Anti-fat Attitudes Research Articles

Counter-conditioning as an intervention to modify anti-fat attitudes

This study examined the effect of anti-fat attitude counter-conditioning using positive images of obese individuals participants completed implicit and explicit measures of attitudes towards fatness on three occasions: no intervention; following exposure to positive images of obese members of the general public; and to images of obese celebrities. Contrary to expectations, positive images of obese individuals did not result in more positive attitudes towards fatness as expected and, in some cases, indices of these attitudes worsened. Results suggest that attitudes towards obesity and fatness may be somewhat robust and resistant to change, possibly suggesting a central and not peripheral processing route for their formation.

Counter-Conditioning as an Intervention to Modify Anti-Fat Attitudes.

This study examined the effect of anti-fat attitude counter-conditioning using positive images of obese individuals participants completed implicit and explicit measures of attitudes towards fatness on three occasions: no intervention; following exposure to positive images of obese members of the general public; and to images of obese celebrities. Contrary to expectations, positive images of obese individuals did not result in more positive attitudes towards fatness as expected and, in some cases, indices of these attitudes worsened. Results suggest that attitudes towards obesity and fatness may be somewhat robust and resistant to change, possibly suggesting a central and not peripheral processing route for their formation.

Implicit Relational Assessment Procedure and Body-Weight Bias: Influence of Gender of Participants and Targets

The Implicit Relational Assessment Procedure (IRAP) and explicit measures were used with 21 college students to determine if body weight of target stimuli (photographic images of slim and overweight individuals) influenced perceptions of intelligence. The explicit measure was a computerized adaptation of the Anti-Fat Attitudes Questionnaire designed to reduce participant error. A Covert Perception Task was developed as an additional explicit measure in which participants rated the likelihood of success of slim and overweight job applicants. Correlational analyses were used to determine if disparity between current and idealized body mass index (BMI) influenced responding. Statistical analyses were applied to data to determine influence exerted by the gender of participants and/or by the gender of the portrayed target stimuli. Findings are discussed in relation to pro-slim versus anti-fat bias and gender differences in body-weight bias related to participants and targets.

Anti-fat Prejudice and Stereotypes in Psychology University Students

The purpose of this study was to explore the anti-fat attitudes and stereotyped beliefs toward fat people in a group of 104 psychology university students. We used the Anti-fat Attitudes Scale and the Dislike of Fat People Scale, Semantic Differential Technique for analyzing the representation of Fat People, Thin People, and Self-Concept, and Fat Stereotypes Questionnaire with positive and negative traits about female fat people. Results showed that psychology university students expressed low levels of anti-fat attitudes and of dislike of fat people. Over 70% of respondents attributed to the female fat people mainly positive traits linked to happiness, sweetness, kindness, and generosity. Psychology university students judged fat people similar to thin people. A positive representation of fat people was associated with low levels of anti-fat prejudice and positive stereotyped beliefs toward female fat people. Future research could verify the persistence of these positive attitudes toward fat people in Italian context with other types of participants.

Overcoming Economic Barriers to Implement International Nutrition Education in an Urban University

HAES paradigm, while also addressing diversity and social justice. Social Cognitive Theory was used to guide the development of the HAES GE course. Students studied the impact environmental cues can have on body image and health behaviors and modeled HAES patterns to peers. Description: Health at Every Size: A non-diet approach to wellness provides an overview of social, cultural and environmental influences of body esteem. Topics include size discrimination, body dissatisfaction, intuitive eating and activity. Evaluation: Changes in dieting patterns, intuitive eating scores, body esteem scores, and anti-fat attitudes of students enrolled in the course compared to students in a traditionally taught nutrition course will be presented. Conclusions and Implications: Data analysis is in progress, though essays written by students in the HAES GE course post intervention suggest notable shifts in attitudes surrounding anti-fat bias and lower body dissatisfaction. GE courses should be considered for implementing HAES interventions. Funding: None.

Antifat attitudes in a sample of women with eating disorders.

