Obesity stigma as a globalizing health challenge

Abstract

BACKGROUND: Based on studies conducted in the global north, it is well documented that those who feel stigmatized by overweight/obesity can suffer extreme emotional distress, be subject to (often legal and socially-acceptable) discrimination, and adjust diet and exercise behaviors. These lead to significant negative health impacts, including depression and further weight gain. To date, weight-related stigma has been conceptualized as a problem particular to the highest income, industrialized, historically thin-valorizing societies like the US, Australasia, and Western Europe. MAIN BODY: There is limited but highly suggestive evidence that obesity stigma is an emergent phenomenon that affects populations across the global south. Emergent evidence includes: implicit and explicit measures showing very high levels of weight stigma in middle and low-income countries, complex ethnographic evidence of widespread anti-fat beliefs even where fat-positivity endures, the globalization of new forms of "fat talk," and evidence of the emotional and material damage of weight-related rejection or mistreatment even where severe undernutrition is still a major challenge. CONCLUSION: Recognizing weight stigma as a global health problem has significant implications for how public health conceives and implements appropriate responses to the growing "obesity epidemic" in middle and lower income settings.