Responding to weight stigma: Helpful and unhelpful coping strategies

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The prevalence of high-weight status is increasing globally, with approximately 60% of people in the UK considered "overweight" or "obese" by BMI standards, and similar rates in many other countries. Despite this, higher-weight individuals experience prejudice and discrimination in practically every domain of daily living, including education, employment, healthcare, and interpersonal relationships. We know from other oppressed groups that stigma is associated with poorer health and life outcomes, and in the last ten years, these effects have been demonstrated also in the case of weight stigma. A better understanding of how these processes occur and identification of potential targets for intervention to reduce resulting harms is of critical importance to public policy.Little is known about how the impact of weight stigma is transmitted, and even less on how the harms can be minimised. My PhD work focused predominantly on internalised weight stigma (IWS) - the phenomenon where higher-weight people devalue themselves because of their weight. IWS has been linked with a range of physical and psychological health problems, and unhelpful coping strategies such as disordered eating, avoidance of exercise, social isolation, and substance use. IWS is also an intermediary in many of the problems associated with experiencing stigma from others. However, we do not know why some people internalise societal stigma, others are largely unaffected, and some actively resist and challenge the stigma.During my PhD, I developed the first questionnaire to measure weight stigma resistance and demonstrated that resistance was associated with improved psychological wellbeing. I also drew on research from the mental health stigma literature and identified a number of key characteristics of internalisers and resisters. One important factor was whether the individual had a strong group identity - that is, whether they feel a sense of kinship and belonging with other higher-weight people. People with high group identity were less likely to internalise and more likely to resist. Another important factor was whether or not they felt that body weight was under individual control and simply a matter of willpower. Those who believed they could become slimmer tended not to resist stigma and were more likely to internalise it. But perhaps most interestingly, believing that stigma of higher-weight people was not justified helped to define resisters even if they didn't have high group identity and whether or not they felt their weight status was controllable. This means that it may be possible to develop health promotion interventions that take a social justice-based approach: that stigma is wrong whatever the circumstances and people deserve to be treated equally and with respect whatever their weight. Such an intervention may improve psychological wellbeing in higher-weight individuals regardless of their current beliefs and feelings about their weight.My goal is to pursue this avenue of research within academia. This fellowship would enhance my future applications for research funding and faculty positions in a number of ways. Two small studies would help me test the statistical properties of my stigma resistance measure, and would increase the likelihood that my resistance research will be published in a top journal where it would have a greater impact. Another study I would like to do would explore the relationship between both being stigmatised and observing other people being stigmatised on health, wellbeing, and use of unhealthy coping strategies in a large sample of medical students over the course of their training. I would also use the opportunity to build professional networks, disseminate my work more widely, enhance subject-specific knowledge, and acquire additional research, teaching, and other acadmic skills that would significantly strengthen my future career prospects and help me take the next steps toward an independent research career.