One of the main problems of patients with eating disorders is their body dissatisfaction. Although these individuals usually are not satisfied with their bodies there are not many investigations that focus on how these patients see people with real weight problems. For this reason, in this study it is analyzed how women with eating disorders see obese people. A total of 104 participants (35 with anorexia nervosa, 28 with bulimia nervosa, 16 with eating disorder not otherwise specified and 25 controls) were selected to conduct the study. To measure anti-fat attitudes the Spanish version of the Antifat Attitudes Questionnaire was used. To measure if participants had body dissatisfaction it was used the Spanish versions of the Body Shape Questionnaire. Finally, anthropometric measures (height and weight) were taken in order to calculate the BMI (kg/m(2)), as well as some socio-demographic information. It was found that participants with bulimia nervosa showed scores higher on antifat attitudes than the rest of the participants. Additionally, it was found that this result was influenced by the body dissatisfaction of the participants. These results suggest that negative attitudes toward obese people may influence an individual's body image. One way of maintaining a positive body image (especially, the subjective dimension, body satisfaction) is to compare oneself with those perceived as physically inferior (people with weight problems), a strategy that is especially relevant when the mass media insists in depict extreme thin women.

The Stigmatizing Effect of Visual Media Portrayals of Obese Persons on Public Attitudes: Does Race or Gender Matter?

Overweight and obese persons are frequently stigmatized in news media. The present study is the first to systematically compare public reactions to positive and negative images of obese persons accompanying news reports on obesity (while manipulating gender and race of the target)and their effects on generalized attitudes and social distance toward obese persons. The authors conducted 3 randomized experimental studies using online surveys to assess public perceptions of positive versus stereotypical images of obese adults (who varied by gender and race) accompanying a neutral news report about obesity. The sample included 1,251 adults, who were recruited through a national survey panel during May of 2010. Participants who viewed negative, stereotypical images of obese targets increased social distance, antifat attitudes, and ratings of laziness and dislike toward obese persons, whereas positive, nonstereotypical images induced more positive attitudes. These findings remained consistent when accounting for sociodemographic variables. African American female obese targets portrayed in images evoked higher ratings of dislike and social distance compared with Caucasian targets, but ratings were similar for male and female targets. This study provides evidence that images of obese person accompanying written media influence public attitudes toward obese people, and may reinforce weight stigmatization if images contain stereotypical portrayals of obese persons. Implications for efforts to report about obesity in the news media are discussed.

Integrating Weight Bias Awareness and Mental Health Promotion Into Obesity Prevention Delivery: A Public Health Pilot Study

IntroductionPromoting healthy weight is a top priority in Canada. Recent federal guidelines call for sustained, multisectoral partnerships that address childhood obesity on multiple levels. Current healthy weight messaging does not fully acknowledge the influence of social determinants of health on weight.MethodsAn interactive workshop was developed and implemented by a team of academic researchers and health promoters from the psychology and public health disciplines to raise awareness about 1) weight bias and its negative effect on health, 2) ways to balance healthy weight messaging to prevent the triggering of weight and shape preoccupation, and 3) the incorporation of mental health promotion into healthy weight messaging. We conducted a full-day workshop with 342 Ontario public health promoters and administered a survey at preintervention, postintervention, and follow-up.ResultsParticipation in the full-day workshop led to significant decreases in antifat attitudes and the internalization of media stereotypes and to significant increases in self-efficacy to address weight bias. Participants reported that the training heightened their awareness of their own personal weight biases and the need to broaden their scope of healthy weight promotion to include mental health promotion. There was consensus that additional sessions are warranted to help translate knowledge into action. Buy-in and resource support at the organizational level was also seen as pivotal.ConclusionProfessional development training in the area of weight bias awareness is associated with decreases in antifat attitudes and the internalization of media stereotypes around thinness. Health promoters’ healthy weight messaging was improved by learning to avoid messages that trigger weight and shape preoccupation or unhealthful eating practices among children and youth. Participants also learned ways to integrate mental health promotion and resiliency-building into daily practice.

The effect of physicians’ body weight on patient attitudes: implications for physician selection, trust and adherence to medical advice

Research has documented negative stigma by health providers toward overweight and obese patients, but it is unknown whether physicians themselves are vulnerable to weight bias from patients. This study assessed public perceptions of normal weight, overweight or obese physicians to identify how physicians' body weight affects patients' selection, trust and willingness to follow the medical advice of providers. An online sample of 358 adults were randomly assigned to one of three survey conditions in which they completed a questionnaire assessing their perceptions of physicians who were described as normal weight, overweight or obese. Participants also completed a measure of explicit weight bias (Fat Phobia Scale) to determine whether antifat attitudes are associated with weight-related perceptions of physicians. Respondents reported more mistrust of physicians who are overweight or obese, were less inclined to follow their medical advice, and were more likely to change providers if the physician was perceived to be overweight or obese, compared to normal-weight physicians who elicited significantly more favorable reactions. These weight biases remained present regardless of participants' own body weight. Inspection of interaction effects revealed opposing effects of weight bias between the obese/overweight and normal-weight physician conditions. Stronger weight bias led to higher trust, more compassion, more inclination to follow advice, and less inclination to change doctors when the physician was presented as normal weight. In contrast, stronger weight bias led to less trust, less compassion, less inclination to follow advice and higher inclination to change doctors when the physician was presented as obese. This study suggests that providers perceived to be overweight or obese may be vulnerable to biased attitudes from patients, and that providers' excess weight may negatively affect patients' perceptions of their credibility, level of trust and inclination to follow medical advice.

