Perceived Weight Discrimination Research Articles

Sociodemographic predictors of perceived weight discrimination.

Perceived weight discrimination is associated with increased risk for chronic diseases and reduced life expectancy. Nevertheless, little is known about perceived weight discrimination in racial, ethnic, and sexual minority groups or in individuals at the intersections of those groups. The goal of this study was to identify sociodemographic predictors of perceived weight discrimination. A diverse sample of adults (37% Black/African American, 36% Latino, 29% sexual minority) with a body mass index (BMI) ≥ 18.5 kg/m2 were recruited from a national US panel to complete an online survey (N = 2454). Perceived weight discrimination was assessed with the Stigmatizing Situations Survey-Brief (SSI-B). Using hierarchical linear regression analysis, SSI-B scores were predicted from the four sociodemographic characteristics of interest (gender, race, ethnicity, and sexual orientation) while controlling for BMI, age, education, and income (Step 1). At Step 2, all two-way interactions between the four sociodemographic characteristics were added to the model. At Step 1, higher SSI-B scores were observed for Latino (vs. non-Latino) adults, sexual minority (vs. heterosexual) adults, younger (vs. older) adults, adults with higher (vs. lower) levels of education, and adults with higher (vs. lower) BMI. At Step 2, race interacted with gender, ethnicity, and sexual orientation to predict SSI-B scores such that relatively higher scores were observed for non-Black women, Black men, adults who identified as Black and Latino, and non-Black sexual minority adults. Perceived weight discrimination varied across sociodemographic groups, with some subgroups reporting relatively high frequency. Black race appeared to be protective for some subgroups (e.g., Black women), but risk-enhancing for others (e.g., Black men, individuals who identified as Black and Latino). Additional research is needed to identify specific factors that cause certain sociodemographic groups -and indeed, certain individuals-to perceive higher levels of weight discrimination than others.

Exploring Factors Associated with Gender Differences in Perceived Stress among Adults with Higher Body Weight in the United States—A Cross-Sectional Analysis

This study aimed to explore factors associated with perceived stress in adults with higher body sizes. An analysis of data from participants who self-reported higher body weight was conducted (n = 1716). The mean (standard deviation) age was 55.92 (15.94) years and 71.3% and 28.7% identified themselves as women and men, respectively. Gender differences in perceived stress, desire for weight loss, trust in physicians, body affirmation, and perceived weight discrimination were examined. Perceived stress and perceived weight discrimination were significantly higher in women than in men, while trust in physicians and body affirmation was higher in men than women. Trust in physicians and body affirmation were both negatively associated with perceived stress. Perceived weight discrimination and desire for weight loss were both positively associated with perceived stress. Trust in physicians, body affirmation, and perceived weight discrimination were examined as mediators of the observed gender differences between men and women. Trust in physicians, body affirmation, and perceived weight discrimination were significant mediators of the relationship between gender and perceived stress. These results suggest that a possible point of intervention for addressing gender differences in rates of perceived stress among higher body weight adults may be to increase trust in physicians, encourage body affirmation, and reduce weight discrimination.

The role of stress and health behaviour in linking weight discrimination and health: a secondary data analysis in England

ObjectiveTo examine the role of stress and health-risk behaviours in relationships between weight discrimination and health and well-being.DesignSecondary data analysis of an observational cohort study.SettingThe English Longitudinal Study of Ageing.ParticipantsData...

Comparison of Perceived Weight Discrimination between Polish and German Patients Underwent Bariatric Surgery or Endoscopic Method versus Conservative Treatment for Morbid Obesity: An International Multicenter Study.

Objectives: The aim of this study was to compare the level of discrimination among patients with obesity living in Poland and Germany. Methods: This was a retrospective cross-sectional international multicenter survey study including 564 adult participants treated for morbid obesity at selected healthcare facilities in Germany (210 patients) and in Poland (354 patients). Discrimination was evaluated using a custom-made questionnaire based on the related literature. Results: The level of obesity discrimination did not differ between German and Polish patients (p = 0.4282). The presence of obesity was reported to be associated to a large or a very large extent with the feeling of social exclusion and discrimination by 46.63% of German participants and 42.09% of Polish ones (p = 0.2934). The mean level of discrimination related to the lack of employment was higher in patients who underwent bariatric surgery or endoscopic method than in those who underwent conservative treatment (for Germany: 2.85 ± 1.31 (median, 3) vs. 2.08 ± 1.31 (median, 1), p = 0.002; for Poland: 2.43 ± 1.15 (median, 2) vs. 1.93 ± 1.15 (median, 1), p = 0.005). The level of discrimination was associated with sex, age, the degree of obesity, and treatment-related weight loss (p < 0.05). Conclusions: Our findings confirm that obesity significantly affects the social and economic well-being of patients. There is a great need to reduce weight stigma and to take measures to alleviate the socioeconomic and psychological burden of obesity.

