Weight Stigma and Hypothalamic-Pituitary-Adrenocortical Axis Reactivity in Individuals Who Are Overweight

Ann Behav Med. 2019 Mar 20;53(4):392-398. doi: 10.1093/abm/kay042.


Background: Stigmatized people exhibit blunted cortisol responses to many stressors.

Purpose: To examine the cortisol responses of individuals who are overweight to a stigma-related stressor involving interviewing for a weight-discriminatory company.

Methods: We recruited 170 men and women (mean age = 35.01) from towns located within about a 30-min drive of the study center. Weight was assessed using body mass index (BMI) and self-perceptions about being overweight. Participants were exposed to a laboratory stressor, modeled after the Trier Social Stress Test. In the stigmatizing condition, participants gave a supposedly videotaped speech about what makes them a good candidate for a job at a company that was described as having a weight-discriminatory health insurance benefit. Participants in the nonstigmatizing condition made a supposedly audiotaped speech for a company whose health insurance benefit was not described. Cortisol reactivity was then assessed.

Results: Participants who rated themselves as overweight or who were overweight according to their BMI evidenced a blunted cortisol response in the weight-stigmatizing condition, whereas lean participants in the weight-stigmatizing condition showed the rise in cortisol levels that typically occurs following the Trier Social Stress Test.

Conclusions: People who experience the chronic stress of being stigmatized due to their weight show blunted cortisol responses just as other chronically stressed people do.

Keywords: Blunted cortisol; HPA axis reactivity; Social identity threat; Weight stigma.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Body Mass Index
  • Female
  • Humans
  • Hydrocortisone / analysis*
  • Hypothalamo-Hypophyseal System / physiopathology*
  • Male
  • Overweight / physiopathology*
  • Overweight / psychology
  • Pituitary-Adrenal System / physiopathology*
  • Saliva / chemistry
  • Social Stigma*
  • Stress, Psychological / physiopathology*
  • Stress, Psychological / psychology


  • Hydrocortisone