Attitudes towards obesity in the Swedish general population: the role of one's own body size, weight satisfaction, and controllability beliefs about obesity

Weight bias among Canadians: Associations with sociodemographics, BMI and body image constructs

This cross-sectional study examined the associations between sociodemographic characteristics, BMI, and body image constructs (body satisfaction and weight bias internalization; WBI) and explicit weight bias. A near-representative sample of 995 English-speaking Canadian adults (52% Female) completed a survey which assessed explicit weight bias (Anti-Fat Attitudes questionnaire), body satisfaction (Body Shape Satisfaction Scale), WBI (Modified Weight Bias Internalization Scale), and self-reported height and weight. Multiple linear regression analyses were run. Results showed that the variable that explained the most variance in explicit weight bias was WBI, followed by BMI. Higher levels of WBI and a lower BMI were both significantly associated with greater explicit weight bias. Male sex was associated with both disliking people with obesity and thinking obesity is attributable to lack of willpower, whereas female sex was associated with worrying about weight gain. The current findings emphasize the importance of future research efforts aimed at preventing or mitigating WBI to reduce negative attitudes about people with obesity.

Correlates of Weight Bias in Adults From the NutriNet-Santé Study

INTRODUCTION

Explicit weight bias is an underlying cause of weight stigma, but its associations with individual characteristics are not well known. This study aimed to assess explicit weight bias in French adults and to explore the associations with weight status and sociodemographic characteristics.

METHODS

Adults from the NutriNet-Santé cross-sectional study (France, 2020, n=33,948, 52% women after weighting procedures) completed the Anti-Fat Attitudes Questionnaire assessing three dimensions: Dislike (antipathy toward people with obesity), Fear of fat (concerns about body weight), and Willpower (belief in weight controllability). Associations with weight status and sociodemographic characteristics were examined using multivariable ANCOVA models in 2022.

RESULTS

Fear of fat and Willpower scores were higher than Dislike scores (mean [SD]=4.0 [2.0], 3.3 [1.7] and 1.9 [1.3], respectively). Fear of fat was higher among women, whereas Dislike and Willpower were higher among men (all p<0.0001). Obesity was associated with greater Fear of fat scores (p<0.0001, mean difference versus normal-weight participants [95% CI]=0.35 [0.24, 0.46] in women, 0.36 [0.17, 0.56] in men), lower Dislike scores (-0.38 [-0.45, -0.32] in women, -0.43 [-0.56, -0.30] in men), and lower Willpower scores (-1.00 [-0.18, -0.90] in women, -0.40 [-0.57, -0.23] in men). In both genders, lower income was associated with lower Dislike, Fear of fat, and Willpower scores (all p<0.0001), and lower education was associated with greater Fear of fat and Willpower scores (all p<0.0001).

CONCLUSIONS

Explicit weight bias was driven by the fear of gaining weight and the belief in weight controllability. This study provides new insights into which population subgroups should be targeted by interventions aimed at reducing explicit weight bias.

Stigma Toward Bariatric Surgery in the Netherlands, France, and the United Kingdom: Protocol for a Cross-cultural Mixed Methods Study

Background

Bariatric surgery is an effective procedure for the treatment of obesity. Despite this, only 0.1% to 2% of eligible individuals undergo surgery worldwide. The stigma surrounding surgery might be a reason for this. Thus far, no research has systematically studied the nature and implications of bariatric surgery stigma. The limited studies on bariatric surgery stigma are often conducted from the perspective of the public or health care professions and either use small and nonrepresentative samples or fail to capture the full essence and implications of the stigma altogether, including attitudes toward patients and perpetrators of the stigma. In addition, studies from patients’ perspectives are limited and tend to address bariatric surgery stigma superficially or implicitly. Finally, the extent to which cultural factors shape and facilitate this stigma and the experiences of patients have not yet been researched.

Objective

This study aimed to explore the perceptions, experiences, and consequences of bariatric surgery stigma from the perspective of the public, health care professionals, and patients before and after bariatric surgery. Furthermore, although the concept of stigma is universal, every society has specific cultural norms and values that define acceptable attributes and behaviors for its members. Therefore, this study also aimed to explore the extent to which cultural factors influence bariatric surgery stigma by comparing the Netherlands, France, and the United Kingdom.

