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Chazelle T, Guerraz M, Palluel-Germain R. Modeling body size information within weight labels using probability distributions. PSYCHOLOGICAL RESEARCH 2024:10.1007/s00426-024-02006-y. [PMID: 39039209 DOI: 10.1007/s00426-024-02006-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 07/06/2024] [Indexed: 07/24/2024]
Abstract
What images of bodies do we associate with thinness and fatness? Can our representations of weight-related words be described by simple probability distributions? To answer these questions, the present study examined participants' perceptions of a set of weight-related words using a pictural scale. 259 French women indicated the thinnest, fattest, and best-fitting figures for 13 words. We then used their responses to construct PERT probability distributions, simple skewed distributions allowing to visualize what body sizes were associated with each word. In particular, the variability of the distributions showed how different weight labels can have more or less precise meanings. We found some evidence that the lowest body mass index associated with a label shifted towards thinner figures as body dissatisfaction increased. Using the same method, we investigated the boundaries of what participants consider the ideal body, and showed that the inclusion of their own body in these boundaries predicted their levels of body dissatisfaction. We argue that PERT distributions can be a useful, easy-to-use tool in body image research for modeling the representations of weight labels in different populations.
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Affiliation(s)
- Thomas Chazelle
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000, Grenoble, France
| | - Michel Guerraz
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000, Grenoble, France
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Anastasiadou D, Tárrega S, Fornieles-Deu A, Moncada-Ribera A, Bach-Faig A, Sánchez-Carracedo D. Experienced and internalized weight stigma among Spanish adolescents. BMC Public Health 2024; 24:1743. [PMID: 38951859 PMCID: PMC11218352 DOI: 10.1186/s12889-024-19246-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 06/24/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Weight stigma has negative consequences for both physiological and psychological health. Studies on weight stigma in adolescence, particularly from general populations, are scarce in the Mediterranean area. The main aim of this study is to describe the prevalence of experienced and internalized weight stigma among a representative sample of adolescents from the Spanish city of Terrassa, and to determine its association with sociodemographic variables and weight status. METHODS Drawing on data from the initial assessment of a longitudinally funded project on weight stigma in adolescents, a cross-sectional survey-based study was conducted using random multistage cluster sampling. Weight stigma experiences, their frequency and sources, and weight bias internalization with the Modified Weight Bias Internalization Scale (WBISM) were assessed in a sample of 1016 adolescents. Adjusted odds ratios (AOR) between sociodemographic variables, weight status and having experienced weight stigma, and having reported high scores of WBISM (WBISM ≥ 4) were estimated by multiple logistic regression models. RESULTS The prevalence of weight-related stigma experiences was 43.2% in the sample (81.8 in adolescents with obesity) and the prevalence of high levels of weight bias internalization was 19.4% (50.7 in adolescents with obesity). Other kids and school were the most prevalent sources of weight stigma, with society and family being other significant sources of stigma reported by girls. A significantly higher risk of having experienced weight stigma was observed in girls (AOR = 2.6) and in older adolescents (AOR = 1.9). Compared to normal weight adolescents, all weight statuses showed higher risk, being 3.4 times higher in adolescents with underweight and reaching 11.4 times higher risk in those with obesity. Regarding high levels of weight bias internalization, girls had a risk 6.6 times higher than boys. Once again, a "J-shaped" pattern was observed, with a higher risk at the lowest and highest weight statuses. The risk was 6.3 times higher in adolescents with underweight, and 13.1 times higher in adolescents with obesity compared to those with normal weight. CONCLUSIONS Considering the high prevalence of experienced and internalized weight stigma among adolescents in Spain, especially in adolescents with obesity and girls, it seems important to implement preventive strategies in different settings and address all sources of stigma.
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Affiliation(s)
- Dimitra Anastasiadou
- Eating and Weight-Related Problems Unit, Universitat Autònoma de Barcelona, Edifici B. Campus de la UAB. 08193, Bellaterra (Cerdanyola del Vallés), Barcelona, Spain
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Edifici B. Campus de la UAB. 08193, Bellaterra (Cerdanyola del Vallés), Barcelona, Spain
| | - Salomé Tárrega
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Edifici B. Campus de la UAB. 08193, Bellaterra (Cerdanyola del Vallés), Barcelona, Spain
- Department of Epidemiology and Methodology of Social and Health Sciences, Faculty of Health Sciences at Manresa, Universitat de Vic - Universitat Central de Catalunya (UVic- UCC), Av. Universitària, 4-6, Manresa, 08242, Spain
- Research Group in Epidemiology and Public Health in the Digital Health context (Epi4Health), Institute for Research and Innovation in Life and Health Sciences in Central Catalonia (IRIS-CC), Ctra. De Roda Núm. 70, Vic, 08500, Spain
| | - Albert Fornieles-Deu
- Eating and Weight-Related Problems Unit, Universitat Autònoma de Barcelona, Edifici B. Campus de la UAB. 08193, Bellaterra (Cerdanyola del Vallés), Barcelona, Spain
- Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona Serra Húnter fellow, Edifici B. Campus de la UAB, 08193, Bellaterra (Cerdanyola del Vallés), Barcelona, Spain
| | - Albert Moncada-Ribera
- Head of Community and Health Service, Social Rights Section, City Council of Terrassa, Ca. Torres Garcia 35, Terrassa, Barcelona, 08221, Spain
| | - Anna Bach-Faig
- Food Lab Research Group, Faculty of Health Sciences (2021 SGR 01357), Open University of Catalonia (UOC), Barcelona, 08018, Spain
| | - David Sánchez-Carracedo
- Eating and Weight-Related Problems Unit, Universitat Autònoma de Barcelona, Edifici B. Campus de la UAB. 08193, Bellaterra (Cerdanyola del Vallés), Barcelona, Spain.
