Culture, Obesity Stereotypes, Self-Esteem, and the “Thin Ideal”: A Social Identity Perspective

Feeling our place in the world: an active inference account of self-esteem

Self-esteem, the evaluation of one's own worth or value, is a critical aspect of psychological well-being and mental health. In this paper, we propose an active inference account of self-esteem, casting it as a sociometer or an inferential capacity to interpret one's standing within a social group. This approach allows us to explore the interaction between an individual's self-perception and the expectations of their social environment.When there is a mismatch between these perceptions and expectations, the individual needs to adjust their actions or update their self-perception to better align with their current experiences. We also consider this hypothesis in relation with recent research on affective inference, suggesting that self-esteem enables the individual to track and respond to this discrepancy through affective states such as anxiety or positive affect. By acting as an inferential sociometer, self-esteem allows individuals to navigate and adapt to their social environment, ultimately impacting their psychological well-being and mental health.

The Mental "Weight" of Discrimination: The Relationship between Perceived Interpersonal Weight Discrimination and Suicidality in the United States

Extant research has investigated the relationship between body weight and suicidality because obesity is highly stigmatized, leading to social marginalization and discrimination, yet has produced mixed results. Scholars have speculated that factors associated with body weight, such as weight discrimination, may better predict suicidality than body weight itself. We consider this possibility among a sample of 12,057 adult participants ages 33 to 43 in Wave V of the National Longitudinal Study of Adolescent to Adult Health through investigation of the relationships between weight discrimination and two dimensions of suicidality-suicide ideation and attempts. We also examine gender as a moderator of these relationships. We find that weight discrimination is positively associated with both suicide ideation and attempts, and this relationship is similar among men and women. Our findings underscore the need to address issues of weight discrimination in our society to better promote mental well-being.

Intercultural insights on the impact of different non-idealized models on men's body image and advertising perceptions

This experiment with 363 Irish and Flemish men aged 19 to 30 years (M = 23.56, SD = 2.36) investigated exposure to different male model ads (i.e. muscular, slim, plus-size, overall diversity, and no models) on well-being (i.e. body image, low body fat and muscularity attitudes, self-objectification, and self-esteem) and advertising outcomes (i.e. ad attitudes, brand attitudes, and purchase intent). Moderation effects of country and masculinity (i.e. dominance, winning) were investigated. The diversity condition generated more positive effects for low body fat attitudes than the muscular, slim, and no model conditions. Yet, no differences appeared for this outcome between the diversity and plus-size condition. No effects for the other well-being and advertising variables were found. Moderation analyses revealed higher purchase intent in the slim condition for men high in dominance. No effects were found for country and winning. Findings suggest that non-idealized models have protective effects for some men.

A Systematic Review on the Association between Obesity and Mood Disorders and the Role of Gut Microbiota

Obesity is a complex health condition that increases the susceptibility to developing cardiovascular diseases, diabetes, and numerous other metabolic health issues. The effect of obesity is not just limited to the conditions mentioned above; it is also seen to have a profound impact on the patient’s mental state, leading to the onset of various mental disorders, particularly mood disorders. Therefore, it is necessary to understand the mechanism underlying the crosstalk between obesity and mental disorders. The gut microbiota is vital in regulating and maintaining host physiology, including metabolism and neuronal circuits. Because of this newly developed understanding of gut microbiota role, here we evaluated the published diverse information to summarize the achievement in the field. In this review, we gave an overview of the association between obesity, mental disorders, and the role of gut microbiota there. Further new guidelines and experimental tools are necessary to understand the microbial contribution to regulate a balanced healthy life.

Validation of a Greek adaptation of the Anti-Fat Attitudes Questionnaire

The Anti-Fat Attitudes Questionnaire (AFA) measures prejudicial attitudes that are held about individuals with overweight BMI or obesity. Despite increased interest in research on anti-fat attitudes worldwide, the psychometric properties of the AFA have rarely been examined in non-English speaking populations. The present study aimed to address this gap in the literature by translating and validating the AFA in the Greek language. An online, community-based sample of 642 individuals (364 women) responded to the Greek translation of the AFA and measures of appearance satisfaction and appreciation, disordered eating, self-esteem and depression. Results indicated that the original three-factor solution of the AFA was maintained in both the Principal and Confirmatory Factor Analyses. Additionally, internal consistency, test-retest reliability and convergent validity all showed adequate results. These findings provide support for the use of the AFA in Greek-speaking populations. The availability of the Greek AFA adds to the toolbox of body image scholars working in the Greek context.

Cognitive Defusion and Psychological Flexibility Predict Negative Body Image in the Chinese College Students: Evidence from Acceptance and Commitment Therapy

Body dissatisfaction is a global phenomenon. Despite the significant cultural difference, most research on negative body image was conducted in Western countries. How do cognitive fusion and psychological flexibility relate to negative body image in the Chinese population? In the present study, this question was investigated through the intervention technique, Acceptance and Commitment Therapy (ACT). Here, 86 young Chinese university students with high negative physical self were invited, in which 42 students received 10 sessions of group-based ACT intervention in a clinical setting while the remained acted as the control group with no intervention. Pretests showed no statistical differences in negative body image between these two groups, while both cognitive fusion and psychological flexibility predicted negative body image. Post-pre tests showed no change in the control group, while enhanced cognitive defusion and psychological flexibility in the ACT group. Individual differences in psychological flexibility and cognitive defusion enhancement predicted improved body image. A strong association of implicit body image with Fatness and Shortness changes suggested that although with individual differences, those components could be internalized during the intervention in the College students.

