Obesity’s effects on relationships and health appear to be diminishing in regions where its prevalence is higher

Obese individuals often face difficulties in relationships, employment and health, but a recently published study Psychological Science found that the severity of these problems may depend on where they live. The research found that in regions where obesity is more common, the associated social and health problems are less pronounced. These findings suggest that social attitudes and cultural norms surrounding obesity may play an important role in shaping its consequences.

Obesity is a global health problem, and prevalence rates have doubled worldwide since 1990. Today, one in four adults in Europe and one in three adults in the United States live with obesity. In addition to well-documented health risks such as cardiovascular disease and mental health problems, individuals with obesity often face social stigma, discrimination, and economic disadvantages. They are more likely to experience unstable relationships, unemployment and social exclusion, which further increases the health burden of this condition.

The researchers aimed to investigate whether these results varied with local obesity prevalence. Basic theory suggests that social prejudices and stigma tend to target traits that deviate from the norm. If obesity is more common in an area, it may be seen as less unusual, potentially reducing the discrimination and negative stereotypes associated with it.

“Obesity affects many people, especially in the Western world, and has serious consequences for those affected. Our project was motivated by the fact that obesity rates vary greatly between and within countries,” said study author Jana Berkessel, a researcher at the Center for European Social Research at the University of Mannheim.

“For example, there are some regions in the United States where approximately 50 percent of the population lives with obesity, while in other regions only 5 percent of the population lives with obesity. People with obesity in regions with low obesity rates will be much more prominent and therefore have very different social experiences every day.” can easily be imagined.”

Researchers used data from more than 3.4 million people in the United States and the United Kingdom. The study was divided into three parts examining the role of regional differences and societal attitudes in the consequences of obesity.

Study 1 used data from the Behavioral Risk Factor Surveillance System, a large-scale, nationwide study conducted in the United States. This dataset included responses from 2.8 million respondents in more than 2,400 counties. Participants provided self-reported information about their weight, height, relationship status, employment, and general health. By linking these individual responses to regional obesity rates, researchers were able to evaluate how the consequences of obesity differ depending on the local prevalence of the condition.

Study 2 repeated the analysis using data from the BBC Laboratory in the United Kingdom, a similarly large-scale study but with notable differences across regional cultural contexts. This dataset included 180,000 participants from 378 regions and provides a cross-country perspective on how regional obesity prevalence affects individual outcomes.

Study 3 extended the findings by combining US data with information from Project Implicit, a large-scale initiative measuring explicit weight bias. Explicit weight bias refers to overtly expressed stereotypes and prejudices against individuals with obesity, such as the assumption that they are lazy or undisciplined. This latest study aimed to understand whether regional differences in weight bias could explain why the consequences of obesity are less severe in some regions than others.

To measure regional obesity prevalence, researchers calculated the proportion of individuals in each region with a body mass index (BMI) of 30 or higher. Regional obesity prevalence was then analyzed along with explicit weight bias scores to determine their impact on social, economic, and health outcomes reported by participants.

The findings revealed that in both countries, individuals with obesity generally face more difficulties in relationships, employment and health compared to those who are not obese. However, the scope of these challenges varied significantly by region.

In regions with low obesity prevalence, individuals with obesity were more likely to be single than those without obesity. In the United States, for example, people with obesity in areas with low obesity prevalence were 1.2 times more likely to be single than their non-obese peers. Conversely, in counties with high obesity prevalence, this disparity disappeared or even reversed; Individuals with obesity are slightly less likely to be single than those who are not obese.

Obesity-related health problems, such as reporting poor general health, also varied regionally. In areas with low obesity, individuals with obesity were four times more likely to report poor health compared to their non-obese peers. However, in regions where obesity is high, this probability decreased to 1.5 times. Although health inequalities still exist, their reduced severity in regions with high obesity rates highlights the potential moderating effect of cultural norms and social acceptance on perceived or reported health outcomes.

The researchers found that apparent weight bias was lower in areas where obesity was more common. This reduced bias partly explained why the social and health consequences of obesity were less severe in these regions. For example, in high-obesity regions, the likelihood of being single or reporting poor health was mediated by lower levels of weight bias.

“We found across two datasets that obesity has negative social, economic and health consequences, but that these consequences are less severe in some regions,” Berkessel told PsyPost. “For me, this means that at least some of the negative consequences of obesity are socially interpreted and therefore can be reduced. To give just one example, one way to change society’s views on obesity could be more realistic representation of different body sizes in the media.”

However, employment outcomes for individuals with obesity were less affected by regional obesity prevalence. In both the United States and the United Kingdom, individuals with obesity were consistently more likely to be unemployed than those without obesity, regardless of local obesity rates and weight trends. This suggests that factors beyond regional attitudes may contribute to these persistent inequalities.

The study highlights significant regional differences in the consequences of obesity, but it has limitations. First, the data come primarily from Western countries and the findings may not generalize to non-Western cultures with different attitudes towards obesity. Second, the cross-sectional design of the study does not establish causality. It is unclear whether living in areas with high obesity reduces the impact of obesity or whether individuals with obesity are more likely to remain in these areas. Finally, while weight bias has been identified as a mediator, other factors such as social comparisons or environmental adaptation may also contribute to regional differences.

“In my research, I am generally interested in how the social context in which we live affects our physical and psychological health,” Berkessel said. “For example, in a recent study (Ebert, Berkessel and Jonsson, 2023, PsychScience) examined whether a state’s political climate is associated with the longevity of political partisans. In another study (Berkessel et al., 2021, PNAS) I found that in countries that are less religious, money has a stronger impact on our well-being.”

Study, “On the Unequal Burden of Obesity: Adverse Consequences of Obesity Depend on Regional Obesity Prevalence”, written by Jana B. Berkessel, Tobias Ebert, Jochen E. Gebauer and Peter J. Rentfrow.