Weight stigma “gets under the skin”-evidence for an adapted psychological mediation framework-a systematic review

Abstract

Objective: Research consistently shows a negative view of individuals with obesity in the general public and in various other settings. Stigma and discrimination can be considered chronic stressors, as these factors have a profound impact on the psychological well-being of the affected individuals. This article proposes a framework that entails a mediation of the adverse effects of discrimination and stigmatization on mental well-being through elevated psychological risk factors that are not unique to weight but that could affect overweight and normal-weight individuals alike. Methods: A systematic review was conducted to assess the prevalence of psychological risk factors, such as self-esteem and coping, in individuals with obesity. Results: Forty-six articles were assessed and included for detailed analysis. The number of studies on these topics is limited to certain dimensions of psychological processes. The best evaluated association of obesity and psychosocial aspects is seen for self-esteem. Most studies establish a negative association of weight and self-esteem in children and adults. All studies with mediation analysis find a positive mediation through psychological risk factors on mental health outcomes. Conclusions: This review shows that elevated psychological risk factors are existent in individuals with obesity and that they may be a mediator between weight discrimination and pathopsychological outcomes.

Parental Perception of Weight Status and Weight Gain Across Childhood

“…Likewise, experiencing stigma and feeling judged negatively because of one’s body size is associated with disordered eating and maladaptive coping responses, such as over-eating 17,33 . Whether these observations relate to the present findings now warrants detailed investigation, as a number of psychological models suggest that stigma can be threatening and damaging 34,35 . It is possible that the negative connotations attached to labelling a child as ‘overweight’ could change the way parents interact with their child (e.g.…”

Does Knowing Hurt? Perceiving Oneself as Overweight Predicts Future Physical Health and Well-Being

“…These findings suggests that weight stigma may trigger a cycle of stress, maladaptive coping responses, further weight gain, and poor health (Blodorn et al, 2016;Brewis, 2014;Hunger et al, 2015;Sikorski, Luppa, Luck, & Riedel-Heller, 2015;Tomiyama, 2014). However, it has not been clear whether simply recognizing oneself as being overweight in our current social climate may set in motion this negative cycle leading to weight gain and poor health.…”

Publically Misfitting: Extreme Weight and the Everyday Production and Reinforcement of Felt Stigma

“…2012; Sikorski et al. 2015). Recent research suggests that fat stigma is a major (but not well‐recognized) population‐level driver of obesity and chronic disease (Hatzenbuehler et al.…”