Methods

This paper describes the protocol for a multiphase mixed methods research design. In the first part, we will conduct a scoping review to determine the current knowledge on bariatric surgery stigma and identify knowledge gaps. In the second part, semistructured interviews among patients before and after bariatric surgery will be conducted to explore their experiences and consequences of bariatric surgery stigma. In the third part, surveys will be conducted among both the public and health care professionals to determine the prevalence, nature, and impact of bariatric surgery stigma. Surveys and interviews will be conducted in the Netherlands, France, and the United Kingdom. Finally, data integration will be conducted at the interpretation and reporting levels.

Results

The study began in September 2020 and will continue through September 2025. With the results of the review, we will create an overview of the current knowledge regarding bariatric surgery stigma from patients’ perspectives. Qualitative data will provide insights into patients’ experiences with bariatric surgery stigma. Quantitative data will provide information related to the prevalence and nature of bariatric surgery stigma from the perspective of the public and health care professionals. Both qualitative and quantitative data will be compared for each country.

Conclusions

The findings from this study will lead to new insights that can be used to develop strategies to reduce bariatric surgery stigma and improve access, use, and outcomes of bariatric surgery.

International Registered Report Identifier (IRRID)

PRR1-10.2196/36753

Anti-fat attitudes of Nutrition undergraduates in Brazil toward individuals with obesity

Abstract Obesity-related prejudice and discrimination may have a source in health professionals and students. The objective was to assess anti-fat attitudes among Brazilian nutrition undergraduates who reported demographic data, weight, height and responded the Antifat Attitudes Test (AFAT) and the Brazilian Silhouette Scales to assess body image satisfaction and perception. Total and subscales of AFAT scores were compared among categories using the Mann-Whitney U test. Associations of participants’ characteristics with the AFAT were analyzed using multiple linear regression. Total AFAT score was positively associated with male sex (ß: .13; p < .001), age (ß: .06; p < .001), educational institution outside capital (ß: .03; p < .05), private institutions (ß: .08; p < .001); and negatively associated with income (ß: -.05; p = .006), participants who perceived themselves with increased BMI (ß: -.15; p < .001) and those at the third year of course (ß: -.05; p = .041). Subscales scores were positively associated with male sex and age; and negatively associated with those who perceived themselves heavier. They have anti-fat attitudes especially if they were man, older, from private institutions, are at the beginning of the course, and have lower household income - and less weight bias if they perceived with increased BMI.

Asymmetric effects of obesity on loneliness among older Germans. Longitudinal findings from the Survey of Health, Ageing and Retirement in Europe

OBJECTIVES

The aim of this longitudinal study was to examine whether the onset and the end of obesity was associated with loneliness.

METHOD

Nationally representative longitudinal data from Germany were taken from the Survey of Health, Ageing and Retirement in Europe (wave 5 to wave 7; n = 10,446 observations in the analytical sample). Using the three item loneliness scale (UCLA), loneliness was measured. According to the WHO thresholds, obesity was defined as BMI ≥ 30 kg/m². Asymmetric fixed effects (FE) regressions were used.

RESULTS

Conventional FE regression analysis revealed that changes in obesity status were associated with changes in loneliness (men: β = -.19, p < .05; women: β = .19, p < .05). Asymmetric FE regressions showed that in men the onset of obesity was associated with a decrease in loneliness (β = -.31, p < .05), whereas the end of obesity was not associated with loneliness. Asymmetric FE regressions showed that in women, the onset of obesity was associated with an increase in loneliness (β = .33, p < .01), whereas the end of obesity was not associated with loneliness.

CONCLUSION

Findings showed that the onset of obesity has different consequences in terms of loneliness for older women and men in Germany, whereas the end of obesity was not associated with changes in loneliness scores. We recommend that future studies should distinguish between the onset and the end of obesity - which comes along with important practical implications. When older women report transitions to obesity, efforts to prevent loneliness may be of importance.

