People living with overweight or obesity face pervasive stigmatisation, social devaluation, and discrimination based on their body size. OEN UK has launched the ‘Stand Up to Weight Stigma’ campaign to highlight the nature and extent of this discrimination in various different settings and bring change.

OEN member, Liv Sewell spoke with Dr Stuart W. Flint, Associate Professor of the Psychology of Obesity at the University of Leeds, about the extent and impact of weight-based stigma in the media. In this post Liv summarises what we know…

Weight stigma refers to negative attitudes and social devaluation of individuals because of their excess body weight or body size. It is something we see daily in news coverage, and it is also consistently and continuously evident across all forms of media. Media permeates our lives and so, given the consistent and continuous devaluation of people living with overweight or obesity, the media creates and maintains negative, stigmatising attitudes towards people living with obesity. 

Media content has this insidious impact on individuals from a very young age. Research has shown that children as young as three years old are familiar with, and able to apply, stigmatising weight-based stereotypes (Cramer & Steinwert, 1998), for example associating individuals with a larger body size with laziness.

Consequently, it is now widely recognised that negative attitudes towards people living with obesity are embedded in our society through media content (Rubino et al., 2020). Whilst negative representations of people living with obesity in health, education, and family settings all contribute to the maintenance of weight stigma; the widespread use of negative stereotypes of people with excess body weight in the media renders the social devaluation of people living with obesity acceptable at a societal level (Flint et al., 20162018).

How media content stigmatises people living with obesity

There are many ways in which weight stigma operates in the media. Two processes you will be familiar with are stereotyping and dehumanising.

It is commonplace to see media content using simplified and inaccurate generalisations in their representation of individuals (both real and fictional) with excess body weight. Research exploring portrayals of people living with obesity in the media has shown that stereotyping is used in a subtle and sophisticated way. For example, a striking pattern of stigmatising stereotypes is that they are age specific, in that they seem to be adapted according to what is developmentally or socially valuable for the target audience. 

In content aimed at primary school age children, stereotypes of people with larger body sizes as gluttonous, or as having no friends, are common. Whereas in content created for teenagers, people with larger body size are stereotyped as lacking intelligence, being less attractive or being less sexually desirable. 

In content developed for an adult audience, it is commonplace for people living with obesity to be depicted as gluttonous, incompetent, lacking self-discipline, self-awareness and motivation, as a burden on society and personally to blame for their condition (Baker et al., 2020Flint et al., 2016). 

Content analysis of images used in news stories about obesity has shown that the images accompanying news stories contribute to such representations, with people living with obesity significantly more likely to be pictured eating or drinking, and significantly less likely to be pictured exercising or in professional clothing, than people without overweight or obesity (Heuer et al., 2011).

Such depictions are not only inaccurate generalisations but also inconsistent with evidence, widely recognised in the scientific community, that the causes of obesity are complex and include contributing factors which are outside of a person’s control (e.g., genetics, obesogenic environment, psychological impact of stigma, metabolic disorder; for an overview of current scientific consensus, see Rubino et al., 2020).

‘There’s a lack of empathy, compassion and, ultimately, respect for people living with obesity … We’ve become so accepting of this because stigma is continuous and consistent – virtually every single day we’re seeing stigmatising media, but we’re not always picking up on it and, in some instances, we’re not calling it out as we should do.’ 

Dr Stuart W. Flint

The dehumanisation of people living with obesity is widespread in media content. Research has exposed the frequent use of language which dehumanises, such as the application of references to animals which are notable for their size or eating patterns (Flint et al., 2016). Research investigating the types of images utilised in content engaging with the topic of obesity has shown that people living with overweight or obesity are significantly more likely to have their heads cropped out of photos, and less likely to be pictured fully clothed than people without obesity (Heuer et al., 2011). 

It is notable that stereotyping and dehumanisation in content addressing another group of people in society or people with other diseases (e.g., cardiovascular disease or cancer), would not be considered acceptable. These practices are derogatory and antithetical to journalists’ professional Code of Conduct (National Union of Journalists, 1936).

The impact of stigmatising content in the media

The impact of stigmatising content in the media is far reaching due to the potency of media to shape popular beliefs across society, and therefore shape the culture of various sectors (e.g., health, education, employment). Stigmatising media content contributes to the reality that people living with obesity experience bias and discrimination daily. 

Research has shown that media content which stigmatises people living with obesity, using inaccurate and derogatory stereotypes and dehumanising representations, leads to people treating people living with obesity differently compared to others (bias), which leads to discrimination towards people living with obesity (e.g., reducing or removing access to healthcare based on weight). For example, experimental studies have found that exposure to stigmatising content leads to increased weight bias (Pearl et al., 2012Frederick et al., 2016), and that weight bias predicts discriminatory behaviour (O’Brien et al., 2008). 

It is popularly held that negative portrayals of obesity and stigmatisation should be propagated as it supports or encourages behaviour change as a means of reducing a person’s weight. However, research suggests this position is unfounded. Weight stigma does not have a beneficial effect on people living with overweight or obesity. 

