An investigation of weight bias against women and its associations with individual difference factors

Obesity and individual performance: the case of eSports

BACKGROUND/OBJECTIVES

The study considers the problem of the inclusion of people with obesity in the context of the growing role of computer-based work. Negative stereotypes about people with obesity still hold even when they are irrelevant in tasks that require little physical activity.

SUBJECTS/METHODS

Using data from the realm of competitive video gaming (eSports) and image recognition-based metric of body mass index metric derived from artificial intelligence, we examine the individual performance depending on weight. The sample includes 821 players and 127,533 player performance observations.

RESULTS

For shorter tasks, individuals with normal weight performed better than individuals with obesity. For longer tasks, however, people with Class III (severe) obesity outperformed all others, and their advantage increased with task duration.

CONCLUSIONS

Our findings shed light on an understanding of how actually body features are related to objective individual performance in a competitive context.

Weight-based discrimination in financial reward and punishment decision making: causal evidence using a novel experimental paradigm

BACKGROUND/OBJECTIVES

Cross-sectional research has demonstrated weight-related stigma and discrimination, however experimental research providing causal evidence of financial-based weight discrimination is lacking. The aim of these preregistered experiments was to examine whether a novel paradigm in which participants attributed financial rewards and punishments could be used to detect weight bias.

SUBJECTS/METHODS

One-hundred and twenty-one individuals participated in experiment 1 and one-hundred and sixty-six individuals participated in experiment 2. Both studies were conducted online, and participants were provided with biographies of hypothetical individuals in which weight-status was manipulated (normal weight vs. overweight/obesity) before being asked to provide rewards and punishments on their cognitive performance. In experiment 1 (within-participants design) participants observed one individual they believed to be normal weight and one individual they believed to be overweight/have obesity. In experiment 2 (between-participants design) participants observed one individual whilst also being provided with information about food addiction (Food addiction is real + individual with overweight/obesity vs. food addiction is a myth + individual with overweight/obesity vs control + individual with normal weight).

RESULTS

In experiment 1, participants punished individuals who were described as having overweight/obesity to a greater extent to individuals who were normal weight (Hedge's g = -0.21 [95% CI: -0.02 to -0.41], p = 0.026), but there was no effect on rewards. They were also less likely to recommend individuals with overweight/obesity to pass the tasks (X²(1) = 10.05, p = 0.002). In experiment 2, participants rewarded individuals whom they believed were overweight/obese to a lesser extent than normal-weight individuals (g = 0.49 [95% CI: 0.16 to 0.83]. There was no effect on punishment, nor any impact of information regarding food addiction as real vs a myth.

CONCLUSION

Using a novel discrimination task, these two experiments demonstrate causal evidence of weight-based discrimination in financial decision making.

Experimental manipulation of muscularity preferences through visual diet and associative learning

Body preferences are somewhat flexible and this variability may be the result of one's visual diet (whereby mere exposure to certain bodies shifts preferences), associative learning mechanisms (whereby cues to health and status within the population are internalised and affect body preferences), or a mixture of both visual diet and associative learning effects. We tested how these factors may drive changes in preferences for muscularity in male bodies across a male and female sample. Three studies were conducted where participants viewed manipulation images of high and/or low muscle mass males which were either aspirational (high status clothing and posture) and/or neutral (no obvious cues to status). Preferences for muscularity were recorded before and after exposure to such manipulation images to assess whether body preferences had changed following manipulation. We found evidence for both the visual diet and associative learning hypotheses. Exposure to non-muscular male bodies decreased preferences for muscular bodies irrespective of image valence. Exposure to aspirational non-muscular male bodies alongside neutral muscular male bodies also led to a decrease in muscularity preferences. Further, when manipulation conditions are less obviously skewed towards a particular body type, preferences still shifted in the direction of the most prevalent body type, suggesting that demand characteristics are unlikely to have confounded results of previous adaptation experiments with more obvious manipulations.

