Obesity can be deadly. It’s a chronic health condition that can result in lifelong bodily changes, increase the risk of many health conditions, and harm vital organs. But there’s another killer when it comes to obesity: social stigma—and there’s no shortage of it. In fact, obesity is one of the most stigmatized health conditions, even within the healthcare system itself. From social ridicule to fatal medical misdiagnosis, people with obesity often struggle with mistreatment, with many wrongly believing that stigma and the resulting shame will motivate people with obesity to get thin. But if over 40% of Americans are obese, and more are overweight, then how much is that shame really helping? Instead, stigma prevents people with obesity from getting the help they deserve and perpetuates dangerous weight-related misinformation. 

Obesity-Related Stigma Leaves Lasting Scars

Stigma is an external societal force involving discrimination, hate, and exclusion. Many who perpetuate obesity-related stigma often do so because they believe obesity is self-inflicted as a result of personal poor life choices, and claim that people with obesity deserve stigma as a form of criticism. Social media only makes it worse. People online cruelly put down others to uplift themselves, breeding weight-related stigma and encouraging people to compare themselves and others on a shared scale of beauty and weight. With these factors, it’s no surprise that obesity has developed into one of the most stigmatized health conditions. 

However, obesity is typically caused by outside factors that people can’t control: “Obesity is a multifactorial disease due to environmental and psycho-social factors and genetic variants,” the World Health Organization describes. “The prevalence of overweight and obesity are those that limit the availability of healthy and sustainably-produced food at locally affordable prices spaces for physical activity and the absence of adequate legal and regulatory environments.” Given the United States’ lack of healthy, beneficial systems in food, economy, and infrastructure, it makes sense that obesity is so common. In fact, these systems can encourage obesity, making it difficult to avoid or recover from the condition, especially when affected in childhood. As such, obesity-related stigma holds no ground as healthy criticism. Instead, it leaves long-lasting psychological scars and, in some cases, can even be fatal. 

Shame is More Than Just Hurt Feelings

Shame is the internal feeling that results from stigma, akin to regret, guilt, embarrassment, and even self-hatred. This negative force is not a healthy, long-term motivator for building sustainable weight-loss habits or seeking medical help. In fact, shame can result in the opposite effect, as it’s often correlated with increased avoidance behaviors for people with obesity. For example, efforts to improve their body, like running in the neighborhood or working out in the family living room, might feel too mortifying to attempt. Additionally, a person with obesity might be prevented from wanting to improve a body they’re constantly told to hate. Shame can even lead to dangerous self-destructive and self-harming behaviors in severe cases, with studies showing that obesity is associated with increased suicide attempts and behavior. In this way, intentionally causing a person with obesity to feel shame can do more than discourage healthy behaviors, but can reinforce the very patterns of avoidance and even self-destruction that make improving one’s health more difficult. Shame, therefore, becomes a life-threatening determinant of health by influencing how a person cares, or doesn’t care, for their body.

Life-Threatening Stigma in the Medical Field

Shame resulting from obesity-related stigma transcends societal repercussions—it can also have devastating effects in the medical field. According to researchers Luna Dolezal and Barry Lyons, “Shame's influence is so insidious, pervasive and pernicious, and so critical to clinical and political discourse around health … its impact is sufficiently powerful for it to be considered an affective determinant of health.” When people who are obese are surrounded by shame, it’s not going to be easy to talk to a doctor about the very condition they’ve been judged for. Not only that, but people with obesity are more likely to avoid healthcare for medical problems unrelated to their weight, with a major reason being the mistrust perpetuated by the healthcare professionals who carry obesity-relatedstigma.  Researchers at the Department of Medical and Surgical Sciences at the University of Bologna described a case in which medical professionals failed to investigate a 108-pound abdominal carcinoma tumor in a patient. Instead of performing proper screenings, the patient was misdiagnosed with obesity. This patient was unable to walk without help and would have likely died if the tumor were never discovered. Situations like this are unfortunately common, with many people with obesity describing similar experiences: doctors failing to listen to their health concerns, defaulting to weight-loss as a “cure-all” for unrelated conditions, or refusing to investigate symptoms under dangerous assumptions. Obesity-related stigma in the medical field goes beyond just misdiagnosis and into intentional ignorance that can be fatal. So with experiences like that, it makes sense why a person with obesity would be hesitant to talk to a doctor who might not even listen to them. Stigma isn’t just causing people with obesity to feel bad—it can be preventing them from getting life-saving treatment, even for unrelated conditions. 

GLP-1 Medications Are Not “Cheating”

FDA-approved weight-loss medicines are also surrounded by social stigma. Online, memes and jokes about Ozempic and Hollywood celebrities run rampant, as do rumors of already thin celebrities abusing weight-loss drugs to get even thinner. However, when used correctly, GLP-1 medications can be a good choice for those who are obese or morbidly obese, especially if it’s affecting their health or when caused by other, uncontrollable conditions. Stigma ignores these nuances entirely. Instead, people claim that weight-loss medicine is cheating or an “easy way out.” But let’s be realistic: an adult working 40 hours a week and raising kids likely won’t have the time or energy to do two hours of cardio a day. Instead, when prescribed by a trusted doctor and typically in tandem with building healthy weight-loss habits, weight-loss drugs can be a helpful tool for those who struggle to lose weight otherwise. There should be no stigma, as it only causes shame for those working to improve their weight in ways that realistically work for them. 

Obesity can affect a person’s everyday life in many ways. So why are others making it even harder by continuing to perpetuate hateful, ignorant stigma? It’s not motivating; it’s the opposite, even resulting indangerous, life-threatening effects within the medical field. So, instead of jumping on a bandwagon of shaming someone overweight under the pseudo-knightly guise of encouragement, understand that they likely already feel that pressure. There are always things going on underneath the surface. Instead, we need to replace that stigma with empathy by understanding that every situation is different. Let’s celebrate health journeys instead of criticizing them.