Obesity-associated stigma and physiological markers of stress: evidence from the Dominican Republic

Social stigma is increasingly recognized as a cause of stress-induced pathophysiology. We tested the hypothesis that stigma is associated with obesity-related morbidity, using a cohort of subjects from the Dominican Republic who value fat bodies over thin ones. We surveyed 87 subjects from Batey Algodon-a small region in the Dominican Republic where obesity is not stigmatized. We obtained information on ideal body norms, perceptions of one's own body and self-rated health. We also measured height, weight, waist circumference and blood pressure. We then performed linear regression analyses to ascertain the extent to which body mass index (BMI) and body norm perceptions were related to self-rated health and blood pressure. Self-rated health was strongly associated with one's satisfaction with his or her physical appearance (p < 0.001) and weight (p < 0.001). As expected, self-rated health was not independently associated with BMI in this community, which does not stigmatize obesity. However, BMI was nevertheless associated with both systolic and diastolic blood pressure (p < 0.05). While de-stigmatizing obesity may improve perceptions of health, it might not significantly reduce the incidence of hypertension among heavier persons. Copyright (C) 2008 John Wiley & Sons, Ltd.