Reduce Weight Bias Research Articles

Development and Assessment of a Course to Reduce Weight Bias in Undergraduate Health Promotion Students

Experiencing discrimination based on body size has numerous health consequences and negatively affects motivation for positive health behaviors. Because weight bias is particularly prevalent among health professionals, interventions to reduce weight bias in this group are essential. The purpose of this mixed-methods, 15-week study was to develop and examine the effect of a college course focused on reducing weight bias in health promotion undergraduates. In this study ( N = 64), quantitative change in implicit and explicit weight bias among students enrolled in a course to reduce weight bias was compared with a control group and two other groups of students in the health promotion degree program. Qualitative data were also analyzed through content analysis of pre- and postsemester writing assignments among students in the course focused on weight bias. Statistical analyses revealed a significant reduction in explicit weight bias among students in the course focused on weight bias with no significant changes in explicit weight bias for any other group. There were no significant changes in implicit weight bias for any group. Content analysis of qualitative data was consistent with the quantitative reductions in extrinsic weight bias. Students shared substantially more nuanced understandings of obesity postsemester. Furthermore, the persistence of internal contradictions in students’ analyses illustrates the particular challenge in reducing implicit bias. These results demonstrate that, although intrinsic weight bias may be more difficult to change, a college course focused on reducing weight bias can facilitate significant reductions in extrinsic weight bias among health promotion undergraduates.

Addressing weight bias and discrimination: moving beyond raising awareness to creating change.

Weight discrimination is the unjust treatment of individuals because of their weight. There have been very few interventions to address weight discrimination, due in part to the lack of consensus on key messages and strategies. The objective of the third Canadian Weight Bias Summit was to review current evidence and move towards consensus on key weight bias and obesity discrimination reduction messages and strategies. Using a modified brokered dialogue approach, participants, including researchers, health professionals, policy makers and people living with obesity, reviewed the evidence and moved towards consensus on key messages and strategies for future interventions. Participants agreed to these key messages: (1) Weight bias and obesity discrimination should not be tolerated in education, health care and public policy sectors; (2) obesity should be recognized and treated as a chronic disease in health care and policy sectors; and (3) in the education sector, weight and health need to be decoupled. Consensus on future strategies included (1) creating resources to support policy makers, (2) using personal narratives from people living with obesity to engage audiences and communicate anti-discrimination messages and (3) developing a better clinical definition for obesity. Messages and strategies should be implemented and evaluated using consistent theoretical frameworks and methodologies.

Effect of a College Course to Reduce Weight Bias among Undergraduate Pursuing a Health Degree

Effect of a College Course to Reduce Weight Bias among Undergraduate Pursuing a Health Degree

Can Legislation Prohibiting Weight Discrimination Improve Psychological Well‐Being? A Preliminary Investigation

AbstractWeight‐based discrimination is pervasive and increases vulnerability to poor mental health among targeted individuals. Legislation prohibiting weight discrimination has been proposed as an avenue for reducing social injustice. The present research examines how mere knowledge of such legislation may improve the psychological well‐being of individuals who have experienced unfair treatment due to weight. In an experiment administered online, 214 adults with overweight/obesity read a vignette exemplifying weight discrimination and were randomly assigned to one of two conditions, in which they were informed that weight discrimination was illegal or legal, and then responded to questionnaires assessing internalized weight bias, affect, perceived pervasiveness of weight discrimination, and support for anti‐discrimination legislation. Analysis of covariance revealed that participants with obesity in the Illegal condition exhibited lower levels of internalized weight bias than did participants in the Legal condition. Participants in the Illegal condition also exhibited less negative affect and more positive affect than did those in the Legal condition. No significant effects of condition on perceived pervasiveness of weight discrimination or legislation support emerged. Findings suggest that mere knowledge of legislation prohibiting weight discrimination has the potential to reduce weight bias internalization and improve affective responses among individuals with obesity.

Weight bias: a call to action.

Weight-related issues (including excess weight, disordered eating and body concerns) are often considered as comprising distinct domains of ‘obesity’ and ‘eating disorders’. In this commentary we argue that the concept of weight bias is an important variable when considering wellbeing across the spectrum of weight-related issues. We make the following six points in support of this argument: i) weight bias is common and has adverse health consequences, ii) shaming individuals for their body weight does not motivate positive behaviour change, iii) internalized weight bias is particularly problematic, iv) public health interventions, if not carefully thought out, can perpetuate weight bias, v) weight bias is a manifestation of social inequity, and vi) action on weight bias requires an upstream, population-level approach. To achieve sustainable reductions in weight bias at a population level, substantive modifications and collaborative efforts in multiple settings must be initiated. We provide several examples of population-level interventions to reduce weight bias.

