Internalized Weight Stigma Explained

Explore why some clients self-sabotaging eating behaviors.

Why do some clients struggle to change their diet? What is the underlying cause of this yo-yo-like dieting behavior? This issue of The Knot takes a deeper dive into understanding how internalized weight stigma is problematic and how two mindful eating counseling tools are helpful.

Internalized weight stigma happens over time when people who are classified as higher-weight come to accept and believe the derogatory and discriminatory cultural depictions (i.e., as irresponsible, gluttonous, and lazy) of higher-weight individuals. The image below is a visual example of weight stigma, portraying this gentleman in a way that amplifies stereotypes and reinforces a sense of othering.

A systematic review of the literature has demonstrated that the empirical study of this phenomenon is in its infancy (Pearl and Puhl, 2018). But early findings illustrate a significant detrimental impact on mental (e.g., depression, anxiety, body dissatisfaction) and physical health (e.g., metabolic syndrome, weight cycling) as well as related health behaviors through rejection of dietary advice, binge eating and exercise avoidance (Ratcliffe and Ellison, 2015; Jackson and Steptoe, 2017; Puhl and Himmelstein, 2018).

These harmful effects are also affecting people with type 2 diabetes.

Understanding why internalized weight stigma exists and how it impacts clients with diabetes is necessary for providing weight-inclusive diabetes care.

Weight stigma present is present in national guidelines and diabetes prevention campaigns¹. Congratulations are in order if as a healthcare professional, you are able to recognize internalized weight stigma and identify weight-centric thinking.

The next question becomes, how do I respond? You know that telling the client, “Stop thinking like that.” or “Society is wrong.” is supportive but often lands as blame and energizes the self-blame cycle. As a weight-inclusive professional in the diabetes community, you want to help your clients let go of internalized weight stigma. The question is, what to do?

Mindful Eating can help clients with internalized weight stigma because it

1. Helps them recognize the present moment non-judgmentally. (Internalized weight bias is recounting or anticipating events)

2. Fosters curiosity about their present moment experience vs asking about future or past experiences.

For paid subscribers, I will review two activities that are helpful. Inclusive Diabetes Care also has self-paced professional CPE programs that are ideal for Dietitians, Diet Technicians, Health and Fitness professionals, Community Health Workers, Social Workers, and Case Managers.