Insights
Weight stigma, not BMI, has biggest impact on mental health after weight-loss surgery
New research shows that weight stigma—not body weight itself—has the biggest impact on mental health and healthy behaviours in the years following weight-loss surgery.
The study found that patients who had undergone metabolic bariatric surgery, commonly referred to as weight-loss surgery, tended to experience a significant reduction in weight stigma. This decrease—not a lower BMI (body mass index)—was linked to improved mental health and healthier eating habits. By contrast, those who continued to experience stigma after surgery were more likely to report higher levels of depression, anxiety, and disordered eating.
Researchers surveyed nearly 150 people who had received the surgery, which remains the most effective evidence-based treatment for severe obesity. The procedure is known to reduce many health risks more common in people with obesity, including type 2 diabetes, heart disease, and all-cause mortality.
“We think of a lot of health issues for these patients as being a given,” said Dr Larissa McGarrity, the study’s lead author and a clinical psychologist in physical medicine and rehabilitation at University of Utah Health. “But the cumulative effect of stigma and discrimination actually contributes to a large part of the physical and mental health problems that we disproportionately see for patients with obesity compared to the general population.”
The results are published in Health Psychology.
While many assume weight-loss surgery leads to a guaranteed improvement in quality of life, McGarrity noted that this is not always the case. Some areas, such as social support and satisfaction in romantic relationships, may actually worsen.
However, participants in the study did report much lower levels of weight stigma—shame, blame, and guilt around body weight or shape—in the years following surgery.
McGarrity, who is also an associate professor at the Spencer Fox Eccles School of Medicine at the University of Utah, said the degree of change in experienced weight stigma was especially notable. “The degree of change far exceeded clinically established norms in terms of what’s meaningful for a patient’s life and the impact they would notice,” she said.
This reduction in stigma was associated with significant improvements in both mental and physical health. Previous research has shown that the chronic stress of weight stigma contributes directly to many of the health risks associated with obesity. In this study, patients who experienced less stigma after surgery reported lower levels of anxiety and depression. They were also less likely to engage in disordered eating, such as binge eating, and more likely to maintain their weight loss over time.
Importantly, McGarrity noted that weight loss itself was not responsible for these improvements. Changes in BMI did not correlate with depression, anxiety, or dysregulated eating—suggesting that social factors, rather than biological ones, are driving the changes in health and wellbeing.
Not all patients experienced a drop in stigma. For around 40 per cent of respondents, weight stigma persisted, continuing to affect their quality of life and increasing their risk of mental health issues, disordered eating, and weight regain.
As the survey was conducted among patients treated at University of Utah Health, the researchers acknowledged that further studies will be needed to determine whether the findings apply to more diverse populations.
The authors say their work highlights the urgent need to address weight stigma in both healthcare settings and society more broadly.
“The wide-ranging effects of weight stigma are one of the most important things I’m thinking about from both a research and clinical perspective,” McGarrity said. “Weight loss is helpful for a whole lot of things, but that change in weight stigma may actually be the more powerful thing for mental health and quality of life over time.”
The longer someone has type 2 diabetes, the higher their cardiovascular disease risk, and changes in red blood cells may help explain it, new research suggests.
The study found red blood cells from patients with long-term diabetes harmed blood vessel function, while no such effect was seen in those newly diagnosed.
After seven years of follow-up, the blood cells of people initially diagnosed had developed the same harmful properties.
Zhichao Zhou, associate professor at Karolinska Institutet and lead author, said: “What really stands out in our study is that it is not only the presence of type 2 diabetes that matters, but how long you have had the disease.
“It is only after several years that red blood cells develop a harmful effect on blood vessels.”
Researchers at Karolinska Institutet in Sweden studied animals and patients with type 2 diabetes.
They identified microRNA-210, a small RNA that helps regulate gene activity, as a possible early biomarker of cardiovascular risk.
When its levels were restored in red blood cells, blood vessel function improved.
Eftychia Kontidou, doctoral student and first author, said: “If we can identify which patients are at greatest risk before vascular damage has already occurred, we can also become better at preventing complications.”
The researchers are now investigating whether the biomarker can be used in larger population studies.
The Global Initiative on Ageing and Longevity has launched a North American chapter to boost innovation and economic transformation in the longevity sector.
The organisation, known as GIA-L, said the new chapter will strengthen its mission to help people of all ages thrive across longer, healthier lives and tap into the growing longevity economy.
Building on its work with United Nations agencies and global partners, GIA-L said the US chapter will enhance its ability to advance initiatives at national and international levels.
Dr Alison Bryant has been appointed as the inaugural chair.
She currently serves as chief operating officer of the Learning Economy Foundation, a global non-profit developing digital infrastructure to transform education, skills and economic opportunity. Her previous roles include positions at Sesame Workshop and AARP.
Dr Bryant said: “We have a tremendous opportunity to strengthen public-private partnerships that improve life and learning across the age span.”
“This is the moment to reimagine how societies support people at every stage of life by aligning innovation, collaboration, and practical action that benefits all generations.”
Luis Gallegos, president of GIA Longevity, said: “Dr Bryant represents the leadership, strategic insight, and commitment to innovation that GIA Longevity calls for as we enter a new chapter of growth.”
GIA-L works with organisations to co-create products, services and models designed for a longevity-driven economy.
The UK has banned junk food adverts on TV before 9pm and online at all times to tackle childhood obesity.
The rules are expected to remove up to 7.2bn calories from children’s diets each year, reduce the number of children living with obesity by 20,000 and deliver around £2bn in health benefits over time.
Evidence shows advertising shapes what and when children eat, forming preferences from a young age and increasing the risk of obesity and related illnesses in later life.
Obesity and overweight are linked to at least 13 different types of cancer, as well as type 2 diabetes, heart disease and other conditions that affect healthy ageing.
At the start of primary school, 22.1 per cent of children in England are living with overweight or obesity, rising to 35.8 per cent by the time they leave. Children living with obesity are far more likely to live with obesity as adults.
Ashley Dalton, minister for health, said: “We promised to do everything we can to give every child the best and healthiest start in life.”
“By restricting adverts for junk food before 9pm and banning paid adverts online, we can remove excessive exposure to unhealthy foods – making the healthy choice the easy choice for parents and children.
“We’re moving the dial from having the NHS treat sickness, to preventing it so people can lead healthier lives and so it can be there for us when we need it.”
Colette Marshall, chief executive at Diabetes UK, said:
“With type 2 diabetes on the rise in young people, the need to improve children’s health in the UK has never been greater.
“Obesity is a major risk factor for type 2 diabetes, and the condition can lead to more severe consequences in young people – leaving them at risk of serious complications like kidney failure and heart disease.
“The long-awaited move to restrict junk food advertising – along with other measures such as mandatory healthy food sales reporting for businesses and the extension of the Soft Drinks Industry Levy – can help protect the health of our children, creating a future where conditions like type 2 diabetes can be prevented in young people.”
The measures form part of a broader government approach to prevention, including extending the Soft Drinks Industry Levy to cover more products such as sugary milk-based drinks, and a ban on the sale of high-caffeine energy drinks to under-16s.
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