Measuring Medical Student Attitudes and Beliefs Regarding Patients Who Are Obese

Research shows obesity bias to undermine the patient-doctor relationship and lead to substandard care. The authors developed and tested an instrument to measure medical students' attitudes and beliefs about obese patients. The authors conducted a literature search to identify validated measures of obesity bias. Because they identified no appropriate scale, they decided to design a novel survey instrument: the Nutrition, Exercise and Weight Management (NEW) Attitudes Scale. An expert panel generated items which focus groups of third-year medical students then discussed. Next, experienced medical educators judged and weighted the remaining revised items. Then, second- and fourth-year medical students completed the scale alongside two previously validated measures of obesity bias, the Anti-Fat Attitudes Questionnaire (AFA) and Beliefs About Obese Persons Scale (BAOP). Third-year students completed the NEW Attitudes Scale before and after a simulated encounter with an obese standardized patient instructor. The authors tested the validity and reliability. The final instrument comprised 31 items. A sample of 201 judges rated the items. A sample of 111 second- and fourth-year medical students completed the survey (mean score 24.4, range -37 to 76 out of a possible -118 to 118; higher scores indicate more positive attitudes). Pearson correlations between the NEW Attitudes Scale and AFA and BAOP were, respectively, -0.47 and 0.23. Test-retest reliability was 0.89. Students scored 27% higher after completing the standardized patient-instructor encounter (P < .001). The NEW Attitudes Scale has good validity and reliability and may be used in future studies.

The influence of a defendant’s body weight on perceptions of guilt

To investigate the influence of a defendant's weight on simulated jurors' perceptions of guilt. Participants were 471 lean and overweight adults (mean body mass index: 25.34±5.91) who read a vignette describing a case of check fraud while viewing one of four images of the alleged defendant (a lean male, a lean female, an obese male or an obese female). Participants rated the defendant's culpability on a 5-point Likert scale and completed measures of anti-fat attitudes. Male respondents endorsed greater overall weight bias than females (F (1470)=23.815, P<0.01, η(2)=0.048). A three-way interaction was detected between participant sex, defendant sex and defendant weight on perceptions of guilt such that when the defendant was female, male participants were significantly more likely to find her guilty if she was obese than if she was lean (guilt ratings=4.05±0.83; 3.31±1.03, respectively; F(1467)=5.935, P=0.015, R(2)=0.060). In addition, lean male participants were significantly more likely to believe that the obese female defendant met criteria for check fraud, and indicated greater belief she would be a repeat offender, compared with the lean female defendant (t(90)=2.081, P=0.040; t(90)=2.395 P=0.019, respectively). There were no differences in perceptions of guilt or responsibility between the obese male and the lean male defendants. The results of this novel study indicate that both weight and gender of a defendant may affect juror perceptions of guilt and responsibility.

Gender differences in antifat attitudes

Differences between women and men in the expression of prejudice toward obese people coexist with widespread antifat attitudes. It has been argued that these differences stem from women's tendency to internalize the social norm of slimness and to develop eating concerns, while men tend to resort to externalization and to showing antifat attitudes. Data obtained from 597 students (264 male and 333 female) revealed that men showed more prejudice against obese people, and that women had high scores in eating problems questionnaires. Finally, it is discussed why men and women adopt different strategies to deal with the social norm of thinness.

