Abstract
BackgroundRates of obesity have increased globally and weight stigma is commonly experienced by people with obesity. Feeling stigmatised because of one’s weight can be a barrier to healthy eating, physical activity and to seeking help for weight management. The aim of this study was to identify predictors of perceived weight among middle-older aged patients with obesity attending general practices in socioeconomically disadvantaged urban areas of Australia.MethodsAs part of a randomised clinical trial in Australia, telephone interviews were conducted with 120 patients from 17 general practices in socioeconomically disadvantaged of Sydney and Adelaide. Patients were aged 40–70 years with a BMI ≥ 30 kg/m2. The interviews included questions relating to socio-demographic variables (e.g. gender, language spoken at home), experiences of weight-related discrimination, and the Health Literacy Questionnaire (HLQ). Multi-level logistic regression data analysis was undertaken to examine predictors of recent experiences of weight-related discrimination (“weight stigma”).ResultsThe multi-level model showed that weight stigma was positively associated with obesity category 2 (BMI = 35 to < 40; OR 4.47 (95% CI 1.03 to 19.40)) and obesity category 3 (BMI = ≥ 40; OR 27.06 (95% CI 4.85 to 150.95)), not being employed (OR 7.70 (95% CI 2.17 to 27.25)), non-English speaking backgrounds (OR 5.74 (95% CI 1.35 to 24.45)) and negatively associated with the HLQ domain: ability to actively engage with healthcare providers (OR 0.12 (95% CI 0.05 to 0.28)). There was no association between weight stigma and gender, age, education or the other HLQ domains examined.ConclusionsWeight stigma disproportionately affected the patients with obesity most in need of support to manage their weight: those with more severe obesity, from non-English speaking backgrounds and who were not in employment. Additionally, those who had experienced weight stigma were less able to actively engage with healthcare providers further compounding their disadvantage. This suggests the need for a more proactive approach to identify weight stigma by healthcare providers. Addressing weight stigma at the individual, system and population levels is recommended.Trial registrationThe trial was registered with the Australian Clinical Trials Registry ACTRN126400102162.
Highlights
Rates of obesity have increased globally and weight stigma is commonly experienced by people with obesity
About half were in obesity Category 1, while the other half were in Category 2 or 3
Weight discrimination was more likely to be experienced by patients in higher obesity categories, who were not employed, who spoke a language other than English at home and who had lower scores on the Health Literacy Questionnaire (HLQ) domain that measures the ability to actively engage with healthcare providers (AE)
Summary
Rates of obesity have increased globally and weight stigma is commonly experienced by people with obesity. People in higher categories of obesity are at substantially increased health risk because mortality increases sharply as body mass index (BMI: kilograms/metres2) rises above 30 [5]. In addition to physical health risks, people with obesity commonly experience weight-related stigma (“weight stigma”) [6,7,8]. People with obesity experience all three forms of stigma, including discrimination in employment settings (e.g. not hired for a job), educational settings (e.g. discouragement from seeking higher education), from service providers (provision of poorer service), and in interpersonal relationships (e.g. being treated with less courtesy and respect than other people and/or being insulted) [11]. Interviews with people with obesity suggested that they internalised this stigma, agreed with the negative judgements of others, and felt shame and inferiority [6, 9]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
