Ethnic differences in the stigma of obesity: Identification and engagement with a thin ideal

The Roles of Social Comparison Orientation and Regulatory Focus in College Students' Responses to Fitspiration Posts on Social Media: Cross-sectional Study

BACKGROUND

Information shared via social media influences college students' self-perceptions and behavior, particularly, "fitspiration" posts (ie, images of healthy food, people exercising, or fitness quotations). There are mixed findings regarding the mental health implications of fitspiration and its potential to motivate healthy behavior. Individual differences such as social comparison orientation and regulatory focus could aid in determining for whom fitspiration may be helpful versus harmful, though these characteristics have received limited attention in terms of students' fitspiration perceptions.

OBJECTIVE

This cross-sectional study examined associations between students' fitspiration use (ie, intentional versus unintentional exposure while using social media), response tendencies (ie, feelings about the self and motivation to be physically active), social comparison orientation, and regulatory focus.

METHODS

College students (N=344; 239/344, 69.5% women) completed an electronic survey in which they self-reported demographic information, the frequency of their social media use, exposure to fitspiration posts, typical feelings in response to fitspiration posts, and typical motivation for physical activity after viewing fitspiration posts. They also completed validated self-report measures of social comparison orientation and regulatory focus.

RESULTS

College students reported frequent exposure to fitspiration posts on social media and that they experienced negative feelings in response to these posts more often than positive feelings. Average motivation for physical activity was rated as feeling motivated "some of the time." However, students who reported more negative feelings after viewing fitspiration also reported greater motivation to be physically active after exposure. Associations between the frequency of intentional fitspiration use and motivation for physical activity after viewing fitspiration posts were moderated by social comparison orientation (b=-0.01, P=.03) but not by regulatory focus (b=-0.002, P=.67).

CONCLUSIONS

Negative feelings about the self may be motivating for students with weak social comparison orientation, as fitspiration may highlight a discrepancy between one's real and ideal self that does not prompt dejection or disengagement. However, negative feelings for prevention-focused students might not be as motivating because there are no salient negative models to avoid. Further research into these associations is warranted and could inform future efforts to promote student health and well-being during college.

Integrating cognitive dissonance and social consensus to reduce weight stigma

Weight stigma is pervasive and has a range of deleterious effects. Among the most promising approaches for modifying this form of stigma are cognitive dissonance and social consensus. Due to their theoretical connection, this study tested the effects of an experimental manipulation of cognitive dissonance blended with social consensus for targeting weight stigma. It also added to research investigating the effects of cognitive dissonance on weight stigma by investigating a broader range of stigma measures. Participants were university students aged 18-35 years (N = 98) who were randomly allocated to one of four experimental conditions: blended cognitive dissonance, standard cognitive dissonance, blended control or standard control. Stigma measures included the perceived characteristics of, affective reactions towards, social avoidance of, and blameworthiness attributed to a higher-weight individual, and general weight stigma. Results showed that those in the cognitive dissonance conditions reported significantly lower weight stigma than those in the non-dissonance, control conditions. Moreover, those in the blended cognitive dissonance condition with higher in-group identification reported less negative affective reactions than those with lower in-group identification. The results provide consistent support for cognitive dissonance as an approach for reducing weight stigma and some additive support for an integrated cognitive dissonance and social consensus approach.

The Relationship Between Internalized Weight Stigma During Pregnancy and Breastfeeding: A Prospective Longitudinal Study

OBJECTIVE

This study aimed to examine the relationship between internalized weight stigma during pregnancy and breastfeeding outcomes at 1 month post partum among individuals with prepregnancy overweight or obesity. Secondarily, the study explored the temporal stability of internalized weight stigma from the third trimester to 1 month post partum via the Weight Bias Internalization Scale (WBIS).

METHODS

A total of 103 pregnant individuals with overweight or obesity were recruited for this study. Participants completed the WBIS during the third trimester and self-reported breastfeeding initiation, continuation, and exclusivity outcomes at 1 month post partum. A paired t test and binomial logistic regression were conducted with covariates hierarchically added to the model.