The Effect of Own Body Concerns on Judgments of Other Women’s Body Size

We investigated the relationships between healthy women’s estimates of their own body size, their body dissatisfaction, and how they subjectively judge the transition from normal to overweight in other women’s bodies (the “normal/overweight” boundary). We propose two complementary hypotheses. In the first, participants compare other women to an internalized Western “thin ideal,” whose size reflects the observer’s own body dissatisfaction. As dissatisfaction increases, so the size of their “thin ideal” reduces, predicting an inverse relationship between the “normal/overweight” boundary and participants’ body dissatisfaction. Alternatively, participants judge the size of other women relative to the body size they believe they have. For this implicit or explicit social comparison, the participant selects a “normal/overweight” boundary that minimizes the chance of her making an upward social comparison. So, the “normal/overweight” boundary matches or is larger than her own body size. In an online study of 129 healthy women, we found that both opposing factors explain where women place the “normal/overweight” boundary. Increasing body dissatisfaction leads to slimmer judgments for the position of the “normal/overweight” boundary in the body mass index (BMI) spectrum. Whereas, increasing overestimation by the observer of their own body size shifts the “normal/overweight” boundary toward higher BMIs.

Body image across the adult lifespan: A longitudinal investigation of developmental and cohort effects

The current study examined patterns of normative change and cohort effects in body image across the male and female adult lifespan. Body satisfaction was assessed in longitudinal data spanning six years, from 2010 to 2015. Cohort sequential latent growth curve modelling was utilized to assess patterns of mean-level change due to both aging and cohort effects in 15,264 participants (62.9 % women) aged between 18-94 years (M = 46.55, SD = 14.24). Results demonstrated a very slight increase in body satisfaction across the lifespan for both men and women. Cohort effects demonstrated that for women aged 54 years and below, all but two cohorts (24-29 and 34-39 years) displayed an upward trajectory in their body satisfaction over the 5-year period of assessment. No consistent cohort effects were evident for men. Finally, men, relative to women, consistently displayed higher levels of body satisfaction across the lifespan. This study provides insights into the trajectory of body image across the lifespan for men and women. The findings also suggest recent (cohort) improvements in body image for women, and potential explanations for this unexpected shift are discussed.

Motivating or stigmatising? The public health and media messaging surrounding COVID-19 and obesity: a qualitative think aloud study

Purpose

The purpose of this study is to explore how individuals with overweight and obesity living in the UK respond to the public health and media messaging surrounding COVID-19 and obesity.

Design/methodology/approach

Qualitative interview study with a think aloud protocol. A total of 10 participants self-reported to have overweight, obesity or as actively trying to lose weight were recruited through social media and were asked to think aloud whilst exposed to four sets of public health and media materials describing the link between COVID-19 and obesity. Interviews were conducted over zoom, recorded and transcribed verbatim.

Findings

Three primary themes were identified through thematic analysis: “flawed messaging”, “COVID-19 as a teachable moment” and “barriers to change”. Transcending these themes was the notion of balance. Whilst the messaging around COVID-19 and obesity was deemed problematic; for some, it was a teachable moment to facilitate change when their future self and physical health was prioritised. Yet, when focussing on their mental health in the present participants felt more overwhelmed by the barriers and were less likely to take the opportunity to change.

Practical implications

Findings hold implications for public health messaging, highlighting the need for balance between being educational and informative but also supportive, so as to achieve maximum efficacy.

Originality/value

This study offers a novel and useful insight into how the public health and media messaging concerning COVID-19 risk and obesity is perceived by those with overweight and obesity.

Investigating the Linkages between BMI, Body Image, and SATAQ among Young Asian Females

Sociocultural attitudes toward appearance and its linkage to body mass index (BMI) and body image is a relationship worth studying, especially in Asia, where the idealization of thinness can be prominent. The Sociocultural Attitudes Toward Appearance Questionnaire (SATAQ) developed by Heinberg et al. in 1995 was used in this study to examine whether these beliefs have been internalized. Furthermore, the Body Esteem Scale (BES) was used to quantify body image. The formal in-person survey was administered in Taipei, Taiwan. There were 301 valid samples out of 330 surveyed respondents. To enhance the representativeness of the samples, a stratified sampling technique was applied to generate survey data with valid samples following gender and age distributions of the population between the ages of 14 and 28. The internalization dimension represented how strongly the respondents considered the importance of the socially accepted concept of appearance based on personal perceived social norms. The other dimension, awareness, represented the sociocultural pressures from the outside world, such as from the image of slimness illustrated in the media or group, in comparison to personal beliefs. Our results demonstrated that respondents with above-normal BMIs internalized the socially preferred standards of thinness more than respondents with normal or under-normal BMIs. Furthermore, results also revealed, overall, a negative relationship between SATAQ and body image and between body image and BMI. The study highlights the need to emphasize “fitness over thinness” to help improve negative body image among young Asian females.

