- OpenAlex
- W4308370645
- Cited by
- 59
- References
- 55
- Citations by year
- 2026: 18 · 2025: 21 · 2024: 16 · 2023: 4
- FWCI
- 15.33
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- International Journal of 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 self-stigma, physical health outcomes, hypertension, hyperglycemia, arthritis, infertility, health care utilization, health care provider bias, delayed care, sedentary behavior, health behavior
- MeSH terms
- Weight Prejudice, Adult, Humans, Patient Acceptance of Health Care, Health Behavior, Outcome Assessment, Health Care, Social Stigma, Chronic Pain
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