Empathy and perspective-taking: Examination and comparison of strategies to reduce weight stigma.

Considerable evidence indicates that individuals with obesity are vulnerable to stigma and discrimination. However, comparably less research has examined strategies to reduce weight bias, and the existing evidence is mixed. To help clarify these findings and incorporate prejudice-reduction interventions that have been successfully applied to other stigmatized groups (i.e., empathy-induction and perspective-taking), we experimentally tested and compared four different, brief stigma-reduction interventions in a national sample of American adults. Participants (N = 650) were randomly assigned to 1 of 4 experimental conditions (Empathy, Perspective-Taking, Causal Information, or Empathy/Information Hybrid) or a control condition. Outcome variables included explicit weight bias (Fat Phobia), social distance, and affective reactions to individuals with obesity. The empathy and perspective-taking conditions induced more empathy than the control and informational conditions, and altered affective reactions towards persons with obesity in the expected directions. However, no experimental condition reduced Fat Phobia or social distance relative to the control condition. The current findings suggest that empathy-evoking and perspective-taking strategies may increase empathy and alter affective reactions towards individuals with obesity; however, these strategies remain questionable as effective means to reduce weight stigma.

Weight bias reduction in health professionals: a systematic review.

Innovative and coordinated strategies to address weight bias among health professionals are urgently needed. We conducted a systematic literature review of empirical peer-reviewed published studies to assess the impact of interventions designed to reduce weight bias in students or professionals in a health-related field. Combination sets of keywords based on three themes (1: weight bias/stigma; 2: obesity/overweight; 3: health professional) were searched within nine databases. Our search yielded 1447 individual records, of which 17 intervention studies satisfied the inclusion criteria. Most studies (n = 15) included medical, dietetic, health promotion, psychology and kinesiology students, while the minority included practicing health professionals (n = 2). Studies utilized various bias-reduction strategies. Many studies had methodological weaknesses, including short assessment periods, lack of randomization, lack of control group and small sample sizes. Although many studies reported changes in health professionals' beliefs and knowledge about obesity aetiology, evidence of effectiveness is poor, and long-term effects of intervention strategies on weight bias reduction remain unknown. The findings highlight the lack of experimental research to reduce weight bias among health professionals. Although changes in practice will likely require multiple strategies in various sectors, well-designed trials are needed to test the impact of interventions to decrease weight bias in healthcare settings.

Obesity Education as an Intervention to Reduce Weight Bias in Fashion Students

<p>The purpose of this work was to explore the effectiveness of an educational intervention aimed at reducing weight bias. Senior fashion students (<em>n</em><em> </em>= 11) enrolled in a 16 week special topics course, “plus-size swimwear design”, completed assignments of selected obesity related educational readings and guided critical reflection. Student assignments were analyzed for qualitative evidence regarding weight bias. The Beliefs About Obese Persons scale was administered before and after the intervention with mean scores tested for statistical significance. The intervention increased student perceptions that genetic and environmental factors play an important role in the cause of obesity and decreased students’ negative stereotypes regarding obese consumers. Educational reading and critical reflection was effective in improving fashion students’ beliefs and stereotypes regarding obese people. This widely accessible and easily replicable program can serve as a model and springboard for further development of educational interventions to reduce weight bias among fashion related students.</p>

Weight-centrism in psychology: Implications and new directions from the field of fat studies

ABSTRACTThe authors explore the field of psychology’s adherence to a weight-centric model of health and the implications for propagating weight bias in research, education, and practice. Invoking the field of fat studies, they then suggest ways of reducing weight bias in these domains via use of alternative methods and materials. In doing so, they highlight the weight-neutral Health At Every Size® paradigm as a potential means of guiding scholarship, teaching, and applied work in psychology and related behavioral health science fields.

Intergroup contact and weight bias reduction.

Intergroup contact and weight bias reduction.

Weight Bias: What Do We Know and Where Can We Go from Here?

