Understanding internalised weight bias: a guide to self-acceptance

What is internalised weight bias?

Internalised weight bias is a negative inner voice that many people living with overweight or obesity carry with them. It's a voice that occupies valuable mental space and feeds self-criticism.

Dr Stephanie de Giorgio, GP, weight loss specialist, co-founder and Chief Clinical Officer, Genwell Health, UK explains that internalised weight bias is common among people living with overweight or obesity.

“If you have internalised weight bias, it can influence the decisions you make about yourself,” she says. “Unfortunately, it can also lead you to think less of yourself and blame your weight for many of the challenges you face. This inner monologue is something that is very difficult to live with.”

Dr Stephanie de Giorgio, GP, weight loss specialist, Chief Clinical Officer, Genwell Health, UK (and Betty)

According to De Giorgio, internalised weight bias can have profound effects on your psychological wellbeing and physical health.

De Giorgio explains that internalised weight bias can persist even in people who have previously had overweight or obesity and have since lost weight.

“For people who have lived in a larger body, feelings of being unworthy of love, a job, or someone’s time - or the belief that they constantly fail because they can’t control their eating - tend to stick,” she says. “For some, these feelings can resurface even at a lower body weight. Conversely, there are people with a larger body weight who don’t struggle with this, while someone who has gained just a few pounds might experience it sooner.”

How to manage inner weight bias?

Managing internalised weight bias is a challenging process that often requires a blend of self-compassion, self-acceptance, and professional support.

Let go of self-blame

A key step in managing internalised weight bias is accepting that having overweight or obesity is not your fault. All those persistent feelings of guilt, shame, or self-blame - such as feeling bad about what or how much you eat - are harmful to your mental wellbeing. It’s important to recognise that having these feelings is not your fault either.

“It’s your brain reacting to what society has imposed on you,” says de Giorgio. “Once you have made that connection, you can start being kinder to yourself. You can begin to understand that you are not a failure, not weak-willed, and not greedy.

“You are deserving of all the nice things in the world that everybody else has.”

Recognise that setbacks can happen

Losing weight and feeling free of it can be an amazing experience. However, if your weight starts to return, it can come back quickly and in significant amounts. This can be discouraging, often leaving people feeling like they’ve failed even more than before.

De Giorgio explains that many people with overweight or obesity experience cycles of losing and regaining weight. This isn’t a sign of failure - it’s physiology.

“When we lose weight, our bodies naturally try to return to their previous weight,” she says. “The feeling of failure often comes from thinking we should have stayed at a lower weight, but in reality, that struggle is simply going against our body’s natural tendencies.”

Seek professional support

De Giorgio recommends that you may need professional support to overcome the effects of internalised weight bias, as it can be difficult to address on your own. She explains that if you’ve struggled with weight management throughout your life - regardless of your body size - professional guidance can be especially helpful, since internalised weight bias may have been present for many years.

She highlights compassion-based therapy and cognitive analytic therapy as particularly effective approaches.

“Therapy can also include reading materials or talking things through with someone else,” adds de Giorgio. “The challenge is that even after working on these thoughts, you’re still exposed to negative messages from the world. That’s why professional support can be so important - it’s a big thing to fight off your own.”

De Giorgio concludes by emphasising that we all need to recognise the harm of societal weight stigma and inner weight bias.

“In order to fix one, we have to diminish the other, because they come as a pairing,” she says. “We need to be very certain that we don't put all the emphasis on the person living with obesity to ‘fix’ themselves.

“We all have a duty - including healthcare professionals - to educate about obesity and fight back against societal stigma, so that people living with obesity don't develop such damaging feelings about themselves.”

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