Changing your body changes your eating attitudes: embodiment of a slim virtual avatar induces avoidance of high-calorie food

The virtual-reality full-body illusion paradigm has been suggested to not only trigger the illusory ownership of the avatar's body but also the attitudinal and behavioral components stereotypically associated to that kind of virtual body. In the present study, we investigated whether this was true for stereotypes related to body size: body satisfaction and eating control behavior. Healthy participants underwent the full-body illusion paradigm with an avatar having either a larger or a slimmer body than their own, and were assessed for implicit attitudes towards body image and food calorie content at baseline and after each full-body illusion session. Results showed that the illusion emerged regardless of the avatar's body size, whereas the perceived dimension of the own body size changed according to the avatar's body size (i.e., participants felt to be slimmer after embodying their slim avatar and larger after embodying their large avatar). Crucially, we found that implicit attitudes towards food, but not those towards one's own body, were modulated by the size of the virtual body. Compared to baseline, ownership of a slimmer avatar increased the avoidance of high-calorie food, whereas ownership of a larger avatar did not induce changes. Our findings suggest that the illusory feeling of being slimmer drives also the food-related stereotypes associated with that body size, increasing the regulation of eating behaviors.

Body Image Projection Bias in Heterosexual Romantic Relationships: A Dyadic Investigation

Guided by projection bias perspectives, this article sought to advance understanding of the associations between body image and relationship and sexual satisfaction within heterosexual romantic relationships. Across two studies, both members of heterosexual dating and/or married couples reported on their body image, perceptions of partner's attraction to the self, own attraction toward the partner, and relationship satisfaction. Study 2 also incorporated measures of participants' body mass index (BMI) and sexual satisfaction. Across both studies, women with poorer body image perceived their partner to be less attracted to them (irrespective of their partner's actual attraction to them, or how attracted they were to their partner), which in turn was associated with lower relationship and sexual satisfaction. For men, attraction to their partner was consistently associated with their own relationship satisfaction. Results demonstrate that projection biases are a possible mechanism through which body image is associated with romantic relationship and sexual satisfaction, and hint at the particular relevance of appearance-related projection biases for women's relationship and sexual satisfaction.

Cultural efficacy predicts body satisfaction for Māori

This paper examines the relationship between body mass index (BMI), self-esteem and self-reported confidence and capability in expressing oneself culturally as Māori (cultural efficacy) for 5,470 Māori who participated in Te Rangahau o Te Tuakiri Māori me Ngā Waiaro ā-Pūtea | The Māori Identity and Financial Attitudes Study (MIFAS) in 2017. Adjusting for demographics, self-reported health, education and socio-economic status, we found that a higher BMI was associated with lower body satisfaction and self-esteem. However, higher scores on cultural efficacy were associated with higher levels of body satisfaction and self-esteem for respondents. Furthermore, the negative association between BMI and both body satisfaction and self-esteem was weaker for those with higher cultural efficacy. This held for BMI scores of 25, 30, and 35+. While our data suggest higher cultural efficacy may directly or interactively shield Māori from developing lowered self-esteem typically associated with higher BMI in Western populations, further research, using more comprehensive measures of body satisfaction should explore the extent to which Māori may find the Western "thin ideal" personally desirable for their own bodies.

Towards a sociocultural model of weight stigma

PURPOSE

Weight stigma is pervasive and is associated with numerous physical and psychological health consequences, including decreased body satisfaction. Understanding of contributing factors to weight stigma remains limited, although researchers have consistently documented the connection between weight controllability beliefs and weight stigma. Sociocultural factors, including thin-ideal internalization and related social-cognitive correlates, are in the nascent stages of exploration to further our understanding of weight stigma.

METHODS

In this study, we tested an emerging sociocultural model of weight stigma, examining the influence of thin-ideal internalization and appearance-related comparisons on weight stigma, statistically controlling for weight controllability beliefs and accounting for thin-ideal environmental influences. Participants were 137 MTurk workers living in the United States.

RESULTS

We found that increased thin-ideal information was associated with thin-ideal internalization, which in turn was related to both upward and downward appearance-related comparison tendencies. These comparisons were then significantly related to weight stigma, controlling for weight controllability beliefs. There were significant indirect effects of both upward and downward appearance-related comparison tendencies on the relation between thin-ideal internalization and weight stigma.

CONCLUSION

These results extend limited prior research examining the association between the thin-ideal and appearance-related comparisons with weight stigma, and contribute to a more nuanced understanding of this complex phenomenon.

LEVEL OF EVIDENCE

Level V, cross-sectional study.

Body Image Disturbances and Weight Bias After Obesity Surgery: Semantic and Visual Evaluation in a Controlled Study, Findings from the BodyTalk Project

Purpose

Body image has a significant impact on the outcome of obesity surgery. This study aims to perform a semantic evaluation of body shapes in obesity surgery patients and a group of controls.