This workshop will begin by introducing the prevalence and consequences of weight bias and provide background information on the causes and theories explaining the pervasiveness of weight bias in society. This panel will focus on practical strategies and research projects aimed at reducing weight bias in the health and education sectors. In education, a number of professional development interventions addressing weight bias demonstrated significant improvements in teachers’ awareness of and sensitivity to student weight-related experiences. In health care, some pilot studies have shown short-term improvements in attitudes and beliefs about weight but there is an urgent need for a larger scale strategy to facilitate interdisciplinary collaborative professional development in the area of weight bias over the long term. The goal of this workshop is to provide a foundation to understand the causes and consequences of weight bias and practical tips on how to reduce it in day-to-day practices. Participants will be engaged through various learning styles using images, videos and interactive group discussions with the panelists.

The Effect of Effort and Weight Controllability on Perceptions of Obese Individuals

We examined the impact of offset controllability (capability of losing weight) and offset effort (efforts to lose weight) on judgments of an obese target. Participants (n = 216) read about an obese person whose body weight was controllable/uncontrollable, and who did/did not put in effort to eat healthily and exercise. Effort played a more important role than controllability in evaluations of the target. Targets who put in effort to be healthy were ascribed fewer obesity stereotypes, evoked less disgust, and were considered to have a more acceptable lifestyle. These findings extend attribution theory and have implications for strategies to reduce weight bias.

Diffusing obesity myths.

Misinformation or myths about obesity can lead to weight bias and obesity stigma. Counteracting myths with facts and evidence has been shown to be effective educational tools to increase an individuals' knowledge about a certain condition and to reduce stigma.The purpose of this study was to identify common obesity myths within the healthcare and public domains and to develop evidence-based counterarguments to diffuse them. An online search of grey literature, media and public health information sources was conducted to identify common obesity myths. A list of 10 obesity myths was developed and reviewed by obesity experts and key opinion leaders. Counterarguments were developed using current research evidence and validated by obesity experts. A survey of obesity experts and health professionals was conducted to determine the usability and potential effectiveness of the myth-fact messages to reduce weight bias. A total of 754 individuals responded to the request to complete the survey. Of those who responded, 464 (61.5%) completed the survey. All 10 obesity myths were identified to be deeply pervasive within Canadian healthcare and public domains. Although the myth-fact messages were endorsed, respondents also indicated that they would likely not be sufficient to reduce weight bias. Diffusing deeply pervasive obesity myths will require multilevel approaches.

Weight bias among professionals treating eating disorders: Attitudes about treatment and perceived patient outcomes

This study aimed to assess weight bias among professionals who specialize in treating eating disorders and identify to what extent their weight biases are associated with attitudes about treating obese patients. Participants were 329 professionals treating eating disorders, recruited through professional organizations that specialize in eating disorders. Participants completed anonymous, online self-report questionnaires, assessing their explicit weight bias, perceived causes of obesity, attitudes toward treating obese patients, perceptions of treatment compliance and success of obese patients, and perceptions of weight bias among other practitioners. Negative weight stereotypes were present among some professionals treating eating disorders. Although professionals felt confident (289; 88%) and prepared (276; 84%) to provide treatment to obese patients, the majority (184; 56%) had observed other professionals in their field making negative comments about obese patients, 42% (138) believed that practitioners who treat eating disorders often have negative stereotypes about obese patients, 35% (115) indicated that practitioners feel uncomfortable caring for obese patients, and 29% (95) reported that their colleagues have negative attitudes toward obese patients. Compared to professionals with less weight bias, professionals with stronger weight bias were more likely to attribute obesity to behavioral causes, expressed more negative attitudes and frustrations about treating obese patients, and perceived poorer treatment outcomes for these patients. Similar to other health disciplines, professionals treating eating disorders are not immune to weight bias. This has important implications for provision of clinical treatment with obese individuals and efforts to reduce weight bias in the eating disorders field.

Are Anti-Stigma Films a Useful Strategy for Reducing Weight Bias Among Trainee Healthcare Professionals? Results of a Pilot Randomized Control Trial

Background: Weight bias is an important clinical issue that the educators of tomorrow's healthcare professionals cannot afford to ignore. This study, therefore, aimed to pilot a randomized controlled trial of the effects of educational films designed to reduce weight stigmatization toward obese patients on trainee dietitians' and doctors' attitudes. Methods: A pre-post experimental design with a 6-week follow-up, which consisted of an intervention group (n = 22) and a control group (n = 21), was conducted to assess the efficacy of brief anti-stigma films in reducing weight bias, and to test whether future, larger-scale studies among trainee healthcare professionals are feasible. Results: Participants at baseline demonstrated weight bias, on both implicit and explicit attitude measures, as well as strong beliefs that obesity is under a person's control. The intervention films significantly improved explicit attitudes and beliefs toward obese people, and participant evaluation was very positive. The intervention did not significantly improve implicit anti-fat bias. Conclusion: The current study suggests both that it is possible to conduct a substantive trial of the effects of educational films designed to reduce weight stigma on a larger cohort of trainee healthcare professionals, and that brief educational interventions may be effective in reducing stigmatizing attitudes in this population.

