Abstract
BackgroundPeople living with severe obesity report high levels of weight-related stigma. Theoretically, this stigma undermines weight loss efforts. The objective of this study is to test one proposed mechanism to explain why weight loss is so difficult once an individual becomes obese: that weight-related stigma inhibits physical activity via demotivation to exercise.MethodsThe study focused on individuals who had bariatric surgery within the past 5 years (N = 298) and who report a post-surgical body mass index (BMI) ranging from 16 to 70. Exercise avoidance motivation (EAM) and physical activity (PA) were modeled as latent variables using structural equation modeling. Two measures of weight stigma, the Stigmatizing Situations Inventory (SSI) and the Weight Bias Internalization Scale (WBIS) were modified for people with a long history of extreme obesity for use as observed predictors.ResultsExercise avoidance motivation (EAM) significantly mediated the association between both experienced (SSI) and internalized (WBIS) weight stigma and physical activity (PA) in this population.ConclusionExercise avoidance motivation, influenced by weight stigma, may be a significant factor explaining the positive relationship between higher body weights with lower levels of physical activity.
Highlights
People living with severe obesity report high levels of weight-related stigma
In a study of adult females with a body mass index (BMI) at or over 25, Pearl, Puhl, and Dovidio [21] found a significant effect of experienced weight stigma on exercise behavior and, further, that internalized weight stigma partially mediated this association
Results for covariates showed, on average, that the bariatric patients in the sample were middle aged (54 years old), primarily female, highly educated and affluent, that they lost 33% of their weight at the time of surgery, that they still had a high body mass index (BMI > 30), and that surgery was performed more than 21 months before the survey
Summary
People living with severe obesity report high levels of weight-related stigma. Theoretically, this stigma undermines weight loss efforts. While exercise avoidance was not a specific target of this study, these more negative attitudes towards exercise may express as a general reluctance to engage in activity (i.e., exercise avoidance) These studies suggest that the mechanisms fueling exercise avoidance include direct and immediate concerns of judgment or mistreatment, and that internalized stigma may undermine self-efficacy [17, 21,22,23] to create a “why try” mentality when it comes to weight loss, when an individual is overweight [10, 19, 21, 24,25,26,27]
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