More than just numbers: the expanding burden of non-communicable diseases.

Individuals in larger bodies experience stigmatizing attitudes about weight and shape from numerous social contexts (e.g., family, peers, media []; healthcare professionals []) that devalue fatness and perpetuate negative assumptions about size. One form of weight stigma is anti-fat attitudes, henceforth referred to as negative attitudes towards obesity (e.g., ascribing qualities such as laziness, poor self-control, and lack of willpower to individuals of higher weight []). Negative attitudes towards obesity are reinforced by sociocultural thinness ideals () and beliefs that weight reflects health and personal responsibility (). Importantly, people of all sizes can hold anti-fat attitudes, including people in larger bodies (). Repeated experiences of weight stigma may lead people in larger bodies to develop negative beliefs about obesity (). Chronic exposure to teasing and discrimination can contribute to the internalization of negative weight stereotypes (), known as self-directed stigma (). Self-directed stigma can reinforce negative attitudes towards obesity, as individuals strive to distance themselves from a socially devalued identity, potentially increasing the risk of eating disorders (EDs; ; ). Negative attitudes towards obesity are also observed among individuals with low weight, who often hold similar negative beliefs about people in larger bodies (). However, the relation between weight status and negative attitudes towards obesity, especially within the context of EDs, remains largely unexplored. It is conceivable that lower-weight individuals experience strong thin ideal internalization through social validation tied to thinness (), reinforcing negative attitudes toward obesity, whereas higher-weight individuals may internalize and sometimes project these views onto others with larger bodies as a means of psychological distancing or self-protection (; ).