Identifying as fat: Examining weight discrimination and the rejection-identification model

Discrimination towards fat individuals is pervasive in the United States, and perceptions of weight discrimination are associated with poor physical and mental health outcomes (e.g., low well-being). The rejection-identification model theorizes that perceptions of group-based discrimination may lead people to identify with their stigmatized group, subsequently helping them maintain well-being. We applied the rejection-identification model to weight discrimination to understand whether positively identifying as fat may mediate the impact of perceived weight-group discrimination on well-being. Across two samples (N = 739), fat-group identification, ingroup affiliation, and body affirmation were tested as mediators of the association between perceived weight discrimination and well-being. We also examined support for weight-related social change. Results showed that fat identification was a significant mediator, associated positively with discrimination but negatively with well-being; fat identification also was positively associated with greater support for weight-related social change. Body affirmation was a significant mediator of well-being and support for weight-related social change. Identifying as fat does not seem to provide the same benefits to well-being observed for other social identities (e.g., ethnicity); perceiving one’s own body positively, however, may be a potential pathway through which weight discrimination’s consequences can be reduced. Implications for well-being, identity, and the rejection-identification model are discussed.

Patient-Centered Care for Obesity: How Health Care Providers Can Treat Obesity While Actively Addressing Weight Stigma and Eating Disorder Risk

Patient-Centered Care for Obesity: How Health Care Providers Can Treat Obesity While Actively Addressing Weight Stigma and Eating Disorder Risk

Weight Location Moderates Weight-Based Self-Devaluation and Perceived Social Devaluation in Women

Overweight and obese (“heavyweight”) people devalue themselves because, it has been proposed, they are socially devalued. However, for women, social valuation depends not only on how much weight they carry but also on where on their bodies they carry it. Here, we investigated whether weight-based self-valuation and perceived social valuation similarly depend on body shape. Study 1, using a nationally representative sample from National Health and Nutrition Examination Survey (NHANES; N = 1,093 reproductive-aged women), showed that, controlling for body fat, weight labeling (by self and others) and wanting to lose weight depended on body shape. Study 2, in a direct test of predictions using an undergraduate sample of women (N = 215), showed that with increased body fat, women with an abdominal weight distribution reported more self-devaluation (e.g., lower self-esteem) and perceived social devaluation (e.g., higher perceived weight discrimination); women with a gluteofemoral weight distribution, however, were shielded—partially or fully—from these adverse effects of increased body fat.

Examining the impact of perceived weight discrimination on reported eating and exercise among White and Latino/a adults

A large body of research suggests that, among White individuals, perceived weight discrimination has deleterious consequences for eating and exercise outcomes; however, the research literature on perceived weight discrimination among other racial/ethnic groups is limited. The primary goal of the present study was to examine the associations of perceived weight discrimination with eating and exercise thoughts and behaviors among White versus Latino/a participants. A sample of White (N = 50) and Latino/a (N = 281) undergraduate college students with higher body weight (BMI: M = 30.65, SD = 5.42) completed self-report measures assessing perceived weight-based discrimination, frequency of intake of unhealthy and healthy foods, and frequency of both thoughts about exercise and exercise behaviors; we examined relationships among these variables within White versus Latino/a participants. Results showed that perceived weight discrimination was associated with more frequent intake of unhealthy foods, more frequent exercise thoughts, and less frequent exercise behaviors among White participants, and that there were no significant associations between perceived weight discrimination and the eating and exercise measures of interest among Latino/a participants. These findings highlight a number of potential avenues for future research to identify the mechanisms underlying these differential associations of perceived weight discrimination to eating and exercise behaviors across racial/ethnic groups.

Internalized Weight Bias, Teasing, and Self-Esteem in Children with Overweight or Obesity.

