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Weight stigma, bias and discrimination

Last updated 05-08-2025

Weight stigma, bias and discrimination have wide-ranging impacts on a person’s health and wellbeing. This page outlines the prevalence of weight stigma, where and how it can occur and the consequences for those affected.

Key Evidence

01

Weight stigma and bias refers to negative attitudes toward and beliefs about others because of their weight

02

Weight-based discrimination occurs when individuals are treated unfairly because of misconceptions about their weight or size and is commonly experienced by people living with obesity

03

Despite growing efforts to end weight stigma, it is experienced in a range of settings including healthcare, education and employment as well as from family, friends, and the media

04

Weight stigma is harmful for physical and mental health, and does not support increased participation in health promoting behaviours

05

Widespread changes are needed to reduce weight stigma in the community and healthcare settings

What is weight stigma, bias and discrimination?

Weight stigma refers to “social devaluation and denigration of individuals because of their excess body weight, and can lead to negative attitudes, stereotypes, prejudice, and discrimination”.1 Weight stigma and bias refers to negative attitudes toward and beliefs about others because of their weight and can be explicit (overt, conscious beliefs), implicit (automatic, negative perceived attributes and stereotypes outside of conscious awareness), or internalised (about ones-self, such as self-blame and self-directed weight stigma, as well as agreeing with stereotypes and self-devaluation2).1 Weight discrimination occurs when individuals are treated unfairly because of their weight or size. Weight-based stereotypes refer to negative generalisations made about people with a higher weight, such as they are lazy, gluttonous, lack willpower, are unmotivated to improve their health and are personally to blame for their weight.1 A key contributor to these stereotypes and weight stigma is the misconception that obesity is entirely within an individual’s control and can be reversed by simply choosing to eat less and exercise more.1

Weight stigma is pervasive in our society

Weight stigma is experienced in many social contexts, including at home, education settings, workplaces, healthcare and media including social media.13 The media contributes substantially to weight stigma through inaccurate framing of obesity and use of inappropriate images, language and terminology that blames obesity on the individual, fuelling the negative stereotypes.4 It is pervasive in news, entertainment media (such as movies and TV series) and advertising disseminated via mass media, including television and social media.5 In Australia and other Western countries, dominant cultural and social norms associate thinness with health and attractiveness, which is further perpetuated by diet culture.36

A meta-analysis of mostly U.S. studies found the percentage of people with obesity who said they had experienced weight discrimination was 19% for people with a BMI 30-35kg/m2, and 42% for people with a BMI ≥35kg/m2, with higher rates of discrimination experienced by women than men.7 Weight stigma (including teasing, unfair treatment and discrimination) was reported by 56-61% of participants in a weight management program from Western countries including Australia.8 Again, participants with higher BMI were more likely to report weight stigma than those with a lower BMI.8 The study also looked at experiences of weight stigma across different ages, and found that childhood and adolescence was when the most frequent as well as most distressing weight stigma was experienced.8 Children and adolescents usually experience weight stigma and discrimination as bullying, teasing and victimisation which can occur in person, such as at school or online, particularly via social media.139 Parents, teachers and adolescents all report body weight as the most common reason for bullying.10

Weight stigma and public health messaging

Concerns have been raised that public health messaging in obesity prevention campaigns and policy that focuses on personal responsibility such as ‘eat less, move more’, contributes to weight stigma.611 However, there is mixed evidence to support this contention, with some studies finding increased perceived weight stigma following exposure to such communications,12131415 while others have found no clear evidence of adverse impacts on weight-based social stereotypes or weight stigma.16171819 Population-based evaluations and experimental research has found such campaigns can be effective in promoting healthy intentions and behaviour change among people of varying body weight,15162021 whereas some other research has found this style of messaging to be ineffective in this regard.1422 Studies comparing different types of public health messaging addressing diet, physical activity and body weight have found differential effects of such communications on health behaviours and well-being, depending on the audience's BMI or perceived weight.202324