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Edifici B. Campus de la UAB. 08193, Bellaterra (Cerdanyola del Vallés), Barcelona, Spain.
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Standen EC, Ward A, Mann T. The role of social norms, intergroup contact, and ingroup favoritism in weight stigma. PLoS One 2024; 19:e0305080. [PMID: 38900716 PMCID: PMC11189193 DOI: 10.1371/journal.pone.0305080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 05/22/2024] [Indexed: 06/22/2024] Open
Abstract
Although average body size in the U.S. has increased in recent decades, stigma directed at individuals with higher weight has not diminished. In this study, we explored this phenomenon by investigating the relationship between people's perceived social norms regarding higher weight and their reported levels of weight bias (i.e., anti-fat attitudes). Our predictions for perceived social norms drew on the concepts of intergroup contact and ingroup favoritism, which were also probed in this study. We hypothesized that both greater descriptive norms and more favorable injunctive norms regarding higher weight would be associated with lower reported weight bias. Individuals' quantity and quality of social contact with people with higher weight were also predicted to be associated with lower weight bias. Finally, we predicted that individuals who perceived themselves as heavier would display ingroup favoritism (i.e., report less weight bias). Participants (N = 272) from the United States completed a set of online questionnaires about their perceived social norms, social contact with people with higher weight, and explicit weight bias. We found support for each of these pre-registered predictions (ps < 0.03), and post hoc analyses revealed that quality, but not quantity, of social contact with individuals with higher weight was an important predictor of lower weight bias. Together, these findings provide insight into the social psychology of weight bias and help to lay a theoretical foundation for future efforts to reduce weight stigma.
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Affiliation(s)
- Erin C. Standen
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Andrew Ward
- Department of Psychology, Swarthmore College, Swarthmore, Pennsylvania, United States of America
| | - Traci Mann
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, United States of America
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Webber SC, Thille P, Liu K, Wittmeier K, Cain P. Determining Associations Among Health Orientation, Fitness Orientation, and Attitudes Toward Fatness in Physiotherapists and Physiotherapy Students Using Structural Equation Modeling. Physiother Can 2024; 76:220-229. [PMID: 38725602 PMCID: PMC11078247 DOI: 10.3138/ptc-2022-0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 08/30/2022] [Accepted: 09/06/2022] [Indexed: 05/12/2024]
Abstract
Purpose Research suggests physiotherapists hold negative attitudes and beliefs toward fatness and fat people. Physiotherapists are also health-conscious, and invested in healthy lifestyle behaviours including physical activity. Our purpose was to describe relationships between health orientation, fitness orientation, and fat attitudes. Methods Physiotherapists (n = 187) and physiotherapy students (n = 34) completed an online survey (Health Orientation Scale, Multidimensional Body-Self Relations Questionnaire, Fat Attitudes Assessment Toolkit). Structural equation modeling estimated associations between fat attitudes (dependent variable) and health and fitness orientation (independent variables). Results Participants scored high in orientation toward fitness and health. We found strong positive associations between fitness orientation and health orientation (p < 0.001). Health orientation was not significantly associated with fat attitudes (p = 0.075), whereas increased age was associated with more positive fat attitudes (p < 0.01). Although most participants acknowledged that factors outside an individual's control contribute to body weight, many also agreed with normative negative perspectives. Conclusions Physiotherapists are highly oriented toward fitness and health. This may underlie beliefs in the controllability of body weight and contribute to negative attitudes toward fatness and fat people. Further research, with greater sample sizes is necessary to further investigate associations between health orientation and fat attitudes.
