Belly fat. No one wants it, but women are much harder on themselves about extra pounds wrapped around their middle than men are, regardless of how much they weigh.
And the more they beat themselves up about their "spare tire," the more likely women are to gain weight in this high-risk area, new research suggests. Visceral (belly) fat wraps around the organs in the abdomen, and is thought to be more dangerous than other types of fat.
"This study contributes to a growing evidence base which shows that blaming oneself for one's weight and engaging in self-stigma may be harmful to health, particularly for women," said Rebecca Puhl, deputy director at the Rudd Center for Food Policy and Health at the University of Connecticut.
This isn't surprising given how societal ideals of female beauty emphasize thinness, said Puhl, who has no ties to the new research. "Women who have bodies that deviate from this unrealistic ideal are vulnerable to blame, shame and stigma, often publicly, as we see so frequently on social media platforms," she noted.
They feel like they're at fault, and turn the stigma inward. As a result, women may be more likely to use food as a way to cope with stress and other negative emotions, Puhl said.
Researchers led by Natalie Keirns, a doctoral candidate in clinical psychology at Oklahoma State University, set out to understand how self-stigma about weight affects belly fat in men and women. Seventy men and women completed a questionnaire that rates self-stigma about weight on an ascending scale of 1 to 7. Researchers also used scans to measure visceral and total body fat in all participants.
Women scored 3.5 on average on this scale, compared with 2.7 among men. For women, each 1-point rise in their score corresponded to an average increase of 0.14 pounds of visceral fat. By contrast, there was no relationship between score and visceral fat in men.
Weight stigma is a chronic stressor that forces people to churn out higher levels of the stress hormone cortisol, which in turn leads to the accumulation of more visceral fat and greater risk for heart disease, the researchers concluded.
The ultimate goal should be to eliminate weight stigma, Puhl said.
"This requires shifting societal attitudes about weight, educating the public about the complex causes of obesity, challenging harmful ideals of thinness, treating weight discrimination as a legitimate injustice, and implementing policies to prohibit unfair treatment of people because of their weight," Puhl said.
Unless and until this happens, it's important to raise awareness of the harms of weight stigma and provide more support for people who are experiencing weight stigma, she said.
"Removing personal blame is key, and that requires changing the existing narrative in our society that continues to ignore the complex causes of body weight regulation," Puhl said.
American Heart Association volunteer expert Dr. Chiadi Ericson Ndumele agreed. He is the Robert E. Meyerhoff assistant professor of cardiology in the Department of Medicine at Johns Hopkins University School of Medicine in Baltimore.
Internalizing weight bias may also lead to avoidance of doctors, Ndumele noted. Women may feel judged about their weight by health care professionals and avoid medical care as a result, he said.
"Weight stigma gets in the way of our ability to really address obesity in the most constructive ways," Ndumele said. "When an individual understands the complexity around obesity, they are less likely to feel stigma and more likely to adopt a healthy lifestyle."
Obesity is not caused by laziness or lack of willpower. Instead, it is sired by a complex relationship between your genes, your hormones, your choices and your environment, he said.
The study did have its share of limitations. It only measured the relationship between self-stigma and belly fat at one point in time, which makes it difficult to determine cause and effect, Ndumele said.
The findings will be presented this weekend at the American Heart Association's annual online meeting. Research presented at meetings is typically considered preliminary until published in a peer-reviewed journal.
The American Heart Association offers tips on how to lose weight and keep it off.
SOURCES: Rebecca Puhl, PhD, professor, department of human development and family sciences, and deputy director, Rudd Center for Food Policy and Health, University of Connecticut, Hartford; Chiadi Ericson Ndumele, MD, PhD, MHS, Robert E. Meyerhoff Assistant Professor of Cardiology, department of medicine, Johns Hopkins University School of Medicine, Baltimore; American Heart Association's annual online meeting, Nov. 13-15, 2021