RESULTS

The average prepregnancy BMI was 33.53 (SD 7.17) kg/m² (range = 25.4-62), and average prenatal WBIS scores were 25.95 (SD 11.83). No difference was found in mean prenatal and postpartum scores (25.95 [SD 11.83]; 26.86 [SD 13.03], respectively; t₉₄ = -0.83, P = 0.41), evidencing temporal stability in WBIS scores from pre to post partum. Prenatal WBIS scores did not predict breastfeeding initiation, continuation, or exclusivity at 1 month post partum in either unadjusted or adjusted models.

CONCLUSIONS

Collectively, this sample displayed low weight bias internalization, which was not predictive of breastfeeding initiation, continuation, or exclusivity at 1 month post partum. Future research is needed to develop a pregnancy-specific weight stigma measure.

Are Feminine Body Weight Norms Different for Black Students or in Black Schools? Girls' Weight-Related Peer Acceptance across Racialized School Contexts

Adolescent girls with overweight or obesity are less socially integrated than their thinner peers. We examine racial-ethnic differences in girls' weight-related friendship patterns, especially noting Black-white distinctions given their different norms about the ideal feminine form. We also test whether schools with more Black students see diminished weight-related differences in peer integration for all girls and/or for Black girls. Using 1994-1995 data from the National Longitudinal Study of Adolescent to Adult Health, we predict the number of friendship nominations girls receive conditional on their weight status, race-ethnicity, and school's racial composition. Both white and Black girls with overweight or obesity are less integrated than their thinner peers regardless of the school's Black enrollment rate. Hispanic girls with overweight are more integrated than white girls with overweight, particularly in schools with low Black enrollments. The relative consistency of girls' weight-related friendship patterns demonstrates the ubiquity of dominant feminine thinness norms.

The Association Between Weight-Based Teasing from Peers and Family in Childhood and Depressive Symptoms in Childhood and Adulthood: A Systematic Review

RECENT FINDINGS

Depressive symptoms may be a psychological correlate of weight-based teasing from peers and/or family. However, it is unclear whether the association of weight-based teasing with depressive symptoms differs by time (short term vs. long term), sex (males vs. females), or source (family vs. peers).

PURPOSE

The purpose of this systematic review was to (1) examine whether the frequency of weight-based teasing differs according to sex and source and; (2) examine whether the association of weight-based teasing with depressive symptoms varies according to time, sex, and source.

METHODS

On February 16, 2018, a combination of keywords within three concepts, (i) children and adults, (ii) weight-based teasing source, and (iii) mental health outcomes, were searched in four databases (PubMed, PsycINFO, Scopus, and Web of Science) for relevant articles. Cross-sectional and longitudinal original research articles were included, and studies were excluded if the relationship between weight-based teasing and depressive symptoms was not explicitly measured.

RESULTS

The search yielded 3572 articles, and nineteen studies were included in the final analysis. Experiences of weight-based teasing occurred significantly more among girls than boys. Weight-based teasing was significantly associated with depressive symptoms in both short and long term. Weight-based teasing exhibited a greater association with depressive symptoms in girls vs. boys and when it came from multiple sources than from either source alone. However, it remains uncertain whether one source of teasing is more common than the other, since only two studies found peers to be a more common source of weight-based teasing compared to family. Weight-based teasing from peers and family is associated with depressive symptoms, and girls are more psychologically vulnerable than boys. Interventions are required to reduce weight-based teasing and its harmful psychological effects.

Stereotypes of physical attractiveness and social influences: The heritage and vision of Dr. Thomas Cash

Dr. Thomas Cash conducted seminal work on the beliefs and stereotypes related to attractiveness as well as their impact, and their transmission through cultural and interpersonal processes. This initial work has inspired and given rise to an important body of research significantly increasing our understanding of these processes. Here we review the initial contributions and research directions set up by Dr. Cash, as well as the main findings of the research that has built on his foundations. Specifically, we review findings related to the existence of attractiveness stereotypes and appearance ideals, research examining the social and interpersonal impacts of such stereotypes, and finally the sociocultural transmission of these beliefs. Future directions related to the extension of our understanding to appearance characteristics beyond shape and weight, as well as increased focus on minority identities and their intersection, are proposed.

