Weight stigmatization increases physiological stress and appetite markers in women with obesity over 120 minutes.

Experimental evidence indicates that exposure to weight stigma can lead to sustained elevations in cortisol and ambulatory blood pressure. However, little is known about its acute effects on other physiological markers. This study aimed to explore the feasibility of measuring the physiological response of weight stigma, a novel weight stigmatising paradigm and preliminary efficacy signals. In a prospective randomised feasibility study, women living with obesity were assigned to either a weight stigmatising or non-weight stigmatising paradigm (15 min) and physiological response measured from baseline to 120 min. Eighteen women living with obesity were recruited (nine participants in each group; mean age 43.2 years (SD 10.3); body mass index of 45.8 kg/m (SD 5.9); 72.2% White ethnicity). Preliminary efficacy showed an observed acute increase in plasma cortisol (26.7 pg/mL, 95% CI -5.5 to 58.9), alongside increased systolic blood pressure (12.7 mmHg, 95% CI 0.6-24.8), self-reported stress (17.4 mm 95% CI 1.6-33.3), appetite (hunger/desire to eat; 16.8 mm, 95% CI 2.0-31.7; 20.9 mm 95% CI 5.1-36.7, respectively), reduction in peptide YY (-11.8 pg/mL 95% CI -21.6 to -2.01) and fullness (-13.9 95% CI -27.6 to -0.3). No differences were found between the intervention and control group in all measured parameters. Furthermore, this study showed that recruitment, randomisation and measuring real-time physiological response was feasible. This is the first feasibility study attempting to comprehensively characterise the acute physiological impact of experiencing weight stigma in people living with obesity in an experimental setting. Future appropriately powered studies are needed to confirm the preliminary efficacy findings.