Background: Although 2/3 of US adults and nearly 1/3 of US children have overweight or obesity, weight stigma is common. Many with overweight or obesity ascribe negative ideas to themselves, resulting in internalized weight bias (IWB). In adults, IWB has been associated with psychosocial problems; however, this relationship has been studied little in children. This study aims to describe IWB in children with overweight and obesity and to study the association of children's IWB with experienced weight bias, self-esteem, and their parents' IWB. Methods: Children ages 9-18 with overweight or obesity completed the Weight Bias Internalization Scale (WBIS), Rosenberg Self-Esteem Scale, and Perception of Teasing Scale; parents completed the Weight Bias Internalization Scale-Modified and the Perceived Weight Discrimination Scale. Descriptive statistics were used to assess IWB, self-esteem, and experienced weight stigma. Chi-square and t-tests were used to examine associations between categorical and continuous variables, respectively. Multivariate linear regression was used to identify correlates of IWB in children. Results: Of 111 child participants, the median WBIS score was 2.8 out of 7. Higher IWB was associated with more peer teasing (p < 0.001) and lower self-esteem (p < 0.001). IWB in children was not associated with child BMI z-score (p = 0.590) or higher parent IWB (p = 0.287). Conclusions: Children with overweight and obesity who have experienced more teasing by peers or who have lower self-esteem are more likely to have a higher IWB. However, increasing child BMI z-score and parent IWB are not associated with higher child IWB.

Psychological and social functioning are associated with reports of perceived weight discrimination across eight years

This research uses the Health and Retirement Study to identify psychological and social factors that prospectively predict new reports of perceived weight discrimination among individuals who measure in the obese weight category. Participants (Mage = 66.89, SD = 8.33; 58% women) reported on their personality and social isolation, had a body mass index (BMI) ≥ 30, reported no perceived weight discrimination at baseline, and completed at least one assessment over the up to 8-year follow-up (N = 3,064). Eleven percent of participants reported new experiences of perceived weight discrimination. Higher Neuroticism and loneliness at baseline were associated with new reports; Conscientiousness was protective. This research adds to models of weight stigma by identifying psychological and social factors that contribute to reporting new instances of perceived weight discrimination.

Perceived weight discrimination and performance in five domains of cognitive function

ObjectiveIndividuals who perceive unfair treatment because of their body weight have been found to be at increased risk of poor health outcomes, including risk of dementia. The present research examines the relation between weight discrimination and performance in five cognitive domains (episodic memory, speed-attention, visuospatial ability, language, numeric reasoning) and whether the associations extend to other common attributions for discrimination (age, gender, race). MethodParticipants (n = 2593) were from the Harmonized Cognitive Assessment Protocol (HCAP) sub-study of the Health and Retirement Study (HRS). HCAP participants completed a battery of cognitive tasks that measured the five focal cognitive domains. Participants reported on their perceived experiences with discrimination at the previous regular HRS assessment. ResultsIn models that accounted for demographic covariates and BMI, weight discrimination (reported by 6% of participants) was associated with a two-fold increased risk of poor performance on tasks of episodic memory, speed-attention, visuospatial ability, and numeric reasoning. Body mass index was largely unrelated to performance in the five cognitive domains. The other attributions for discrimination were generally unrelated to cognition, but there were sex- and race-specific associations for gender and race discrimination, respectively. ConclusionsThe present study identified attribution- and domain-specific associations between discrimination and cognitive performance in older adulthood.

Perceived Weight Discrimination Mediates the Prospective Association Between Obesity and Physiological Dysregulation: Evidence From a Population-Based Cohort

Obesity is thought to cause ill health because of the biological strain that excess fat has on physiological function. We tested an alternative explanation in a population-based sample of 3,609 older English adults—that the pervasive discrimination experienced by individuals with excess weight may in part explain why obesity is associated with subsequent multisystem physiological dysregulation, measured via clinical indicators of cardiovascular, metabolic, and immune function. We found that both obesity and perceived weight discrimination predicted an increase in physiological dysregulation from baseline to follow-up 4 years later. Perceived discrimination because of body weight experienced by individuals with obesity explained more than one quarter of the prospective association between obesity and a deterioration in biomarkers of health status. These findings highlight the possibility that the stigma experienced by individuals with obesity may play an important role in explaining the obesity-related disease burden.