Women With Obesity Are Not as Curvy as They Think: Consequences on Their Everyday Life Behavior

Two studies explore the impact of body size on daily life activities of women with obesity. In the first study, ethnographic techniques (first-person perspective video recordings) and subsequent interviews based on the video recordings were used. Results showed atypical behavior of women with obesity and ex-obese women related to memories of embarrassing experiences regarding personal body size (sitting, passing doors sideways, over-careful navigation in public space, and choosing clothes sizes too large.) Women with obesity seem to behave as if they thought they had a larger body than it actually was. These atypical behaviors are related to memories of embarrassing experiences regarding personal body size and stigma. Overweight women exhibit the same behavior but to a lesser and less systematic degree. In the second study, the represented (imagined) body size was compared to the perceived (in a mirror) body size with digital morphing techniques. In the mirror condition, the perceived image is accurate, while in the absence of a mirror women with obesity overestimate their body size by about 30%. Moreover, overestimation of imagined body size increased according to the weight status. Finally, women who had bariatric surgery had poorer estimates than women who had not. This would result of being continuously reminded of obesity and its stigma by daily embarrassing experiences, by being confronted with an environment designed for normal weight (e.g., narrow seats, turnstiles etc.) that makes obesity salient. We suggest that body size overestimation is a case of accentuation where things that matter are perceived bigger. These results could also been explained by the allocentric lock theory.

Novel ranking of protective and risk factors for adolescent adiposity in US females

OBJECTIVE

Rank the importance of potentially modifiable psychosocial, dietary and environmental risk and protective factors for female adolescent obesity in order to target and inform public health prevention efforts. Utilizing the largest dataset available that captures the onset of the adolescent obesity surge in the USA, the study provides a more robust understanding of paediatric obesity risk factors.

METHODS

Data were obtained from an observational, longitudinal study conducted between 1989 and 2001, the NHLBI Growth and Health Study. This study includes girls aged 9-19 years from three urban US locations, with Black and White girls generally represented equally. Data were analysed using multiple regression, random forest and propensity score matching to determine the strongest adiposity risk and protective factors during ages 9-12 predicting adiposity at age 19 with multiple methods to maximize the ability to identify possible public health interventions. Multiple linear regression and random forest analysis identified the strongest associations among 288 risk and protective factors selected from the study's literature review. For the 190 factors associated with follow-up adiposity from the data, propensity score matching was used to control for confounding of these factors.

RESULTS

Findings suggest that highest priority interventional targets across the domains surveyed are lowering specific nutrients; eating meals with others or during activities without skipping; parents fixing evening snacks; improving perceptions of non-extremes as the healthy weight; improving self-worth, physical activity and social competence; and limiting any negative impact of dieting relatives. Similar associations were observed for Black and White girls.

CONCLUSION

The clinical implications of these findings allow health practitioners to target behavioural change efforts and address social and environmental factors that have demonstrated higher prioritization value for early obesity interventional efforts for adolescents.

The Weight of Things: Understanding African American Women's Perceptions of Health, Body Image, and Attractiveness

Negative attitudes toward being overweight or obese are widespread, and these notions perpetuate into conceptions about one's health. Clinically, being overweight is associated with health problems such as diabetes, hypertension, heart disease, and many other illnesses. African American women, who are generally larger in body size, are a particular target for health interventions. However, these women have resisted the "obesity" label, arguing that dominant measures of health are White norms and oppressive. Through the use of in-depth interviews, this study investigates how African American women understand and experience healthfulness, body image, and barriers to each. Findings show that African American women are ambivalent in their acceptance of dominant markers of health and expressed an almost universal disdain for the thin ideal as a marker of "good" health and a positive body image. Moreover, participants articulated a suspicion of formal medical measurements of obesity.

