Written by: Paulina Calcaterra, Psy.D, Perinatal Psychology Fellow
In a recent conversation with a friend navigating her first pregnancy, she shared how often she encountered weight stigma in the healthcare system. She described the pressure she felt from an OBGYN provider she had just met, who urged her to pursue weight loss. Despite never having inquired about her history of disordered eating or her relationship with food and movement, the provider handed her pamphlets on diet and exercise and warned her that her pregnancy could become high-risk.
What this provider failed to recognize was that my friend already followed a balanced, nourishing diet, cooked most of her meals at home, and maintained a regular strength-training routine. She wasn’t asking for advice on weight loss—she was asking for healthcare professionals who could support her health holistically. The weight stigma she faced created enormous stress during her pregnancy and ultimately became a barrier to accessing safe and compassionate medical care.
Weight Stigma and Diet Culture Beyond Pregnancy
Even outside the perinatal period, weight and dieting dominate our social landscape. Media constantly promote the latest weight-loss tips or dieting fads. This barrage of judgment about our bodies and food choices reflects broader cultural phenomena known as weight stigma and diet culture.
For birthing people who are already managing the physical and emotional transitions of pregnancy and postpartum life, this can be especially harmful. People living in larger bodies and their healthcare providers are beginning to challenge these stigmatizing norms in favor of approaches that prioritize health rather than weight. A note on language: many advocates fighting weight bias use the term “fat” as a neutral descriptor to reclaim the term and move away from words that carry significant stigma (“obese”, “overweight”) or terms that sound like euphemisms (“curvy,” “plus size”) which can imply discomfort or shame about weight. However, for those who might not feel comfortable using the term “fat” in this way, terms such as “person of size,” “higher weight,” or “larger bodied” are recommended as alternatives. Higher weight individuals will have their own preferences regarding language and providers or loved ones should honor these choices when speaking to them.
What Are Weight Stigma and Diet Culture?
Weight stigma is the discrimination or mistreatment of individuals based on body size. It’s rooted in the belief that living in a larger body is evidence of personal failure or lack of discipline. It manifests in microaggressions—like a relative recommending “slimming” colors—and more serious harms, such as healthcare providers skipping necessary screenings, which can lead to missed diagnoses and worse health outcomes (Alberga et al., 2019; Graham et al., 2022).
Weight stigma often coincides with diet culture, the societal belief system that moralizes thinness and promotes restrictive eating. Instead of learning to listen to our own bodies’ signals of hunger and fullness, diet culture encourages rules-based eating: calorie counting, fasting windows, or rigid “clean eating.” These patterns can easily spiral into disordered eating behaviors.
The Consequences: What Does the Research Say?
Weight stigma and diet culture have measurable negative effects. For instance, studies show:
- Up to 84% of women and 61% of men report being dissatisfied with their body (Fiske et al., 2014; Faw et al., 2021).
- About 20% of young women engage in extreme weight control behaviors, such as skipping meals or purging after eating (Neumark-Sztainer et al., 2011).
- Weight stigma is linked to depression, anxiety, substance use, suicidal ideation, and even heart disease due to physiological stress responses (Pearl & Puhl, 2018; Tomiyama, 2014; Panza et al., 2019).
In healthcare, these biases lead patients to avoid medical care altogether. Up to 74% of medical providers have been shown to hold implicit anti-fat attitudes (Phelan et al., 2015), which impacts diagnosis, communication, and treatment. Despite clear evidence of harm, weight-focused care persists—and often undermines both mental and physical well-being.
Weight Stigma in Pregnancy and the Postpartum Period
Weight bias is particularly damaging during pregnancy and postpartum recovery. These are periods already fraught with vulnerability around body changes, appetite shifts, and pressure to “bounce back.” For those experiencing fertility challenges, pressure to achieve health and a particular body weight can be especially amplified. Women are vulnerable to developing disordered eating behaviors during these periods—researchers estimate that about 5% of pregnant women may experience eating disorders, which are associated with adverse effects for the baby and mother (Ozturk & Ouyaba, 2024). Research has found that about 13% of postpartum individuals suffer from eating disorders (Pettersson et al., 2016).
Medical guidelines often emphasize avoiding “excessive” weight gain in pregnancy, and higher weight pregnant individuals are sometimes even advised to lose weight—despite evidence showing that this can be harmful. In fact, one study found that higher weight individuals who lost weight during pregnancy were more likely to deliver babies classified as small for gestational age (Kapadia et al., 2015).
Weight stigma in pregnancy has been linked to:
- Decreased quality of healthcare
- Increased anxiety, depression, and disordered eating
- Gestational diabetes and breastfeeding challenges
- Avoidance of prenatal care and reduced autonomy in birthing choices (Hill & Incollingo, 2020; Dever et al., 2025)
Larger bodied birthing parents have reported being denied fertility treatments, breastfeeding support, and even access to birthing pools or vaginal births due to their weight. The risks associated with weight stigma often outweigh the medical risks of weight itself.
So, What Does This Mean?
There is a growing movement toward weight-inclusive care—care that prioritizes overall health and mental well-being without making weight loss the goal. Providers and loved ones can play a key role in fostering this shift.
Two promising alternative frameworks include:
- Health at Every Size (HAES): This model emphasizes equitable, respectful care regardless of body size and promotes sustainable health behaviors without focusing on weight. HAES-based interventions have been linked to improvements in blood pressure, physical activity, self-esteem, and disordered eating symptoms (Bacon et al., 2005).
- Intuitive Eating: This approach encourages people to tune into their own hunger, fullness, and satisfaction cues instead of following rigid diet rules. It has been shown to generally improve physical health markers like blood pressure, reduce eating disorder symptoms, and support glycemic control. In pregnant and postpartum populations, it has been associated with optimal weight changes through gestation and following birth; lower anxiety and depression; improvements in gestational diabetes and glycemic control (Gao et al., 2024; Paterson et al., 2019; Leahy et al., 2017; Quanash et al., 2022).
Final Thoughts
Given the extensive evidence of harm caused by weight stigma—and the effectiveness of holistic, weight-inclusive care—it is troubling that diet culture continues to dominate pregnancy care. We must advocate for a new standard: one that uplifts birthing people of all sizes, affirms their lived experiences, and promotes true health equity.
Whether you are a healthcare provider, a support person, or a birthing individual yourself, you have a role to play in challenging weight stigma and helping build a more affirming world for all birthing bodies.
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