Mindfulness Capability Mediates the Association Between Weight-Based Stigma and Negative Emotion Symptoms

A cross-sectional study was conducted to examine how mindfulness capability influences the relationship between weight-based stigma (i.e., weight stigma concerns and perceived weight discrimination) and negative emotion symptoms by using a sample of 293 with overweight and obesity (52.9% female; mean age of 22.5 years; standard deviation of 0.68). The questionnaires comprised a survey on weight-based stigma, the Short Inventory of Mindfulness Capability, and the Depression Anxiety Stress Scale, and the variables of interest were measured before data analysis. The analytical results support the hypotheses that mindfulness capability is negatively related to weight-based stigma and negative emotion symptoms, but it is positively related to negative emotion symptoms. Moreover, the results of the hierarchical regression analysis suggest additional effects of mindfulness capability on negative emotional symptoms when controlling for gender, age, body mass index (BMI), and weight-based stigma (B = − 0.31, p < .001, R2 = 0.32). Finally, the results of the mediation effect analysis verify the significant indirect effects of weight-based stigma on negative emotion through mindfulness capability (effect = 0.0160, 95% confidence interval [0.0059, 0.0302] in model 1; effect = 0.0272, 95% confidence interval [0.0106, 0.0497] in model 2). Our findings can contribute to the theoretical literature about the salutary effects of mindfulness on attenuating the negative impacts of weight-based stigma. The research on mindfulness-based interventions targeted at weight-based stigma is expected, and future directions to improve the current study are discussed.

Perceived weight discrimination and risk of incident dementia.

Body mass index (BMI) and obesity have a complex relation with risk of dementia that evolves over the lifespan. Research in other domains indicates that the social experience of body weight, not just BMI, is associated with worse health outcomes. The present research uses data from the Health and Retirement Study (N=12,053) to test whether weight discrimination is associated with increased risk of dementia over an up to 10-year follow-up independent of BMI and other relevant clinical and behavioral risk factors. Participants who reported weight discrimination had a 40% increased risk of incident dementia (Hazard Ratio=1.40; 95% Confidence Interval=1.12–1.74), controlling for age, sex, race, ethnicity, education. The association between weight discrimination and incident dementia held controlling for BMI, diabetes, hypertension, depressive symptoms, smoking, physical activity, and genetic risk status. The present research indicates that the stigma associated with weight is associated with dementia risk independent from obesity. This research highlights that the detrimental effect of obesity on cognitive health in older adulthood may occur through the adverse social experience of body weight in addition to the biological consequences of excess weight.

Perceived Weight Discrimination and School Connectedness Among Youth: Does Teacher Support Play a Protective Role?

Weight discrimination has been associated with poor academic performance and decreased school attendance. Little is known about weight discrimination and students' feelings of belonging to their school. This study examined the association between weight discrimination and school connectedness among adolescents. Teacher support was examined as a protective factor. Middle school students (N = 639; 57% white; Mean age = 12.16 years) completed a health behaviors survey. Weight discrimination from peers and/or good friends was dichotomized into never versus experienced weight discrimination. The mean of 5 school connectedness items assessed level of school connectedness. Teacher support was measured by taking the mean of 4 teacher support items. Hierarchical linear regression was used to examine the association between weight discrimination and school connectedness. Teacher support was tested as a moderator. Weight discrimination was associated with lower levels of school connectedness (p < .05). Teacher support was associated with higher levels of school connectedness (p < .001) but did not moderate the association between weight discrimination and school connectedness. The association between weight discrimination and low levels of school connectedness is important as students spend most of their time at school and should benefit from the positive effects of feeling connected to school.

Obesity, perceived weight discrimination, and hair cortisol: a population-based study

Background and purposeStigmatization of individuals with obesity is pervasive and may act as a psychological stressor. The present study examined whether perceived weight discrimination mediated the relationship between obesity and cortisol, an objective marker of chronic stress, in a population-based sample. MethodsData were from the English Longitudinal Study of Ageing (n = 1872). Height and weight were objectively measured in 2008/09. Experiences of weight-related discrimination were reported via questionnaire in 2010/11. Hair cortisol concentrations were determined from the scalp-nearest 2 cm hair segment in 2012/13. Mediation analyses tested the role of perceived weight discrimination in the associations between obesity and BMI and hair cortisol concentration, adjusting for age, sex, ethnicity, socio-economic status, smoking status, depression and hair-related factors. ResultsObesity, BMI and perceived weight discrimination were positively related to hair cortisol (all p < .01). Perceived weight discrimination significantly mediated associations between obesity and hair cortisol (β = 0.021, SE = 0.007, 95% CI 0.007–0.036) and BMI and hair cortisol (β = 0.001, SE = 0.0004, 95% CI 0.0004–0.002), accounting for 19% of the total effect of obesity and 23% of the total effect of BMI on hair cortisol. ConclusionsPerceived weight discrimination is an important mediator of the association between obesity and cortisol. Interventions combating weight stigma and discrimination or promoting strategies for coping with stress could help to lessen the psychological and physiological burden of obesity.

