Mapping weight stigma in food-based dietary guidelines across thirteen countries in Latin America and the Caribbean: a qualitative analysis

Background: Weight stigma is a growing public health concern with documented harms to physical, mental and social well-being. Food-Based Dietary Guidelines (FBDGs), central to nutrition education and policy, may unintentionally reinforce stigmatising narratives. In the Latin America and the Caribbean (LAC), where the obesity is shaped by complex determinants, this study aims to uncover the presence and patterns of weight stigma in national FBDGs and inform the development of more inclusive, person-centred nutrition policies. Methods: A content analysis was performed. We used the Weight Stigma Heat Map (WSHM) to assess thirteen national FBDGs and four technical documents from LAC countries. Ten thematic areas focused on language, imagery, behavioural framing, and representations of health were analysed. Inter-evaluator agreement was evaluated using Bangdiwala's test. Findings: Most FBDGs contained explicit or implicit weight-stigmatising content. Common patterns included portraying weight loss as a universal health goal, using alarmist language around obesity, and framing body weight as fully modifiable through individual behaviour, often without acknowledging individual variability or clinical context. Thinness was often linked to physical activity, while higher weight was associated with sedentarism and poor choices. Structural determinants were rarely acknowledged. Only Saint Vincent and the Grenadines adopted a more inclusive, environmentally focused approach. Inter-evaluator agreement was high (Bangdiwala's B = 0.93), supporting the reliability of the coding process. Interpretation: National FBDGs across LAC frequently reflect moralising and reductionist narratives that may perpetuate weight stigma. Revising these documents through a person-centred lens, grounded in human rights, social justice, and a multifactorial understanding of obesity is essential to promote equitable public health nutrition. Funding: No funding was received for this study.

Lugar de Publicación

Estados Unidos

Citación

The Lancet Regional Health Americas, Vol. 57 (2026) pp. 1-18

Palabras clave

Obesity, Weight stigma, Weight bias, Food and nutritional health promotion, Public health

Licencia

Atribución-NoComercial-CompartirIgual 3.0 Chile (CC BY-NC-SA 3.0 CL)

Licencia URL

http://creativecommons.org/licenses/by-nc-sa/3.0/cl/

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