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Metabolic Risk Increased in Obese People Who “Self-Stigmatize”

Obese individuals who “self-stigmatize” about their weight may be at higher risk for developing metabolic problems, according to a study recently published in Obesity.

Researchers led by Rebecca L. Pearl, PhD, of the University of Pennsylvania in Philadelphia, write that obese people are often seen as lazy and unattractive, and to blame for their excess weight, and that due to this “weight bias,” they face “weight stigma”. “Weight stigma is a prominent psychosocial consequence of obesity that is associated with increased risk for depression, anxiety, body dissatisfaction, and low self-esteem,” the authors write.

Pearl and her team theorized that this stress could increase cardiometabolic risk in these individuals with obesity who self-stigmatize, or what they call “weight bias internalization, WBI”. The researchers examined 159 obese adults who enrolled in a weight-loss trial. The participants completed the Weight Bias Internalization Scale and Patient Health Questionnaire (a measure of depression). The answers were compared to labwork that tested for risk factors of metabolic syndrome. Fifty-one of the participants (32%) had metabolic syndrome, and the odds of meeting the criteria for metabolic syndrome were greater in the patients with higher WBI, the authors write. “Analyzed categorically, high (vs. low) WBI predicted greater odds of metabolic syndrome and high triglycerides (Ps < 0.05)” even after controlling for the effects of body mass index and depression..”

The authors conclude that obese people with WBI are at greater risk for developed metabolic syndrome. However, they are careful to point out that this study was cross-sectional, so a converse relationship could be present (obese individuals with worse health may be more prone to WBI). They also write that these findings only pertain to people who were actively seeking weight loss treatment, so they may not be indicative of the broader population. “Further research is needed to develop and test the effects of interventions that aim to reduce WBI among individuals with obesity,” they write. “To inform these interventions, future research efforts should focus on identifying specific biological and behavioral pathways—such as lipoprotein profiles, dietary intake, and engagement in physical activity—between WBI and cardiometabolic risk.”