Weight Stigmatization among Physical Therapy Students and Registered Physical Therapists

INTRODUCTION

Weight stigmatization is reflected in anti-fat attitudes and stereotypical perceptions of people who are overweight; it has been demonstrated to be prevalent in many segments of society across multiple countries. Studies examining the prevalence of weight stigmatization use different research tools, which can hinder inter-study comparisons. There is also evidence indicating weight stigmatization among registered physical therapists, although its magnitude differs between studies. Limited information exists regarding the attitudes and beliefs of physical therapy (PT) students toward individuals with obesity. Examining weight stigmatization among PT students is particularly important for developing appropriate educational interventions that may influence the professional lives of future physical therapists.

OBJECTIVE

This study aims to characterize and compare the stigmatizing attitudes and beliefs of PT students and certified physical therapists regarding people with obesity in Israel. Its secondary objective is to translate three weight stigmatization questionnaires into Hebrew and determine their psychometric properties.

METHODS

A cross-sectional, anonymous, and computerized self-report survey was completed by 285 certified physical therapists (average age 39.6 ± 10.1 years) and 115 PT students (average age 26.4 ± 4.9 years). The study used three validated weight stigma questionnaires employed in earlier studies to determine different aspects of weight stigmatization: the Fat Phobia Scale (short form; FPS), Anti-Fat Attitudes (AFA) questionnaire, and Beliefs about Obese People (BAOP). These questionnaires were translated into Hebrew and their psychometric properties ascertained.

RESULTS

Similar to the original English versions, the translated versions of the three questionnaires demonstrated good internal consistency (Cronbach's α values of FPS = 0.77; AFA = 0.75; BOAP = 0.59). The three questionnaires showed a low correlation. No significant difference was noted in the FPS and AFA scores between groups, reflecting that both demonstrated average weight stigmatization (FBS in both groups: average score of 3.6 out of 5; AFA therapists: 3.3 ± 1.2, students: 3.0 ± 1.2 out of 9). However, significant between-group differences were observed for BOAP, which examines beliefs regarding individuals' control over their weight (therapists: 16.4 ± 5.6, students: 18.0 ± 5.7 out of 48; p < 0.01).

CONCLUSION

Student and certified physical therapists demonstrate average levels of weight stigmatization, as reflected in the FPS and AFA scores. Nevertheless, compared to certified physical therapists, physical therapist students believe more strongly that obesity cannot be controlled by the individual. The students' beliefs could affect their clinical judgment and behavior as health care professionals in the future. Therefore, anti-fat attitudes and stereotypical perceptions should be addressed and remediated early using educational interventions during the study period.

Implicit and explicit anti-fat bias among Asian females

Obesity is not only associated with an increased risk of numerous health problems, but also with high rates of stigmatization and weight-related bias. Anti-fat attitudes have been shown to be prevalent in Western samples; however, there is a lack of studies investigating both implicit and explicit anti-fat bias in Asian populations. There is also limited research investigating the relationship between anti-fat attitudes and weight-related behavioral intentions. Thus, this study aimed to examine anti-fat bias and its effect on behavioral intentions using three types of measures-implicit, explicit, and a revised behavioral intention measure-in a sample of 104 Asian females in Singapore. Significant differences were found between implicit and explicit bias: on average, participants exhibited strong implicit but no explicit anti-fat bias (p < 0.001). Furthermore, only implicit anti-fat bias was found to be a significant predictor of behavioral intentions (p < 0.05), after accounting for body mass index, and sociodemographic variables. In conclusion, the present study revealed that implicit anti-fat bias is present among Asian females and is a valid predictor of weight-related behavioral intentions. However, anti-fat bias is often not expressed explicitly, possibly influenced by collectivistic beliefs. More studies are needed to better understand similarities and differences between Asian and Western populations regarding attitudes toward overweight and obese individuals.

Teachers' Influence on Weight Perceptions in Preschool Children

AIM

This study examined the influence of teachers, mothers, and children themselves on weight misperceptions of preschool children.

BACKGROUND

Preschool children should have correct perceptions of their weight and develop a positive body image and healthy weight-control behaviors throughout childhood.

METHODS

This study used a descriptive cross-sectional design based on the biopsychosocial model. We analyzed 388 triads of Korean children aged 3-6 years, their mothers, and teachers.

RESULTS

Children's body mass index (BMI) and weight satisfaction, mothers' BMI; teachers' education level, BMI, perception of and satisfaction with children's weight, body image, and attitude toward obesity were predictors of children underestimating their weight. Mothers' education level and BMI; teachers' BMI, satisfaction with children's weight, and body image were predictors of children overestimating their weight.