How to lose weight bias fast! Evaluating a brief anti-weight bias intervention

Although experiencing weight bias is associated with poor physical and psychological health, health professionals often stigmatize overweight and obese clients. The objective of this study was to evaluate a brief educational intervention that aimed to reduce weight bias among Australian pre-service health students by challenging beliefs about the controllability of weight. Non-equivalent group comparison trial. Undergraduate psychology students were assigned to an intervention (n= 30), control (n= 35), or comparison (n= 20) condition. The intervention condition received a lecture on obesity, weight bias, and the multiple determinants of weight; the comparison condition received a lecture on obesity and the behavioural determinants of weight; and the control condition received no lecture. Beliefs about the controllability of weight and attitudes towards overweight and obese people were assessed 1 week pre-intervention, immediately post-intervention, and 3 weeks post-intervention. After receiving the lecture, participants in the intervention group were less likely to believe that weight is solely within individual control and were also less likely to hold negative attitudes towards overweight and obese people and rate them as unattractive. These changes were maintained 3 weeks post-intervention. There were no such changes in the control or comparison groups. Disparagement of overweight and obese peoples' social character increased over time for participants in the control condition but did not change in the comparison or intervention groups. This study provides evidence that brief, education-based anti-weight bias interventions show success in challenging weight controllability beliefs and reducing weight bias among pre-service health students.

Obesity stigma: A newly recognized barrier to comprehensive and effective type 2 diabetes management

The purpose of this article is to increase awareness regarding the social problem of obesity stigma and its effects on persons with type 2 diabetes mellitus (T2DM). In addition, practical strategies to dispel stigma and improve diabetes care that nurse practitioners (NPs) can integrate into practice will be introduced. Thorough review of the literature was conducted including MEDLINE, PsycINFO and CINAHL, spanning the years 1994-2008. Obesity and diabetes are both epidemics that demand immediate attention; however, obesity stigma can act as a barrier to ongoing management of both conditions. Obese patients with T2DM may feel responsible not only for their weight but also their diabetes. Therefore, NPs can employ specific counseling strategies that may be beneficial with T2DM obese patients to improve continuity of care while decreasing weight-related stigmatization. Negative attitudes toward obesity by healthcare professionals can act as a barrier to diabetes management. Primary care providers including NPs must begin through self-reflection to recognize their own attitudes regarding weight-stigma and how these attitudes may affect their patients. By implementing effective strategies to reduce weight bias, an environment conducive to diabetes and lifestyle modification management may prevent patients from forgoing care.

Weight stigmatization and bias reduction: perspectives of overweight and obese adults

This study employed qualitative methods with a sample of overweight and obese adults to identify and describe their subjective experiences of weight bias. Participants (274 females and 44 males) completed an online battery of self-report questionnaires, including several open-ended questions about weight stigmatization. These questions asked them to describe their worst experiences of weight stigmatization, their perceptions of common weight-based stereotypes, their feelings about being overweight and their suggestions for strategies to reduce weight stigma in our culture. Participants reported experiencing weight stigma across a range of contexts and involving a variety of interpersonal sources. Close relationship partners (such as friends, parents and spouses) were the most common source of their worst stigmatizing encounters. Participants challenged common weight-based stereotypes (notably, that obese individuals are 'lazy') and reported that they would like the public to gain a better understanding of the difficulties of weight loss, the causes of obesity and the emotional consequences of being stigmatized. Education was reported as the most promising avenue for future stigma-reduction efforts. The experiences and opinions expressed were not significantly different for men versus women or overweight versus obese individuals. A minority of participants expressed beliefs suggestive of self-blame and internalization of weight-based stereotypes. These results indicate that while obese individuals experience weight bias across many domains, more stigma-reduction efforts should target stigmatizing encounters in close relationships, including parents, spouses and friends of obese persons.