Science mapping research on body image: A bibliometric review of publications in Body Image, 2004-2020

Science mapping is a methodology that combines quantitative analysis, classification, and visualisation to identify the composition and inter-relationships between bibliographic objects. Here, we used bibliometric science mapping to identify the overarching structure, evolution of research themes and research fronts, and geographic spread of body image research. We examined 2,783 keywords in 1,107 articles published in Body Image between 2004 and 2020, selected as being representative of body image research during this period. Co-occurrence analysis of the keywords enabled us to identify five general themes in the literature: "clinical and weight-related issues", "body image and disordered eating", "positive body image and objectification", "media effects", and "ethnicity/race". Burst analysis allowed us to identify research fronts in this research, with work on social media and positive body image in particular being identified as emergent. Finally, co-author analysis indicated that body image research networks are heavily focused on a small handful of nations, although there is evidence of a recent shift toward greater geographic spread. Our results, and the provision of interactive maps and extensive tables, should allow readers to examine connections between research clusters and areas, generate novel research ideas, and more fully understand the evolution and future trajectories of body image research.

Does obesity lead to loneliness and perceived social isolation in the second half of life? Findings from a nationally representative study in Germany

AIM

Little is known about the link between obesity and loneliness as well as perceived social isolation. Therefore, the objective of this longitudinal study is to clarify whether the onset and the end of obesity is associated with changes in perceived social isolation as well as loneliness (stratified by sex) in older age.

METHODS

Longitudinal data were used from wave 5 (year 2014) and 6 (year 2017) of the German Ageing Survey - a nationally representative sample of community-dwelling individuals aged ≥40 years in Germany. Established tools were used to quantify loneliness and perceived social isolation. A body mass index ≥30 kg/m² was used to classify individuals as being obese. Asymmetric fixed effects regressions were used.

RESULTS

Regressions showed that the end of obesity was associated with decreases in perceived social isolation among women (β = -0.24, P = 0.01), but not in men (with significant sex differences). The onset of obesity was not associated with changes in perceived social isolation. Neither the beginning of obesity nor the end of obesity was associated with changes in loneliness.

CONCLUSIONS

Our findings emphasize the importance of overcoming obesity for women in the second half of life. As most of the existing studies were conducted in Germany, studies from other countries are of importance to understand this association better. Geriatr Gerontol Int 2021; 21: 836-841.

Lack of guilt, shame, and remorse following weight stigma expression: a real-time assessment pilot study

Objective

Weight stigma is pervasive and is associated with negative health and psychological outcomes. Few studies have examined weight stigma perpetration or the emotions individuals experience after perpetrating weight stigma. This study used experience sampling to explore the nature and frequency of weight stigma behaviors and cognitions and moral emotions (shame, guilt, remorse, pride) in the perpetrator following weight stigma perpetration.

Methods

Participants were college students (N = 31, 77.1% female). Participants completed baseline measures of anti-fat attitudes and one week of experience sampling phone prompts assessing: (1) weight stigma behaviors and cognitions and (2) moral emotions. Generalized estimating equation analyses were used to model trajectories of moral emotions after weight stigma events.

Results

Thirty-one participants reported 1,008 weight stigma events over 7.5 days. Feelings of guilt, shame, and remorse decreased after weight stigma perpetration. Individuals also reported feeling less proud after engaging in weight stigma.

Conclusions

Weight stigma occurs frequently as reported by perpetrators. A lack of remorse, guilt, and shame is evident in undergraduates after they express weight stigma; however, individuals in this study also reported feeling less pride after perpetration. This study highlights the need for future studies to explore the expression of weight stigma from the perspective of perpetrators instead of targets. Results highlight the pervasiveness and normative nature of weight stigma perpetration in everyday life and the need to better understand the emotional response following weight stigma perpetration as a potential mechanism of its perpetuation.

The Association Between Obesity and Social Isolation as Well as Loneliness in the Adult Population: A Systematic Review

PURPOSE

Obesity is associated with adverse health outcomes and can result in feelings of loneliness or social isolation, for example due to stigmatization. These factors are in turn associated with morbidity and mortality. Thus far, a systematic review is lacking with regard to the association between obesity, social isolation and loneliness. Therefore, our aim was to fill this gap in knowledge.

