People with type 2 diabetes experience stigma because of both their diabetes and their weight, according to a study published in Clinical Diabetes by researchers at the UConn Rudd Center for Food Policy and Obesity. These stigmatising experiences contribute to unhealthy eating behaviours, lower physical activity and poorer health. The findings were reported in the paper, ‘Weight Stigma and Diabetes Stigma: Implications for Weight-Related Health Behaviors in Adults With Type 2 Diabetes’, published in Clinical Diabetes.
Specifically, individuals with type 2 diabetes who experience weight stigma in healthcare or differential treatment from others because of their diabetes are more likely to turn to food as a coping strategy and binge-eat, compared to those who have not experienced these forms of stigma. Additionally, when individuals with type 2 diabetes internalise the negative judgments they receive because of their diabetes and/or weight, they are more likely to binge-eat, engage in less physical activity, and report worse overall health.
"Despite increasing calls for efforts to address stigma in the diabetes field, there has been little research attention to stigma faced by people with type 2 diabetes," explained Dr Rebecca Puhl, lead author of the study and Deputy Director at the Rudd Center. "Given high rates of obesity among people with type 2 diabetes, these individuals are not only at risk of experiencing diabetes stigma, but also at risk of stigma because of their weight, both of which can have a detrimental effect on health."
To examine health links with diabetes stigma and weight stigma, researchers used an online, healthcare-focused research panel of 1,227 adults with type 2 diabetes. Survey questions asked respondents about their experiences of diabetes stigma and weight stigma, as well as their eating behaviours, levels of physical activity and self-rated health.
Key findings of the study include:
Being treated differently by others because of one's diabetes and engaging in self-stigma were both associated with eating as a coping strategy and binge-eating
53% of respondents reported they had been stigmatised for their weight and 44% had experienced weight stigma from a healthcare provider on more than one occasion.
Individuals who felt judged about their weight by doctors reported more frequent binge eating and were more likely to eat as a coping strategy in response to stress or negative emotions.
Internalised stigma was associated with eating as a coping strategy, binge eating, lower physical activity and worse perceived health.
Study authors encourage additional research on the topic, as these findings are among the first to highlight the important relationship between diabetes stigma and health behaviours. In addition, these findings are particularly important for healthcare providers who play a pivotal role in diabetes management.
"Initiatives to improve the health and well-being of individuals with type 2 diabetes must consider the harmful roles of diabetes stigma and weight stigma," added Puhl. "By bringing more attention to these forms of stigma in the diabetes field, progress can be made to identify effective approaches to support people with type 2 diabetes and reduce the harmful impacts of stigma on their health."