Also, simplistic messaging focused only on diet and physical activity to prevent or treat obesity, neglects the evidence that obesity is caused by genetic, psychological, environmental, economic, commercial and social determinants, as well as the impact of changed biology of people living with obesity.6 Exposing the public to such simple messaging also risks deflecting public attention away from understanding the social determinants of obesity and detracting from public support for policy-oriented solutions.25 Therefore, care must be taken to carefully design, pre-test and evaluate public health campaigns with people of varying perceived and actual weight status to ensure that they do not have unintended consequences of perpetuating harmful weight-based stereotypes, contributing to weight stigma or undermining support for policy solutions.14

Consequences of weight stigma, bias and discrimination

Weight stigma, including internalised weight stigma, has considerable adverse consequences on an individual’s psychological and physical health, it increases mortality and reduces quality of life.192627 Research shows that the negative health impacts of weight stigma are not explained by weight status, indicating stigma itself contributes to poorer health.1928 Weight stigma can have significant social (reduced interaction), emotional (feelings of shame, self-blame and vulnerability), behavioural (unhealthy coping mechanisms) and even physiological (chronic stress) consequences which have negative impacts on long-term health and wellbeing.2930 Weight stigma increases psychological distress and is associated with an increased risk of depression, anxiety, low self-esteem, poor body image, substance abuse, suicidal thoughts and behaviours, and unhealthy eating behaviours.19 The impact of weight stigma extends to measurable physiological stress such as high cortisol and C-reactive protein, and increased cardio-metabolic risk.19

Researchers describe the misperception that the social influence of weight stigma may motivate individuals to change their diet and exercise behaviours.93132 However, experiences of weight stigma commonly lead to unhealthy eating behaviours such as disordered eating, binge eating, using food as a coping strategy, and unhealthy weight control as well as lower physical activity from less self-efficacy, lower motivation and engagement in physical activity, and avoidance.9 Consequently, this can contribute to weight gain or difficulties with weight maintenance.933

Children and adolescents experience similar psychological and physical health effects from weight stigma as adults.3234 In particular, experiences of weight stigma increase risk of depression, anxiety, body dissatisfaction, lower self-esteem, substance use, self-harm and suicidality.35 Weight stigma also negatively impacts youth socially and academically, and increases risk of obesity, type 2 diabetes, and cardiovascular disease in later life.3235 Weight stigma in youth can have long lasting effects, with disordered eating and unhealthy weight control behaviours persisting over time into adulthood.3235 Weight stigma, bias and discrimination in healthcare can also have significant effects on health and wellbeing. For more information about this, please see the Obesity Evidence Hub page Weight stigma in healthcare.

Lived experience of weight stigma

The Weight Issues Network (WIN) is a national organisation established in 2019 to provide a voice and support for people living with and affected by overweight or obesity. WIN has produced the advocacy report ‘The Personal Costs of Weight Issues in Australia’, which shares the experience of living with obesity, particularly the considerable harms regularly experienced from weight stigma.33

"I just think that sometimes the obesity stigma is so loud and so normal that it can overshadow the reality of the situation, which is that it’s actually really hard. I’ve only ever had the obesity conversation from a weight loss perspective, but if I’ve learnt anything it’s that the physical impact is nothing compared to the toll it takes psychologically, but nobody talks about it..."36

WIN Recommendations to reduce weight stigma36

  • The lived experience voice and perspective to be included in the development of plans, strategies, design of treatment pathways, research, and debates on weight issues in a person-centred approach. The human element and complexity of the challenge needs to be recognised to reduce stigma.
  • Clear anti-stigma policies, education approaches and tools for schools, universities/higher education, employers, social services, research and healthcare providers should be developed and implemented. These should include an understanding of the complexities of obesity, and standard respectful terminology.
  • Government statements, plans, policies and campaigns to consult people with lived experience to help reduce risks of unintentional stigma.
  • Relevant public health communications are developed considering potential stigma harm. These should not further weight stigma or be a major risk factor for eating disorders or disordered eating.
  • Portrayal of people with obesity in the media should be respectful. Framing and images with stereotypes perpetuate and reinforce stigma.
  • Evidence-based support and/or resilience training should be available and subsidised for those who are particularly affected by weight stigma. Stigma in society will not change overnight and internalised weight stigma is deeply harmful.