MATERIALS AND METHODS

Three established electronic databases (PubMed, PsycInfo, as well as CINAHL) were searched. Observational studies examining the link between obesity and loneliness or social isolation were included. Disease-specific samples were excluded.

RESULTS

In sum, six studies have been included. While some studies point to an association between obesity and increased loneliness levels, it should be acknowledged that findings are mixed. Study quality was quite high.

CONCLUSION

This systematic review showed that the literature is inconclusive and incomplete. Further research is required to shed further light on these associations. Moreover, studies from countries outside Europe, based on longitudinal data and using objective assessments of obesity, are urgently required. Gender differences should be further explored.

Attitudes and beliefs in Swedish midwives and obstetricians towards obesity and gestational weight management

Background

Gestational weight interventions are important in maternity care to counteract adverse pregnancy events. However, qualitative findings indicate potential obstacles in the implementation of interventions due to the sensitivity of the subject and existing obesity stigma. Pregnant women have reported disrespectful or unhelpful communication, while some midwives seem to avoid the topic, as not to upset women. This descriptive study aimed to provide knowledge about maternity care providers’ beliefs about obesity, and their attitudes towards gestational weight management.

Method

A web survey was emailed to Swedish maternity care clinics. Existing questionnaires, “Beliefs About Obese People” (BAOP), “Perceived weight bias in health care” and “Attitudes toward obese patients” was used, supplemented with questions formulated for this study. An open free-text question allowed participants to provide a deeper and more nuanced picture of the topic.

Results

274 respondents (75% midwives and 25% obstetricians) participated. One third of respondents found obesity to be a more sensitive topic than smoking or alcohol habits, and 17% of midwives agreed to the statement: “I sometimes avoid talking about weight so as not to make the pregnant woman worried or ashamed”. Having had training in motivational interviewing seemed positively associated with midwives’ inclination to talk about body weight, especially with women with obesity (p = .001), whereas years of working experience were not associated. Having received obesity education increased confidence in providing adequate information, but still only 46% felt they had enough knowledge to provide diet and exercise advice to pregnant women with obesity. Qualitative data revealed great empathy for women with obesity, and a wish to have more obesity education and access to other professionals.

Conclusion

Swedish maternity care staff displayed empathy for women with obesity and found gestational weight interventions important, but almost one fifth of midwives sometimes avoid the subject of body weight for fear of upsetting women. Education about obesity facts, training in person-centered communication, i.e. motivational interviewing, and access to dieticians may facilitate gestational weight management implementation.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12884-020-03438-1.

Weight stigma and psychological distress: A moderated mediation model of social identification and internalised bias

Links between weight stigma and negative health outcomes are well documented, but risk and protective factors remain unclear. In this study, 458 higher-weight Australian adults completed online self-report measures of perceived weight stigma, weight-based social identification (identity centrality), internalised weight bias, and psychological distress. Associations between these variables were investigated in line with the rejection-identification model and the social identity approach to health. Perceived stigma was positively associated with social identification and psychological distress. Simple mediation analysis showed a positive indirect effect of perceived stigma on psychological distress through social identification. However, moderated mediation analysis revealed that this indirect effect was dependent on internalised bias. Among participants who reported low internalised bias, social identification was associated with lower psychological distress; but for those with high internalised bias, this relationship was reversed. Findings suggest that perceived weight stigma, weight-based social identification, and internalised weight bias are key factors that should be considered together in the design and evaluation of interventions to improve the mental health of higher-weight individuals.

Does weight-related stigmatisation and discrimination depend on educational attainment and level of income? A systematic review

OBJECTIVES

Obesity is considered a global health issue, because of its health-related consequences and also because of its impact on social status as a result of stigma. This study aims to review the quantitative state of research regarding socioeconomic characteristics' influence on weight-related stigmatisation and discrimination. Based on Bourdieu's Theory of Class and his concept of 'habitus', it is assumed that people with a higher level of education and income show stronger negative attitudes towards people with obesity.

METHOD

A narrative systematic literature review was conducted in 2017 using PubMed, PsychINFO, Web of Science and the Cochrane Library. Seventeen studies that measured weight bias and either educational attainment or level of income were included in the analysis.