CONCLUSIONS

Teachers influence weight misperceptions of preschool children. Intervention programs for teachers should incorporate more accurate perceptions of children's weight and promote healthy body image.

Weight bias against women in a university acceptance scenario

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/m(2)) and emaciated (<15 kg/m(2)) 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.

Physiotherapists demonstrate weight stigma: a cross-sectional survey of Australian physiotherapists

QUESTION

Do physiotherapists demonstrate explicit and implicit weight stigma?

DESIGN

Cross-sectional survey with partial blinding of participants. PARTICIPANTS responded to the Anti-Fat Attitudes questionnaire and physiotherapy case studies with body mass index (BMI) manipulated (normal or overweight/obese). The Anti-Fat Attitudes questionnaire included 13 items scored on a Likert-type scale from 0 to 8. Any score greater than zero indicated explicit weight stigma. Implicit weight stigma was determined by comparing responses to case studies with people of different BMI categories (where responses were quantitative) and by thematic and count analysis for free-text responses.

PARTICIPANTS

Australian physiotherapists (n=265) recruited via industry networks.

RESULTS

The mean item score for the Anti-Fat Attitudes questionnaire was 3.2 (SD 1.1), which indicated explicit weight stigma. The Dislike (2.1, SD 1.2) subscale had a lower mean item score than the Fear (3.9, SD 1.8) and Willpower (4.9, SD 1.5) subscales. There was minimal indication from the case studies that people who are overweight receive different treatment from physiotherapists in clinical parameters such as length of treatment time (p=0.73) or amount of hands-on treatment (p=0.88). However, there were indications of implicit weight stigma in the way participants discussed weight in free-text responses about patient management.

CONCLUSION

Physiotherapists demonstrate weight stigma. This finding is likely to affect the way they communicate with patients about their weight, which may negatively impact their patients. It is recommended that physiotherapists reflect on their own attitudes towards people who are overweight and whether weight stigma influences treatment focus.

Obesity bias in training: attitudes, beliefs, and observations among advanced trainees in professional health disciplines

OBJECTIVE

This study examined weight bias among students training in health disciplines and its associations with their perceptions about treating patients with obesity, causes of obesity, and observations of weight bias by instructors and peers.

METHODS

Students (N = 107) enrolled in a post-graduate health discipline (Physician Associate, Clinical Psychology, Psychiatric Residency) completed anonymous questionnaires to assess the above variables.

RESULTS

Students reported that patients with obesity are a common target of negative attitudes and derogatory humor by peers (63%), health-care providers (65%), and instructors (40%). Although 80% of students felt confident to treat obesity, many reported that patients with obesity lack motivation to make changes (33%), lead to feelings of frustration (36%), and are non-compliant with treatment (36%). Students with higher weight bias expressed greater frustration in these areas. The effect of students' weight bias on expectations for treatment compliance of patients with obesity was partially mediated by beliefs that obesity is caused by behavioral factors.

CONCLUSIONS

Weight bias is commonly observed by students in health disciplines, who themselves report frustrations and stereotypes about treating patients with obesity. These findings contribute new knowledge about weight bias among students and provide several targets for medical training and education.

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

OBJECTIVE

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.

METHOD

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.

RESULTS

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.

DISCUSSION

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.

Stigmatizing attitudes differ across mental health disorders: a comparison of stigma across eating disorders, obesity, and major depressive disorder

The aim of the current article was to compare stigmatizing attitudes toward eating disorders (EDs), including anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED), with stigma toward another weight-related condition (obesity) and a non-weight-related mental disorder (major depressive disorder [MDD]). Participants (N = 447) read five vignettes describing a woman with AN, BN, BED, obesity, or MDD and responded to questionnaires examining stigmatizing attitudes. The targets with EDs were blamed more for their condition than the targets with MDD, whereas persons with obesity were held more responsible for their condition than any other target. On the other hand, the target with MDD was perceived as more impaired than any other target. Lack of self-discipline was attributed more to the development of BED and obesity than to any other condition. Stigmatizing attitudes vary across mental health disorders, and future research should aim to specifically target stigmatizing beliefs to reduce and prevent discrimination toward mental health disorders and obesity.