Weight Bias Against Women in a University Acceptance Scenario

ABSTRACT This study examined weight bias against women in a hypothetical university acceptance scenario. One-hundred-and-ninety-eight volunteers from the community in Britain completed a weight bias measure in which they were asked to select the woman they were most and least likely to select for a place at university from an array of figures varying in body size. Participants also completed the Anti-Fat Attitudes Survey, the Short-Form of the Fat Phobia Scale, the Attitudes Toward Obese Persons Scale, and the Beliefs About Obese Persons Scale. Results showed that participants were biased against both obese (> 30 kg/m2) and emaciated (<15 kg/m2) women. Further analyses showed that weight bias was only significantly predicted by greater antipathy toward fat persons and more negative attitudes toward obese persons. These results provide evidence that the general public hold biased beliefs about access to higher educational opportunities as a function of the body size of applicants.

Well-Being and Prejudice toward Obese People in Women at Risk to Develop Eating Disorders

The literature has found that eating disorders (ED) patients usually have a depression and anxiety diagnosis. However, not many investigations have studied the relationship between ED and well-being. One of the main problems of patients with ED is their body image. These individuals usually see themselves too big but there are not many investigations that focus on how these patients see people with real weight problems. For this reason in this study it is analyzed how women in risk to develop ED see obese people. 456 female students were selected. It was found that women with high scores in the different subscales of the Eating Attitudes Test 26 (EAT-26; dieting, bulimia and oral control) had lower well-being (both subjective and psychological) and worse attitudes toward obese people (measured with Antifat Attitudes Test, AFA, Beliefs About Obese People Scale, BAOP, and Attitudes Toward Obese People Scale, ATOP) compared with women with low scores in the EAT-26.

Food addiction in adults seeking weight loss treatment. Implications for psychosocial health and weight loss

The present study examined food addiction symptomology and its relationship to eating pathology and psychological distress among adults seeking weight loss treatment. A primary interest was an examination of the relationship between food addiction symptoms and short-term weight loss. Adults beginning a behavioral weight loss program (N=57) were given the Yale Food Addiction Scale (YFAS) as well as measures of psychological distress, disordered eating, weight bias, and weight-focused attitudes. Weight loss was measured after 7weeks. Severity of food addiction was related to increased depression, emotional eating, binge eating, anti-fat attitudes, internalized weight bias, body shame, and low eating self-efficacy, but not body satisfaction. Increased food addiction symptomology was also related to less weight lost at 7weeks. Findings suggest that individuals attempting to lose weight while combating symptoms of food addiction may be especially prone to eating-related pathologies, internalized weight bias, and body shame. Importantly, findings provide evidence that food addiction may undermine efforts to lose weight. The pathology associated with addiction (e.g., tolerance, withdrawal) could make the adoption of more healthful eating habits especially difficult.

No Clear Winner: Effects of The Biggest Loser on the Stigmatization of Obese Persons

Previous research has largely ignored the question of whether watching reality weight-loss TV shows influences viewers to form a negative obesity stereotype. This study examines antecedents and outcomes of watching The Biggest Loser with the Orientation1–Stimulus–Orientation2–Response (O-S-O-R) model. The study found that individuals who are more concerned with their weight (O1) watch more episodes of The Biggest Loser (S). Meanwhile, consumption of The Biggest Loser leads to greater perceived locus of weight control (O2), indicating that body weight is under personal control. Perceived locus of weight control, in turn, significantly predicts the attribution of obesity to personal responsibility (R). Ultimately, attributing obesity to personal responsibility leads to the formation of anti-fat attitudes (R). This study offers an integrative theoretical framework to investigate media effects on the formation of an obesity stigma by using the O-S-O-R model. The results imply that certain lifestyle transformation media, such as The Biggest Loser, might reinforce the notion that individuals control their own weight and thus further amplify the obesity stigma.

The Effects of Reality Television on Weight Bias: An Examination of The Biggest Loser

Weight-loss reality shows, a popular form of television programming, portray obese individuals and their struggles to lose weight. While the media is believed to reinforce obesity stereotypes and contribute to weight stigma, it is not yet known whether weight-loss reality shows have any effect on weight bias. The goal of this investigation was to examine how exposure to 40-min of The Biggest Loser impacted participants' levels of weight bias. Fifty-nine participants (majority of whom were white females) were randomly assigned to either an experimental (one episode of The Biggest Loser) or control (one episode of a nature reality show) condition. Levels of weight bias were measured by the Implicit Associations Test (IAT), the Obese Person Trait Survey (OPTS), and the Anti-fat Attitudes scale (AFA) at baseline and following the episode viewing (1 week later). Participants in The Biggest Loser condition had significantly higher levels of dislike of overweight individuals and more strongly believed that weight is controllable after the exposure. No significant condition effects were found for implicit bias or traits associated with obese persons. Exploratory analyses examining moderation of the condition effect by BMI and intention to lose weight indicated that participants who had lower BMIs and were not trying to lose weight had significantly higher levels of dislike of overweight individuals following exposure to The Biggest Loser compared to similar participants in the control condition. These results indicate that anti-fat attitudes increase after brief exposure to weight-loss reality television.