RESULTS

The results of the studies included were inconsistent: six of these studies were found to support the hypothesis, whereas two of the studies contradicted it. The remaining seven studies did not show any significant correlation between weight bias and either education or income.

CONCLUSION

In light of the inconsistent and heterogeneous results of the studies that report a significant association between weight bias and socioeconomic variables, the findings must be discussed concerning their cultural context, that is, cultural and governmental differences. Furthermore, educational attainment seems to be more likely to predict weight bias than income. The review revealed a lack of research when it came to examining the impact of socioeconomic capital on weight bias.

Intensive care nurses' implicit and explicit attitudes and their behavioural intentions towards obese intensive care patients

AIMS

To examine qualified intensive care nurses' implicit and explicit attitudes towards obese intensive care patients and whether their attitudes are associated with their behavioural intentions towards these patients.

BACKGROUND

Obese intensive care patients may experience more stress than do normal-weight patients. Intensive care nurses' attitudes and the way they address their care are thus vital. Despite a range of studies revealing that health professionals hold anti-fat attitudes towards obese patients, there is a lack of knowledge about intensive care nurses' implicit and explicit attitudes and if such attitudes are associated with behavioural intention.

DESIGN

A cross-sectional survey.

METHODS

From November 2017 - January 2018, a web-based survey was conducted with 159 qualified intensive care nurses (84.3% women, mean age 45.52 years) recruited through 16 intensive care units and Facebook. The survey consisted of implicit attitude tests, explicit bias scales, the Anti-fat Attitude questionnaire, vignettes measuring behavioural intention, and demographic questions.

RESULTS

Intensive care nurses reported implicit preferences for thin over thick people and found obese individuals slightly 'worse' and 'lazy', comprising less willpower than thin individuals. Attitudes were not associated with behavioural intention.

CONCLUSION

This study provides new knowledge about qualified intensive care nurses' anti-fat attitudes and behavioural intention towards obese intensive care patients. These findings should be acknowledged by policymakers, clinical healthcare providers and educators to secure optimal care for these patients.

IMPACT STATEMENT

These results should be used in nursing attitude change programmes, in intensive care units, and among nursing educators, focusing on increasing nurses' knowledge of the complexities of obesity. Further research on obese intensive care patients' healthcare experiences and the impact that healthcare providers' anti-fat attitudes and behaviours has on patients' perceived care quality is needed.

"…or else I close my ears" How women with obesity want to be approached and treated regarding gestational weight management: A qualitative interview study

INTRODUCTION

The importance of helping pregnant women maintain a healthy lifestyle and prevent excessive gestational weight gain is well recognized, but pregnant women do not always perceive communication about body weight as respectful or helpful. Furthermore, fear of inducing shame or guilt can prohibit some midwives from talking about body weight, especially if the woman has obesity. We aimed to explore what women of reproductive age with obesity regard to be the most important and relevant aspects when discussing gestational weight management.

METHODS

Qualitative interview study using focus groups and individual semi-structured interviews with 17 women of reproductive age (19-39 y) with obesity. Thematic analysis was used to analyze the data.

RESULTS

We identified three themes: 1) Importance of obtaining vital medical information; 2) A wish to feel understood and treated with respect; 3) Midwives' approach is crucial in sensitive key situations, which include bringing up the subject of body weight, weighing, providing weight-related information, coaching lifestyle modification, dealing with emotional reactions and ending a conversation.

CONCLUSIONS

A majority of the interviewed women wished to receive information about risks about obesity and gestational weight gain, and recommendations on weight management. However, the risk of midwives offending someone by raising the topic may be increased if the pregnant woman believe that gestational weight gain is uncontrollable by the individual. Also, several situations during maternity care meetings can be stigmatizing and make women less receptive to advice or support. Women suggest that a good working alliance is likely to be achieved if midwives have knowledge about the causes of obesity, take interest in the patients' background, have a non-judgmental approach and refrain from giving unsolicited advice.

Potential unintended consequences of graphic warning labels on sugary drinks: do they promote obesity stigma?

