Obesity is a "global epidemic," affecting people of all ages and socioeconomic levels. Being overweight or obese puts people at risk for serious health problems. It also exposes them to profound stigmatization and discrimination across a wide variety of domains. Experiencing racial and ethnic discrimination has been linked to poorer mental and physical health, including cardiovascular disease, hypertension, blood pressure reactivity, and depression. The effects of experiencing weight-based stigmatization (WS) on health, however, have been largely ignored. The proposed research addresses the psychological, behavioral, and biological effects on overweight men and women of experiencing or anticipating WS. We propose that WS is stressful and triggers a cascade of negative emotions, cognitions and biological responses that can damage mental and physical health. We also propose that experiencing or anticipating WS impairs health by activating processes that contribute to weight gain among those who are or perceive themselves to be overweight. These include increasing stress-related eating and reducing self-control capacity essential for regulating diet and exercise. We propose that WS also increases motivation and intentions to avoid stigma by losing weight while simultaneously decreasing the capacity to do so via the processes described above. This further exacerbates threat and can lead the overweight to engage in stigma-avoidance behaviors with negative health implications, such as avoiding exercise, or engaging in unhealthy behaviors to lose weight. We propose to conduct 4 experiments to test these hypotheses.
Our aims are to demonstrate that for individuals who are overweight, social contexts that activate concerns about WS, including exposure to public health messages about the obesity epidemic: 1) are stressful, as indexed by increased blood pressure, cortisol reactivity, emotions, and activated stereotypes, 2) decrease self-regulatory capacity, as indexed by poorer performance on cognitive tasks requiring self-control and by reduced capacity of people who are overweight to resist consuming fattening food, and 3) increase motivation and intention to avoid stigma by attempting to lose weight, while decreasing individuals'capacity to do so, thus contributing to unhealthy eating behaviors and avoidance of exercise. We also propose to test three potential moderators of the above effects as well as several mediators of these effects. In addition, we will examine the downstream consequences of eating in response to WS. Collectively, these experiments will provide a better understanding of the psychological, physiological, and behavioral effects of weight stigma, including increased risk for cardiovascular disease, depression, and weight gain, and how these effects may be mitigated. Findings hold enormous potential to illuminate psychological processes that may contribute to, and potentially reduce, obesity and will have implications for the design of public campaigns to reduce the obesity epidemic.

Public Health Relevance

This research examines the psychological, behavioral and biological effects of being a target of weight stigma and discrimination. We propose that among overweight individuals, exposure to or anticipation of weight stigmatization increases stress and heightens risk for cardiovascular disease, contributes to obesity by leading to stress-related eating and by reducing capacity for self-control essential for regulating diet and exercise, and contributes to unhealthy behaviors to avoid further stigma. Findings will inform and increase the effectiveness of weight loss interventions and will have implications for how public policies aimed at reducing the obesity epidemic should be framed to maximize effectiveness while minimizing harm.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
3R01HL112818-02S2
Application #
8912580
Study Section
Social Psychology, Personality and Interpersonal Processes Study Section (SPIP)
Program Officer
Stoney, Catherine
Project Start
2013-02-01
Project End
2016-01-31
Budget Start
2014-09-08
Budget End
2015-01-31
Support Year
2
Fiscal Year
2014
Total Cost
$24,257
Indirect Cost
$7,060
Name
University of California Santa Barbara
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
094878394
City
Santa Barbara
State
CA
Country
United States
Zip Code
93106
Hunger, Jeffrey M; Major, Brenda (2015) Weight stigma mediates the association between BMI and self-reported health. Health Psychol 34:172-5