What is an attractive body? Using an interactive 3D program to create the ideal body for you and your partner

What is the ideal body size and shape that we want for ourselves and our partners? What are the important physical features in this ideal? And do both genders agree on what is an attractive body? To answer these questions we used a 3D interactive software system which allows our participants to produce a photorealistic, virtual male or female body. Forty female and forty male heterosexual Caucasian observers (females mean age 19.10 years, s.d. 1.01; 40 males mean age 19.84, s.d. 1.66) set their own ideal size and shape, and the size and shape of their ideal partner using the DAZ studio image manipulation programme. In this programme the shape and size of a 3D body can be altered along 94 independent dimensions, allowing each participant to create the exact size and shape of the body they want. The volume (and thus the weight assuming a standard density) and the circumference of the bust, waist and hips of these 3D models can then be measured. The ideal female body set by women (BMI = 18.9, WHR = 0.70, WCR = 0.67) was very similar to the ideal partner set by men, particularly in their BMI (BMI = 18.8, WHR = 0.73, WCR = 0.69). This was a lower BMI than the actual BMI of 39 of the 40 women. The ideal male body set by the men (BMI = 25.9, WHR = 0.87, WCR = 0.74) was very similar to the ideal partner set by the women (BMI = 24.5, WHR = 0.86, WCR = 0.77). This was a lower BMI than the actual BMI of roughly half of the men and a higher BMI than the other half. The results suggest a consistent preference for an ideal male and female body size and shape across both genders. The results also suggest that both BMI and torso shape are important components for the creation of the ideal body.

Visual diet versus associative learning as mechanisms of change in body size preferences

Systematic differences between populations in their preferences for body size may arise as a result of an adaptive ‘prepared learning’ mechanism, whereby cues to health or status in the local population are internalized and affect body preferences. Alternatively, differences between populations may reflect their ‘visual diet’ as a cognitive byproduct of mere exposure. Here we test the relative importance of these two explanations for variation in body preferences. Two studies were conducted where female observers were exposed to pictures of high or low BMI women which were either aspirational (healthy, attractive models in high status clothes) or non-aspirational (eating disordered patients in grey leotards), or to combinations thereof, in order to manipulate their body-weight preferences which were tested at baseline and at post–test. Overall, results showed good support for visual diet effects (seeing a string of small or large bodies resulted in a change from pre- to post-test whether the bodies were aspirational or not) and also some support for the associative learning explanation (exposure to aspirational images of overweight women induced a towards preferring larger bodies, even when accompanied by equal exposure to lower weight bodies in the non-aspirational category). Thus, both influences may act in parallel.

Body size matters in provision of help: factors related to children's willingness to help overweight peers

Although children who are overweight may be vulnerable to negative social experiences, little is known about whether children will offer help to peers who are overweight. The present study examined whether children would offer aid to peers who are overweight with everyday tasks (such as picking up toys). This study also examined whether weight stereotypes and intentions to befriend these peers are related to intentions to help. Fifty-one children, aged 4-8, were interviewed about their stereotypes and behavioral intentions. Findings revealed that children were less likely to help overweight than average weight peers. Children who did not hold positive stereotypes about thinness and those who chose to play with overweight peers were more likely to help peers who are overweight. Results suggest that weight prejudice is pervasive and that children who are overweight might not be offered aid in classroom settings, highlighting the need for early intervention.

An assessment of body appreciation and its relationship to sexual function in women

Objectification theory posits internalization of an observer's gaze may negatively impact women's feelings about their bodies, which may subsequently affect their sexual function. Subjective body image and body size (i.e., body mass index [BMI]) have mixed relationships to women's sexuality, but assessment of positive body image as a sign of resistance to objectification has not been researched. This study explored relations between body appreciation and sexual function in women and assessed whether body size impacted this relationship. Cross-sectional data were collected online from 247 women, ages 18 to 58. Body appreciation scores were modestly negatively correlated with BMI, while BMI was not related to sexual function scores. After controlling for sexual orientation, partner status, and age, body appreciation predicted the arousal, orgasm, and satisfaction aspects of sexual function. Practitioners' encouragement of body appreciation may improve sexual function in a way that encouraging a reduction in body size may not.