Overweight and obesity

People living with overweight and obesity can experience weight stigma and bias across a wide range of social settings, negatively affecting their health and quality of life. A leading contributor to weight stigma is the misconception that obesity is caused by factors solely within an individual’s control. However, this disregards the complex nature of overweight and obesity and the obesogenic environment in which people find themselves. For more information, see Causes of overweight and obesity.

Weight stigma occurs, deliberately or inadvertently, in the media, in health care and researcher settings, and sometimes in public health campaigns and policies designed to help people living with overweight and obesity (Lawrence et al. 2022).

The National Obesity Strategy 2022–2032 prioritises tackling weight stigma and discrimination. It highlights how action to prevent, treat and manage overweight and obesity should prevent and reduce weight stigma. The aim is to establish better understanding of weight stigma in all different settings and building an understanding of the complex causes of overweight and obesity, as well as the system barriers that perpetuate inequity (Commonwealth of Australia 2022). A range of Australian and international studies have found high levels of both explicit and implicit weight bias among health professionals, with more than half exhibiting some form of weight bias towards people living with obesity (Fruh et al. 2016).

Experiences of weight stigma are associated with physical and mental health consequences including depression, body image concerns, reduced quality of life and increased mortality risk (Sutin et al. 2015). Additionally, contrary to common misconceptions that experiences of weight stigma are beneficial to stimulating behaviour change, these experiences lead to maladaptive behavioural responses. These include evading situations with physical activity, disordered eating, and avoidance or disengagement from health care, which in some instances may lead to weight gain (Lawrence et al. 2022).

Individuals living with overweight and obesity often internalise weight stigma, directing these attitudes and beliefs towards themselves, devaluing themselves and their role in society (Bidstrup et al. 2021). Weight stigmatisation can also trigger physiological changes that lead to the onset of high mortality conditions, independent of BMI (Tomiyama et al. 2018).

Weight stigma is experienced differently by women and men and has gendered impacts on health and health-seeking behaviours. Women are more frequently exposed to weight‑based judgement in social, health care and media settings, reflecting stronger societal expectations around body size and appearance. In contrast, men experience stigma more often in clinical contexts linked to health risk and disease severity. These gendered experiences shape responses to stigma; women are more likely to engage in repeated weight‑loss efforts and commercial or preventive treatments, whereas men are more likely to delay care and present later with obesity‑related complications (Lawrence et al. 2022; Puhl et al. 2021).

Eating disorders and disordered eating

Eating disorders are serious, complex mental illnesses accompanied by physical and mental health complications which may be severe and life threatening. They are characterised by disturbances in behaviours, thoughts and feelings towards body weight and shape, as well as food and eating. The mortality rate for people with eating disorders is up to six times higher compared to people without eating disorders. 

Eating disorders and disordered eating are increasing in prevalence, occurring in people of any age, weight, size, shape, gender identity, sexuality, cultural background or socioeconomic group (National Eating Disorders Strategy 2023). There is an overlap between eating disorders and disordered eating and obesity, where they can co-occur. It is important to acknowledge this, as eating disorders are under-recognised and undertreated in people living with overweight and obesity (NEDC 2023). Weight stigma further exacerbates this problem by creating barriers to health care access for those living with overweight and obesity (Butterfly Foundation 2021). 

The National Eating Disorder Collaboration (NEDC) has outlined prevention as a key action area. Eating disorder prevention refers to actions, programs or policies that aim to reduce modifiable risk factors for eating disorders, and bolster protective factors to reduce the likelihood that a person will experience an eating disorder (National Eating Disorders Strategy 2023). These preventive actions, programs or policies may also seek to address the broader factors that impact on health, such as the wider determinants of health, obesogenic environments and social determinants.

For more information see the Butterfly Foundation and the National Eating Disorders Collaboration.