How 'weight stigma' affects people dealing with obesity

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According to the World Health Organization, 2.5 billion adults aged 18 years and older were overweight in 2022, including over 890 million adults who were living with obesity.

Obesity gives rise to several health complications, but some people living with the condition also face another challenge - the stigma that is associated with being overweight. Stemming from oversimplified notions of health and personal responsibility, weight stigma is fuelled by the assumption that obesity is merely a consequence of poor lifestyle choices.

However, that is far from true.

Dr Aparna Govil Bhasker, Consultant Bariatric and Laparoscopic Surgeon, MetaHeal Surgery Center, and Saifee, Apollo and Namaha Hospitals, Mumbai, explains, "Society often reduces obesity to a simplistic equation: eat less, move more. But if that were true, obesity would have disappeared long ago. Obesity is a complex, chronic and progressive disease influenced by genetics, metabolism, hormones, medications, gut microbiota, mental health and environmental factors. Stress, sleep deprivation and medical conditions all contribute, making weight management far more than just a matter of will power."

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Burden of judgement

For many people, the judgement they face regarding their weight is more distressing than the physical challenges of obesity itself.

Dr Bhasker reveals, "One of my patients, a 32-year-old working mother of a 16-month-old baby girl, struggled with persistent weight stigma despite her best efforts. She had tried everything - calorie counting, portion control, intermittent fasting, medical diets, naturopathy - only to be met with the same assumptions and comments: she must be eating too much, she must not be trying hard enough, it must be her fault."

"Her life was a relentless cycle of responsibilities - juggling work, home and motherhood, leaving her exhausted beyond measure. She wanted to prioritise her health but struggled to find the time and energy," she further shares.

Ignoring all other factors, people cling to the narrative of personal failure when it comes to obesity.

"A patient once recalled how, in a single day, eight different people commented on her weight. That night, she couldn't sleep - not because of hunger or discomfort, but because their cruel words replayed over and over in her mind, louder than any diagnosis she had ever received," shares Dr Bhasker.

Sharing another case, the doctor says, "Another patient shared the pain of childhood ridicule: "They called me a hathi (elephant)." Even after losing 50 kg, the stigma did not disappear - it merely changed form, from fat shaming to skinny shaming."

Harms of weight stigma

When individuals repeatedly hear that their weight defines their worth, they begin to believe it. "They may blame themselves for their struggles, experience deep-seated shame and develop unhealthy coping mechanisms. Some avoid social interactions or medical care altogether, fearing judgment and humiliation. The stigma becomes a self-fulfilling prophecy - pushing them into isolation, reducing self-esteem, and making sustainable health changes even harder to achieve," Dr Bhasker expresses.

Calling for a change, she says, "Weight stigma needs to be addressed at multiple levels - through education, policy changes and a cultural shift in how we view health and body diversity. One of the most powerful things we can do is to acknowledge that the struggles of people living with obesity are real, to let them know that their worth is not defined by a number on the scale. Because sometimes, the heaviest burden is not the body itself but the weight of society's judgment."

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