Perception of weight-bias among migrants

Abstract

Introduction: Stigmatization of overweight and obese individuals is common. However, little is known about the experience of weight-bias from the perspective of individuals with a migration background. Methods: Data of three surveys on attitudes towards overweight was analysed: paper-pencil surveys among medical students (n = 671) and health care professionals (n = 773) at Leipzig University and a representative survey (computer assisted telephone interview) among the German general population (n = 3003). All questionnaires included questions on socio-demographics, weight and height, whether participants perceived themselves as under-, normal-, or overweight, and whether participants had ever felt discriminated because of their weight. Migration background was defined as the participant and at least one parent not being born in Germany or participant's nationality being other than German. Results: In none of the three samples participants with and without migration background differed in regard to mean BMI (medical students: 22.06 [standard deviation 1.99] versus 22.00 [2.68], health care professionals: 23.57 [2.84] versus 23.47 [3.77], and general population: 25.43 [4.32] versus 25.62 [4.69]), or distribution among BMI categories (under-, normal-, over-, or very overweight) based on BMI or based on self-perception. Among medical students 31.43% (n = 11) with migration background versus 19.19% (n = 118) without migration background stated to have ever felt discriminated because of their weight (p = 0.077). Among health care professionals 37.50% (n = 9) with versus 19.19% (n = 118) without migration background (p = 0.011), and among the general population 11.52% (n = 28) with versus 6.89% (n = 190) without migration background stated to have ever felt discriminated because of their weight (p = 0.008). In multivariable logistic regression analysis (stepwise forward) among medical students, health care professionals, and the general population migration background, female gender, BMI as well as perceiving oneself as underweight or overweight were positively associated with a higher risk of ever having felt discriminated because of their weight. Discussion: Even in the absence of differences in actual BMI, migration background seems to be a predictor for perceived weight-bias. This finding is consistent among three different survey populations, including a representative sample of the German general public. The results may indicate that individuals with migrant background might be at an increased risk of being discriminated because of their weight. They may also suggest an increased sensitivity for stigma and bias among individuals with migrant background and may thus highlight an important area of vulnerability among this population.