Cross-sectional and Prospective Examination of Weight Misperception and Depressive Symptoms Among Youth with Overweight and Obesity

This study aims to determine the association between weight misperception (considering oneself average or underweight) and depressive symptoms among youth with overweight/obesity. Linear regression models (adjusted for age, BMI, parental education, percent poverty) were used to examine cross-sectional (wave II, 1996, n = 3898, M _age = 15.9, SD = 0.13) and longitudinal (from wave II to IV, 1996-2008/2009, n = 2738, M _age = 28.5, SD = 0.06) associations between weight misperception and depressive symptoms (Center for Epidemiologic Studies-Depression Scale) in a subsample of White, Black, Asian, Hispanic, and Multi-racial male and female youth with overweight/obesity participating in the National Longitudinal Study of Adolescent Health. Average BMI was 29.0 (0.16) at wave II and 35.7 (0.23) at wave IV. Thirty-two percent misperceived their weight status as average weight (n = 1151, 30 %) or underweight (n = 99, 3 %). In fully adjusted cross-sectional models, White (β = -1.92, 95 % CI = -2.79, -1.06) and Multi-racial (β = -4.43, 95 % CI = -6.90, -1.95) youth who perceived themselves as average weight had significantly lower depressive symptoms compared to accurate weight-perceivers. In fully adjusted longitudinal models, White youth (β = -0.41, 95 % CI = -0.81, -0.004) who perceived themselves as average weight had significantly lower depressive symptoms 12 years later. Findings suggest that weight misperception may be protective against depression among White adolescents and young adults with overweight/obesity. Clinical and population interventions should consider potential harmful effects of correcting weight misperceptions on the mental health of youth with overweight/obesity.

Intersectionality: An Understudied Framework for Addressing Weight Stigma

INTRODUCTION

Obesity is an ongoing public health concern in the U.S. Weight stigma is linked to a number of obesogenic health outcomes, which complicate obesity treatment and prevention. Despite higher rates of obesity in female and minority populations, little research has examined weight stigma in non-white women and men. This study investigated intersectionality in weight stigma and health-related coping responses to stigmatizing experiences across racial groups.

METHODS

In 2015, a total of 2,378 adults completed questionnaires about weight stigma, weight bias internalization, and coping strategies. Analyses were conducted in 2016.

RESULTS

No differences in weight stigma emerged as a function of race or gender, but women reported higher weight bias internalization (B=0.19, p=0.004). Further, black men and women reported less weight bias internalization than white men and women (B=-0.43, p=0.009). Compared with white women, black women were less likely to cope with stigma using disordered eating (B=-0.57, p=0.001), whereas Hispanic women were more likely to cope with stigma using disordered eating (B=0.39, p=0.020). Black men were more likely than white men to cope with stigma via eating (B=-0.49, p=0.017).

CONCLUSIONS

Findings highlight that weight stigma is equally present across racial groups, but that groups internalize and cope with stigma in different ways, which exacerbate health risks. Increased research and policy attention should address stigma as an obstacle in prevention and treatment for obesity to reduce weight-based inequities in underserved populations.

"You better not leave me shaming!": Conditional indirect effect analyses of anti-fat attitudes, body shame, and fat talk as a function of self-compassion in college women

The present investigation provided a theoretically-driven analysis testing whether body shame helped account for the predicted positive associations between explicit weight bias in the form of possessing anti-fat attitudes (i.e., dislike, fear of fat, and willpower beliefs) and engaging in fat talk among 309 weight-diverse college women. We also evaluated whether self-compassion served as a protective factor in these relationships. Robust non-parametric bootstrap resampling procedures adjusted for body mass index (BMI) revealed stronger indirect and conditional indirect effects for dislike and fear of fat attitudes and weaker, marginal effects for the models inclusive of willpower beliefs. In general, the indirect effect of anti-fat attitudes on fat talk via body shame declined with increasing levels of self-compassion. Our preliminary findings may point to useful process variables to target in mitigating the impact of endorsing anti-fat prejudice on fat talk in college women and may help clarify who is at higher risk.

