Weight stigma, a significant social determinant of health, directly impacts biopsychosocial outcomes and hinders health equity, according to authors of a recent paper in Obesity Reviews.

The World Obesity Federation convened experts to review global evidence on weight stigma in obesity prevention and management. The working group comprised 41 representatives from diverse regions. They aimed to understand global stigma, examine how obesity-related narratives contribute, and recommend changes to reduce stigma.

The experts reported that people with higher body weights face pervasive stigma, which can lead to adverse health consequences.

“Recent systematic reviews highlight consistent evidence that people who experience and/or internalize weight stigma are at risk for biopsychological distress,” wrote Sarah Nutter, PhD, and coauthors. “Researchers documenting the physical and psychological health consequences of weight stigma have found that it is associated with increased physiological dysregulation (eg, increased cortisol and inflammation), symptoms of depression and anxiety, disordered eating behaviors including restrictive eating, exercise avoidance, and suicidal ideation.”

Through extensive discussion and sub-group analysis, the working group synthesized their findings into a comprehensive position statement, outlining recommendations to reduce weight stigma. These include:

❯ Distinguishing between body size and obesity;

❯ Using person-first language;

❯ Considering individual language preferences;

❯ Using non-stigmatizing language and imagery in communications with patients;

❯ Engaging in weight-neutral health promotion wherever possible;

❯ Engaging in policy efforts to reduce weight stigma;

❯ Promoting human rights-based approaches to reduce weight stigma and discrimination;

❯ Raising awareness of weight stigma; and

❯ Continuing to expand research on weight stigma.

The working group encouraged strategies to foster a more inclusive and equitable approach to obesity prevention and management.

“There is growing evidence of stigma against people with higher body weights in all regions of the world. Given the far-reaching and detrimental impacts of weight stigma, it is critical for the global community to address this significant social determinant of health and wellbeing and to make efforts to change public discourse to reduce weight-stigmatizing narratives,” Dr. Nutter and colleagues wrote.