Obesity is a global epidemic and a risk factor for non-communicable diseases and mortality. More than half of the population in 34 of the OECD countries are currently overweight, whereas one in four is obese. From 2010 to 2016, there was a 3 % increase in the number of people suffering from obesity, i.e., – 50 million more people in the OECD countries.

One of the measures for the damages associated with obesity is the lost years of life (1). Among the OECD countries, the life span in Mexico is shortened by 4.2 years, in Poland and Russia by 3.9 years, in the USA and Hungary 3.7 years, in Romania 3.5 years, in Israel—3.4 years, in Ireland 2.9 years, in France 2.7, in South Korea 1.7 and in Indonesia 1.5 years due to obesity. The list is closed by Japan – where obesity shortens life by only one year. Diseases associated with obesity will claim the lives of approximately 90 million people in OECD countries over the next 30 years.

Education and socio-economic background affect obesity. Reciprocally, obesity damages labor market outcomes that, in turn, contribute to reinforcing existing social inequalities (2). Obese people have poorer job prospects compared to normal-weight people, they are less likely to be employed and have more difficulty re-entering the labor market (3). Obese people are less productive at work due to more sick days and fewer worked hours, and they earn about 10% less than non-obese people. Addressing obesity and the associated negative labor market outcomes would help break the vicious circle of social and health inequalities.

Indeed, numerous studies have demonstrated the positive relationship between poverty and obesity. Yet, the extent to which obese people have an increased perception of being poor when the actual level of income is controlled remains an open question.

Previous studies have revealed the stigmatization of obese persons by society. Obese people have frequently been found to use language, which reflects poor self-identity following the perceived negative impact of their weight (4). Likewise, obese persons seem to suffer more from poor self-esteem, as well as a higher level of vulnerability and a propensity to depression, particularly among women (5).

Previous studies have also demonstrated wage and other penalties against obese people – particularly women (6–14).

Yet, with one exception (8); the question that remained open is the self-awareness of obese women and men to these penalties. Our study contributes by demonstrating this awareness while the income level is controlled. They support the awareness of more obese women, manifested by their subjective ranking as “not poor,” to lower prospects of finding a job.

The objective of the current study is to demonstrate that obese people suffer not only from poor self-esteem, but also from increased sense of subjective poverty among both genders, even when the actual level of income is controlled. The rationale of our study is the following. A-priori, compared to normal weight persons there is no reason that obese persons would have a sense of excess poverty where the level of income is controlled. Yet our study is the first to clearly demonstrate elevated awareness to weight discrimination among obese persons.

Indeed, many studies in the literature demonstrate wage discrimination against obese persons and particularly women. Based on panel setting, Caliendo and Gehrsitz (12) suggest that for a 1-point BMI increase in Germany, wage drops by 0.6–0.7% among women both in blue and white-collar professions (page 216). The authors mention the robust findings in the literature that unlike women, men are either not subject to weight penalties or premia in the labor market, or at least experience a diminished wage penalty [e.g., (15, 16)]. Campos-Vazquez and Gonzalez (17) show lower prospects of finding a job among obese women in Mexico, but not among obese men. Finally, Prioschery et al. (18) demonstrate the importance of western values referring to the body silhouettes and obesity of South African urban females.

Puhl and Brownell (19) argue that discrimination against obese persons can be documented in three important areas of living: employment, education, and health care. 28% of teachers in one study claimed that becoming obese is the worst thing that can happen to a person; controlling for income and grades, parents provide less college support for their overweight children than for their “thinner” children; 24% of nurses said that they are “repulsed” by obese persons.

Finally, Böckerman et al. (20), suggest that the outcomes obtained from economic models using the narrower genetic risk score as an instrument indicate 6.9% lower wages, 1.8% fewer years employed, and a 3-percentage point higher probability of receiving any social income transfers following a one-unit increase in BMI in Finland.¹ Note, however, that unlike Böckerman et al. (20), who discusses the impact of the genetic profile, the current paper discusses the socio-cultural factor, namely, the impact of the social stigma on the subjective sense of poverty among obese persons.