Nonverbal and paraverbal behavior in (simulated) medical visits related to genomics and weight: a role for emotion and race

It is crucial to examine patient reactions to genomics-informed approaches to weight management within a clinical context, and understand the influence of patient characteristics (here, emotion and race). Examining nonverbal reactions offers a window into patients' implicit cognitive, attitudinal and affective processes related to clinical encounters. We simulated a weight management clinical interaction with a virtual reality-based physician, and experimentally manipulated patient emotional state (anger/fear) and whether the physician made genomic or personal behavior attributions for weight. Participants were 190 overweight females who racially identified as either Black or White. Participants made less visual contact when receiving genomic information in the anger condition, and Black participants exhibited lowered voice pitch when receiving genomic information. Black participants also increased their interpersonal distance when receiving genomic information in the anger condition. By studying non-conscious nonverbal behavior, we can better understand the nuances of these interactions. Trial registry clinicaltrials.gov NCT01888913.

"It runs in my family …": The association of perceived family history with body dissatisfaction and weight bias internalization among overweight women

Aspects of poor body acceptance (BA), such as internalized weight bias and dissatisfaction with one's shape and size, are the strongest predictors of disordered eating and are associated with reduced engagement in healthy behaviors. Perceiving oneself as having a family history of overweight (PFH) could boost BA by increasing attributions for inherited, biological causes of weight. A community sample of 289 women who were overweight from the Washington, DC metropolitan area who were dissatisfied with their current weight (68% Black; 32% White) enrolled in this study in 2012. PFH of overweight was associated with decreased internalized weight bias among white women and marginally increased body shape satisfaction generally. The relationship between PFH and BA was not explained by biological attributions for weight. Perceptions that overweight runs in one's family can be protective with respect to BA. This is suggestive of the potential benefit of integrating family-based approaches into weight management interventions.

Predicting anti-fat attitudes: individual differences based on actual and perceived body size, weight importance, entity mindset, and ethnicity

The purpose of the current study was to examine the relative impact of actual and perceived weight, weight importance, entity mindset, and ethnicity on anti-fat attitudes as well as to examine whether certain variables play the role of mediator. Participants included a multiethnic U.S. sample of 923 female undergraduates who completed a series of measures online. Lower BMI, higher perceived weight, higher importance of weight, endorsement of an entity mindset, and identification as White as compared to Black, Hispanic, or Asian predicted higher overall anti-fat attitudes. Examination of the individual Antifat Attitudes Questionnaire subscales (i.e. dislike, fear of fat, and willpower) using Relative Weight Analysis suggested that weight importance is an important predictor of multiple aspects of anti-fat attitudes. In addition, weight importance mediated the relationship between perceived weight and fear of fat as well as the relationship between ethnicity and dislike. Implications of findings and future research directions are discussed.

Self-reported experiences of discrimination and health: scientific advances, ongoing controversies, and emerging issues

Over the past two decades, research examining the impact of self-reported experiences of discrimination on mental and physical health has increased dramatically. Studies have found consistent associations between exposure to discrimination and a wide range of Diagnostic and Statistical Manual of Mental Disorders (DSM)-diagnosed mental disorders as well as objective physical health outcomes. Associations are seen in cross-sectional as well as longitudinal studies and persist even after adjustment for confounding variables, including personality characteristics and other threats to validity. However, controversies remain, particularly around the best approach to measuring experiences of discrimination, the significance of racial/ethnic discrimination versus overall mistreatment, the need to account for "intersectionalities," and the importance of comprehensive assessments. These issues are discussed in detail, along with emerging areas of emphasis including cyber discrimination, anticipatory stress or vigilance around discrimination, and interventions with potential to reduce the negative effects of discrimination on health. We also discuss priorities for future research and implications for interventions and policy.

