When it comes to the way people stigmatize different body shapes and sizes, words can hurt more than just your feelings. New research suggests they may have real health consequences.
People who reported feeling diminished by negative stereotypes about their weight were three times more likely to have a heightened risk of diabetes, heart disease and stroke than people with similar weights and mental health who did not feel affected, according to a recent study published in the journal Obesity.
"Above and beyond the effects of weight, this internalization of weight bias is associated with poor health," the study's lead author, Rebecca Pearl, told The Huffington Post.
"There is this misconception that's out there that a little bit of stigma might help to motivate people or ... get people to change their health behaviors," said Pearl, an assistant professor at the Center for Weight and Eating Disorders at the University of Pennsylvania's Perelman School of Medicine. "That's not the case."
Fat shaming is bad for your health
Past studies suggest that individuals who feel shamed for their physical appearance or weight are at increased risk of depression, anxiety, body dissatisfaction and low self-esteem. Other research shows that people who are body-shamed tend to weigh more, have greater waist circumferences and a greater tendency to become obese over time ― and that people who face weight discrimination also face a higher risk of mortality over time.
This latest study is important, Pearl explained, because it suggests that fat shaming can affect health measures that are known to bring on diabetes, heart disease and stroke.
The new study included 159 overweight or obese adults, ages 21 to 65, who had signed up for a larger trial to evaluate a weight-loss maintenance program. They rated how much they felt stigmatized by weight-related stereotypes ― a measure known as weight bias internalization ― and indicated how much they agreed with statements like "My weight is a major way that I judge my value as a person" or "I feel anxious about being overweight because of what people might think of me."
Everyone in the study also underwent a medical exam that measured blood pressure, waist circumference, triglyceride levels, HDL cholesterol and glucose. People with unhealthy measures in any three of those areas were diagnosed with metabolic syndrome (the name for a group of conditions that raise your risk of heart disease, diabetes and stroke).
The data revealed that people who reported higher levels of weight bias internalization were three times more likely to have metabolic syndrome than people who reported low levels of weight bias internalization. People who felt the most stigmatized were also six times more likely to have high triglyceride levels.
Why it's important to call out weight bias
When people agree with harmful stereotypes about their bodies, it can really shake their confidence and their ability to make healthy changes, Pearl said.
"Given all the messages of shame and blame around weight that are out there, it's really hard to not internalize some of these messages," she explained.
According to Pearl, health care providers need to be sensitive about these issues when they're counseling patients. They should pay attention to whether patients call themselves lazy or criticize themselves because of their weight, she said ― and they should find ways of supporting their patients' health behavior goals without criticizing them.
"Weight is a complex issue," Pearl said. "It involves biological factors, environmental factors and things that do not involve personal characteristics at all. It's important for people to remember that weight is not a reflection of personal character."
Given all the messages of shame and blame around weight that are out there, it's really hard to not internalize some of these messages. Rebecca Pearl, Center for Weight and Eating Disorders, University of Pennsylvania
Pearl encourages people who feel stigmatized because of their weight to remind themselves how they break these stereotypes ― in school, in their careers or in their personal lives.
Setting specific, achievable, concrete goals to improve health behaviors can also help people be more confident and ignore the negative stereotypes out there, she added.
And for the public, it's important to call out weight bias or discrimination when they see it, Pearl said.
"It is not acceptable to shame others because of their weight," she said. "It is important to understand that obesity is not the result of laziness or a lack of individual willpower."
More diverse, longer studies will reveal more
Pearl emphasizes that her study was relatively small, so further research with with larger, more diverse groups is needed. The majority of participants in the study were African-American women, who are not often well-represented in obesity research.
The study authors note that certain race-related factors could have affected the results, though it's not clear how. Longitudinal studies that follow individuals over time are also needed to show whether fat-shaming makes heart disease and stroke risk factors worse.
But even with all those caveats, this study adds even more evidence that weight stigma has negative implications for health, Pearl said.
Sarah DiGiulio is The Huffington Post's sleep reporter. You can contact her at sarah.digiulio@.