The Role of Stigma in Weight Loss Maintenance Among U.S. Adults (original) (raw)
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Weight stigma as a psychosocial contributor to obesity
American Psychologist
Weight stigma is a key aspect of the lived experience of individuals with obesity, and adversely affects health. This article provides an overview of recent evidence examining links between experiences of weight stigma and weight-related behaviors and health (e.g., maladaptive eating, physical activity, stress, obesity, weight loss), including health consequences for individuals with heightened vulnerability to weight stigma (e.g., youth and people seeking bariatric surgery) and implications for clinicians working with individuals who have obesity. This literature points to weight stigma as a psychosocial contributor to obesogenic behaviors, yet the role of weight stigma in weight loss among treatment-seeking individuals has received little attention. Research priorities are identified, including the need for future studies to (a) determine the potentially predictive value of specific characteristics of weight-stigmatizing experiences for weight loss (such as the time period, interpersonal sources, and coping responses for stigma experiences), (b) identify mechanisms through which weight stigma may undermine or facilitate weight-related treatment outcomes, and (c) test strategies that can be implemented in weight management programs to reduce the negative impact of weight stigma on health behaviors. Broadly, more attention should be directed to weight stigma in the obesity field as a relevant psychosocial factor in obesity-focused prevention and treatment. Public Significance Statement This article reviews evidence of the ways in which weight stigma may contribute to obesity in youth and adults, such as maladaptive eating behaviors, stress, and weight gain. Additionally, it highlights the importance of addressing weight stigma in clinical practice, through education and efforts to promote a supportive culture of patient care for individuals who are vulnerable to weight stigma.
Journal of Health Psychology, 2009
Experiences of obesity stigmatization and fear of fat, body image, and self-esteem, were examined in relation to weight loss and weight maintenance. Participants in obesity treatment (n=185) with more stigmatizing experiences had poorer body image and greater fear of fat. Higher initial BMI, more stigmatizing experiences, lower body dissatisfaction, and greater fear of fat predicted greater weight loss. Higher initial BMI and more stigmatizing experiences predicted greater weight maintenance after 6 months in treatment. These findings suggest that despite the negative psychological correlates of stigmatization, experience and fear of obesity's negative consequences may also be associated with improved treatment outcome.
Confronting and Coping with Weight Stigma: An Investigation of Overweight and Obese Adults*
Obesity, 2006
Objective: This study examined experiences of weight stigmatization, sources of stigma, coping strategies, psychological functioning, and eating behaviors in a sample of 2671 overweight and obese adults. Research Methods and Procedures: The total sample was partitioned into two subsamples for investigation. Sample I was comprised of 2449 adult women, and Sample II was a matched sample of adult men and women (N ϭ 222) that was disaggregated to investigate gender differences. Both samples completed an online battery of self-report questionnaires measuring frequency of weight stigmatization and coping responses to deal with bias, the most common sources of the bias, symptoms of depression, self-esteem, attitudes about weight and obesity, and binge eating behaviors. Results: Experiences of weight stigmatization, in many forms and across multiple occasions, was common in both samples. A variety of coping strategies were used in response. More frequent exposure to stigma was related to more attempts to cope and higher BMI. Physicians and family members were the most frequent sources of weight bias reported. No gender differences were observed in types or frequency of stigmatization. Frequency of stigmatization was not related to current psychological functioning, although coping responses were associated with emotional well-being. Discussion: These findings raise questions about the relationship between stigma and psychological functioning and have important implications for obesity treatment and stigma reduction intervention efforts, both of which are discussed.
The Negative and Bidirectional Effects of Weight Stigma on Health
Oxford Handbooks Online, 2017
This chapter introduces a model describing the mechanisms by which weight stigma can lead to poorer health outcomes among people who are or who perceive themselves to be overweight. It is proposed that enacted weight stigma (discrimination) directly impairs the health of heavier weight individuals by changing the social and material aspects of their lives in ways that are detrimental to health. It is also proposed that perceived weight stigma can lead to social identity threat, which in turn can indirectly impair health by increasing stress and negative emotions, physiological reactivity, calorie intake, and stigma-avoidance behaviors. Finally, it is proposed that weight stigma is bidirectional, in that experiencing weight stigma leads to weight gain or inhibits weight loss through increased eating and other biobehavioral mechanisms, which in turn lead to further stigmatization. Implications for health and recommendations for future research are discussed.
Eating and Weight Disorders, 2009
There are significant economic and psychological costs associated with the negative weight-based social stigma that exists in American society. This pervasive anti-fat bias has been strongly internalized among the overweight/obese. While the etiology of weight stigma is complex, research suggests that it is often greater among individuals who embrace certain etiological views of obesity or ideological views of the world. This investigation examined 1) the level of internalized weight stigma among overweight/obese treatment seeking
Internalizing Weight Stigma: Prevalence and Sociodemographic Considerations in US Adults
Obesity (Silver Spring, Md.), 2018
This study aimed to conduct a comprehensive assessment of the presence, severity, and sociodemographic correlates of weight bias internalization (WBI) across three distinct samples of US adults. Levels of WBI were compared in (1) a sample of adults with obesity and heightened risk of weight stigma (N = 456), (2) an online community sample (N = 519), and (3) a national online panel (N = 2,529). Samples 2 and 3 comprised adults with and without obesity. Participants completed identical self-report measures, including demographic variables and weight-related factors, to determine their relationship with low, mean, and high levels of WBI. At least 44% of adults across samples endorsed mean levels of WBI (as determined by sample 3). The highest levels of WBI were endorsed by approximately one in five adults in the general population samples and by 52% in the sample of adults with obesity. Individuals with the highest WBI were white, had less education and income, were currently trying to...
Residual stigma: Psychological distress among the formerly overweight
Social Science & Medicine, 2012
Little is known about the psychological state of those who leave a stigmatized group. We examined individuals who previously belonged to a stigmatized group, the overweight, and then became normal weight. Negative stereotypes, including those relating to obesity, are internalized from the time of childhood onward; therefore, it was assumed they would become lingering selfstereotypes among individuals who were no longer externally targeted. Drawing on a nationally representative sample, we examined for the first time whether formerly overweight individuals are susceptible to any anxiety disorder, any depressive disorder, and suicide attempts. As predicted, the likelihood of any anxiety disorder and any depressive disorder for the formerly overweight group was significantly greater than for the consistently normal-weight group, and not significantly different from the consistently overweight group. Further, the formerly overweight group was significantly more likely to attempt suicide than the other groups. Also as predicted, perceived weight discrimination partially mediated the relationship between weight status and these outcomes. The cohort consisted of 33,604 participants in the United States. The results suggest that losing a self-image shaped by stigma is a more protracted process than losing weight.
Variations in weight stigma concerns
Health Psychology Research, 2016
Over the past 40 years, obesity rates in the United States have grown significantly; these rates have not grown uniformly across the United States (18 of the 20 counties with the highest obesity rates are located in the South). Obesity increases cardiovascular disease risk factors and new research has highlighted the negative psychological effects of obesity, known as weight stigma, including decreased selfcontrol resources, over eating, and exercise avoidance. The primary objective of this study was to determine if weight stigma concerns varied regionally and if social behaviors influenced this variation. In two studies, we collected cross-sectional data from participants in the United States including height and weight, weight stigma concerns, and perception of friends’ preoccupation with weight and dieting. We also collected each participant’s home zip code which was used to locate local obesity rate. We established differences in the relationship between body mass index and weig...