We propose a new measure for the influence of western socio-cultural values and norms associated with discrimination against obese women. Given the lower prospects among these women of finding a job, one would anticipate a positive relationship between obesity (represented by higher body-mass index BMI = kg . mete r 2 ) (where weight is measured in kilograms and height is measured in meters) and higher ranking of poverty.²

This study is based on the longitudinal survey carried out by the Israeli Central Bureau of Statistics (ICBS) (21) and based on a representative sample of the Israeli population. The survey reports the response of interviewers to the following question: “During the last 15 years, how often did you consider yourself poor?” on a scale of 1 = “often” to 4 = “never,” as well as an objective measure of income [total gross annual income from all sources in NIS (the local Israeli currency, where 1 NIS ≈ $0.31)]. Additional recorded information is the weight and height of each individual, from which the BMI measure may be calculated.

Findings clearly demonstrate a drop in the projected probability of self-ranking as “not poor” with BMI ranging from 0.73 to 0.37 (females) – 0.48 (males) when income is controlled. Similar outcomes are obtained when the independent variables are lagged and thus avoid endogeneity concerns. Finally, additional outcomes support the conclusion that the lagged BMI Granger-cause self-ranking of poverty for women, but not for men. Consequently, the outcomes of our study demonstrate awareness to the economic outcomes of discriminations against obese persons. These phenomena are plausible given the lower frequency of dates and jobs opportunities (17, 22), which, in turn, diminishes the Social and Economic Status (SES) in the long run.

The contribution of this study lies in its focus on economic parameters. The focus of previous studies was obesity as a precursor of lack of self-confidence, as well as increased depression and vulnerability (4, 22), or the genetic component of obesity as a precursor of lower wages, fewer years employed, and a higher probability of receiving any social income transfers (20). Yet, to the best of our knowledge, the current study is the first to measure the subjective sense of poverty among obese persons (i.e., how often you consider yourself poor) when the level of income is controlled. Thus, the outcomes of our study can be interpreted as the degree of awareness of the social stigma concerning obese persons among potential employers, parents, and mates. In this context, a recent article by Campos-Vazquez & Gonzalez (17) indeed demonstrated a lower prevalence of job offers to obese women – where all the other C.V. factors were controlled.

In sum, the contribution of this research lies in the new method proposed to assess the permanent income of obese persons. According to Friedman (23) the permanent income hypothesis is a theory of consumer spending stating that people will spend money at a level consistent with their expected long-term average income. The outcomes of the current study indicate that the level of permanent income among obese people is lower than their current income.

According to twin studies, approximately 80% of obesity emanates from genetic factors (24). Consequently, research findings stress the need to educate the public against prejudices on the grounds of obesity. In particular, our study seeks to evoke awareness among potential employers, which, in turn, might motivate avoidance of, or at least reduction in, an implicit wage penalty against obese women.

The implication of twin studies is the comparison between identical (monozygotic) twins. This is a conventional methodology in medical literature, particularly where the indication of genetic disorder emerges. In research, concordance is often discussed in the context of both members of a pair of twins. Twins are concordant when both have, or both lack a given trait.

One example is Ji and An (25). Using the twin study design, and subsequent control for genetics and shared environmental effects, the authors found negative association between harsher parenting in communication and BMI in German twin families. Another example is Lietzén et al. (26), who studied the effects of regular exercise training on LFC, PFC, and metabolism in monozygotic twin pairs discordant for BMI.³

The remainder of this article is organized as follows. Section 2 provides the description of data and methods. Section 3 gives the results. Finally, section 4 provides discussion and section 5 concludes and summarizes.

This study introduces a novel approach to examining the impact of societal norms on obese women, focusing on their economic self-perception. By controlling for income levels over a two-year period, the research reveals a significant decrease in the likelihood of obese individuals ranking themselves as “not poor,” particularly among women (from 0.73 to 0.37), and men (0.48). This underscores how weight biases influence economic self-assessment, independent of actual income variations.

Moreover, the study contributes to understanding the concept of permanent income among obese individuals, highlighting a discrepancy between their current and expected long-term income levels. Unlike prior research focusing mainly on self-esteem impacts, this study reveals a heightened perception of poverty among obese persons, indicating broader societal implications beyond health outcomes.