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Affiliation(s)
- Sandra C. Webber
- From the:
Department of Physiotherapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Patricia Thille
- From the:
Department of Physiotherapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kun Liu
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kristy Wittmeier
- Department of Pediatrics and Child Health, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Patricia Cain
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia
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Nakamura Y, Asano M. Developing and validating a Japanese version of the Weight Self-Stigma Questionnaire. Eat Weight Disord 2023; 28:44. [PMID: 37195385 DOI: 10.1007/s40519-023-01573-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 05/11/2023] [Indexed: 05/18/2023] Open
Abstract
PURPOSE Weight bias internalization (WBI) is significantly associated with negative physiological and psychological consequences. Given its negative effects, appropriate measurement of WBI is required for weight management and mental and physical health in people with weight problems. One of the most reliable and frequently used questionnaires to assess WBI is the Weight Self-Stigma Questionnaire (WSSQ). However, a Japanese version of the WSSQ has not yet been developed. Thus, the current study aimed to develop a Japanese version of the WSSQ (WSSQ-J) and validate its psychometric properties in the Japanese context. METHODS A total of 1454 Japanese participants (age 34.44 ± 6.92; male = 498) with diverse weight statuses (Body mass index: 21.44 ± 3.52, 13.79-41.40 kg/m2) completed an online survey for the WSSQ-J. The internal consistency of the WSSQ-J was estimated by calculating Cronbach's α. Confirmatory factor analysis (CFA) was then carried out to confirm that the factor structure of the WSSQ-J was the same as that of the subscales of the original WSSQ. RESULTS The WSSQ-J had a Cronbach's α of 0.917, indicating good internal consistency. In CFA, the comparative fit index was 0.945, the root mean square error of approximation was 0.085, and the standardized root mean square residual was 0.040, indicating that the two-factor model showed satisfactory goodness-of-fit. CONCLUSION This study replicated the original findings related to the WSSQ, showing that the WSSQ-J is a reliable WBI questionnaire consisting of two factors. Therefore, the WSSQ-J would be a reliable tool for assessing WBI among Japanese. LEVEL OF EVIDENCE Level V, descriptive cross-sectional study.
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Affiliation(s)
- Yuko Nakamura
- Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, 3-8-1, Komaba, Meguro-Ku, Tokyo, 153-8902, Japan.
- University of Tokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM), Meguro-Ku, Tokyo, 153-8902, Japan.
| | - Michiko Asano
- Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, 3-8-1, Komaba, Meguro-Ku, Tokyo, 153-8902, Japan
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Gajewski EM. Effects of weight bias training on student nurse empathy: A quasiexperimental study. Nurse Educ Pract 2023; 66:103538. [PMID: 36577259 DOI: 10.1016/j.nepr.2022.103538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/06/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022]
Abstract
AIM This study aimed to identify the efficacy of weight bias training on the empathy skills of student nurses when working with a person with obesity. BACKGROUND Weight bias with nurses harboring negative attitudes towards patients with obesity results in inferior care and patients' reluctance to seek medical care. Empathy is a communication skill used in nursing to build trust and rapport with patients to provide optimal patient-centered care. METHODS This study used a quasi-experimental design with 121 undergraduate nursing students in their first semester of the nursing program. The students completed learning activities on weight bias, including reading an article on weight bias, watching a video showing an individual with obesity's experiences in the healthcare setting and participating in a group discussion and reflection on the article and video. In addition, students completed the Jefferson Scale of Empathy-Health Professions Students' version before and after the learning activities. Following the learning activities, students participated in a simulation activity with a standardized patient wearing an obesity suit. The standardized patient completed the Jefferson Scale of Patient Perceptions of Nurse Empathy to rate the patient's perception of the nursing student's level of empathy based on their interactions in the simulation scenario. RESULTS A comparison of the scores on the Jefferson Scale of Empathy-HPS showed there was not a significant difference in the scores before learning activities (M = 15.45, SD = 12.7) and post-learning activities (M = 15.94, SD = 11.5); t(120) = 0.476, p = .635. Data analysis identified significant changes in empathy scores on the Jefferson Scale of Empathy-HPS in the accelerated second-degree cohort with differences in scores before learning activities (M = 113.7, SD = 10.5) and post-learning activities (M = 116.5, SD = 13.4); t(50) = 2.02, p = .049. The traditional cohort did not have a significant change in empathy scores. Empathy scores and the patient's perception of empathy scores showed no relationship. Most (79 %) of the patient's perception of empathy scores was moderate. Student comments in this study support the findings that some nursing students harbor weight bias towards individuals with obesity. CONCLUSION There is a need to identify learning activities that eliminate weight bias in the nursing student population and result in the student's ability to demonstrate appropriate communication skills and nursing behaviors in a nondiscriminatory manner to the patient with obesity. To improve empathy behaviors, students should practice communication skills throughout the nursing curriculum.
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Affiliation(s)
- Ellen M Gajewski
- School of Nursing, Oakland University, 433 Meadow Brook Road, Rochester, MI 48309-4452, United States.
