Project Summary/Abstract
Discrimination is a critical social determinant of health that underlies poor health outcomes. One common but
understudied form of discrimination is weight discrimination. Weight discrimination is the behavioral
manifestation of weight stigma—the social devaluation of people with excess body weight. Findings suggest
that the stress produced by weight discrimination prompts weight gain, creating a vicious cycle between weight
discrimination and obesity. Further, there is now well-documented evidence that experiencing weight
discrimination is associated with increased risk for cardiovascular disease. Little is known, however, about
mechanisms explaining the link between weight discrimination and poor cardiovascular health. Using a
rigorous experimental approach, this project will identify mechanisms through which weight discrimination
harms health. Findings will facilitate the long-term goal of this research: developing interventions to decrease
the negative health consequences of weight discrimination. As a step toward this goal, this project proposes
three experiments in which a diverse sample of adults with obesity will be randomly assigned to experience
(vs. not experience) weight discrimination in a controlled experimental setting. Drawing on previous research
and our pilot data, the interpersonal contexts chosen for these studies simulate situations in which people with
obesity commonly experience weight discrimination in their daily lives (e.g., health care and employment
settings). The following aims will be tested: (1) Identify early-stage cognitive, affective, behavioral, and
physiological mechanisms activated by experimentally manipulated weight discrimination; (2) Identify
psychological variables (e.g., internalized weight bias) that moderate effects of weight discrimination; and (3)
Identify demographic characteristics (e.g., gender, race) that moderate effects of weight discrimination.
Exposure to weight discrimination (vs. control) is hypothesized to result in elevated responses on early-stage
mechanisms that culminate in poor cardiovascular health (e.g., impaired self-regulation, cognitive vigilance to
signs of social disapproval, higher negative emotion, more social withdrawal and comfort eating, increased
cortisol secretion and inflammation). This research will identify novel and highly modifiable targets for
interventions designed to reduce the negative health effects of weight discrimination. In testing moderator
variables, this work will identify individuals who display particular vulnerability vs. resilience to the harmful
effects of discrimination. Information about moderators will thus help future intervention efforts target those
individuals most likely to benefit from intervention. Given the high prevalence of obesity and the millions of
Americans affected by weight discrimination, this research will address a crucial public health issue. At a
broader level, this work will provide critical insight into mechanisms that underlie adverse health effects of other
common forms of social stigma such as discrimination due to race, ethnicity, sexual orientation, or social class.