Weight-Based Stigma an Obstacle to Sustaining Weight Loss

An overweight woman buying fruit at a grocery store. (UConn Rudd Center Photo)
A new study from the UConn Rudd Center suggests that internalized negative weight-based attitudes in particular undermine personal efforts to sustain weight loss. (UConn Rudd Center Photo)

SHARELINES

Losing weight is a struggle for many Americans, but maintaining weight loss can be an even greater challenge. In a new study from the University of Connecticut, researchers have identified a new barrier that may make it even more difficult to maintain a healthy weight.

Researchers examined the role of weight stigma as a potential contributor to weight-loss maintenance and weight regain in a national sample of 2,702 American adults. Findings showed that people who internalized weight stigma were poorer at maintaining weight loss, compared to people who did not engage in self-directed stigma or self-blame.

“Our study suggests that – regardless of encountering experiences of weight-based teasing, stigma, or unfair treatment – it may be that internalized negative weight-based attitudes and self-blame are particularly detrimental for personal efforts to sustain weight loss,” said Rebecca Puhl, lead author and deputy director of the Rudd Center for Food Policy and Obesity at UConn. Puhl is also a professor-in-residence in the Department of Human Development and Family Studies.

Previous research has shown that weight stigma contributes to increased psychological distress, binge eating, reduced physical activity, and obesity. Yet very little is known about weight stigma as a factor that may specifically influence weight regain or interfere with the ability to maintain weight loss.

The new study, published March 1 in Annals of Behavioral Medicine, focused exclusively on 549 participants in the national sample who had intentionally lost at least 10 percent of their body weight in the past year. These participants were then classified into two groups: those who regained the weight they had lost (235), and those who kept the weight off (314) over the next year.

Key findings of the new study show:

  • Internalized weight stigma significantly predicted poorer weight-loss maintenance, even after accounting for demographic characteristics, perceived stress, physical health, and weight loss behaviors, which have all been identified as important factors affecting weight loss maintenance. The new study showed that for every one unit increase in weight-stigma internalization, the odds of maintaining weight loss decreased by 28 percent.
  • Participants’ subjective views about their own weight also contributed to weight-loss maintenance, even after accounting for multiple factors linked to sustained weight loss. Specifically, people who viewed their weight status to be higher (regardless of their actual weight) were poorer at maintaining weight loss.

“Overall, our findings provide initial evidence that overlooked psychosocial factors, like weight stigma, may hinder weight-loss maintenance,” says Diane Quinn, professor of psychological sciences at UConn and a study co-author.

The new findings underscore the need to obtain a clearer understanding of the roles that weight stigma (both internalized and experienced) and self-perceived weight may play in sustaining weight loss. These insights can help inform development of new interventions for the maintenance phase of weight loss, when success rates are poor.

Other study authors include UConn graduate student in psychological sciences Bradley Weisz, and Young Suh of the University of Massachusetts Medical School.