Perceived weight discrimination and high-risk health-related behaviors.

Perceived weight discrimination has been associated with several health-risk behaviors related to eating and physical activity. The purpose of this research is to test whether weight discrimination is associated with nonweight-related high-risk behaviors that put the individual's health at risk. As part of a larger survey on health and well-being, participants (N = 5,163) reported on their experiences with weight discrimination and their engagement in four high-risk behaviors: current cigarette smoking, driving while intoxicated, risky sexual/drug use behaviors, and seat belt use. Logistic regression was used to test the association between weight discrimination and each behavior, controlling for relevant demographics and BMI. Perceived weight discrimination was associated with increased risk of cigarette smoking (odds ratio [OR] = 1.64, 95% confidence interval [CI] = 1.36-1.99), driving while intoxicated (OR = 2.01, 95% CI = 1.60-2.54), risky sexual/drug use behaviors (OR = 2.17, 95% CI = 1.69-2.80), and not using a seat belt (OR = 1.53, 95% CI = 1.15-2.03). With the exception of seat belt use, all associations remained significant controlling for depressive symptoms. The results of this research indicate that the harmful associations between weight discrimination and health-risk behaviors are not limited to behaviors related to eating and physical activity but extend to high-risk behaviors that may contribute to the association between weight discrimination and poor health.

Association between perceived weight discrimination and physical activity: a population-based study among English middle-aged and older adults

ObjectiveTo examine the association between perceived weight discrimination and physical activity in a large population-based sample.DesignData were from 2423 men and 3057 women aged ≥50 years participating in Wave 5...

Perceived weight discrimination mediates the prospective relation between obesity and depressive symptoms in U.S. and U.K. adults.

Objective: Obesity has been shown to increase risk of depression. Persons with obesity experience discrimination because of their body weight. Across 3 studies, we tested for the first time whether experiencing (perceived) weight-based discrimination explains why obesity is prospectively associated with increases in depressive symptoms. Method: Data from 3 studies, including the English Longitudinal Study of Ageing (2008/2009–2012/2013), the Health and Retirement Study (2006/2008–2010/2012), and Midlife in the United States (1995/1996–2004/2005), were used to examine associations between obesity, perceived weight discrimination, and depressive symptoms among 20,286 U.S. and U.K. adults. Results: Across all 3 studies, Class II and III obesity were reliably associated with increases in depressive symptoms from baseline to follow-up. Perceived weight-based discrimination predicted increases in depressive symptoms over time and mediated the prospective association between obesity and depressive symptoms in all 3 studies. Persons with Class II and III obesity were more likely to report experiencing weight-based discrimination, and this explained approximately 31% of the obesity-related increase in depressive symptoms on average across the 3 studies. Conclusion: In U.S. and U.K. samples, the prospective association between obesity (defined using body mass index) and increases in depressive symptoms in adulthood may in part be explained by perceived weight discrimination.

Nurses' Weight Bias in Caring for Obese Patients: Do Weight Controllability Beliefs Influence the Provision of Care to Obese Patients?

Given the pervasive stigma faced by obese individuals in family, work, and health care settings, the present study aimed to explore whether nurses' weight controllability beliefs influence their perception of how care is provided to obese patients. To this end, 73 nurses from an acute care hospital completed the Weight Control/Blame Subscale of the Antifat Attitudes Test and reported on their perception of discrimination in, and available resources for, the provision of care to obese patients. Nurses endorsing stronger beliefs that weight lies under individual control were more likely to report discrimination of obese patients in clinical practice. Weight bias, higher care intensity, and lack of necessary resources were the main reasons reported for perceived weight discrimination. Our results support theories placing internal attribution of overweight and conflict over resources at the origin of weight stigma and call for appropriate interventions to improve nurses' work environment and reduce their weight bias.