A new study suggests that the psychological benefits often reported after weight-loss surgery may have less to do with shedding pounds—and more to do with shedding stigma.
Published in Health Psychology on June 5, the research explores how perceptions of weight-based discrimination before and after bariatric surgery shape patients’ mental health, eating behaviors, and weight outcomes. The findings highlight that the key factor in post-surgical well-being may not be weight loss itself, but rather a reduction in social stigma.
The Hidden Impact of Stigma
For Autumn Huett, the struggle with body image began in early childhood. Before kindergarten, she already feared rejection because of her size. In high school, after losing more than half her body weight through restrictive diets and extreme exercise, she was celebrated in the local news—yet her self-worth remained fragile.
Though she maintained high academic performance, Huett recalls feeling as though appearance overshadowed her accomplishments. “This vanity project seemed more important than anything else,” she said in an interview with Live Science.
After regaining the weight—an outcome research suggests is common—Huett found herself scrutinized in public. Attempts to manage her eating and exercise became obsessive in private, leading to bingeing, self-harm, and depression. Two psychiatric hospitalizations during college followed, all while her weight and emotional health remained closely entwined.
By 2022, Huett underwent bariatric surgery and achieved significant, though below-average, weight loss. Still, she felt judged—both by society and herself. “If you still appear overweight and don’t meet your weight goal, you’re seen as a failure,” she said.
Study: Stigma, Not Size, Drives Mental Health Outcomes
Clinical psychologist Dr. Larissa McGarrity of University of Utah Health, who co-authored the study, says Huett’s experience is far from unique. Her team found that weight stigma—not body size itself—was a major predictor of post-surgical mental health.
The study followed 148 patients 1.5 to 3 years after undergoing weight-loss surgery. Researchers assessed their experiences of weight-based discrimination in the week prior to survey participation, along with mental health, eating behaviors, and weight changes.
Over 90% reported experiencing weight stigma before surgery, but about 60% saw this stigma decrease significantly afterward. Those who felt less judged after surgery experienced better overall mental health and greater weight loss. However, the amount of weight lost did not directly correlate with improved psychological well-being.
Approximately 40% of participants reported continued stigma after surgery, which was linked to higher risks of depression, anxiety, disordered eating, and less favorable weight outcomes. In other words, the emotional toll of discrimination—not body weight—emerged as a key barrier to long-term recovery.
“This study underscores that even years after surgery, patients can’t escape weight stigma,” said McGarrity. “And it significantly affects their mental health.”
A Common Misconception About Weight
Weight discrimination is rooted in the belief that body size is solely a matter of willpower—diet and exercise alone. But research paints a more complex picture: genetics, biology, psychology, and social context all play major roles. Without medical intervention, sustained weight loss remains extremely difficult for most people.
Weight bias is widespread. Over 40% of U.S. adults report having experienced weight discrimination at some point. Studies increasingly link stigma to chronic stress, inflammation, anxiety, depression, and disordered eating—ultimately harming the very health it’s supposed to improve.
“There is strong evidence that weight stigma is pervasive and damaging,” said Dr. Rebecca Puhl, deputy director of the Rudd Center for Food Policy and Health at the University of Connecticut, who was not involved in the new study.
While bariatric surgery remains the most effective clinical treatment for severe obesity, surprisingly little research has focused on how patients experience stigma in its aftermath. McGarrity’s study helps fill that gap.
Surgery Doesn’t Immunize Against Judgment
Past studies have shown that while many patients experience psychological improvement post-surgery, others do not—or even worsen. This latest research reinforces that discrimination is an independent factor influencing outcomes.
The study has limitations. It relied on self-reported data and did not randomly assign participants to different levels of stigma, which limits its ability to establish causality. All participants came from one geographic region, and stigma was assessed at a single time point.
Still, experts say the findings are significant. “We need more research on how weight bias affects people after surgery,” said Puhl. “And we need to address stigma at every stage of the treatment process—not just assume it disappears after weight loss.”
Rethinking Public Health Messaging
McGarrity urges public health officials, policymakers, and media professionals to examine how their messages about body size affect real people. “We must ask ourselves whether our conversations around weight are actually harming health,” she said.
On a personal level, she added, individuals can show more empathy toward those struggling with weight—not just repeat generic advice to “eat less and move more.”
Huett agrees. “If you’re surrounded by a world that constantly shames you for your body, that shame becomes a wall you have to climb over just to move forward,” she said.
Today, Huett focuses on changing her own inner dialogue. “This journey is hard. You have to filter out so much noise. But you’re not a failure for not being thin. You’re not defeated.”
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