Residual stigma: psychological distress among the formerly overweight

Abstract

Little is known about the psychological state of those who leave a stigmatized group. We examined individuals who previously belonged to a stigmatized group, the overweight, and then became normal weight. Negative stereotypes, including those relating to obesity, are internalized from the time of childhood onward; therefore, it was assumed they would become lingering self-stereotypes among individuals who were no longer externally targeted. Drawing on a nationally representative sample, we examined for the first time whether formerly overweight individuals are susceptible to any anxiety disorder, any depressive disorder, and suicide attempts. As predicted, the likelihood of any anxiety disorder and any depressive disorder for the formerly overweight group was significantly greater than for the consistently normal-weight group, and not significantly different from the consistently overweight group. Further, the formerly overweight group was significantly more likely to attempt suicide than the other groups. Also as predicted, perceived weight discrimination partially mediated the relationship between weight status and these outcomes. The cohort consisted of 33,604 participants in the United States. The results suggest that losing a self-image shaped by stigma is a more protracted process than losing weight.

Copyright © 2012 Elsevier Ltd. All rights reserved.

Figures

Fig. 1

Elevated suicide attempts, any depressive disorders, and any anxiety disorders in the formerly overweight group, compared with the subsequently overweight and consistently normal weight groups during past year. Note: *p < .05, **p < .01, ***p < .0001. Odds ratios are adjusted for age, sex, income, and number of chronic-physical-health conditions. There were no significant differences between the formerly overweight group and the consistently overweight group with respect to any depressive disorder and any anxiety disorder. However, the formerly overweight group demonstrated significantly elevated odds for suicide attempts, compared with the consistently overweight group.