Summary: In a small feasibility study in women with obesity, a 15-minute weight-stigmatising paradigm showed preliminary within-group rises in cortisol, blood pressure, stress, and hunger and falls in peptide YY and fullness, but found no statistically significant differences between the stigma and control groups.
PICO Summary
| Element | Detail |
|---|---|
| Population | 18 women living with obesity (mean BMI 45.8, mean age 43.2), randomised feasibility study (9 per group). |
| Intervention | 15-minute weight-stigmatising paradigm to induce acute stress, with physiological measures to 120 minutes. |
| Comparison | 15-minute non-weight-stigmatising paradigm. |
| Outcome | Preliminary signals: cortisol +26.7 pg/mL, systolic BP +12.7 mmHg, stress +17.4 mm, hunger +16.8 mm, desire to eat +20.9 mm, peptide YY -11.8 pg/mL, fullness -13.9 mm. No statistically significant between-group differences. Recruitment, randomisation, and real-time measurement were feasible. |
Expert Commentary
Weight stigma is not a soft concept, it plausibly drives real physiology, cortisol, blood pressure, appetite hormones, and it may help explain why stigmatising care backfires and promotes the very eating it claims to discourage. So I am glad someone is trying to measure it properly. What this paper is, though, must be stated plainly: a feasibility study of eighteen women that found no statistically significant differences between the stigma and control conditions. The eye-catching numbers, the cortisol and blood-pressure rises, the peptide YY fall, are within-group preliminary signals the authors explicitly present as hypothesis-generating, not proof, and with nine women per arm the study was never powered to confirm them. Its genuine achievement is methodological: showing that this can be recruited, randomised, and measured in real time. Can I use this with my patients? Not as evidence of a specific physiological effect size, but it reinforces what I already practise, treating patients with obesity without stigma, because the direction of harm is biologically credible and ethically obvious regardless. I would await an adequately powered trial before drawing physiological conclusions, and I welcome that this groundwork makes one feasible.
References
Brown A, Wingrove J, Flint SW. A randomised feasibility study assessing acute physiological responses to weight stigma in women living with obesity. Clin Obes. 2026;16(2):e70073. doi:10.1111/cob.70073