The Hidden Burden: How Weight Stigma Impacts Mental Health | Dr. Kerri Fullerton ND

There was a time when running into someone I hadn’t seen in a while made my heart race — not from excitement, but from shame.

The weight I had lost was back. Again. And with it came the fear of judgment, the silent assessments I imagined behind every, “Hi, how are you?”

My anxiety wasn’t just about how I looked. It was about the constant monitoring of how I was perceived. The pressure to “fix” my body. The shame of being in a body that didn’t meet the expectations I had once seemed to fulfill.

For years, I thought it was my fault — that I just hadn’t tried hard enough. That if I could just get it together, I’d finally feel at peace.

But peace doesn’t come from shrinking. It comes from no longer believing the lie that your body makes you less worthy of care, respect, or mental well-being.

Why We Need to Talk About Weight Stigma and Mental Health

When we talk about mental health, we often focus on stress, trauma, or brain chemistry — and all of those matter. But there’s another, less visible factor that impacts mental health every single day: weight stigma.

The phrase “weight stigma and mental health” rarely appears in the same sentence outside of academic literature. But in real life? They’re deeply intertwined.

People living in larger bodies experience higher rates of anxiety, depression, and disordered eating — not because of their body size, but because of the shame, judgment, and dismissal they face because of it.

What Is Weight Stigma?

Weight stigma is the systemic and social discrimination based on body size. It shows up in:

• Doctor’s who tell people to lose weight instead of conducting a proper assessment
• Comments from family, friends, or strangers that disguise concern as cruelty
• Media and wellness spaces that equate thinness with virtue and health

It also shows up inside our own heads, in the form of internalized bias: the belief that we are the problem. That if we just had more discipline, we wouldn’t feel this way.

But weight stigma is not a personal failing. It is a cultural one.

The Mental Health Toll of Weight Stigma

Recent studies continue to highlight how deeply weight stigma impacts mental health. A 2022 meta-analysis published in The Journal of Adolescent Health found a strong link between weight stigma and poorer mental health outcomes in youth, especially when internalized shame was present. Similarly, a 2023 study by Puhl et al. found that college students who experienced interpersonal and anticipated weight stigma reported higher rates of anxiety, depression, and disordered eating behaviours. A 2020 meta-analysis in Obesity Reviews also reinforced that weight stigma significantly contributes to poor mental health outcomes, including stress, low self-esteem, and psychological distress.

Here’s how it plays out:

• Anxiety: Fear of judgment, avoidance of social situations, hypervigilance around food and movement
• Depression: Internalized blame, body shame, isolation
• Disordered eating: Restriction, bingeing, or obsessive food behaviours often rooted in body dissatisfaction
• Low self-worth: A sense that your value is conditional on changing your body

Body size doesn’t cause these issues. They’re caused by the way society treats people based on body size.

The Body Remembers: When Stigma Becomes a Stressor

Weight stigma doesn’t just live in the mind. It also activates the body’s stress response.

When you’re constantly navigating a world that scrutinizes and shames your body, your nervous system stays on high alert. This leads to:

• Elevated cortisol levels
• Sleep disruptions
• Digestive issues
• Blood sugar imbalances
• Immune dysregulation

You may feel exhausted, wired, or burned out — while others dismiss your experience and suggest it’s all in your head.

But this is what happens when you live in a body that’s treated like a problem to solve.

The Shame Spiral in Healthcare

One of the most damaging places weight stigma shows up is in healthcare.

Healthcare providers often overlook accurate diagnoses for patients in larger bodies, delay proper care, and attribute symptoms to weight before conducting thorough assessments. This erodes trust and increases anxiety.

I hear this often from my own patients: “They didn’t even touch me. Just told me to lose weight.”

So, when the people meant to help you end up reinforcing the shame you’ve internalized, it becomes harder to advocate for your mental and physical needs.

What Healing Looks Like

To heal the impact of weight stigma and mental health, start by changing the story – not your body.

• That you are allowed to take up space
• That you are not the cause of your anxiety
• That your body is not a moral issue
• That your pain is real and worthy of care

Supportive, weight-neutral care can look like:

• Gentle, sustainable nutrition and movement that support your energy
• Validating care that investigates rather than blames
• Therapy and community spaces that unpack internalized shame
• Letting go of the idea that health has to look a certain way

Final Thoughts: You Are Not Broken

The connection between weight stigma and mental health is powerful, underrecognized, and deeply deserving of attention.

If you feel like you’ve been carrying something heavy, you have. It’s not weakness. It’s the weight of a culture that asks you to make yourself smaller in every way.

You are allowed to want more. Not more discipline — more peace, more compassion, more truth.

And if you’re ready to explore what that could look like, I’m here.

With you through the mess and the magic,

Kerri

And if you’re looking for a gentler way to connect with food and your body, You can download my free intuitive eating guide — a compassionate starting point for building trust with yourself again.

References:

1. Warnick JL, et al. Weight stigma and mental health in youth: a meta-analytic review. J Adolesc Health. 2022;71(3):333–341. https://pubmed.ncbi.nlm.nih.gov/34791368/
2. Puhl RM, Himmelstein MS, et al. Experiences of weight stigma and links to mental health in college students. Appetite. 2023. https://pubmed.ncbi.nlm.nih.gov/37758003/
3. Emmer C, Bosnjak M, Mata J. The association between weight stigma and mental health: A meta-analysis. Obesity Reviews. 2020;21(1):e12935. https://onlinelibrary.wiley.com/doi/10.1111/obr.12935
4. Puhl RM, Heuer CA. Obesity stigma: important considerations for public health. Am J Public Health. 2010;100(6):1019-1028.
5. Tomiyama AJ. Weight stigma is stressful. A review of evidence for the Cyclic Obesity/Weight-Based Stigma model. Appetite. 2014;82:8-15.
6. Pearl RL. Weight bias and stigma: Public health implications and structural solutions. Soc Issues Policy Rev. 2018;12(1):146-182.
7. Alberga AS, et al. Weight bias: a call to action. J Eating Disorders. 2016;4:34.