The findings also suggest a gender-specific effect, where lagged BMI significantly predicts self-ranking of poverty among women but not men, suggesting differential economic impacts based on weight.

Public policy implications are substantial, advocating for interventions to mitigate weight-based discrimination in employment and social settings. Efforts to enhance self-esteem and economic opportunities for obese individuals, similar to campaigns for other marginalized groups, are recommended.

Research findings support the awareness of more obese women, manifested by their subjective ranking as “not poor,” to lower prospects of finding a job.

This support is consistent with the results demonstrating a drop in the projected probability of self-ranking as “not poor” with the BMI from 0.73 to 0.37 among females. Differently put, the study reveals the inclination of more obese women to rank themselves as “poor” and less obese women to rank themselves as “not poor.” Given that the income level is controlled, under equal conditions, higher BMI will elevate the women’s tendency to feel poorer compared to their less obese counterparts.

Research findings thus stress the need to educate the public against prejudices on the grounds of obesity, particularly given that 0.78–0.81 of the weight gain is attributed to heritability (24). In that context, Shugart (47) demonstrate a shift in the American public opinion following The Oprah Winfrey Show, from an historical attribution of obesity to personal responsibility to cultural explanations. Ophra Winfrey is known for her own public struggle with obesity, which she often engages in on her show. This serves further to anchor the moral authority on the topic and the reflection of the fact that obesity is not necessarily the outcome of lack of will power. Consequently, there is no reason why employers should offer obese women less job opportunities compared to their normal weight counterparts [e.g., (17)].

In particular, our study seeks to evoke awareness among potential employers, which, in turn, might motivate avoidance of, or at least reduction in, an implicit wage penalty against obese women (to which the women are aware of according to a possible interpretation of our findings).

This conclusion is further supported by Ásgeirsdóttir et al. (8), Chung and Lim (48), and Arbel et al. (6, 7).

Ásgeirsdóttir et al. (8) suggest that only females show a positive willingness to pay (WTP) for not being overweight. Based on their income level, and to achieve the same happiness level, the reduction of weight for overweight females is associated with WTP of $3,608–$37,488 per year.

Based on Korea National Health and Nutrition Examination Survey (2010–2014), Chung and Lim (48) found that obesity prevalence more than doubled with a shift from less to more educated women. While 34.3% of the less-educated women were defined “obese,” this prevalence reduced to only 16.0% among the highly educated women. Given the return on higher human capital, higher education is also positively associated with income level. In this context Mathieu-Bolh (49) suggests that among socio-economic characteristics poverty seems to be connected to obesity in rich countries, albeit this relationship might be more elusive than expected.

Arbel et al. (6) demonstrate another aspect of the penalty against obese women: their need to compromise on men with shorter height as mates. The literature demonstrates positive association between the height of the men, and owning a car, having more children, and living in a single family detached unit. Stefanczyk et al. (50), for instance, showed that shorter men are rated by others as less masculine, less physically attractive, of lower social and professional status, and less competent compared with taller men.

Finally, Arbel et al. (7) explored the relationship between self-evaluation of apartments and obesity as a proxy for self-esteem, particularly among women. One would anticipate a lower self-evaluation of apartment value among obese women following the influence of western values and norms regarding a slim body image of women, namely, social obesity penalties. The authors demonstrate that for both genders, BMI is negatively correlated with self-evaluation of apartments. Yet, compared to males, the cognitive error in price evaluation is smaller among women.

The current study proposes and applies a new measure for the influence of western social values and norms associated with discrimination against obese women. Based on a follow-up survey of two years, we estimate the relationship between projected probability of self-ranking of poor individuals and obesity, when the income level is controlled. Findings clearly demonstrate a drop the projected probability of self-ranking as “not poor” with BMI from 0.73 to 0.37 (females) – 0.48 (males) when income is controlled. Similar outcomes are obtained when the independent variables are lagged and thus avoid endogeneity concerns. Finally, additional outcomes support the conclusion that the lagged BMI Granger-cause self-ranking of poverty for women, but not for men.

