Obesity stigma in the US and Germany


By John DiTraglia



Last week we expostulated about fat shaming and said that besides being rude it didn’t work to get people to be thin. The rationale for turning on stronger fat shaming is called the normalization hypothesis that proposes that one possible reason for the obesity epidemic is that since so many of us are now bigger around we have come to accept it as normal and have stopped fighting it. According to the normalization hypothesis, a higher prevalence of obesity in a country is expected to lower stigma due to processes that view obesity as a common or normal phenomenon.

Contrary to the normalization hypothesis and demonstrating lack of effect of fat shaming is a new study that conducted telephone surveys in Germany and the United States (total sample = 2,802) by using vignettes for the description of a person with obesity. (1) Their findings indicate that a comparatively high prevalence of obesity like in the US 38% was associated with a higher level of obesity stigma than in Germany where the prevalence of obesity is much lower, 24%.

These investigators report that the differences in the extent and consistency of obesity stigma in Germany and the US were strong. So our higher rates of obesity are not being helped by more stigmatization but it is hard to believe the converse is true – that fat shame causes worse obesity. But it is possible that fat shaming is worse than useless, since there is some evidence that obesity stigma could trigger psychological (i.e. social isolation, stress, decreased well-being) as well as physical health adversities (i.e. promotion of unhealthy lifestyles, further weight gain).

Don’t do it.

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By John DiTraglia

John DiTraglia M.D. is a Pediatrician in Portsmouth. He can be reached by e-mail- jditrag@zoomnet.net or phone (740) 354-6605.

1. Kim TJ, Makowski AC,dem Knesebeck OV. Obesity stigma in Germany and the United States – Results of population surveys. PLoS ONE 14(8): e0221214. Published: August 20, 2019 https://doi.org/10.1371/journal.pone.0221214

John DiTraglia M.D. is a Pediatrician in Portsmouth. He can be reached by e-mail- jditrag@zoomnet.net or phone (740) 354-6605.

1. Kim TJ, Makowski AC,dem Knesebeck OV. Obesity stigma in Germany and the United States – Results of population surveys. PLoS ONE 14(8): e0221214. Published: August 20, 2019 https://doi.org/10.1371/journal.pone.0221214