Obesity-related social stigma and its social, psychological, and health implications among Saudi women in clinical settings: A cross-sectional study

Abstract

Obesity-related social stigma is increasingly recognized as a structural psychosocial determinant of health, yet empirical evidence from Middle Eastern clinical settings remains limited. This study aimed to examine the associations between obesity-related social stigma and social, psychological, and health-related implications among Saudi women attending bariatric and obesity medicine clinics in Jeddah. A cross-sectional correlational design was employed. Data were collected from 220 Saudi women with overweight or obesity (BMI ≥ 25 kg/m²) attending obesity medicine clinics in two governmental hospitals in Jeddah between January and December 2025. Validated and researcher-developed scales were used to assess obesity-related stigma, negative social identity, selective social withdrawal, engagement in stigmatizing behaviors, psychological security, self-criticism, binge eating, and adoption of extreme weight-loss methods. Internal consistency reliability ranged from α = 0.766 to α = 0.945. Pearson correlation coefficients and multiple linear regression models with HC3 robust standard errors were estimated, controlling for BMI, age, education level, income, and employment status. Stigma was significantly and positively associated with adverse outcomes across all social, psychological, and health-related domains (all p < 0.001). Following adjustment for BMI and sociodemographic covariates, stigma remained a statistically significant independent predictor of all outcome dimensions, with standardized coefficients ranging from β = 0.733 to β = 0.799 and explained variance ranging from 59% to 72%. These findings indicate that obesity-related stigma functions as an independent psychosocial risk factor among Saudi women in clinical settings. Obesity-management programmes should integrate stigma-reduction strategies, psychological screening, and stigma-sensitive healthcare training alongside standard biomedical treatment.