Reducing weight bias and stigma

Significant change is required to reduce the prevalence and harms of weight stigma.13693536 A joint international consensus statement for ending stigma of obesity was published in 2020.1 The statement recognised the harms of weight stigma and developed 13 recommendations that spanned a range of settings including media, healthcare, public health, research, and policies and legislation.1 In 2021, the World Obesity Federation (WOF) organised a working group of practitioners, researchers, policymakers, youth advocates, and individuals with lived experience of obesity to develop the following global recommendations for changing global obesity narratives to reduce weight stigma.3 Additional information on ending weight stigma is also available on their website.

  1. Distinguish between body size and obesity.
  2. Use person-first language.
  3. Consider individual language preferences.
  4. Use non-stigmatising language and imagery.
  5. Engage in weight-neutral health promotion.
  6. Engage in legislative and policy efforts to reduce weight stigma.
  7. Promote human rights-based approaches to tackle weight stigma and discrimination.
  8. Raise awareness of weight stigma.
  9. Increase the global evidence base.

Australia’s National Obesity Strategy 2022-2032 guides the prevention, reduction and treatment of overweight and obesity in Australia.37 The strategy specifically mentions the need to tackle weight stigma and discrimination, and that it is everyone’s responsibility.37 Australia’s public health authorities have the opportunity to help reduce weight stigma by moving away from oversimplified messages that focus on individual responsibility.6 Instead, they can build people’s understanding of the complex causes of obesity, the healthcare options available, adopt weight inclusive practices and improve the portrayal of people with obesity to reduce negative stereotypes.136936 In addition to involving individuals with lived experience of obesity,636 public health and health promotion professionals can utilise resources such as the Weight Stigma Heat Map to reduce perpetuating weight stigma in their work.38

Australia has limited legal protections for weight-based discrimination unless it relates to disability (including disease or illness), with only Victoria and the Australian Capital Territory offering protections under “physical features” legislation.36 The adoption of weight discrimination laws nationally could help strengthen the rights of people with obesity as well as shift social norms away from perpetuating weight stigma.69

Organisations reducing weight stigma, providing weight inclusive resources for individuals and clinicians, and supporting people with obesity

The Obesity Collective is Australia’s peak body for obesity, with a vision to reduce the health and wellbeing impacts of obesity. One of its core principles is to fight weight stigma and their website includes a range of resources to support this.

The Weight Issues Network (WIN) is a national organisation established in 2019 to provide a voice and support for people living with and affected by overweight or obesity. The network includes those with lived experience, along with parents, carers, family members, friends and clinicians. WIN is active in promoting improved health care policies for obesity, and fighting weight stigma, bias and discrimination.

Size Inclusive Health Australia is a non-profit, member-based association that brings together health care professionals, training and the highest quality information for size inclusive care, including the Health at Every Size® (HAES®) approach.

Eating disorder organisations also offer relevant resources and support on weight stigma. The National Eating Disorders Collaboration (NEDC) works to improve the understanding, prevention and treatment of eating disorders in Australia. The Butterfly Foundation is dedicated to supporting people affected by eating disorders and body dissatisfaction. Both organisations work to reduce weight stigma, elevate lived experienced perspectives and support weight-inclusive healthcare.

Content for this page was reviewed and updated by Josephine Marshall at Deakin University, and reviewed by Helen Dixon at the Centre for Behavioural Research in Cancer at Cancer Council Victoria. For more information about the approach to content on the site please see About | Obesity Evidence Hub.