Materials and Methods

Thirty-four obesity surgery (OS) subjects, stable after weight loss (average 48.03 ± 18.60 kg), and 35 overweight/obese controls (MC), were enrolled in this study. Body dissatisfaction, self-esteem, and body perception were evaluated with self-reported tests, and semantic evaluation of body shapes was performed with three specific tasks constructed with realistic human body stimuli.

Results

The OS showed a more positive body image compared to HC (p < 0.001), higher levels of depression (p < 0.019), and lower self-esteem (p < 0.000). OS patients and HC showed no difference in weight bias, but OS used a higher BMI than HC in the visualization of positive adjectives (p = 0.011). Both groups showed a mental underestimation of their body shapes.

Conclusion

OS patients are more psychologically burdened and have more difficulties in judging their bodies than overweight/obese peers. Their mental body representations seem not to be linked to their own BMI. Our findings provide helpful insight for the design of specific interventions in body image in obese and overweight people, as well as in OS.

Adolescents' understanding of obesity: a qualitative study from rural South Africa

Background

Levels of obesity are rising in South Africa, notably among adolescent females. Excessive energy-dense diets and physical inactivity are among the factors contributing to this increase. Given that these factors are largely behavioural, understanding young people’s views of obesity can contribute to more targeted behavioural interventions. Yet little is known of how rural South African adolescents view obesity.

Objectives

The aim of this study was to explore rural South African adolescents’ views of obesity, including their understanding of its causes, consequences, and solutions.

Methods

This qualitative study took place within the MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) study area, in rural northeast South Africa. Three focus group discussions were held with male (n = 16) and female adolescents (n = 15), aged 14–19 years in 2018. Data were analysed using thematic analysis and the Social Cognitive Theory used to frame the findings.

Results

Participants presented conflicting views of obesity, with both positive and negative opinions expressed. Causes of obesity were seen to be multifactorial, including genetics, diet, lack of physical activity, and HIV treatment. Adolescents proposed medication and hospitalisation as ways to address obesity. When discussing interventions to address obesity, adolescents expressed the need for more information, suggesting that providing information to both themselves and their family members as part of interventions would be important.

Conclusions

Rural South African adolescents have a complex perspective of obesity, likely driven in part by the current nutrition transition underway and do not inherently see individual behaviour as a driver or mitigator of obesity. Complex interventions including the involvement of other household members are needed to change adolescents’ views on the role of the individual, and ultimately, change both individual and household behaviour to prevent obesity.

Predictors of Weight Bias in Exercise Science Students and Fitness Professionals: A Scoping Review

BACKGROUND

Although previous studies have reported weight bias among students and professionals in exercise science, physical education, kinesiology, and fitness instruction, predictors of weight bias in these professions have not been extensively reviewed.

AIM

The purpose of this scoping review was to explore the available literature on predictors of weight bias in exercise science students and fitness professionals to identify key concepts and research gaps.

METHODS

PubMed and ERIC were searched from January 1990 to May 2019. Eighteen studies were included in this review. A thematic analysis was conducted. Findings. Six main themes were drawn from these studies including beliefs in the personal controllability of weight; sex differences; enrollment in a health sciences-related program; psychosocial and personal factors; knowledge of obesity; lack of personal history, family, or friend with obesity. Our scoping review highlighted diverse predictors of weight bias among exercise science students and professionals that warrant further study and intervention.

Dimensions of national culture associated with different trajectories of male and female mean body mass index in countries over 25 years

Cultural determinants of obesity prevalence have been little studied but could explain significant variations in body mass index (BMI) trajectories among countries. This ecological study quantified longitudinal associations between six dimensions of national culture and mean population BMI over 25 years. National mean male and female BMI data 1990 to 2014 provided dependent variables. National dimensions of culture (from the Hofstede database for up to 87 countries) were independent variables: Individualism, Uncertainty avoidance, Indulgence, Long-term orientation, Power distance, and Masculinity. Analyses used mixed models for repeated measures for each dimension of national culture with male and female adult BMI trajectories, controlling for confounders. A higher mean BMI was significantly associated with higher Individualism, Uncertainty avoidance, Indulgence, and Masculine orientation and with lower Power distance (males only) and lower Long-term orientation (males only). Overall, the national cultural dimensions explained 62.4% (males) and 53.5% (females) of the variance in mean BMI among countries. National cultural characteristics, especially Individualism and Uncertainty avoidance, are strongly related to obesity prevalence, explaining over half of the variance among countries. More research and theory development is needed to understand the pathways for these associations so that cultural contexts can be better accounted for in policies, social marketing messages, and community-based actions for obesity prevention.

Associations Between Romantic Relationship Factors and Body Mass Index Among Weight Loss Surgery Patients

The current study utilized a sample of 183 patients, in romantic relationships, who were either pre- or post-weight loss surgery (WLS), to assess (a) associations between romantic relationship factors and pre- and post-surgery body mass index (BMI), (b) the positive and negative influences of obesity in romantic relationships, and (c) the influence of romantic relationship factors on BMI and the reciprocal. Correlations, confirmatory factor analysis, and multiple linear regression were conducted. Patients endorsed greater negative influence of obesity in their romantic relationships compared to positive influences, and their romantic relationship quality was predicted by several variables, including BMI, in pre- and post-surgery patient groups.