INTRODUCTION

Public health interventions need to balance the benefits with any potential harms. One proposed intervention for reducing sugar-sweetened beverage consumption involves placing graphic warning labels on products and advertisements. A recent study found that a graphic warning label that contained negative imagery of obesity reduced purchases of sugar-sweetened beverages. However, these labels may also promote obesity stigma, which is concerning given that weight stigma is associated with harmful health consequences including weight gain and increased risk of mortality.

METHODS

In Study 1 (n = 681), participants viewed a standard soda label or the graphic warning label online and then completed measures of disgust and prejudice towards people with obesity. In Study 2 (n = 506), participants who identified as having overweight or obesity viewed the graphic warning label online before or after completing measures of mood and state self-esteem.

RESULTS

In Study 1, participants who had viewed the graphic warning label reported higher disgust and weight bias. In Study 2, the majority of participants perceived the warning label to be stigmatizing, and participants displayed worse mood and, through this, lower self-esteem after viewing the label.

CONCLUSIONS

Although the graphic warning label has been found to reduce sugary drink purchases, it also promotes obesity stigma and is perceived as stigmatizing by individuals with overweight and obesity. Given that weight stigma predicts harmful health and well-being consequences, the benefits of graphic warning labels need to be balanced against the potential costs.

Prejudice against obesity in university students studying in health-related departments

PURPOSE

This study was conducted to determine the degree of obesity prejudice exhibited and felt by students attending health-related departments.

DESIGN AND METHOD

The sample included 729 students studying in health-related departments at a university in Turkey who volunteered to take part in the study.

FINDINGS

The average Obesity Prejudice Scale (OPS) score of the students was 75.54±10.43, thus indicating that they tend toward prejudice.

PRACTICAL IMPLICATIONS

According to the results of the study, university students who will be future nurses and other healthcare professionals, tend toward obesity prejudice, negatively impacting health care.

Examining Weight Bias among Practicing Canadian Family Physicians

OBJECTIVES

The aim of this study was to examine the attitudes of practicing Canadian family physicians about individuals with obesity, their healthcare treatment, and perceptions of obesity treatment in the public healthcare system.

METHOD

A national sample of Canadian practicing family physicians (n = 400) completed the survey. Participants completed measures of explicit weight bias, attitudes towards treating patients with obesity, and perceptions that people with obesity increase demand on the public healthcare system.

RESULTS

Responses consistent with weight bias were not observed overall but were demonstrated in a sizeable minority of respondents. Many physicians also reported feeling frustrated with patients with obesity and agreed that people with obesity increase demand on the public healthcare system. Male physicians had more negative attitudes than females. More negative attitudes towards treating patients with obesity were associated with greater perceptions of them as a public health demand.

CONCLUSION

Results suggest that negative attitudes towards patients with obesity exist among some family physicians in Canada. It remains to be determined if physicians develop weight bias partly because they blame individuals for their obesity and its increased demand on the Canadian public healthcare system. More research is needed to better understand causes and consequences of weight bias among health professionals and make efforts towards its reduction in healthcare.

The association between obesity and social exclusion in middle-aged and older adults: findings from a nationally representative study in Germany

Background

There is a lack of studies that focus explicitly on the association between social exclusion and obesity. The aim of the present study was to identify whether social exclusion is associated with obesity in older adults, and whether this association is moderated by sex.

Methods

Data were derived from wave 5 (2014) of the German Ageing Survey - a representative sample of individuals residing in private households aged 40 and over in Germany. A validated scale developed by Bude and Lantermann was used to assess social exclusion. Individuals with body-mass-index ≥30 kg/m² were classified as being obese. Multiple linear regressions were applied in this study.

Results

Linear regressions showed that social exclusion was not associated with obesity in the total sample and in men, whereas women with obesity were less socially excluded than women without obesity (β = −.06, p = .02). The corresponding interaction term (sex x obesity) achieved statistical significance (p = .03).

Conclusions

Our findings emphasize the negative association between social exclusion and obesity in women, but not men, highlighting the complex interplay between social factors and excess weight in individuals aged 40 and above. Future longitudinal studies are needed to clarify this relationship in further detail.

