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Behavior, Psychology and Sociology

International comparisons of weight stigma: addressing a void in the field

International Journal of Obesity volume 45, pages 1976–1985 (2021)Cite this article

Subjects

Abstract

Background/Objectives

Despite substantial evidence documenting weight stigma toward people with higher body weight, international comparative studies are lacking in this field. The few studies that have compared weight stigma across different countries focus on explicit weight-biased attitudes rather than people’s experiences of weight stigma. The present study conducted a multinational systematic comparison of weight stigma in six countries to assess experiences and interpersonal sources of weight stigma.

Subjects/Methods

Adults (N = 13,996) enrolled in WW International (formerly Weight Watchers), residing in Australia, Canada, France, Germany, the UK, and the US completed identical online anonymous surveys in the dominant language for their country. Surveys assessed their history of experiencing weight stigma, the onset of stigmatizing experiences and associated distress from stigma in different time periods, and interpersonal sources of weight stigma.

Results

More than half of participants (55.6–61.3%) across countries reported experiencing weight stigma. Participants with higher BMI were significantly more likely to report weight-stigmatizing experiences than individuals with lower BMI. In all countries, weight stigma experiences were most frequent in childhood and adolescence, with associated distress highest during these time periods. Participants in Germany reported a higher frequency of weight stigma across their whole life, but lower distress associated with stigmatizing experiences, compared to participants in the other five countries. High percentages of participants in each country experienced weight stigma from family members (76.0–87.8%), classmates (72.0–80.9%), doctors (62.6–73.5%), co-workers (54.1–61.7%), and friends (48.8–66.2%).

Conclusions

Weight stigma is prevalent for adults actively engaged in weight management across different Western countries. There were more similarities than differences in the nature, frequency, and interpersonal sources of people’s experiences of weight stigma across the six countries in this study. Findings underscore the need for multinational initiatives to address weight stigma and interventions to support individuals engaged in weight management who experience weight mistreatment.

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Fig. 1: Unadjusted frequency of weight-stigmatizing experiences as a function of life stage and country.

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Notes

  1. It was not permissible by law to collect race/ethnicity or sexual orientation data in France and Germany.

  2. For reference, approximate prevalence rates of adult obesity in the participating countries are as follows: Australia: 30%, Canada: 31%, France: 23%, Germany: 26%, UK: 30%, US: 37% [31].

  3. These findings replicated when modeling weight stigma as a count variable (i.e., sum of the prevalence of ever having been teased, treated unfairly, or discriminated against because of one’s weight).

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Acknowledgements

The authors would like to thank WW members who participated in this study and shared their experiences of weight stigma.

Funding

This study was funded by a grant from WW (formerly Weight Watchers) to the University of Connecticut on behalf of RMP. RLP is supported in part by a Mentored Patient-Oriented Research Career Development Award from the National Heart, Lung and Blood Institute/NIH (#K23HL140176).

Author information

Authors and Affiliations

  1. Department of Human Development & Family Sciences, University of Connecticut, Storrs, CT, USA

    Rebecca M. Puhl

  2. Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT, USA

    Rebecca M. Puhl & Leah M. Lessard

  3. Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    Rebecca L. Pearl & Gary D. Foster

  4. Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA

    Rebecca L. Pearl

  5. Department of Psychological Sciences, Kent State University, Kent, OH, USA

    Mary S. Himmelstein

  6. WW International, Inc., New York, NY, USA

    Gary D. Foster

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Correspondence to Rebecca M. Puhl.

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GDF is an employee and shareholder of WW.

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Puhl, R.M., Lessard, L.M., Pearl, R.L. et al. International comparisons of weight stigma: addressing a void in the field. Int J Obes 45, 1976–1985 (2021). https://doi.org/10.1038/s41366-021-00860-z

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