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Heslehurst N, Evans EH, Incollingo Rodriguez AC, Nagpal TS, Visram S. Newspaper media framing of obesity during pregnancy in the UK: A review and framework synthesis. Obes Rev 2022; 23:e13511. [PMID: 36268693 PMCID: PMC9788256 DOI: 10.1111/obr.13511] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 09/29/2022] [Accepted: 10/05/2022] [Indexed: 12/30/2022]
Abstract
Two thirds of women report experiencing weight stigma during pregnancy. Newspaper media is powerful in framing health issues. This review synthesized UK newspaper media portrayal of maternal obesity. NexisUni was searched to identify newspaper articles, published January 2010 to May 2021, reporting content on obesity during pregnancy. Framework synthesis integrated quantitative and qualitative analysis of the content of articles. There were 442 articles included (59% tabloids and 41% broadsheets). Three overarching themes with interacting sub-themes were as follows: (1) Women were blamed for their weight, risks, and NHS impact. (2) Women were solely responsible for solving obesity, gendered from school age. (3) Women with obesity were a burden on individuals (e.g., themselves, their children, and health professionals), to society, and the NHS. Catastrophizing language framed the "problem," "scale," and "public health concern" of maternal obesity, emphasizing risk, and danger and was alarmist, aggressive, and violent as to elicit fear or devalue women. Articles platformed 'expert' voices rather than women's lived experiences. This review identified that UK newspaper media negatively frames and oversimplifies the topic of maternal obesity. Exposure to blaming and alarmist messaging could increase women's guilt, stigma, and internalized weight bias. The newspaper media should be harnessed to de-stigmatize maternal obesity and promote maternal well-being.
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Affiliation(s)
- Nicola Heslehurst
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | | | | | - Taniya S Nagpal
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, Canada
| | - Shelina Visram
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Nagpal TS, Salas XR, Vallis M, Piccinini-Vallis H, Alberga AS, Bell RC, da Silva DF, Davenport MH, Gaudet L, Rodriguez ACI, Liu RH, Myre M, Nerenberg K, Nutter S, Russell-Mayhew S, Souza SCS, Vilhan C, Adamo KB. Exploring weight bias internalization in pregnancy. BMC Pregnancy Childbirth 2022; 22:605. [PMID: 35906530 PMCID: PMC9338529 DOI: 10.1186/s12884-022-04940-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 07/22/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Recent research has shown that pregnant individuals experience weight stigma throughout gestation, including negative comments and judgement associated with gestational weight gain (GWG). Weight bias internalization (WBI) is often a result of exposure to weight stigma and is detrimental to biopsychological health outcomes. The purpose of this study was to explore WBI in pregnancy and compare scores based on maternal weight-related factors including pre-pregnancy body mass index (BMI), obesity diagnosis and excessive GWG. METHODS Pregnant individuals in Canada and USA completed a modified version of the Adult Weight Bias Internalization Scale. Self-reported pre-pregnancy height and weight were collected to calculate and classify pre-pregnancy BMI. Current weight was also reported to calculate GWG, which was then classified as excessive or not based on Institute of Medicine (2009) guidelines. Participants indicated if they were diagnosed with obesity by a healthcare provider. Inferential analyses were performed comparing WBI scores according to pre-pregnancy BMI, excessive GWG, and obesity diagnosis. Significance was accepted as p < 0.05 and effect sizes accompanied all analyses. RESULT 336 pregnant individuals completed the survey, with an average WBI score of 3.9 ± 1.2. WBI was higher among those who had a pre-pregnancy BMI of obese than normal weight (p = 0.04, η2 = 0.03), diagnosed with obesity than not diagnosed (p < 0.001, Cohen's d = 1.3), and gained excessively versus not (p < 0.001, Cohen's d = 1.2). CONCLUSIONS Pregnant individuals who have a higher BMI, obesity and gain excessively may experience WBI. Given that weight stigma frequently occurs in pregnancy, effective person-oriented strategies are needed to mitigate stigma and prevent and care for WBI.
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Affiliation(s)
- Taniya S Nagpal
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada.
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada.
| | | | - Michael Vallis
- Department of Family Medicine, Dalhousie University, Halifax, NS, Canada
| | | | - Angela S Alberga
- Department of Health, Kinesiology & Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Rhonda C Bell
- Department of Agricultural, Food and Nutritional Sciences, Faculty of ALES, University of Alberta, Edmonton, AB, Canada
| | - Danilo F da Silva
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Margie H Davenport
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Laura Gaudet
- Department of Obstetrics and Gynecology, Queen's University, Kingston, ON, Canada
| | - Angela C Incollingo Rodriguez
- Psychological & Cognitive Sciences, Social Science and Policy Studies, Worcester Polytechnic Institute, Worcester, MA, USA
| | - Rebecca H Liu
- Women's College Hospital Institute for Health System Solutions and Virtual Care (WIHV), Toronto, ON, Canada
| | - Maxine Myre
- Werklund School of Education, University of Calgary, Calgary, AB, Canada
| | - Kara Nerenberg
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Sarah Nutter
- Department of Educational Psychology and Leadership Studies, University of Victoria, Victoria, BC, Canada
| | | | - Sara C S Souza
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Candace Vilhan
- Obesity Canada, Patient Advocate Volunteer, Edmonton, AB, Canada
| | - Kristi B Adamo
- Department of Agricultural, Food and Nutritional Sciences, Faculty of ALES, University of Alberta, Edmonton, AB, Canada
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Kite J, Huang BH, Laird Y, Grunseit A, McGill B, Williams K, Bellew B, Thomas M. Influence and effects of weight stigmatisation in media: A systematic. EClinicalMedicine 2022; 48:101464. [PMID: 35706492 PMCID: PMC9125650 DOI: 10.1016/j.eclinm.2022.101464] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 04/26/2022] [Accepted: 05/05/2022] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The lack of a comprehensive understanding of the role of mass media in perpetuating weight stigma hinders policy formulation. We reviewed the influence of mass media on weight stigmatisation and the effectiveness of media-based interventions designed to prevent or reduce stigma. METHODS We conducted a systematic review across seven databases from inception to December 2021. Included studies assessed exposure to or impact of weight stigma in mass media or examined interventions to reduce stigma through media in populations 12+ years. We synthesised data narratively, categorising studies based on similarity in focus to produce a set of integrated findings. The systematic review is registered in PROSPERO (No. CRD42020176306). FINDINGS One-hundred-and-thirteen records were eligible for inclusion from 2402 identified; 95 examined the prevalence of stigmatising content in mass media and its impact on stigma. Weight stigma was prevalent across media types, with the dominant discourse viewing overweight and obesity as an individual responsibility and overlooking systemic factors. Exposure to stigmatising content was found to negatively influence attitudes towards people with overweight or obesity. Few studies considered methods of reducing stigma in the media, with only two testing media-based interventions; their results were promising but limited. INTERPRETATION Weight stigma in media content is prevalent and harmful, but there is little guidance on reducing it. Future research focus needs to shift from assessing prevalence and impacts to weight stigma interventions. FUNDING None.