References

1. Rubino F, Puhl RM, Cummings DE, et al. Joint international consensus statement for ending stigma of obesity. Nat Med. 2020;26(4):485-497. doi:10.1038/s41591-020-0803-x
2. Latner JD, Barile JP, Durso LE, O’Brien KS. Weight and health-related quality of life: the moderating role of weight discrimination and internalized weight bias. Eat Behav. 2014;15(4):586–90.
3. Nutter S, Eggerichs LA, Nagpal TS, et al. Changing the global obesity narrative to recognize and reduce weight stigma: A position statement from the World Obesity Federation. Obesity Reviews. 2024; 25(1):e13642. doi:10.1111/obr.13642
4. Heuer CA, McClure KJ, Puhl RM. Obesity stigma in online news: a visual content analysis. J Health Commun. 2011;16(9):976-987. doi:10.1080/10810730.2011.561915
5. Kite J, Huang BH, Laird Y, et al. Influence and effects of weight stigmatisation in media: A systematic. EClinicalMedicine. 2022;48:101464. Published 2022 May 20. doi:10.1016/j.eclinm.2022.101464
6. Lawrence BJ, de la Piedad Garcia X, Kite J, Hill B, Cooper K, Flint SW, Dixon JB. Weight stigma in Australia: a public health call to action. Public Health Res Pract. 2022;32(3):e3232224.
7. Spahlholz J, Baer N, König HH, Riedel-Heller SG, Luck-Sikorski C. Obesity and discrimination - a systematic review and meta-analysis of observational studies. Obes Rev. 2016;17(1):43-55. doi:10.1111/obr.12343
8. Puhl RM, Lessard LM, Pearl RL, Himmelstein MS, Foster GD. International comparisons of weight stigma: addressing a void in the field. Int J Obes (Lond). 2021;45(9):1976-1985. doi:10.1038/s41366-021-00860-z
9. Puhl RM. Bias, Discrimination, and Obesity. In: Handbook of Obesity, Two-Volume Set, edited by George A. Bray, and Claude Bouchard, Taylor & Francis Group, 2023. ProQuest Ebook Central, http://ebookcentral.proquest.c....
10. Puhl RM, Lessard LM. Weight Stigma in Youth: Prevalence, Consequences, and Considerations for Clinical Practice. Curr Obes Rep. 2020;9(4):402-411. doi:10.1007/s13679-020-00408-8
11. Varshney N. Cancer Research UK'S obesity campaign in 2018 and 2019: effective health promotion or perpetuating the stigmatisation of obesity? J Med Ethics. 2020 Nov 25:medethics-2020-106192. doi: 10.1136/medethics-2020-106192. Epub ahead of print. PMID: 33239470.
12. Puhl, R., et al. (2013). "Fighting obesity or obese persons? Public perceptions of obesity-related health messages." International Journal of Obesity 37(6): 774-782.
13. Horn, F. and M. I. Jongenelis (2022). "Outcomes of exposure to healthy weight and lifestyle advertising: An experimental study of adults from the United Kingdom." Preventive Medicine Reports 25: 101679.
14. Puhl, R., et al. (2013). "Public reactions to obesity-related health campaigns: a randomized controlled trial." American Journal of Preventive Medicine 45(1): 36-48.
15. Johnstone, G. and S. L. Grant (2019). "Weight stigmatisation in antiobesity campaigns: The role of images." Health Promotion Journal of Australia 30(1): 37-46.
16. Morley B, Nuss T, Gascoyne C, Dixon H, Wakefield M. LiveLighter® 'Junk Food' mass media campaign increases behavioural strategies to reduce consumption. Health Educ Res. 2022 Nov 21;37(6):434-451.
17. Jongenelis, M., et al. (2023). "Exploring Intended and Unintended Reactions to Healthy Weight and Lifestyle Advertisements: An Online Experiment." Health Educ Behav 50(1): 58-69.
18. Rudolph, A. and A. Hilbert (2016). "The effects of obesity-related health messages on explicit and implicit weight bias." Front Psychol 7: 2064.