Association between waist-to-height ratio and anxiety in middle-aged women: a secondary analysis of a cross-sectional multicenter Latin American study

OBJECTIVE

The aim of the study was to evaluate the association between waist-to-height ratio (WHtR) and anxiety in middle-aged women.

METHODS

We carried out a secondary analysis of data from a multicenter study of women between 40 and 59 years old from 11 Latin America countries. Anxiety was assessed using the Goldberg Anxiety and Depression Scale. WHtR was calculated according to World Health Organization standards and categorized in tertiles: upper, middle, and lower using 0.45 and 0.6 as cutoff values. Prevalence ratios (PRs) and 95% CIs were calculated by generalized linear models of Poisson family with robust standard errors, both crude and adjusted models based on statistical and epidemiological criteria.

RESULTS

Data of a total of 5,580 women were analyzed. Mean age was 49.7 ± 5.5 years, and 57.9% were postmenopausal. The 61.3% of women had anxiety and mean WHtR was 0.54 ± 0.1. In the crude model, compared with women in lower tertile, those in the middle (PR: 1.07; 95% CI, 1.01-1.13) and upper (PR: 1.23 95% CI, 1.07-1.29) WHtR tertile were significantly more likely to have anxiety. In the adjusted models, only women in upper tertile were, however, more likely of displaying anxiety than those in lower tertile (PR: 1.13; 95% CI, 1.08-1.18).

CONCLUSIONS

In this series, WHtR was associated with anxiety in middle-aged women. It is advisable to further study this anthropometric measure in order for it to be incorporated in the routine clinical practice and evaluation of middle-aged women.

Health-promoting Lifestyle, Illness Control Beliefs and Well-being of the Obese Diabetic Women

The study examines the role of health-promoting lifestyle and illness control beliefs in well-being of obese diabetic women. Measures of illness control belief, health-promoting lifestyle and obesity-related well-being were given to 100 obese diabetic women selected from outdoors of hospitals in Varanasi. Analysis revealed patients’ stronger belief in ‘doctor-control’ and ‘supernatural-control’ than ‘self-control’ of the disease. Nutrition, interpersonal relations, physical activity and stress management were given more importance in health promotion than spiritual growth-related practices. Belief in ‘self-control’ and ‘doctor-control’ of disease was negatively correlated with ‘psychosocial discomfort’, ‘physical discomfort’ and ‘psychosocial impact’ aspects of obesity, whereas ‘supernatural-control’ showed positive relationship with all aspects. All components of ‘health-promoting lifestyle’ were negatively correlated with ‘physical discomfort’, ‘psychosocial discomfort’ and ‘psychosocial impact’ aspects of obesity. Multiple regression analysis brought out ‘self-control’, ‘supernatural-control’, ‘health responsibility’, ‘physical activity’ and ‘stress management’ as significant predictors of ‘well-being’ of the obese diabetic women.

Weight Stigma in Men: What, When, and by Whom?

OBJECTIVE

This study assessed the weight stigma experiences of men, examining characteristics of men who experienced weight stigma versus men who did not.

METHODS

Data from three samples of men were examined (N = 1,513). Sample 1 consisted of men with obesity at elevated risk for weight stigma. Sample 2 comprised a convenience online panel. Sample 3 included men from a national online panel of US adults. Men in all samples completed almost identical questionnaires assessing demographics, anthropometrics, weight stigma, and dieting.

RESULTS

Approximately 40% of men reported experiencing weight stigma. Weight stigma was associated with increased odds of having a BMI consistent with underweight or obesity relative to normal weight. Verbal mistreatment was the most common form of weight stigma experienced across all life stages for men. The most common sources of weight stigma were peers, family members, and strangers. Men reporting weight stigma were younger and less likely to be married, had higher BMIs, and were more likely to have tried to lose weight in the past year relative to men not reporting weight stigma.

CONCLUSIONS

Understanding differences among men as a function of weight stigma is important for practitioners, as it can identify men who may most benefit from intervention.

Thin idealization and causal attributions mediate the association between culture and obesity stereotypes: An examination of Chinese and American adolescents

