Size discrimination, obesity, and gender: Heath effects and health politics

Background:. There is an increasing sociopolitical focus on obesity and health. The mechanisms of effect of excess weight on health and mortality are poorly understood. While a growing body of research acknowledges health effects of other forms of discrimination, scant attention has been given to size discrimination as an independent determinant of poor health outcomes. Although any obese person may encounter size discrimination, obesity is especially incongruous with social expectations of women, and rates of obesity are higher in poor and minority populations. Thus, health effects of size discrimination combined with sexism and other marginalizing factors may be particularly detrimental. Methods: To develop a framework for examining the relationship between size discrimination and health, the literature was searched for articles about size discrimination and social factors associated with obesity. Results were cross-referenced with articles about social health determinants and health disparities. Results: Stigma associated with obesity is strong, highly prevalent, begins early in life, and is often internalized. Stigmatized groups are subject to overt discrimination. Obese and overweight individuals, especially women, experience pervasive economic, social, and medical discrimination, and these form of discrimination are associated with multiple poor health outcomes. Discussion: It is unknown to what extent size discrimination and weight-related stigma contribute to health disparities. Future research should assess relationships between size discrimination and health, including interactions with other sociopolitical health determinants. Findings could inform innovative policies and interventions that address size discrimination and social stigma. These could prove to be important tools for reducing obesity-related health disparities.