A new study from University of Utah Health has found that long-term improvements in mental health following bariatric surgery are more closely linked to reductions in weight stigma than to actual weight loss.
The research, published in Health Psychology, reveals that patients who reported experiencing less weight-based discrimination after surgery also reported better psychological well-being and healthier eating behaviors. In contrast, those who continued to face weight-related stigma were more likely to suffer from depression, anxiety, and disordered eating—even years after their procedures.
“We tend to assume that people with obesity simply have more health problems,” said Dr. Larissa McGarrity, the study’s lead author and a clinical psychologist in the Department of Physical Medicine and Rehabilitation at University of Utah Health. “But it’s the cumulative effects of stigma and discrimination that drive many of these physical and mental health challenges—not weight itself.”
Surgery Isn’t a Mental Health Cure-All
Bariatric surgery, also known as metabolic or weight-loss surgery, remains the most evidence-based treatment for severe obesity. It is well known to reduce risks for type 2 diabetes, heart disease, and overall mortality. However, the belief that it is a guaranteed fix for quality-of-life issues is a misconception.
According to McGarrity and her team, aspects of life such as social support and relationship satisfaction may actually decline after surgery. The study, which surveyed nearly 150 patients over several years post-surgery, found that while many participants reported a reduction in internalized weight shame, a significant proportion—roughly 40%—still struggled with persistent stigma.
“The degree to which these patients’ lives were affected by reduced stigma went far beyond typical clinical benchmarks,” said McGarrity, who is also an associate professor at the Spencer Fox Eccles School of Medicine.
Stigma, Not BMI, Predicts Mental Health
Importantly, the researchers found that improvements in psychological health were not directly tied to changes in body mass index (BMI). BMI reduction did not correlate with lower rates of depression, anxiety, or eating disorders. Instead, improvements were strongly linked to the patient’s perceived reduction in weight-related shame and discrimination.
Prior research has already shown that chronic exposure to weight stigma leads to heightened stress and worsens many obesity-related health outcomes. This new study reinforces those findings: patients who faced less stigma post-surgery were not only less likely to suffer from mood disorders but also more successful at maintaining weight loss over time.
Persistent Stigma Remains a Barrier
Yet not everyone benefited equally. About 40% of patients continued to report high levels of weight stigma, which was associated with diminished quality of life, psychological distress, eating disorders, and weight regain.
Because the study was conducted among patients treated at University of Utah Health, additional research is needed to determine if these findings apply to broader populations. Nonetheless, the researchers emphasize that the evidence points to a critical takeaway.
“One of the most important clinical and research issues I’ve encountered is the pervasive impact of weight stigma—inside and outside of healthcare settings,” McGarrity said. “Weight loss has its benefits, but over time, reducing stigma may have an even greater impact on mental health and quality of life.”
The full study, titled “Weight Stigma and Bariatric Surgery: Implications for Psychological Health and Long-Term Outcomes,” is available in the journal Health Psychology.
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