Few studies have examined age or cultural differences in the stereotypes adolescents have of persons with obesity. The present research explored the hypotheses that American adolescents have more negative obesity stereotypes than Chinese adolescents and that the effects of culture are mediated by weight attributions and thin idealization. Participants (N = 335; 181 female; M age = 14.83 years, SD = 1.57 years) completed measures of thin idealization and causal attributions and made generalizations from and attributions of stereotypical personality characteristics to obese figures. Not only did stereotypes differ between countries, but generalizations of negative characteristics from obese figures increased with age. In addition, American adolescents more firmly endorsed the 'thin ideal' and were more likely to attribute obesity to internal causes that Chinese adolescents. As anticipated, between-country differences in stereotyping were mediated by thin idealization and causal attributions. Findings are discussed in terms of the 'doctrine of the mean', social identity theory, and dual-process theories. Statement of Contribution The development of obesity stereotypes has been the subject of a number of recent studies. Although scarce, research on adolescents' obesity stereotypes indicates that the strength of these stereotypes increases with age and that these increases are mediated by thin idealization and causal attributions. The current research adds to this growing literature that differences between Chinese adolescents' and American adolescents' obesity stereotypes - in terms of the assignment of stereotypical traits to people with obesity and the generalization of negative traits from an individual person with obesity to people with obesity as a group - are mediated by thin idealization and attributions about obesity's causes. The research also indicates that (1) age differences in obesity stereotyping vary as a function of the method used to measure stereotypes, (2) Chinese adolescents are less likely than American adolescents to attribute obesity to characterological flaws, and (3) American adolescents idealize thinness more than Chinese adolescents.

The Effects of Obesity Myths on Perceptions of Sexual Assault Victims and Perpetrators' Credibility

This study investigated the effects of obesity myths on blame attribution and the perceived credibility of both an alleged sexual assault victim and her perpetrator. Participants were randomly assigned to one of three sexual assault scenarios (in which either the victim or the perpetrator was described as obese and one in which both were described as obese) and responded to questions measuring the blame attribution and perceived the credibility of both individuals. A main effect of scenario was found on the perpetrator's credibility, indicating that participants rated the obese perpetrator as more credible when the victim was obese in comparison with when the victim was nonobese. However, no main effect of scenario was found on the victim's credibility and blame attribution, denoting that the victim's or perpetrator's weight did not influence participants' perceptions of the victim's credibility or blame attribution. The belief in obesity myths was the most significant predictor of victim blaming. However, differing patterns of the effects of obesity myths were found on the victim's credibility and the perpetrator's credibility. The belief in obesity myths was a significant predictor only when the victim was obese, whereas it was not a significant predictor in the scenarios where both the victim and the perpetrator were obese or the perpetrator was obese and the victim was nonobese. As for the perpetrator's credibility, the belief of obesity myths was not a significant predictor. Instead, the scenario was a significant predictor. Implications of obesity-myth endorsement in relation to sexual assault are discussed.

The Effects of Twitter Users' Gender and Weight on Viral Behavioral Intentions Toward Obesity-Related News

In this study, male and female participants were exposed to identical news stories covering obesity topics paired with tweets from Twitter users. Our study aimed at understanding how obesity-related news combined with user-generated social media posts (i.e., tweets) affect consumers' evaluations of online content and viral behavioral intentions (the intentions to like, share, and comment). An experiment (N = 316) explored how gender and weight of a Twitter user (tweeter) affect participants' evaluations and viral behavioral intentions toward news stories. Participants differed in their evaluations of and viral behavioral intentions for news stories as a function of Twitter users' gender and weight, as well as participants' gender. While participants expressed more favorable attitudes toward news stories paired with tweets by overweight than healthy females (with the opposite true for tweets by male users), participants expressed greater viral behavioral intentions for news stories paired with tweets by healthy weight than overweight user. These effects were more pronounced among male than female participants. Findings are discussed within the context of social media posts and their persuasive effects in relation to attitude and behavior changes.

Body image attitude among Chinese college students

The present study aimed to examine body image attitude in Chinese college students and related psychological consequences. A silhouette-matching test was administered to 425 college students in mainland China. Self-esteem, negative emotions, subjective well-being, and eating-disorder-related weight-controlling behaviors were also measured. Only 12.9% of the participants were satisfied with their figure and the extent of body image dissatisfaction was comparable for both sexes. The majority of the female participants indicated a preference to be more slender. Their ideal figure was underweight and was far smaller than the most attractive female figure chosen by male participants. For male participants, the proportion wanting a fuller figure was comparable to that wanting a slimmer figure. Among female participants, body image dissatisfaction negatively correlated with self-esteem and subjective well-being, and positively correlated with negative emotions. Drive for thinness correlated with eating-disorder-related weight-controlling behaviors not only for females, but also for males. Body image dissatisfaction, as a diagnostic feature for major subtypes of eating disorders, may signal serious concern among Chinese college students.

Effect of price and information on the food choices of women university students in Saudi Arabia: An experimental study

OBJECTIVE

To explore the impact of price manipulation and healthy eating information on intended food choices.

DESIGN

Health information was provided to a random half of subjects (vs. information on Saudi agriculture). Each subject chose from the same lunch menu, containing two healthy and two unhealthy entrees, deserts and beverages, on five occasions. Reference case prices were 5, 3 and 2 Saudi Arabian Reals (SARs). Prices of healthy and unhealthy items were manipulated up (taxed) and down (subsidized) by 1 SAR in four menu variations (random order); subjects were given a budget enabling full choice within any menu. The number of healthy food choices were compared with different price combinations, and between information groups. Linear regression modelling explored the effect of relative prices of healthy/unhealthy options and information on number of healthy choices controlling for dietary behaviours and hunger levels.

SETTING

University campus, Saudi Arabia, 2013.