Personality and the Social Experience of Body Weight

Personality traits have been associated consistently with objective and subjective experiences of body weight. We examine whether this association extends to social attitudes and behaviors related to weight. Participants were mothers with children (N=3,099) who completed measures of personality and weight-related attitudes and social interactions. Higher Neuroticism and higher Extraversion were associated with more negative attitudes towards persons with obesity and engagement in fat talk with their friends and around their children. Higher Conscientiousness was associated with fewer negative attitudes and interactions but greater phobia towards obesity, whereas higher Openness and higher Agreeableness were generally associated with more positive attitudes and experiences. The associations for Conscientiousness, Openness, and Agreeableness held only for participants at relatively lower body mass index. Higher Neuroticism and lower Conscientiousness were further associated with the experience of weight discrimination. The present research indicates that in addition to measured weight and body image, personality traits are associated with the social experience of body weight.

The Chronic Pain Myth Scale: Development and Validation of a French-Canadian Instrument Measuring Knowledge, Beliefs, and Attitudes of People in the Community towards Chronic Pain

Background. In order to better design awareness programs on chronic pain (CP), measurement of knowledge, beliefs, and attitudes of people in the community towards this condition is most useful. Objectives. To develop and validate a French-Canadian scale that could be used for this purpose. Methods. Items of the Chronic Pain Myth Scale (CPMS) were developed based on different information sources, reviewed by pain experts, and pretested. The CPMS was administered to 1555 participants among the general Quebec population. Results. The final CPMS contained 26 items allowing the calculation of three subscales scores (knowledge, beliefs, and attitudes towards people suffering from CP, biopsychosocial impacts of CP, and treatment of CP) which showed adequate internal consistency (α = 0.72-0.82). There were statistically significant differences in subscales scores between participants who reported suffering versus not suffering from CP, reported knowing versus not knowing someone who suffers from CP, and reported being versus not being a healthcare professional, which supports the construct validity of the scale. Conclusions. Our results provide preliminary evidence supporting the psychometric qualities of the use of the CPMS for the measurement of knowledge, beliefs, and attitudes towards CP among French-speaking individuals of the Quebec general population.

The role of the "Healthy Weight" discourse in body image and eating concerns: An extension of sociocultural theory

Sociocultural models of body image and eating concerns have highlighted the role of the social discourse in promoting the pursuit of the thin-ideal. Recently, another weight-focused social discourse has gained ground, focused on the goal of maintaining body weight within the boundaries of a weight-range defined as "Healthy." This discourse is somewhat different to the promotion of the thin-ideal; however, it might also be implicated in the development of body image and eating concerns. The present study aimed to extend sociocultural theories of the development of body image and eating concerns by (1) proposing a theoretical model accounting for pressure to maintain a "Healthy Weight", and (2) reviewing the existing evidence for the pathways included in this model. In the proposed model, pressure to maintain a Healthy Weight leads to the internalization of anti-fat attitudes and the need to control weight as well as beliefs in the controllability of weight through diet and exercise. These beliefs may then lead to body preoccupation and disordered eating. The extant literature provides initial support for these relationships; however, empirical testing of this model is necessary to determine its usefulness as an explanatory model and in providing intervention targets for future prevention and intervention efforts.

Understanding the relationship between family communication and the development of weight stigma

<b>Background</b><br /> This study examined the relationship between family communication and weight stigma. The Family Communication Patterns Theory was used as a framework to explain the relationships between two dimensions of family communication (i.e., conversation orientation and conformity orientation) and antifat attitudes (i.e., physical unattractiveness and weight blame).<br /> <br /> <b>Participants and procedure</b><br /> A total of 585 college-aged participants completed an on-line questionnaire. We used the following instruments: body mass index (BMI), Antifat Attitudes Scale (AFAT), Revised Family Communication Patterns Scale (RFCP).<br /> <br /> <b>Results</b><br /> Significant relationships were found between the two dimensions of family communication and antifat attitudes. Conversation orientation was negatively associated with antifat attitudes and conformity orientation was positively associated with antifat attitudes. In addition, pluralistic families were less likely to stigmatize the overweight and obese by demonstrating less discrimination with physical attraction and personal weight blame.<br /> <br /> <b>Conclusions</b><br /> These findings highlight the important association between family communication and antifat attitudes. Families that endorse a pluralistic family type (i.e., high conversation orientation and low conformity orientation) appear to engage in the least amount of discrimination with regard to weight stigma. These families are not only less discriminating of others, they perhaps bring about more awareness and information to family members as compared to other family types.