Reducing Obesity Stigma: The Effectiveness of Cognitive Dissonance and Social Consensus Interventions

Obese individuals experience pervasive stigmatization. Interventions attempting to reduce obesity stigma by targeting its origins have yielded mixed results. This randomized, controlled study examined the effectiveness of two interventions to reduce obesity stigma: cognitive dissonance and social consensus. Participants were college undergraduate students (N = 64, 78% women, mean age = 21.2 years, mean BMI = 23.1 kg/m2) of diverse ethnicities. Obesity stigma (assessed with the Antifat Attitudes Test (AFAT)) was assessed at baseline (Visit 1) and 1 week later, immediately following the intervention (Visit 2). Participants were randomly assigned to one of three intervention groups where they received standardized written feedback on their obesity stigma levels. Cognitive dissonance participants (N = 21) were told that their AFAT scores were discrepant from their values (high core values of kindness and equality and high stigma), social consensus participants (N = 22) were told their scores were discrepant from their peers' scores (stigma much higher than their peers), and control participants (N = 21) were told their scores were consistent with both their peers' scores and their own values. Following the intervention, omnibus analyses revealed significant group differences on the AFAT Physical/Romantic Unattractiveness subscale (PRU; F (2, 59) = 4.43, P < 0.05). Planned contrasts revealed that cognitive dissonance group means were significantly lower than control means for AFAT total, AFAT PRU subscale, and AFAT social/character disparagement subscale (all P < 0.05). No significant differences were found between social consensus and controls. Results from this study suggest that cognitive dissonance interventions may be a successful way to reduce obesity stigma, particularly by changing attitudes about the appearance and attractiveness of obese individuals.

Factors associated with mothers' obesity stigma and young children's weight stereotypes

Parents and children hold negative attitudes about obesity, but little is known about individual differences in obesity stigma. The current study examined authoritarian parenting style, beliefs about the controllability of weight and fear of fat in relation to mothers' dislike of overweight individuals. Factors related to children's weight stereotypes were also investigated. Forty-nine mothers and children (43% girls) participated. Mothers showed more dislike and blame toward adults who are overweight than children who are overweight; parents were most often blamed for children's weight status. Authoritarian parenting and beliefs about controllability were related to mothers' anti-fat attitudes, but fear of fat was not. However, mothers' fear of fat was the best predictor of children's negative stereotypes toward overweight peers. The current study provides some preliminary insight into the role of mothers in children's attitudes about weight. Examining individual difference factors is also useful in planning targeted interventions to lessen obesity stigma.

Internalized Societal Attitudes Moderate the Impact of Weight Stigma on Avoidance of Exercise

Experiences with weight stigma negatively impact both psychological outcomes (e.g., body dissatisfaction, depression) and behavioral outcomes (e.g., dieting, exercise). However, not everyone is equally affected by experiences with weight stigma. This study examined whether internalized societal attitudes about weight moderated the impact of weight stigma. Adult participants (n = 111) completed measures of experiences with weight stigma, as well as two indexes of internalized societal attitudes (the moderators): Internalized anti-fat attitudes and internalization of societal standards of attractiveness. Psychological outcomes included self-esteem, body dissatisfaction, drive for thinness, and bulimic symptoms; behavioral outcomes included avoidance of exercise and self-reported exercise behavior. Weight stigma was positively correlated with body dissatisfaction, drive for thinness, and bulimic symptoms, and was negatively correlated with state and trait self-esteem. Both indexes of internalized attitudes moderated the association between weight stigma and avoidance of exercise: Individuals high in anti-fat attitudes and high in internalization of societal standards of attractiveness were more motivated to avoid exercise if they also experienced a high degree of weight stigma; individuals low in anti-fat attitudes and low in internalization were relatively unaffected. Avoidance of exercise was negatively correlated with self-reported strenuous exercise. These findings suggest that weight stigma can negatively influence motivation to exercise, particularly among individuals who have internalized societal attitudes about weight. Reducing internalization might be a means of minimizing the negative impact of weight stigma and of facilitating healthy weight management efforts.