Holding fat stereotypes is associated with lower body dissatisfaction in normal weight Caucasian women who engage in body surveillance

This study examined the moderating effect of body surveillance on the relationship between fat stereotype endorsement and body dissatisfaction in normal weight women. Participants (N=225) completed online measures of fat stereotyping, body surveillance, body dissatisfaction, and internalized thin ideals. After accounting for thin ideals, body surveillance moderated the relationship between fat stereotypes and body dissatisfaction. Contrary to hypotheses, higher fat stereotype endorsement predicted lower body dissatisfaction in women with higher body surveillance. Conversely, higher fat stereotype endorsement predicted greater body dissatisfaction in women with lower body surveillance. Thus, endorsing fat stereotypes appears protective against body dissatisfaction in normal weight women who extensively engage in body surveillance. For women who hold fat stereotypes and report high body surveillance, we propose that downward appearance comparison may create a contrast between themselves and the people with overweight whom they denigrate, thus improving body dissatisfaction.

Perceived weight discrimination in the CARDIA study: differences by race, sex, and weight status

OBJECTIVE

To examine self-reported weight discrimination and differences based on race, sex, and BMI in a biracial cohort of community-based middle-aged adults.

DESIGN AND METHODS

Participants (3,466, mean age = 50 years, mean BMI = 30 kg/m²) of the Coronary Artery Risk Development in Young Adults (CARDIA) Study who completed the 25-year examination of this epidemiological investigation in 2010-2011 were reported. The sample included normal weight, overweight, and obese participants. CARDIA participants are distributed into four race-sex groups, with about half being African-American and half White. Participants completed a self-reported measure of weight discrimination.

RESULTS

Among overweight/obese participants, weight discrimination was lowest for White men (12.0%) and highest for White women (30.2%). The adjusted odds ratio (95% CI) for weight discrimination in those with class 2/3 obesity (BMI ≥ 35 kg/m²) versus the normal-weight was most pronounced: African American men, 4.59 (1.71-12.34); African American women, 7.82 (3.57-17.13); White men, 6.99 (2.27-21.49); and White women, 18.60 (8.97-38.54). Being overweight (BMI = 25-29.9 kg/m²) vs. normal weight was associated with increased discrimination in White women only: 2.10 (1.11-3.96).

CONCLUSIONS

Novel evidence for a race-sex interaction on perceived weight discrimination, with White women more likely to report discrimination at all levels of overweight and obesity was provided. Pychosocial mechanisms responsible for these differences deserve exploration.

An examination of weight bias among treatment-seeking obese patients with and without binge eating disorder

OBJECTIVE

The objective was to compare weight-bias attitudes among treatment-seeking obese patients with and without binge eating disorder (BED vs. NBO) and to explore racial and sex differences and correlates of weight-bias attitudes.

METHOD

Participants included 221 obese patients (169 female, 52 male) seeking treatment for weight and eating, recruited through primary care settings; of these, 168 patients met BED criteria. Patients completed semi-structured interviews and psychometrically established self-report measures of attitudes about obesity, eating pathology and depression.

RESULTS

Main effects for group (BED vs. NBO) and race (White vs. African American) were significant. Patients with BED had significantly higher levels of negative attitudes towards obesity than NBO patients, while African American patients had significantly lower levels of weight bias than did White patients. Greater negative attitudes towards obesity were significantly correlated with higher levels of depression and eating pathology for all patients.

CONCLUSIONS

Endorsement of negative weight bias was related to binge eating status, race, disordered eating, and depression. Primary care providers should be aware of weight biases among their patients.

Obesity, Labeling, and Psychological Distress in Late-Childhood and Adolescent Black and White Girls

The stigma of childhood obesity has the potential to affect psychological development during the early life course, but few studies examine whether experiencing stigma in childhood and adolescence has lasting ramifications for mental health during the transition to adulthood. Integrating modified labeling theory with a life course perspective, this study examined how obesity at different ages affects psychological distress in late adolescence using longitudinal data on black and white girls. We tested whether parent or friend labeling mediates this relationship and whether distal effects on psychological distress are further mediated through proximal distress using data from the National Growth and Health Study (n = 2,379). Findings showed significant proximal and distal effects of obesity on psychological distress through both parent and friend labeling among white girls. Distal effects on psychological distress were also mediated by proximal psychological distress. Among black girls, there were no distal effects, suggesting weight-based stigma is more consequential for white girls compared to black girls.

