A common assumption is that weight stigma works the same way for everyone. A new US survey of 296 adults with a BMI of 30 or higher suggests that three different things, prejudice, experienced stigma and internalised stigma, can point in different directions across groups. The study is small, drawn from two clinics, and cannot say why the groups differ. What it offers is a measured comparison, with limits the authors name and some the text leaves open.
The paper is “Weight stigma among diverse ethnic groups with obesity in the U.S.: the USA-OBESTIGMA study” by Rodolfo J. Galindo, Giuliana Arevalo, Albert Lecube, Guillermo E. Umpierrez and colleagues, published on 14 February 2026 in the International Journal of Obesity (open access). The paper uses the term “obesity” for people with a BMI of 30 or higher; I use it where I describe the study.
How the data were collected
Between December 2022 and March 2024, patients at two academic outpatient clinics, one in Atlanta (Grady Memorial Hospital, Emory University) and one in Miami (University of Miami), filled in three questionnaires on the same day. Adults with a BMI of 30 or higher were eligible. Of 422 people contacted, 122 declined and 4 were excluded, which leaves 296.
The sample: mean age about 55, 59 percent women, mean BMI 36.7. By self-reported group, 123 were Hispanic (42 percent), 68 non-Hispanic White (23 percent) and 105 non-Hispanic Black (35 percent). The study is part of an initiative of the Spanish Society for the Study of Obesity that runs similar surveys in several countries.
The three instruments measure different things. The Anti-Fat Attitudes scale (AFA, 0 to 9) measures prejudice against people with obesity. The Brief Stigmatizing Situations Inventory (SSI-B, 0 to 9) measures how often someone has lived through stigmatising situations. The Weight Bias Internalization Scale (WBIS, 7-point) measures how far someone has taken on negative stereotypes about their own body.
The results
Group averages differ on every scale, and the group with the highest score is not the same on each. The table shows the means as the paper’s text reports them.
| Scale | Hispanic | Non-Hispanic White | Non-Hispanic Black |
|---|---|---|---|
| Anti-fat attitudes (AFA) | 3.55 | 3.29 | 2.12 |
| Stigmatising experiences (SSI-B) | 1.24 | 2.01 | 1.21 |
| Weight bias internalisation (WBIS) | 2.69 | 2.96 | 2.27 |
All three comparisons are reported as statistically significant (p < 0.001 for AFA and SSI-B, p = 0.0006 for WBIS).
Adjusted for age, sex, income, education and BMI, some differences hold and some do not. For anti-fat attitudes, Black participants scored lower than Hispanic participants (β = -1.385, p < 0.001), while White and Hispanic participants did not differ significantly. For stigmatising experiences, White participants scored higher than Hispanic participants (β = 0.894, p < 0.001), while Black and Hispanic participants did not differ. For internalisation, Black participants scored lower than Hispanic participants (β = -0.626, p < 0.001), and the gap between White and Hispanic participants was borderline (p = 0.055).
Most people with a BMI of 30 or higher did not call themselves obese. Between 69 and 73 percent in each group described themselves as having overweight, and 19 to 29 percent as having obesity. The authors call this a misperception. That is one reading; it also shows that a BMI cut-off and how people describe their own bodies are not the same thing.
Doctors recommending a diet was the most common stigmatising experience in all three groups. The paper reports it for 94.1 percent of White, 83.8 percent of Hispanic and 81.0 percent of Black participants (p = 0.01), including when the person had not come to talk about weight. This is the one item-level figure I use; see the next section for why.
Younger participants reported more stigmatising experiences, and so did those with less than a high school education compared with a graduate degree. The authors link the age finding to earlier studies in which people who developed severe obesity before 18 reported more severe stigma.
Reading it carefully
This is a cross-sectional survey, not an explanation. It shows that group averages differ. It does not show why. The explanations in the discussion, such as different cultural norms around body size, are plausible and untested here. The authors also call higher BMI “a coping mechanism or resilience” as a possible reason for the negative link between BMI and anti-fat attitudes; the study did not measure that.
The sample is small and regional. 296 people from two cities, with a large Hispanic share because of Miami. The authors say the results may not generalise to the US. The groups were recruited in clinics, so they are people who use specialist care, and 122 of 422 people contacted declined. The groups are also unequal in size, with 68 White participants against 123 Hispanic.
Some numbers in the text do not add up, so I leave them out. Several different SSI-B items are reported with identical percentages for the same group: 77.94 percent for White participants on two different items, and 31.14 percent for Hispanic participants on the same two items. Either the items happen to match or something went wrong in the table or text. Tables 1 to 4 are not readable as text in the full text, so I could not check them. For the age effect the text gives β = -0.19 with a standard error of 0.006 and p = 0.024; those three values are not consistent with each other, so I report only the direction. The abstract gives a mean age of 54.9, the text 54.8.
The paper frames weight as a medical problem; I report its findings, not that frame. The discussion describes obesity as “a chronic metabolic disease” and says internalised stigma can drive weight gain. The study did not test either. The authors call for education programmes against weight bias; I report that as their recommendation, not as a finding.
Conflicts of interest. The paper’s funding is internal to the University of Miami. The first author discloses research support from and consulting for several drug and device companies, including Novo Nordisk and Eli Lilly, outside this work. That is worth knowing, not a finding against the paper.
This article reports how one survey measured and compared weight stigma. It does not evaluate any treatment or weight-related intervention.
Why it belongs here
Stigma research in the US is often drawn from White samples, and the authors say so. This study compares three groups side by side and shows that “experienced”, “held” and “internalised” stigma are separate measurements that do not move together. The doctor-recommends-a-diet figure, 81 to 94 percent across groups, is the part that needs the fewest caveats. For earlier studies in this series see our article on the cultural value of fat in the US, Portugal and Mexico and the Hong Kong longitudinal study. For Germany and the UK this survey does not speak: it is US-only.
Source: Galindo RJ, Arevalo G, Zabala Z, Flores I, Soliman D, Moazzami B, Rashied A, Lecube A, Umpierrez GE. “Weight stigma among diverse ethnic groups with obesity in the U.S.: the USA-OBESTIGMA study.” International Journal of Obesity 2026;50:1027-1034, published 14 February 2026, doi.org/10.1038/s41366-026-02028-z. Full text read on 4 October 2026.