A study published on 22 September 2026 asked 301 adults diagnosed with schizophrenia in one Chinese psychiatric hospital whether they had felt judged or treated worse because of their body weight. A little over half said yes. The more interesting result is what did not predict it: body mass index.
The paper, “Perceived weight stigma among adults diagnosed with schizophrenia in China: a cross-sectional study”, is by Jiayuan Peng, Huan Wen, Jianjian Wang, Ka Yan Ho, Xiangmin Tan, Ting Pan and Mei Sun. It appeared in Frontiers in Psychology (volume 17, open access). The authors say that, to their knowledge, only one earlier quantitative study had looked at weight stigma in this population, a US study that measured experienced and internalised stigma, not perceived stigma.
Who took part
Data were collected between June 2023 and January 2024 on inpatient wards of a single tertiary psychiatric hospital, using convenience sampling. Of 315 questionnaires, 14 were excluded because more than 15 percent of items were missing, leaving 301: 155 men and 146 women, mean age 27.0 years. Participants had a diagnosis of schizophrenia under ICD-11 and were judged able to complete the questionnaire on their own.
The mean BMI was 23.6 (range 15.0 to 35.8). This is not a sample of people living in larger bodies. It is a sample of people with a psychiatric diagnosis, and that matters for everything below.
How stigma was measured
Perceived weight stigma was measured with a 10-item yes/no questionnaire (PWSQ), scored 0 to 10. Anyone who answered yes to at least one item was counted as reporting perceived weight stigma. That is a low bar, and the authors say so by defining it explicitly. The mean score was 2.2 out of 10, and about half of all participants scored zero.
Other scales covered internalised weight bias (WBIS), psychological distress (a 0 to 10 distress thermometer), social support and coping style. None of the scales has been specifically validated in people with schizophrenia, which the authors list as a limitation.
The findings
54.2 percent of participants (163 of 301) endorsed at least one item.
In the multivariable model, three things were associated with higher scores:
- Income. Compared with people earning more than 5,000 yuan a month, people earning under 3,000 had expected scores about 1.7 times higher, and people earning 3,000 to 5,000 about 1.6 times higher.
- Internalised weight bias. Each additional point on the WBIS went with an expected score about 10 percent higher.
- Psychological distress. Each additional point on the distress thermometer went with an expected score about 10 percent higher.
BMI was not significantly associated with perceived weight stigma. Neither was weight change since starting antipsychotic medication, once the other factors were in the model. Education and rural or urban residence differed in simple comparisons but not in the final model.
Reading it carefully
The authors offer three possible reasons why BMI did not track stigma: schizophrenia-related stereotypes may overshadow body size in how others judge a person, patients may put symptom stability ahead of weight, and people may attribute weight gain to medication rather than personal failure. These are explanations from earlier literature, not things this study tested.
The study also cannot say which way the links run. It is a snapshot, so distress may raise perceived stigma, stigma may raise distress, or both may follow from something else. The authors add that internalised bias and perceived stigma were both self-reported at the same moment, so some of their overlap may be an artefact of measurement. They did not record antipsychotic type or dose, symptom severity or metabolic conditions. The sample is young, from one hospital and one country, so the 54.2 percent is not a national or international rate.
This article reports the design and findings of one study. It does not evaluate any medication or weight-related intervention, and neither does the paper’s own conclusion, which argues for looking at social and economic context alongside symptoms.
Why it belongs here
Weight stigma is usually discussed as something that happens to people with high BMI. This study is a reminder that the experience can attach to people whose BMI is unremarkable, and that who is most exposed can depend on income and on how much a person has absorbed the bias, not only on the number on a scale. For people who are both fat and living with a mental illness, the two stigmas can stack, a point the authors raise as a framework, not as something measured here.
Germany, the United Kingdom and the United States are not covered by these numbers.
Source: Peng J, Wen H, Wang J, Ho KY, Tan X, Pan T, Sun M. “Perceived weight stigma among adults diagnosed with schizophrenia in China: a cross-sectional study.” Frontiers in Psychology 2026;17, doi.org/10.3389/fpsyg.2026.1928934. Full text read on 30 September 2026.