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Butt M, Su L, Rigby A. Associations of Use of Social Media and Psychopathology and Body Image in Pre- and Post-surgical Bariatric Samples: a Cross-sectional Analysis. Obes Surg 2022; 32:3047-3055. [PMID: 35840849 PMCID: PMC9286706 DOI: 10.1007/s11695-022-06206-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 07/05/2022] [Accepted: 07/07/2022] [Indexed: 11/26/2022]
Abstract
Purpose Interest has grown regarding the impact of social media platforms on mental health including body image and internalized weight bias (IWB) in those who have struggled with weight issues. However, few studies have addressed social media usage in bariatric patient samples. The objective of this study was to understand how the amount of time spent on social media could serve as a predictor for IWB in both pre- and post-operative bariatric patients. Materials and Methods Pre- and post-operative patients at one academic medical center completed self-report measures assessing patients’ IWB, depression, anxiety, body dissatisfaction, sociodemographic variables, and social media usage. Data were collected from March 2019 to April 2020. Statistical methods that included correlations, logistical regression models, and ANOVA analysis were used to determine the relationship between time spent on social media and other covariates. Results A total of 148 responses were collected from the pre-surgical population, with 81 responses from the post-surgical sample. At baseline, the majority of respondents used social media for approximately 1 h per day (n = 37; 27.82%). Time spent on social media was negatively associated with age (r = − 0.24 [− 0.40, − 0.08]), and positively associated with IWB (r = 0.20 [0.02, 0.36]) and anxiety (r = 0.21 [0.01, 0.39]). In the post-operative group, only the 6-month BMI (r = 0.29 [0.05, 0.49]) was positively associated with time spent on social media. Conclusion Given this study’s findings, providers are encouraged to become aware of patients’ use of social media, and to understand the impact social media usage can have on the mental well-being of patients. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1007/s11695-022-06206-6.
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Affiliation(s)
- Melissa Butt
- Department of Family and Community Medicine, Penn State Health, Hershey, PA, 17033, USA.
- Department of Public Health Sciences, Penn State College of Medicine, 500 University Dr. , Hershey, PA, 17033, USA.
| | - Lilly Su
- College of Medicine, Penn State University, Hershey, PA, 17033, USA
| | - Andrea Rigby
- Department of Surgery-Division of Minimally Invasive Surgery, Penn State Health, Hershey, PA, 17033, USA
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Do Registered Dietitians, Nutrition Students, and Laypeople Perceive Individuals with Obesity Differently? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18178925. [PMID: 34501514 PMCID: PMC8431474 DOI: 10.3390/ijerph18178925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 08/20/2021] [Accepted: 08/22/2021] [Indexed: 11/26/2022]
Abstract
(1) Background: Obesity is associated with significant social consequences, and individuals with obesity are regularly affected by weight-related stigmatization experiences. This study compares antifat attitudes among registered dietitians (RD), nutrition students, and laypeople and assesses which factors related to the perceived causes of obesity influence these attitudes. (2) Methods: An online survey was conducted in Brazil with RD (n = 336), nutrition students (n = 300), and laypeople (n = 403) with questionnaires assessing antifat attitudes and perceived causes of obesity. (3) Results: All groups presented low antifat attitudes. Minor differences in antifat attitudes were found among the three groups. Compared to RDs and nutrition students, laypeople presented higher Weight Control/Blame scores, but with a small effect size (η2 = 0.01). Weight bias was predicted by age, sex, and body mass index. External, social, and financial factors were not perceived to be very important in the development of obesity by RD and students. (4) Conclusions: Since slight differences were seen among RD and students compared to laypeople, and some perceptions of the causes of obesity indicate a stigmatized view. It is essential to place a greater focus on educating and updating these health professionals and students about weight stigma and its consequences for the mental and physical health of individuals.
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Stewart SJF, Ogden J. What are weight bias measures measuring? An evaluation of core measures of weight bias and weight bias internalisation. Health Psychol Open 2021; 8:20551029211029149. [PMID: 34377524 PMCID: PMC8323429 DOI: 10.1177/20551029211029149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Research exploring weight bias and weight bias internalisation (WBI) is grounded upon several core measures. This study aimed to evaluate whether operationalisations of these measures matched their conceptualisations in the literature. Using a 'closed card-sorting' methodology, participants sorted items from the most used measures into pre-defined categories, reflecting weight bias and non-weight bias. Findings indicated a high degree of congruence between WBI conceptualisations and operationalisations, however found less congruence between weight bias conceptualisations and operationalisations, with scale-items largely sorted into non-weight bias domains. Recommendations for scale modifications and developments are presented alongside a new amalgamated weight bias scale (AWBS).
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Affiliation(s)
- Sarah-Jane F Stewart
- Sarah-Jane F Stewart, Department of
Psychology, University of Surrey, Stag Hill, Guildford, GU2 7XH, UK.
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