Perceived vulnerability to disease and antifat attitudes in a sample of children and teenagers

PURPOSE

Perceived vulnerability to disease (beliefs about personal susceptibility to contracting an infectious disease) is usually related to the expression of prejudice towards different stigmatized groups. In this study, the relationship between this variable and the expression of the prejudice towards obese people was analyzed.

METHOD

The sample comprised a total of 137 children and teenagers, aged between 12 and 17 years, from a Spanish high school who fulfilled several scales which measure perceived vulnerability to disease, antifat attitudes and perceived controllability of weight. Additionally, body mass index (BMI) was calculated by means of the participants' height and weight.

RESULTS

Perceived infectability (one of the factors of the perceived vulnerability to disease scale) was negatively related to controllability of weight, and germ aversion (the second factor of the vulnerability scale), showed a positive relationship with the antipathy towards obese people. Finally, perceived controllability of weight was positively correlated with BMI.

CONCLUSIONS

The implications of these results in the field of the study of the prejudice toward obese people are discussed. To our knowledge, no other studies have investigated the relationship between perceived vulnerability to disease and antifat attitudes in minors. Additionally, this is the first time that the measured BMI has been used instead of the self-reported one.

Analysis of Attentional Bias towards Attractive and Unattractive Body Regions among Overweight Males and Females: An Eye-Movement Study

Background

Body image distortion is highly prevalent among overweight individuals. Whilst there is evidence that body-dissatisfied women and those suffering from disordered eating show a negative attentional bias towards their own unattractive body parts and others’ attractive body parts, little is known about visual attention patterns in the area of obesity and with respect to males. Since eating disorders and obesity share common features in terms of distorted body image and body dissatisfaction, the aim of this study was to examine whether overweight men and women show a similar attentional bias.

Methods/Design

We analyzed eye movements in 30 overweight individuals (18 females) and 28 normal-weight individuals (16 females) with respect to the participants’ own pictures as well as gender- and BMI-matched control pictures (front and back view). Additionally, we assessed body image and disordered eating using validated questionnaires.

Discussion

The overweight sample rated their own body as less attractive and showed a more disturbed body image. Contrary to our assumptions, they focused significantly longer on attractive compared to unattractive regions of both their own and the control body. For one’s own body, this was more pronounced for women. A higher weight status and more frequent body checking predicted attentional bias towards attractive body parts. We found that overweight adults exhibit an unexpected and stable pattern of selective attention, with a distinctive focus on their own attractive body regions despite higher levels of body dissatisfaction. This positive attentional bias may either be an indicator of a more pronounced pattern of attentional avoidance or a self-enhancing strategy. Further research is warranted to clarify these results.

A national survey of public views about the classification of obesity as a disease

OBJECTIVE

In 2013, the American Medical Association classified obesity as a disease. This study assessed public opinions about this disease classification.

METHODS

In January 2014, a national sample of 1118 adults completed surveys assessing their agreement with 33 statements in support of and against the disease classification of obesity, as well as measures assessing sociodemographic characteristics.

RESULTS

The majority of participants (51-61.7%) agreed with 11 of 17 statements in support of the disease classification of obesity (average agreement across all statements = 51%), including views that it will help people gain access to obesity treatment. A minority of participants (31-47.3%) agreed with 15 of 16 statements against the disease classification (average agreement across statements = 39.5%), including views that it will increase overreliance on medications or surgery to treat obesity (47.3%). Participants' attitudes were unaffected by sex, income, education, or health status but were related to causal beliefs about obesity. The disease classification received more support from African Americans and more opposition by individuals with higher weight stigma.

CONCLUSIONS

This study found more public agreement supporting the disease classification of obesity than opposing it. Further work should identify whether this classification affects health behaviors among individuals with obesity or societal weight stigmatization.