The evidence base actually suggests the opposite to be true, with weight-based stigmatisation having a detrimental impact on the behaviours and wellbeing of people living with obesity. Research has shown that experiences of weight stigma and discrimination make people living with overweight or obesity less motivated to engage in physical activity and less likely to access healthcare and support, such experiences might also increase disordered eating for people with overweight or obesity.

‘If we saw the same types of disrespectful, derogatory stigmatising material about people with a different health condition, cardiovascular disease or cancer, for instance… there would be public outcry about that content.’

Dr Stuart W. Flint

Findings also point to experiences of weight stigma increasing risk of depression and anxiety, low self-esteem, social isolation, substance use, raised blood pressure, chronic inflammation and worsening physical health (for a review see Jackson, 2012). Given the evidence base, it is now widely accepted that weight stigma is likely to drive weight gain rather than reduce it (Tomiyama et al., 2018).

The extent and impact of weight stigma in the media

Weight stigma is pervasive in the media and its impact is far reaching. Stigmatising content deploys inaccurate and derogatory stereotypes and dehumanising representations of people living with obesity. Such representations are a primary contributor to the maintenance of negative, stigmatising attitudes, and discriminatory behaviour towards people living with obesity across our society. 

Contrary to popular belief, there are no positive consequences of stigmatising content. Experiences of weight stigma do not help people to reach a health weight, they actually drive negative health outcomes.

Stigmatising representations in the media frame obesity as the result of personal lifestyle decisions around food and exercise, in stark contradiction of current scientific understanding of obesity where the emphasis has shifted to the complex and multifactorial nature of obesity, and therefore misinform the public. Such a simplistic, ill-informed, and damaging narrative would be unlikely to be considered acceptable if the health condition in question were cancer.

This is why many individuals and organisations working in the field of obesity are calling on the media to change the way they report on obesity related content so that the media combats weight-based stigma and discrimination rather than reinforcing it and supports public health rather than undermining it (Flint, 2018Flint et al., 2018).


Stuart W. Flint is Associate Professor of the Psychology of Obesity at the University of Leeds; President of Scaled Insights, an artificial intelligence company based in Leeds; honorary academic for Public Health England and a Director for Obesity UK. Stuart is interested in understanding and reducing weight-based stigma and discrimination. Stuart’s publications are listed here. Follow @DrStuartFlint on Twitter.

Liv Sewell is a member of OEN UK. Liv provides support with OEN’s online presence and works as an Assistant Psychologist in the NHS. Liv is passionate about the work of OEN and the role of psychology in ending weight stigma.


References

Cramer, P., & Steinwert, T. (1998). Thin is good, fat is bad: How early does it begin? Journal of Applied Developmental Psychology, 19(3), 429–451. https://doi.org/10.1016/S0193-3973(99)80049-5

Baker, P., Brookes, G., Atanasova, D., & Flint, S. W. (2020). Changing frames of obesity in the UK press 2008-2017. Social science & medicine (1982), 264, 113403. https://doi.org/10.1016/j.socscimed.2020.113403

Flint, S.W., Hudson J. & Lavallee D. (2016). The Portrayal of Obesity in U.K. National Newspapers. Stigma and Health, 1 (1), pp. 16-28. https://doi.org/10.1037/sah0000013

Flint, SW, (2018). An open letter to the National Union of Journalists. 06 April 2018. Retrieved from https://oenuk.files.wordpress.com/2021/09/729d0-openlettertothenationalunionofjournalists_6april.pdf

Flint, S. W., Nobles, J., Gately, P., & Sahota, P. (2018). Weight stigma and discrimination: a call to the media. The lancet Diabetes & endocrinology, 6(3), 169-170. https://www.thelancet.com/pdfs/journals/landia/PIIS2213-8587(18)30041-X.pdf

Frederick, D., Saguy, A., Sandhu, G. et al. Effects of competing news media frames of weight on antifat stigma, beliefs about weight and support for obesity-related public policies. Int J Obes 40, 543–549 (2016). https://doi.org/10.1038/ijo.2015.195

Heuer, C. A., McClure, K. J., & Puhl, R. M. (2011). Obesity stigma in online news: a visual content analysis. Journal of health communication, 16(9), 976-987. https://www.tandfonline.com/doi/abs/10.1080/10810730.2011.561915

Jackson, S.E. (2016). Obesity, Weight Stigma and Discrimination. J Obes Eat Disord 2:3. doi: 10.21767/2471-8203.100006.

O’Brien, K. S., Latner, J. D., Halberstadt, J., Hunter, J. A., Anderson, J., & Caputi, P. (2008). Do antifat attitudes predict antifat behaviors?. Obesity (Silver Spring, Md.), 16 Suppl 2, S87–S92. https://doi.org/10.1038/oby.2008.456

Rubino, F., Puhl, R.M., Cummings, D.E. et al. Joint international consensus statement for ending stigma of obesity. Nat Med 26, 485–497 (2020). https://doi.org/10.1038/s41591-020-0803-x

Tomiyama, A., Carr, D., Granberg, E. et al. How and why weight stigma drives the obesity ‘epidemic’ and harms health. BMC Med 16, 123 (2018). https://doi.org/10.1186/s12916-018-1116-5