Sitting on a shelf at the antenatal clinic desk was a folder with the label “big girls” – a file of all the current patients who were obese.

“I couldn’t believe what I was seeing, and in a healthcare setting,” Monash University researcher Dr Briony Hill said.

Dr Hill, an NHMRC Early Career Fellow (2016-2021) in the area of preconception wellbeing and member of CRE HiPP, has focussed her research on weight stigma for women in the preconception, pregnancy and postpartum stages – a little-known and under-researched area that she and her colleagues are working hard to change.

Weight stigma is discrimination or stereotyping based on a person’s weight. According to the Weight Issues Network (WIN), weight discrimination is the fourth most common form of social discrimination amongst adults – and follows closely after age, gender and race discrimination. It is the only form of discrimination still widely thought to be socially acceptable.

Dr Hill said women at the preconception, pregnancy and postpartum stages were particularly vulnerable to weight stigma, which could directly impact their health and that of their unborn baby. 

“People don’t talk about it, but we know it’s a serious problem for many women,” Dr Hill said. “More than half of Australian women will enter pregnancy living with overweight or obesity and between 40-60 per cent of women gain weight during pregnancy that exceeds health recommendations. This makes women vulnerable to weight stigma during one of the most special times of their lives.”

Dr Hill recently published a Review of National and International weight stigma literature in Seminars in Reproductive Medicine, which highlighted the severity of impact to mother and baby. 

“Studies have shown experiences of weight stigma can lead to decreased reproductive healthcare quality, mental health symptoms, poorer health behaviours and a raft of adverse pregnancy outcomes, including heightened risks of preeclampsia and gestational diabetes” Dr Hill said.

“Babies born to mothers living with obesity are also twice as likely to be living with obesity themselves as children, through to adolescence and adulthood.”

“Part of the difficulty is that we still see obesity as an individual’s problem and fault. We need to change this societal view to better support women at these pivotal stages of life.”

In December, the Weight Issues Network released a report – The Personal Cost of Weight Issues in Australia 2020. The report highlights how weight stigma impacts those living in larger bodies.

“For all of my life I have carried more weight than I would like. But, it was only after the birth of my daughter in 2009, that I became more conscious about the health implications of my weight,” Divya Ramachandran, WIN Board Chair said.

Years of experimenting with different weight management approaches – “some harmful, some useful” – led Mrs Ramachandran to pursue academic research in weight-loss and to form the Weight Issues Network.

“We want people to understand that obesity is not a choice, and the shame, bias and discrimination is not helping anybody, but harming many of us,” she said.

Dr Hill welcomed the WIN report as a step towards better educating the public, health professionals and policy makers. “It’s about understanding and recognising weight stigma is a problem – that’s the first step. The second step is learning what we can do to change it,” she said.

For Dr Hill’s work specifically, she is focussed on how people perceive women who conceive while living with overweight or obesity, and those who gain too much weight during pregnancy or struggle to lose weight afterwards. “Once we have a better understanding of women’s stigma experiences at these stages, we will be able to look at how we can fix it,” Dr Hill said.

Dr Hill and Mrs Ramachandran recently spoke to ABC Babytalk with Penny Johnston about weight stigma. Listen to the interview via the ABC website.

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