The stigmatizing effect of visual media portrayals of obese persons on public attitudes: does race or gender matter?

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

The effects of reality television on weight bias: an examination of The Biggest Loser

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

The association of body mass index and externally perceived attractiveness across race/ethnicity, gender, and time

PURPOSE

Being perceived by others as unattractive is associated with negative health and social consequences. Overweight individuals may be more likely to be perceived by others as unattractive, thereby further endangering their well-being. Our objective was to determine whether body mass index (BMI) was associated with perceptions by others regarding attractiveness and whether this relationship was similar across race/ethnicity, gender, and time.

METHODS

We analyzed Waves I and III of the National Longitudinal Study of Adolescent Health, a nationally representative longitudinal study of adolescents. We used participant gender- and race/ethnicity-stratified multinomial logistic regression to examine the association between BMI and interviewer-rated attractiveness (1 = unattractive, 2 = average, 3 = attractive, 4 = very attractive) controlling for participant age, household income, and maternal education.

RESULTS

BMI was positively associated with risk of being categorized as unattractive (relative to very attractive) by the interviewer in black (Wave I: relative risk ratio [RRR] = 1.26, CI: 1.18, 1.33; Wave III: RRR = 1.14, CI: 1.08, 1.20), Hispanic (Wave I: RRR = 1.23, CI: 1.11, 1.36; Wave III: RRR = 1.22, CI: 1.12, 1.34), and white (Wave I: RRR = 1.25, CI: 1.19, 1.32; Wave III: RRR = 1.22, CI: 1.17, 1.28) females in both waves of data collection. Only in African American females, the risk of being rated unattractive with increasing BMI declined significantly between waves (p = .00018). Trends were similar in males, although the magnitude of risk was smaller and nonsignificant in most groups.

CONCLUSIONS

Interviewers were more likely to rate those with higher BMIs as unattractive; this finding was similar across gender and racial/ethnic groups with few exceptions and was stable across time.

Negative weight-based attitudes in treatment-seeking obese monolingual Hispanic patients with and without binge eating disorder

OBJECTIVE

The aims of this study were to compare weight-based attitudes in obese Latino adults with and without binge eating disorder (BED) and to examine whether these attitudes are related to indices of eating disorder psychopathology and psychological functioning.

METHOD

Participants were a consecutive series of 79 monolingual Spanish-speaking-only obese Latinos (65 female, 14 male) participating in a randomized placebo-controlled trial performed at a Hispanic community mental health center. Participants were categorized as meeting the criteria for BED (n = 40) or obese non-binge-eating controls (n = 39) based on diagnostic and semistructured interviews administered by fully bilingual research clinicians trained specifically for this study.

RESULTS

Analyses revealed that negative attitudes toward obesity did not differ significantly between the BED and non-binge-eating groups nor were they correlated with the intensity of eating disorder psychopathology (eg, levels of weight and shape concerns). Overall, the levels of negative attitudes toward obesity in this Latino/Latina group are similar to those reported previously for samples of English-speaking primarily white obese persons.

DISCUSSION

These findings suggest that it may be obesity per se-rather than eating disorder psychopathology or body image-that heightens vulnerability to negative weight-based attitudes.

Leaks, Lumps, and Lines

Women’s bodies have often been positioned in art and popular culture as monstrous or defiled and women’s bodily products (e.g., menstrual fluid, breast milk) as disgusting. This framing has led to the stigmatization of aspects of women’s bodies (e.g., leaking fluids, lumps of fat, and lines in the skin that indicate aging), especially those aspects that are perceived as threats to culture and society. In this article, the author draws on feminist theory, stigma theory, and terror management theory to explain the positioning of menstruating, fat, and old women as threatening and stigmatized. Evidence for the stigma is discussed, as are the effects of stigma on the stigmatized and the stigmatizers. Ways of resisting, reframing, and coping with stigma are suggested.