At a time when global health officials are stepping up efforts to treat obesity, some researchers see a troubling side effect: a growing stigma against fat people.

“Of all the things we could be exporting to help people around the world, really negative body image and low self-esteem are not what we hope is going out with public health messaging,” said Alexandra Brewis, executive director of the School of Human Evolution and Social Change at Arizona State University in Phoenix.

Dr. Brewis and her colleagues recently completed a multicountry study intended to give a snapshot of the international zeitgeist about weight and body image. The findings suggested that negative perceptions about people who are overweight may soon become the cultural norm in some countries, including places where plumper, larger bodies traditionally have been viewed as attractive, according to a new report in the journal Current Anthropology.

The researchers elicited true or false answers to statements like “People are overweight because they are lazy” and “Some people are fated to be obese.”

They tested attitudes among 700 people in 10 countries, territories and cities, including American Samoa, Tanzania, Mexico, Puerto Rico, Paraguay, Argentina, New Zealand, Iceland, Arizona and London.

Dr. Brewis said she fully expected high levels of fat stigma to show up in the “Anglosphere” countries, including the United States, England and New Zealand, as well as in body-conscious Argentina. But what she did not expect was how strongly people in the rest of the testing sites expressed negative attitudes about weight. The results, Dr. Brewis said, suggest a surprisingly rapid “globalization of fat stigma.”

“The change has come very, very fast ,” she said.

To be sure, jokes and negative perceptions about weight have been around for ages. But what appears to have changed is the level of criticism and blame. One reason may be that public health campaigns branding obesity as a disease are sometimes perceived as being critical of individuals rather than the environmental and social factors that lead to weight gain. “A lot of the negative health messages have a lot of negative moral messages that go with them,” Dr. Brewis said.

Surprisingly, stigma scores were high in places that have historically held more positive views of larger bodies, including Puerto Rico and American Samoa.

Stephen McGarvey, a professor of community health at Brown University in Rhode Island who studies Samoan health issues, noted that 25 years ago, Samoan study subjects living in Samoa and New Zealand who viewed thin and large body silhouettes mostly had positive feelings about bigger bodies.

“A public health focus on ‘You can change,’ or ‘This is your fault’ can be very counterproductive,” he said. “Stigma is serious.”

What is not clear from the new research is how pervasive fat stigma has become. With only 700 people included, the study reflects only a snapshot of cultural attitudes in the area studied. In addition, the research did not include any Asian or Arab countries.

In India, for instance, being overweight or obese is associated with being middle class or wealthy, said Scott Lear, associate professor for health sciences at Simon Fraser University in Vancouver. Even so, Dr. Lear agrees the potential for stigmatization exists. “We know in developed countries that obese people are less successful, less likely to get married, less likely to get promoted,” he said.

Nisha Somaia, 38, who lives in New Delhi and pioneered the first plus-size women’s clothing stores in India, said criticism against people who are large was often direct and overt. In India, she said: “Fat equals lazy. Fat equals comedy relief.”

The fashion industry, Ms. Somaia said, seems to promote the ideal of beauty as having a body “like an adolescent boy.”

“I had a highly educated friend confess that she would prefer for her children to be anorexic rather than overweight,” she said.

Marianne Kirby of Orlando, Florida, who writes the fat-acceptance blog TheRotund.com, said the spread of fat stigma was not surprising, given the global push to brand obesity as a major health threat.

“The fundamental message we’re putting into the world is that fat people deserve shame for their own health,” said Ms. Kirby.

Dr. Brewis noted that her study did not show whether people were experiencing more discrimination as a result of the growing fat stigma. “The next big question,” she said, “is whether it’s going to create a lot of new suffering where suffering didn’t exist before.”


By TARA PARKER-POPE