SUBJECTS

99 women students.

RESULTS

In the reference case, 49.5% of choices were for healthy items. When the price of healthy items was reduced, 58.5% of selections were healthy; 57.2% when the price of unhealthy items rose. In regression modelling, reducing the price of healthy items and increasing the price of unhealthy items increased the number of healthy choices by 5% and 6% respectively. Students reporting a less healthy usual diet selected significantly fewer healthy items. Providing healthy eating information was not a significant influence.

CONCLUSION

Price manipulation offers potential for altering behaviours to combat rising youth obesity in Saudi Arabia.

Weight Bias: A Systematic Review of Characteristics and Psychometric Properties of Self-Report Questionnaires

BACKGROUND

People living with overweight and obesity often experience weight-based stigmatization. Investigations of the prevalence and correlates of weight bias and evaluation of weight bias reduction interventions depend upon psychometrically-sound measurement. Our paper is the first to comprehensively evaluate the psychometric properties, use of people-first language within items, and suitability for use with various populations of available self-report measures of weight bias.

METHODS

We searched five electronic databases to identify English-language self-report questionnaires of weight bias. We rated each questionnaire's psychometric properties based on initial validation reports and subsequent use, and examined item language.

RESULTS

Our systematic review identified 40 original self-report questionnaires. Most questionnaires were brief, demonstrated adequate internal consistency, and tapped key cognitive and affective dimensions of weight bias such as stereotypes and blaming. Current psychometric evidence is incomplete for many questionnaires, particularly with regard to the properties of test-retest reliability, sensitivity to change as well as discriminant and structural validity. Most questionnaires were developed prior to debate surrounding terminology preferences, and do not employ people-first language in the items administered to participants.

CONCLUSIONS

We provide information and recommendations for clinicians and researchers in selecting psychometrically sound measures of weight bias for various purposes and populations, and discuss future directions to improve measurement of this construct.

Self-identified Obese People Request Less Money: A Field Experiment

Empirical evidence suggests that obese people are discriminated in different social environments, such as the work place. Yet, the degree to which obese people are internalizing and adjusting their own behavior as a result of this discriminatory behavior has not been thoroughly studied. We develop a proxy for measuring experimentally the "self-weight bias" by giving to both self-identified obese (n = 90) and non-obese (n = 180) individuals the opportunity to request a positive amount of money after having performed an identical task. Consistent with the System Justification Theory, we find that self-identified obese individuals, due to a preexisting false consciousness, request significantly lower amounts of money than non-obese ones. A within subject comparison between self-reports and external monitors' evaluations reveals that the excessive weight felt by the "self" but not reported by evaluators captures the self-weight bias not only for obese but also for non-obese individuals. Linking our experimental results to the supply side of the labor market, we argue that self-weight bias, as expressed by lower salary requests, enhances discriminatory behavior against individuals who feel, but may not actually be, obese and consequently exacerbates the wage gap across weight.

Adiposity and psychosocial outcomes at ages 30 and 35

PURPOSE

To examine associations between adiposity and adult psychosocial outcomes (depressive symptoms, life satisfaction, self-esteem, household income, personal income, savings/investments) in a New Zealand birth cohort, by gender. Adiposity was assessed using Body Mass Index scores classified on a 3-point scale of BMI: <25.0, overweight (25.0-29.9) or obese (≥30).

METHODS

Data were gathered via face-to-face and telephone interviews for the Christchurch Health and Development Study (CHDS), comprising a birth cohort of 1265 children born in Christchurch, New Zealand, in 1977. BMI and psychosocial outcome information was collected in 2007 (30 years; n = 977) and in 2012 (35 years; n = 923).

RESULTS

Population-averaged regression modeling showed evidence of statistically significant (p < 0.05) associations between increasing adiposity and adverse psychosocial outcomes for females, but not for males. After adjustment for child and family background covariates the strength of the associations for females was reduced; with four associations (depressive symptoms, life satisfaction, equivalized household income and savings/investments) remaining statistically significant (p < 0.05). In contrast, for males there was a significant (p = 0.008) positive association between adiposity and higher personal net weekly income after covariate adjustment.

CONCLUSIONS

The findings suggest evidence of gender differences in the associations between adiposity and psychosocial outcomes. For females, there were small but pervasive tendencies for increasing adiposity to be related to more adverse mental health, psychological well-being and economic outcomes; whereas for males adiposity was either unrelated to these outcomes, or in the case of personal income, associated with greater economic advantage. The implications of these findings are discussed.

Life at Both Ends of the Ladder: Education-Based Identification and Its Association With Well-Being and Social Attitudes

Level of formal education is an important divide in contemporary societies; it is positively related to health, well-being, and social attitudes such as tolerance for minorities and interest in politics. We investigated whether education-based identification is a common underlying factor of these education effects. Indeed, education-based identification was stronger among the higher educated, especially for identification aspects that encompass education-based group esteem (i.e., the belief that one’s educational group is worthy and that others think so, too). Furthermore, while group esteem had beneficial effects across educational levels, aspects of identification that were unrelated to group esteem had positive effects for the higher educated but not for the less educated. Thus, the less educated do not benefit from the psychologically nourishing effect of identification that exists for other groups. The stigma and responsibility related to low education could be a common explanation for a wide range of outcomes.

