Fat-Shaming Encourages Unhealthy Behaviours That Lead To Heart Disease Risk, Study Finds

'Blaming and shaming patients with obesity is not an effective tool for promoting weight loss.'

Fat-shaming, and the pain caused by it, could increase the risk of heart disease in obese patients, a new study has found.

Researchers said there is a common misconception that stigma may help motivate people to lose weight, however it actually has quite the opposite effect.

In the study, people who internalised negative weight bias were three times more likely to suffer metabolic syndrome.

This is the name given to a cluster of conditions such as increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels, that increase a person’s risk of heart disease, stroke and diabetes.

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For the study, published in the journal Obesity, researchers from the University of Pennsylvania examined 159 adults with obesity who were enrolled in a larger clinical trial testing the effects of weight loss medication.

The participants completed questionnaires measuring depression and weight bias internalisation - where people apply negative weight stereotypes to themselves - before any intervention was given.

They also underwent medical examinations, which determined whether they had a diagnosis of metabolic syndrome or a cluster of risk factors associated with heart disease.

Initially, no relationship was observed between weight bias internalisation and metabolic syndrome when controlling for participant demographics, such as age, gender and race.

However, when patients were split into two groups, “high” and “low” levels of weight bias internalisation, those with high internalisation were three times more likely to have metabolic syndrome.

The team concluded that higher levels of weight bias internalisation are associated with increased risk for cardiovascular and metabolic disease.

Lead researcher Rebecca Pearl, an assistant professor of Psychology in Psychiatry, said: “When people feel shamed because of their weight, they are more likely to avoid exercise and consume more calories to cope with this stress.

“In this study, we identified a significant relationship between the internalisation of weight bias and having a diagnosis of metabolic syndrome, which is a marker of poor health.”

Co-author Tom Wadden, a professor of Psychology in Psychiatry and director of Penn’s Center for Weight and Eating Disorders, said: “Health care providers, the media, and the general public should be aware that blaming and shaming patients with obesity is not an effective tool for promoting weight loss, and it may in fact contribute to poor health if patients internalise these prejudicial messages.”

He said doctors can play a critical role in decreasing this internalisation “by treating patients with respect, discussing weight with sensitivity and without judgment, and giving support and encouragement to patients who struggle with weight management”.

Additional research, specifically larger, longer-term studies, are now needed to further explore the link between those who internalise weight bias and health issues.

Pearl concluded: “Disparagement of others due to their weight and messages that perpetuate blame and shame, if internalised, can cause harm to the physical and mental health of individuals with obesity.”

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