title: Weight-related stigma is a significant psychosocial stressor in developing countries: Evidence from Guatemala.
abstract: Weight-related stigma is established as a major psychosocial stressor and correlate of depression among people living with obesity in high-income countries. Anti-fat beliefs are rapidly globalizing. The goal of the study is to (1) examine how weight-related stigma, enacted as teasing, is evident among women from a lower-income country and (2) test if such weight-related stigma contributes to depressive symptoms. Modeling data for 12,074 reproductive-age women collected in the 2008-2009 Guatemala National Maternal-Infant Health Survey, we demonstrate that weight-related teasing is (1) experienced by those both underweight and overweight, and (2) a significant psychosocial stressor. Effects are comparable to other factors known to influence women's depressive risk in lower-income countries, such as living in poverty, experiencing food insecurity, or suffering sexual/domestic violence. That women's failure to meet local body norms-whether they are overweight or underweight-serves as such a strong source of psychological distress is particularly concerning in settings like Guatemala where high levels of over- and under-nutrition intersect at the household and community level. Current obesity-centric models of weight-related stigma, developed from studies in high-income countries, fail to recognize that being underweight may create similar forms of psychosocial distress in low-income countries.
authors.affiliation: School of Human Evolution and Social Change, Arizona State University, United States. Electronic address: jhackman@asu.edu.
authors.forename: Joseph
authors.initials: J
authors.lastname: Hackman
authors.affiliation: School of Human Evolution and Social Change, Arizona State University, United States.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Maupin
authors.affiliation: School of Human Evolution and Social Change, Arizona State University, United States.
authors.forename: Alexandra A
authors.initials: AA
authors.lastname: Brewis
mesh_terms: D000293:Adolescent; D000328:Adult; D001835:Body Weight; D003863:Depression / Q000453:epidemiology / Q000209:etiology; D003906:Developing Countries / Q000706:statistics & numerical data; D005260:Female; D005523:Food Supply / Q000706:statistics & numerical data; D006166:Guatemala / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000523:psychology*; D011203:Poverty / Q000706:statistics & numerical data; D012307:Risk Factors; D012742:Sex Offenses / Q000523:psychology / Q000706:statistics & numerical data; D057545:Social Stigma; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology; D013315:Stress, Psychological / Q000209:etiology*
keywords: Depression; Guatemala; Obesity; Psychological stress; Stigma; Weight-stigma