Exposing the Hidden Burden: Breaking Down Diabetes Stigma

By Mariah Z. Leach

Whether it’s a friend, family member, coworker, or even yourself, there’s a strong probability that you know someone living with diabetes.

According to the Centers for Disease Control and Prevention, about 38 million Americans (1 in 10) live with a type of diabetes. Another 98 million adults (more than 1 in 3) also have prediabetes, or a risk of developing diabetes in the future. Yet despite its impact on millions of people, a diagnosis of diabetes can carry a hidden burden: stigma.

The role weight plays in diabetes stigma

Stigma is a negative attitude or stereotype about a particular group of people. When it comes to people living with diabetes, some people hold a misconception that links the condition exclusively to lifestyle choices.

“People may wrongly assume that those with diabetes are solely responsible for their condition due to factors such as diet and exercise, leading to judgment and blame,” says Melissa Geraghty, PsyD, a clinical health psychologist, Director of Mental Health and Support with the U.S. Pain Foundation, and CEO of Phoenix Rising with Dr. G.

In reality, diabetes is a chronic health condition that impacts how your body turns food into energy. Your body breaks down most of the food you eat into sugar, or glucose. When your blood sugar goes up, it signals your pancreas to release insulin, a hormone that regulates glucose. Diabetes occurs either because your body doesn’t make enough insulin (type 1) or your body doesn’t use insulin well (type 2), or it can occur during pregnancy (gestational diabetes). Because of the lack of widespread knowledge about these root causes, people diagnosed with diabetes can face stigma on top of the physical toll the disease takes on their bodies.

Individuals with diabetes, particularly those living with type 2, can face heightened stigma if they are overweight or obese. In this case, society’s pre-existing biases about being overweight, such as the idea that overweight people have poor self-control or lack responsibility, fuel judgment toward individuals with diabetes.

“There is a prevalent misconception that weight is the only cause of type 2 diabetes, which can result in individuals being unfairly judged or blamed for their condition based on their body size,” Geraghty explains. “This weight-related stigma can exacerbate the overall stigma associated with diabetes.”

The impact of stigma

Diabetes stigma can be found everywhere in society, including school, the workplace, or even within families. Research indicates that this stigma is strongly related to psychological distress among people with diabetes, according to the National Institutes of Health. Negative attitudes from society can lead to discrimination and prejudicial treatment. Additionally, the shame, guilt, and self-blame associated with diabetes stigma can hinder an individual’s ability to actively engage in self-care practices, which can impact their overall well-being, as well as their self-esteem.

Unfortunately, diabetes and weight stigma can even impact the medical care a patient receives.

“Stigmatizing attitudes may lead health care professionals to make assumptions about a patient’s lifestyle without considering other contributing factors,” Geraghty warns. “This can result in biased treatment decisions, decreased quality of care, and a reluctance on the patient’s part to seek medical assistance or adhere to treatment plans due to fear of judgment.”

How stigma can be addressed

To address society’s diabetes stigma, it’s crucial to increase public knowledge about the true causes of diabetes, providing accurate information to dispel myths and correct misconceptions. Individuals living with diabetes and those who know them can contribute to increasing such awareness by joining advocacy efforts or sharing posts and articles that explain diabetes.

It’s important to mitigate the impact of stigma on your own self-esteem by seeking support from understanding family or friends. Joining a patient support network or receiving counseling from a mental health professional can also be beneficial.

In spite of the possibility of facing stigma from health care professionals, it’s also crucial that individuals living with diabetes continue to seek adequate treatment for their disease. If you encounter a health care professional who demonstrates diabetes stigma or weight stigma, Geraghty recommends seeking a second opinion. Connecting with providers who exhibit empathy and understanding can help you make decisions about your medical care.

Increasing awareness through collective efforts, challenging preconceived notions, and encouraging patients to continue seeking needed medical treatment are all ways to reduce the negative impact of diabetes stigma and work toward an inclusive society that supports individuals living with diabetes in their progress toward better health.

“Know that you are not alone in living with diabetes,” Geraghty says. “Connecting with other people who understand is an important way to have your experiences validated.”