Weight Stigma and Hypothalamic-Pituitary-Adrenocortical Axis Reactivity in Individuals Who Are Overweight

Background Stigmatized people exhibit blunted cortisol responses to many stressors. Purpose To examine the cortisol responses of individuals who are overweight to a stigma-related stressor involving interviewing for a weight-discriminatory company. Methods We recruited 170 men and women (mean age = 35.01) from towns located within about a 30-min drive of the study center. Weight was assessed using body mass index (BMI) and self-perceptions about being overweight. Participants were exposed to a laboratory stressor, modeled after the Trier Social Stress Test. In the stigmatizing condition, participants gave a supposedly videotaped speech about what makes them a good candidate for a job at a company that was described as having a weight-discriminatory health insurance benefit. Participants in the nonstigmatizing condition made a supposedly audiotaped speech for a company whose health insurance benefit was not described. Cortisol reactivity was then assessed. Results Participants who rated themselves as overweight or who were overweight according to their BMI evidenced a blunted cortisol response in the weight-stigmatizing condition, whereas lean participants in the weight-stigmatizing condition showed the rise in cortisol levels that typically occurs following the Trier Social Stress Test. Conclusions People who experience the chronic stress of being stigmatized due to their weight show blunted cortisol responses just as other chronically stressed people do.