The contribution of this manuscript lies in the new method proposed to assess the permanent income of obese persons. According to Friedman (23) the permanent income hypothesis is a theory of consumer spending stating that people will spend money at a level consistent with their expected long-term average income. The outcomes of the current study indicate that the level of permanent income among obese person is lower than their current income.

Unlike previous studies, our manuscript shows that obese persons suffer not only from poor self-esteem (4, 5, 22), but also from an increased sense of poverty among both women and men even, when the actual level of income is controlled. In response to the question—how often do you consider yourself poor, a higher inclination among obese person to answer “often” was observed. Unlike Böckerman et al. (20), who demonstrate the impact of genetic factors, the current manuscript exemplifies the cultural factors of a social stigma in our thin-obsessed society (22).

The outcomes of our research may be interpreted as the degree of awareness to the social stigma concerning obese persons among potential employers, parents, and mates. This pattern, in turn, adversely affects the Social and Economic Status (SES) in the long run. In this context, a recent article by Campos-Vazquez and Gonzalez (17) indeed demonstrated a lower prevalence of job offers to obese women in Mexico– where all the other C.V. factors were controlled.

Discrimination and prejudice may also be considered as irrational behavior. Preston and Szymanski (51) demonstrated that increasing the proportion of black soccer players is expected to improve the ranking of English football teams. Goldin and Rouse (52) provide evidence suggesting that the blind audition procedure fostered impartial hiring of musicians and increased the proportion of women in symphony orchestras.

The public policy repercussions of our study should be divided into two main components. The first relates to the work of professionals (psychologists, doctors, dietitians, personal trainers and social workers) with obese persons, in an effort to boost their self-esteem, provide motivation for development and assist them in maintaining appropriate nutrition and participating in physical activity programs. Undoubtedly, obesity is a medical problem and the risk factor of many diseases such as cardiovascular diseases (mainly heart disease and stroke), which were the leading cause of death in 2012; diabetes; musculoskeletal disorders (especially osteoarthritis – a highly disabling degenerative disease of the joints); several cancer types (including endometrial, breast, ovarian, prostate, liver, gallbladder, kidney, and colon) (53, 54). Solely from health considerations, obese persons should be monitored and encouraged to reduce weight.

The second component is the need for a broad-based public information campaign, explaining the genetic sources of obesity. About 60–80% of obesity and severe obesity might be explained by genetic factors (55, 56). Indeed, Shugart (47) demonstrate a shift in the American public opinion following The Oprah Winfrey Show, from an historical attribution of obesity to personal responsibility to cultural explanations. Ophra Winfrey is known for her own public struggle with obesity, which she often engages on her show. This serves further to anchor the moral authority on the topic and the reflection of the fact that obesity is not necessarily the outcome of lack of will power. Consequently, there is no reason why employers should offer obese women less job opportunities compared to their normal weight counterparts [e.g., (17)].

The strength of our study may be described as follows:

There are several weaknesses associated with this study. The study uses BMI as a measure of obesity. According to the World Health Organization, on the one hand, like any other measure BMI is not perfect indicator since it is only dependent on height and weight and it does not take into consideration different levels of adiposity based on age, physical activity levels and gender. For this reason it is expected that it overestimates adiposity in some cases and underestimates it in others (53).

On the other hand, BMI is easy to measure and calculate and is therefore the most commonly used tool to correlate risk of health problems with the weight at population level. During the 1970s and based especially on the data and report from the Seven Countries study, researchers noticed that BMI appeared to be a good proxy for adiposity and overweight related problems (53).

Other measures of obesity are also problematic. Association between waist circumferences (WC) and health risks is not a trivial exercise and should be undertaken scientifically using proper techniques (53).

A further discussion of the advantages and disadvantages of BMI and other possible measures of obesity are given in Nirav and Braverman (57), Antonopoulos et al. (58), Bosello et al. (59), Gažarová et al. (60), and Moltrer et al. (61).

Another limitation that should be considered is the self-reported BMI in our sample. Yet, two points should be considered:

Finally, an additional limitation is the possible extension of the proposed empirical model which will considers the potential non-linear effect of obesity. This is a subject for possible future research. Such research should employ parabolic models, which permit non-monotonic increase or decrease with obesity.