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Weight discrimination linked to increased risk of mortality

Researchers Antonio Terracciano and Angelina R. Sutin.
Researchers Antonio Terracciano and Angelina R. Sutin.

In recent years, Florida State University College of Medicine researchers Angelina R. Sutin and Antonio Terracciano have found that people who experience weight discrimination are more likely to become or remain obese, to develop chronic health problems and to have a lower satisfaction with life.

Now they’ve found that people who report being subjected to weight discrimination also have a greater risk of dying. Not because they may be overweight, but because of the apparent effects of the discrimination. Their findings have been published in Psychological Science.

Sutin and colleagues examined data involving more than 18,000 people from separate longitudinal studies, comparing those who reported experiencing weight discrimination with those who did not. Accounting for other factors that might explain a greater risk for mortality, the researchers found that individuals reporting weight discrimination had a 60 percent greater chance of dying over the follow-up period.

“What we found is that this isn’t a case of people with a higher body-mass index (BMI) being at an increased risk of mortality — and they happen to also report being subjected to weight discrimination,” said Sutin, assistant professor of behavioral sciences and social medicine at the medical school. “Independent of what their BMI actually is, weight discrimination is associated with increased risk of mortality.”

Data came from two long-term and ongoing studies. The Health and Retirement Study (HRS), which began in 1992 at the University of Michigan with support from the National Institute on Aging (NIA), involved more than 13,000 men and women with an average age of 68 for the time period Sutin and Terracciano examined.

Midlife in the United States (MIDUS) is a study begun in 1995 by the MacArthur Foundation Research Network on Successful Midlife Development with support from the NIA. Sutin and Terracciano examined MIDUS data involving about 5,000 men and women with an average age of 48.

Results were consistent across both groups of study subjects. In both samples, the researchers accounted for BMI, subjective health, disease burden, depressive symptoms, smoking history, and physical activity as indicators of mortality risk, but the association with weight discrimination remained.

“To our knowledge, this is the first time that this has been shown — that weight discrimination is associated with an increased risk of mortality,” said Terracciano, associate professor in the College of Medicine’s Department of Geriatrics.

Sutin points to a series of studies involving both experimental and epidemiological approaches examining links between weight discrimination and health. “Ours and other groups’ epidemiological work converge with evidence from experimental research,” Sutin said. “The experimental work shows the immediate effects of weightism and our work shows the consequence over the lifespan.”

Weight discrimination is not always meant to be mean-spirited, but a body of evidence demonstrates that it has harmful effects nonetheless. Previous studies indicate that teasing a person to lose weight has the opposite effect over the long-term, including a study by Sutin and Terracciano that was published in PLoS One in 2013. Indeed, people who are stigmatized because of their weight are more likely to engage in the kind of behavior that contributes to obesity, including unhealthy eating and avoiding physical activity.

Some people think, ‘Oh, well, you’re just hurting somebody’s feelings when you say something bad about their weight, but it will motivate them to lose weight, which will save their life,’” Sutin said.

Sutin points out that contrary to such beliefs, in addition to the psychological effects, weightism increases the risk of weight gain and premature mortality. “Our research has shown that very clearly this type of approach does not work and there are really serious consequences to it,” Sutin said.