19. Morley B, Niven P, et al. (2016). Population-based evaluation of the 'LiveLighter' healthy weight and lifestyle mass media campaign. Health Education Research 31(2): 121-35.
20. Dixon H, Scully M, Durkin S, Brennan E, Cotter T, Maloney S, O'Hara BJ, Wakefield M. Finding the keys to successful adult-targeted advertisements on obesity prevention: an experimental audience testing study. BMC Public Health. 2015 Aug 20;15:804.
21. Morley B, Niven P, et al. (2019). Association of the LiveLighter mass media campaign with consumption of sugar-sweetened beverages: Cohort study. Health Promotion Journal of Australia.
22. Young R, Subramanian R, Hinnant A. Stigmatizing Images in Obesity Health Campaign Messages and Healthy Behavioral Intentions. Health Educ Behav. 2016;43(4):412-419. doi:10.1177/1090198115604624
23. Dixon H, Murphy M, Scully M, Rose M, Cotter T. Identifying effective healthy weight and lifestyle advertisements: Focus groups with Australian adults. Appetite. 2016 Aug 1;103:184-191.
24. Rathbone JA, Cruwys T, Jetten J. Non-stigmatising alternatives to anti-obesity public health messages: Consequences for health behaviour and well-being. J Health Psychol. 2022 Jun;27(7):1601-1614.
25. Young, R., et al. (2016). "Individual and social determinants of obesity in strategic health messages: Interaction with political ideology." Health Communication 31(7): 903-910.
26. Wu YK, Berry DC. Impact of weight stigma on physiological and psychological health outcomes for overweight and obese adults: a systematic review. J Adv Nurs. 2018;74(5):1030–42.
27. Sutin AR, Stephan Y, Terracciano A. Weight discrimination and risk of mortality. Psychol Sci. 2015;26(11):1803—11.
28. Puhl RM, Himmelstein MS, Pearl RL. Weight stigma as a psychosocial contributor to obesity. Am Psychol. 2020;75(2):274–89.
29. Vartanian LR, Pinkus RT & Smyth JM. (2018). Experiences of weight stigma in everyday life: Implications for health motivation. Stigma and Health, 3(2), 85–92
30. Pont SJ, Puhl R, Cook SR, Slusser W. Stigma Experienced by Children and Adolescents with Obesity. Pediatrics. 2017; 140(6). pii: e20173034. doi: 10.1542/peds.2017–3034
31. Puhl RM, Heuer CA. Obesity stigma: important considerations for public health. Am J Public Health. 2010;100(6):1019-1028. doi:10.2105/AJPH.2009.159491
32. Jackson SE, Beeken RJ, Wardle J. Perceived weight discrimination and changes in weight, waist circumference, and weight status. Obesity (Silver Spring). 2014;22(12):2485-2488. doi:10.1002/oby.20891
33. Weight Issues Network. The personal costs of weight issues in Australia. Australia; WIN: 2020. Available from: https://weightissuesnetwork.or...
34. Wagner BE, Cook S. Weight Bias and Stigma in Pediatric Obesity. Pediatr Clin North Am. 2024;71(5):819-830. doi:10.1016/j.pcl.2024.07.005
35. Hill B, de la Piedad Garcia X, Rathbone JA, et al. Supporting healthcare professionals to reduce weight stigma. Aust J Gen Pract. 2024;53(9):682-685. doi:10.31128/AJGP-07-23-6906
36. The Butterfly Foundation. Appearance-based discrimination as a human rights issue – the case for legislative reform. 22 May 2023. Available from https://butterfly.org.au/appearance-based-discrimination-as-a-human-rights-issue-the-case-for-legislative-reform/
37. Commonwealth of Australia 2022. The National Obesity Strategy 2022-2032. Health Ministers Meeting. Available from: https://www.health.gov.au/site...
38. Willer F. The Weight Stigma Heat Map: A tool to identify weight stigma in public health and health promotion materials. Health Promot J Austr. 2024;35(2):293-302. doi:10.1002/hpja.745