Copyright © 2008 John Wiley & Sons, Ltd. Obesity-associated stigma and physiological markers of stress: evidence from the Dominican Republic Peter Muennig* ,† and Kara Keating Bench Department of Health Policy and Management, Columbia University, New York, NY, USA * Correspondence to: Peter Muenning, Columbria Uni- versity, Department of Health Policy and Management, 600 West 168 th Street, 6 th Floor, new York, NY 10032 † E-mail: pm124@columbia.edu Stress and Health Stress and Health 25: 241–246 (2009) Published online 9 December 2008 in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/smi.1243 Received 22 May 2008; Accepted 28 October 2008 Summary Social stigma is increasingly recognized as a cause of stress-induced pathophysiology. We tested the hypothesis that stigma is associated with obesity-related morbidity, using a cohort of subjects from the Dominican Republic who value fat bodies over thin ones. We surveyed 87 subjects from Batey Algodón—a small region in the Dominican Republic where obesity is not stigmatized. We obtained information on ideal body norms, perceptions of one’s own body and self-rated health. We also measured height, weight, waist circumference and blood pressure. We then performed linear regression analyses to ascertain the extent to which body mass index (BMI) and body norm perceptions were related to self-rated health and blood pressure. Self-rated health was strongly associated with one’s satisfaction with his or her physical appearance (p < 0.001) and weight (p < 0.001). As expected, self-rated health was not independently associated with BMI in this com- munity, which does not stigmatize obesity. However, BMI was nevertheless associated with both systolic and diastolic blood pressure (p < 0.05). While de-stigmatizing obesity may improve per- ceptions of health, it might not significantly reduce the incidence of hypertension among heavier persons. Copyright © 2008 John Wiley & Sons, Ltd. Key Words obesity; Stress; Social Desirability; Hypertension Introduction In the United States, obesity is heavily stigma- tized, and there is evidence that this stigma affects human health (Cahnman, 1968; Chen & Brown, 2005; Muennig, Jia, Lee, & Lubetkin, 2008; Muennig, Lubetkin, Jia, & Franks, 2006; Puhl & Brownell, 2003). It has been hypothesized that stigma is stressful and that this stress is transduced in the brain into an autonomic response (McEwen, 1998; McEwen & Mirsky, 2002; Muennig, Sohler, & Mahato, 2007; Roy, 2004; Williams, 1999). Psychological stress, when chronic, can lead to autonomic dys- regulation, predisposing afflicted persons to diabetes, heart disease and hypertension (McEwen, 1998; Roy, 2004). These are the very conditions for which obese people are at heightened risk. brought to you by CORE View metadata, citation and similar papers at core.ac.uk provided by Columbia University Academic Commons