There’s a reason your employees might not be feeling like their best selves at work. But they might not know how to talk about it. And they might not know that it has a name. This problem can be defined in two parts: weight bias and weight stigma.
Weight bias is the negative attitudes, beliefs, and stereotypes associated with higher body weight or obesity. Weight bias can manifest as weight stigma — unfair treatment, discrimination, or abuse because of one’s weight. Sadly, more than 40% of adults in the U.S. have faced weight stigma.1 Sixty-four percent report size- or shape-based teasing or discrimination from family, coworkers, friends, classmates and even doctors.2
In the workplace, an alarming 15% of workers report that colleagues have made false assumptions about them based on their weight, and nearly three in four employees who have experienced unfair treatment at work due to their weight say it has made them feel like quitting their job.3
The impact of weight stigma is far-reaching, affecting employees’ health, job opportunities, and earnings. For employers, these impacts present challenges that include morale, culture, productivity, recruiting, retention, healthcare costs, and potential legal issues.
The reality is that employees with obesity may face what is called an “obesity penalty” related to their employment opportunities, career advancement, and wages. Overall, individuals with obesity or higher body weight earn less than their counterparts, even when accounting for other factors like education, experience, and job performance.4
Deeply internalized biases are behind the striking wage gaps. Research finds that employees with obesity are 27% more likely to be perceived as lazy and 23% more likely to be perceived as unmotivated.3 In contrast, average-weight employees are 35% more likely to be perceived as high-performing and 31% more likely to be perceived as motivated.3 These stereotypes can extend to hiring decisions. Over the course of their careers, people with overweight or obesity experience longer periods of unemployment compared to their peers.5 While much of the weight-related bias in hiring may be unconscious, half of people managers say they tend to favor interacting with “healthy-weight” employees.6
Beyond employment experiences and wage gaps, weight stigma’s most significant impact is on overall employee health and well-being. The pervasive, internalized stigma of living with overweight and obesity, not necessarily the weight itself, makes people more susceptible to anxiety, depression, and low self-esteem.7 But the effects of weight stigma are not only on mental health. Research shows that experiencing weight stigma can result in poor metabolic health and increased obesity risk.8
Individuals can be caught in a loop — experiencing weight stigma leads to increased stress and high cortisol levels, which can lead to poor metabolic health and increased risk for obesity. Obesity increases the risk of comorbidities such as hypertension, cardiovascular disease and type 2 diabetes. These health conditions can in turn make people more susceptible to depression and anxiety.
This cycle of declining health can perpetuate weight stigma through increased alcohol and substance use, lower confidence leading to less physical activity and limited social interactions, reluctance to seek help through employer programs, and avoidance of healthcare settings.
The direct business costs associated with obesity are well documented. Costs per employee with obesity are higher for absenteeism, short-term disability, long-term disability, and worker’s compensation.9 For employers, the financial incentive to end weight stigma and promote weight health is significant. When individuals with at least one chronic condition lose sufficient weight to move from being obese to overweight, annual healthcare expenses are reduced by 20%.10
While weight stigma is a societal issue, its prevalence presents an opportunity for employers to lead the way in increasing awareness and shifting the narrative around weight at work. The rapidly evolving weight health landscape has opened the door to increased discussion, presenting employers with the opportunity to be ahead of the curve in addressing weight stigma while realizing tangible business advantages. Strategies to address weight stigma can improve access and equity in weight health care and strengthen inclusive workplace cultures.
When the American Medical Association (AMA) recognized obesity as a disease in 2013, the primary objective was to change how the medical community tackles this complex issue in order to drive better prevention and management of obesity-related conditions. The recognition of obesity as a chronic condition marked a significant shift away from the belief that obesity is the result of personal choice or a lack of willpower. Now employers are following the lead of this clinical guidance to effect change in the workplace.
Providing fully covered benefits that treat obesity as a chronic disease acknowledges the underlying metabolic, genetic, and environmental influences that increase obesity risk. It also facilitates acceptance and insurance coverage for evidence-based treatments, including behavioral therapy, weight-loss medications like GLP-1s, and bariatric surgery.
Advancing science is shifting the emphasis around weight health from relying solely on willpower and lifestyle changes to a more comprehensive, full-spectrum approach that combines behavior change programs with medical treatments when clinically appropriate. Reaping the benefits of improved weight health and ensuring access to care requires a shift in mindset around outdated weight biases and stigma.
Addressing weight bias and weight stigma can be an integral part of your organization’s diversity, equity, and inclusion initiatives. Employers set the tone for their company’s culture, which requires both intention and attention: Intention, in terms of time, energy, and resources. And attention to building clarity with systems and structure. Creating an environment where people feel like they belong—and feel their best—can increase engagement, which also benefits the business.
Adding or enhancing policies to address weight-related bias can go a long way toward shifting attitudes. Emphasizing job-related criteria, qualifications, and contributions helps ensure equity in hiring, promotion, and performance evaluations. In addition, providing training and education to raise awareness about weight stigma and encouraging the formation of employee resource groups focused on body positivity and size inclusivity can help foster an open and supportive culture.
About 86% of U.S. private-sector employees work for establishments that offer employer-sponsored health insurance.11 Employers have tremendous influence and purchasing power to help reduce the costs of weight health care while providing quality care.
Employers can shift the focus of employee health benefits from weight loss to weight health by offering employees access to a full spectrum of solutions, from behavioral health to coaching and clinical support. For more information on "The pivotal role of employers in providing quality weight health care," click here.
1 Lee, K.M., Hunger, J.M. & Tomiyama, A.J. (2021). Weight stigma and health behaviors: evidence from the Eating in America Study. Int J Obes 45, 1499–1509.
2 Pearl RL, Himmelstein MS, Puhl RM, et al. Weight bias internalization in a commercial weight management sample: prevalence and correlates. Obes Sci Pract. 2019;5(4):342-53. ^Puhl RM, Lessard LM, Himmelstein MS, Foster GD. The roles of experienced and internalized weight stigma in healthcare experiences: Perspectives of adults engaged in weight management across six countries.
3 Confronting Weight Bias and Discrimination in the Workplace, SHRM, January 2024.
4 The obesity pay gap is worse than previously thought, The Economist, November 2023.
5 Groves, J., & Wilcox, V. (2023). The impact of overweight and obesity on unemployment duration among young American workers. Economics and human biology, 51, 101280.
6 Laws, Policies Can Counter Weight Discrimination at Work, SHRM, May 2023.
7 Westbury, S., Oyebode, O., van Rens, T. et al. (2023). Obesity Stigma: Causes, Consequences, and Potential Solutions. Curr Obes Rep 12, 10–23.
8 Weight stigma: As harmful as obesity itself?, Harvard Health Publishing, June 2022.
9 Employees with obesity may have higher loss of work productivity than those with normal weight, Endocrine Society, June 2023.
10 Thorpe K, Toles A, Shah B, Schneider J, Bravata DM. Weight Loss-Associated Decreases in Medical Care Expenditures for Commercially Insured Patients With Chronic Conditions. J Occup Environ Med. 2021;63(10):847-851.
11 U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality (AHRQ). (2022). MEPS Insurance Component Chartbook 2022.