Obesity care fails when bias precedes treatment. Across Latin America and the Caribbean, a pervasive but underexamined force — weight stigma — is undermining health outcomes for millions of people living with obesity, operating not just socially but within the very institutions meant to help them. Understanding the scope and mechanisms of this stigma is essential for improving care quality and health equity in the region.
A systematic review synthesizing evidence from 128 studies across Latin America and the Caribbean documents weight stigma operating across five major domains: healthcare systems, educational institutions, workplaces, media, and broader social environments. Among the most clinically significant findings is evidence of both explicit and implicit anti-fat bias among healthcare professionals and medical students — those positioned to deliver care. Children and adolescents face disproportionate weight-based bullying, while adults with obesity experience measurable social exclusion. A recurring cultural narrative framing obesity as a personal moral failure was identified as a key driver reinforcing stigma and deterring individuals from seeking treatment. Notably, the review also flags the near-total absence of legal protections against weight-based discrimination across most countries in the region.
This review arrives at a moment when weight stigma research globally is maturing but remains geographically skewed toward high-income, English-speaking countries. The Latin American dataset fills a meaningful gap, though the aggregation of 128 heterogeneous studies across vastly different national contexts introduces important caveats around comparability and causal inference — most underlying studies are likely observational. The finding that healthcare providers themselves carry measurable bias is not unique to this region; similar patterns have been documented in North America and Europe. What distinguishes this analysis is its scale within a region where structural obesity care infrastructure is already underdeveloped. Clinically, stigma has been linked in prior research to avoidance of medical care, worsening cardiometabolic markers, and poorer mental health outcomes — making its reduction a legitimate clinical priority, not merely an ethical one. This review is best characterized as an important regional synthesis, though large-scale intervention trials measuring stigma-reduction outcomes remain the critical next step.