Multidimensional stigma perception in among adults with obesity: the roles of mental health, social support, and treatment engagement

BACKGROUND: Obesity is a chronic disease that, beyond its physical and psychological repercussions, exposes adult individuals to stigma and negative social attitudes. These experiences may negatively affect self-esteem, mental health, and adherence to treatment regimens. The aim of this study is to evaluate multidimensional stigma perception among of stigma among adults diagnosed with obesity and examine the roles of mental health, social support, and treatment engagement in this context. METHODS: This descriptive cross-sectional study was conducted at a state hospital in the Southeastern Anatolia Region of Türkiye between January and April 2025. The study sample consisted of 139 patients who volunteered to participate in the study and met the inclusion criteria, as determined by a power analysis. Data were collected using a questionnaire and the Chronic Illness Anticipated Stigma Scale (CIASS). Total score of CIASS ranges from 12 to 60, with higher scores indicating greater perceived stigma. Data normality was assessed using the Kolmogorov-Smirnov test. Depending on distribution, Student's t-test, one-way ANOVA, Mann-Whitney U, and Kruskal-Wallis tests were used for group comparisons. Pearson correlation analysis and multiple linear regression analysis were performed. In the regression model, the CIASS total score was used as the dependent variable, and independent variables were selected based on the literature and univariate analysis results. Statistical significance was set at p < 0.05. Data were analysed using SPSS 23 software. RESULTS: Most of the participants (74.1%) reported being exposed to negative attitudes, mainly related to physical appearance (55.4%). In addition, 71.2% reported feeling stigmatised, and the majority of them reported receiving no support from family (69.1%) and society (85.6%). The total mean score of CIASS was 34.35 ± 8.02. Those who were exposed to negative attitudes and reported that stigma affected their treatment process had significantly higher CIASS total scores (p < 0.05). Furthermore, the participants who reported having mental health related to obesity had higher CIASS scores (p < 0.05). CONCLUSIONS: Consequently, it was determined that a great part of obese adults with obesity experienced stigma and had a lack of social support, resulting in a negative effect on psychological well-being and treatment processes. Interventions aimed at increasing awareness of obesity-related stigma and providing education and support for obese adults are recommended.