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May 16, 2026The Lancet Regional Health - Americas1 citationsOpen Access

The weight of society: a qualitative study on how social norms shape body size and weight ideals

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MCM. ContrerasUniversidade Estadual de Campinas (UNICAMP)XSXimena Ramos SalasLund UniversitySBSilvana Ferreira BentoUniversidade Estadual de Campinas (UNICAMP)

Key Points

  • The study explores how weight bias and stigma impact women's perceptions of their body size and related healthcare decisions.
  • Qualitative study conducted at a Family Planning Outpatient Clinic in Brazil.
  • Interviews (n = 6) and focus groups (n = 2, six participants per group) were conducted.
  • Data analyzed using reflexive thematic analysis.
  • Weight bias influences women's perceptions of their body size and health.
  • Biological actions like eating and exercising are shaped by societal norms regarding weight.
  • Women report that weight stigma affects their healthcare decisions and everyday actions.

Abstract

SummaryBackground Weight bias and stigma have transformed body weight from a purely biological attribute into a complex social phenomenon. Social and health scientists continue to critically examine how weight stigmatising discourses and biased perceptions shape attitudes, beliefs and everyday experiences. Studies show that socially mediated subjectivities profoundly affect women's health-related behaviours and decision-making. This study seeks to explore, from the standpoint of patients attending a gynaecological clinic, how weight bias and stigma influence women's perceptions of their own weight and body size and the healthcare decisions they make. Methods This qualitative study was conducted in a Family Planning Outpatient Clinic in the southeastern region of Brazil. Interviews (n = 6) and focus groups (n = 2, six participants per group) with patients were conducted from February to November 2024. All participants identified as women, and the interviews and focus groups were analysed using a reflexive thematic analysis approach. Findings The rationality of weight bias and stigma influences how women perceive their weight and body shape. This turns biological functions, such as eating and exercising, into social actions that respond to imposed norms that shape common sense about what is considered a healthy and desirable weight. Interpretation Medical research and clinical practice often reduce health risk factors to poor personal choices or biological predispositions, while neglecting systemic drivers such as weight bias, stigma and fatphobic representations, medicalised discourses of weight, and neoliberal ideals equating thinness with moral virtue. The rationality behind the embodied realities of women navigating weight-based discrimination reveals how weight bias and stigma shape women's everyday life, social actions and healthcare decisions. Funding São Paulo Research Foundation (FAPESP).

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Cite This Study

Contreras et al. (2026) studied this question.

synapsesocial.com/papers/6a080b4ea487c87a6a40d882https://doi.org/10.1016/j.lana.2026.101491
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