It’s Not You, It’s Me

Much research focuses on the formation of antifat attitudes, but an understanding of antifat bias is incomplete without incorporating self-perceptions. We tested a model in which self-perceptions influenced stereotyping of the same target shown as obese versus thin via antifat attitudes. Participants rated six targets, two of which were the same individual before and after weight loss. Questionnaires assessed participants’ self-perceptions and antifat bias. Multiple group path analysis indicated participants’ body mass index positively predicted greater perceived body size in men and women, though the relationship was stronger for women. Greater perceived body size predicted decreased antifat attitudes, while greater body shame and beliefs about personal control predicted increased antifat attitudes. Antifat attitudes predicted greater negative stereotyping of the target when shown as obese relative to thin. These findings point toward the importance of self-perception in the stigmatization of others and the need to include self-acceptance in weight-bias interventions.

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.

Obesity and Internalized Weight Stigma: A Formulation Model for an Emerging Psychological Problem

Background:Obese individuals frequently experience weight stigma and this is associated with psychological distress and difficulties. The process of external devaluation can lead to negative self-perception and evaluation and some obese individuals develop “internalized weight stigma”. The prevalence of weight stigma is well established but there is a lack of information about the interplay between external and internal weight stigma.Aims:To synthesize the literature on the psychological effects of weight stigma into a formulation model that addresses the maintenance of internalized weight stigma.Method:Current research on the psychological impact of weight stigma was reviewed. We identify cognitive, behavioural and attentional processes that maintain psychological conditions where self-evaluation plays a central role. A model was developed based on clinical utility.Results:The model focuses on identifying factors that influence and maintain internalized weight stigma. We highlight the impact of negative societal and interpersonal experiences of weight stigma on how individuals view themselves as an obese person. Processing the self as a stigmatized individual is at the core of the model. Maintenance factors include negative self-judgements about the meaning of being an obese individual, attentional and mood shifts, and avoidance and safety behaviours. In addition, eating and weight management behaviours become deregulated and maintain both obesity and weight stigma.Conclusion:As obesity increases, weight stigma and the associated psychological effects are likely to increase. We provide a framework for formulating and intervening with internalized weight stigma as well as making therapists aware of the applicability and transferability of strategies that they may already use with other presenting problems.

Impact of information about obesity genomics on the stigmatization of overweight individuals: an experimental study

Advances in genomic technologies are rapidly leading to new understandings of the roles that genetic variations play in obesity. Increasing public dissemination of information regarding the role of genetics in obesity could have beneficial, harmful, or neutral effects on the stigmatization of obese individuals. This study used an online survey and experimental design to examine the impact of genetic versus non-genetic information on obesity stigma among self-perceived non-overweight individuals. Participants (n = 396) were randomly assigned to read either genetic, non-genetic (environment), or gene-environment interaction obesity causal information. A total of 48% of participants were female; mean age was 42.7 years (range = 18-86 years); 75% were white; 45.2% had an annual household income of less than $40,000; mean BMI was 23.4 kg/m(2). Obesity stigma was measured using the Fat Phobia Scale - short form (FPS-S). After reading the experimental information, participants in the genetic and gene-environment conditions were more likely to believe that genetics increase obesity risk than participants in the non-genetic condition (both P < 0.05), but did not differ on obesity stigma. Obesity stigma was higher among whites and Asians than Hispanics and African Americans (P = 0.029), and associated with low self-esteem (P = 0.036). Obesity stigma was also negatively associated with holding 'germ or virus' (P = 0.033) and 'overwork' (P = 0.016) causal beliefs about obesity, and positively associated with 'diet or eating habits' (P = 0.001) and 'lack of exercise' (P = 0.004) causal beliefs. Dissemination of brief information about the role of genetics in obesity may have neither a beneficial nor a harmful impact on obesity stigmatization compared with non-genetic information among self-perceived non-overweight individuals.

Adolescent obesity and life satisfaction: perceptions of self, peers, family, and school

This study contributes to research on adolescent life satisfaction by considering its association with body weight, as mediated by perceptions of self, peers, family, and school. Data from the Health Behaviors in School-Age Children Survey (2001-2002) and OLS regression techniques are used to examine the association between body weight and life satisfaction. We also model these relationships by gender. Results indicate lower life satisfaction among adolescents that are overweight and obese relative to healthy weight youth, and that most of the negative association operates through perceptions of self, peers, parents, and school. We find little or no gender difference in the association between body weight and perceptions of self, peers, parents, and school; however, we find perceptions of body weight are generally more strongly associated with low life satisfaction among girls compared to boys.

"We feel rejected": experiences of women with hirsutism consulting physicians

The aim of the study was to describe how women with hirsutism experience their relationship with health care. Data were collected by tape-recorded individual interviews, which were analyzed by means of qualitative content analysis. The results showed that the relationship with health care, from the perspective of patients with hirsutism, is suboptimal.