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Affiliation(s)
- James Kite
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, NSW, Australia
- Corresponding author.
| | - Bo-Huei Huang
- Charles Perkins Centre, The University of Sydney, NSW, Australia
| | - Yvonne Laird
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, NSW, Australia
| | - Anne Grunseit
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, NSW, Australia
| | - Bronwyn McGill
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, NSW, Australia
| | - Kathryn Williams
- Charles Perkins Centre, The University of Sydney, NSW, Australia
- Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
- Nepean Blue Mountains Local Health District, Kingswood, NSW, Australia
| | - Bill Bellew
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, NSW, Australia
| | - Margaret Thomas
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, NSW, Australia
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Ganesan A, Carter-Sowell AR. Buffering anti-fat attitudes using contact: The roles of contact quantity, duration, favorability, and intergroup anxiety. Body Image 2021; 38:120-126. [PMID: 33887561 DOI: 10.1016/j.bodyim.2021.03.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 03/27/2021] [Accepted: 03/27/2021] [Indexed: 01/25/2023]
Abstract
Decades of intergroup contact research have found that contact with outgroups reduces negative attitudes. Yet, few studies have examined the association between contact and anti-fat attitudes. Furthermore, testing different facets of contact, namely contact quantity versus contact duration, provides more precise theoretical predictions for their effectiveness in this under-tested context. This study examined whether intergroup anxiety was indirectly related to and contact favorability moderated the relationship between contact and anti-fat attitudes, tested through the constructs of contact quantity (i.e., how many individuals interacted with) and contact duration (i.e., how often time was spent). Undergraduates (N = 343; 260 women) based in the United States completed an online survey assessing intergroup contact, contact favorability, intergroup anxiety, and anti-fat attitudes. Analyses of conditional indirect effects showed that longer contact but not more contact reduced intergroup anxiety, which lowered anti-fat attitudes. The indirect paths for both contact types were not conditional upon contact favorability. Contact favorability moderated the association between contact duration and anti-fat attitudes such that longer and more favorable contact lowered anti-fat attitudes. Findings are discussed within the contact hypothesis, and future research should explore the distinct elements of the hypothesis as applicable to anti-fat prejudice in in-person and online contexts.
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Affiliation(s)
- Asha Ganesan
- Department of Psychological & Brain Sciences, Texas A&M University, TX, USA.
| | - Adrienne R Carter-Sowell
- Department of Psychological & Brain Sciences and the Interdisciplinary Critical Studies Program, Texas A&M University, TX, USA
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Berry TR, Myre M. Effects of physical-activity-related anti-weight stigma materials on implicit and explicit evaluations. Obes Sci Pract 2021; 7:260-268. [PMID: 34123393 PMCID: PMC8170581 DOI: 10.1002/osp4.492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/25/2021] [Accepted: 01/29/2021] [Indexed: 11/10/2022] Open
Abstract
Objective Although there exist videos and images created by Obesity Canada and similar organizations (e.g., the Rudd Center for Food Policy and Obesity), it is not known if the materials have the desired effect of reducing stigma against people with obesity and might have the opposite effect of increasing stigma. Therefore, two studies used implicit and explicit evaluations to examine the effectiveness of images and videos intended to reduce weight stigma. Methods Study 1 participants (N = 284; Mage = 31.47 years [SD = 11.26]; 177 self‐identified as women; 83 self‐identified as living with obesity) completed two implicit measures (one with images of people living with obesity and the other with control images) followed by a weight stigma questionnaire. Study 2 participants (N = 308; Mage = 31.54 years [SD = 11.35]; 153 self‐identified as women; 59 self‐identified as living with obesity) were randomly assigned to view an obesity and exercise video and images of persons with obesity, control video and images of persons with obesity, obesity and exercise video and control images, or control video and control images, followed by the implicit measures and explicit evaluation questionnaire. Results Implicit evaluations of the control images were more positive than the images of persons with obesity. Participants with no history of obesity who saw the control video and control images had lower weight stigma compared to participants in the other conditions. Conclusions Materials created to reduce weight stigma might not be effective among people with no history of obesity themselves or via a family member or friend. Intervention and health promotion researchers may wish to investigate effects of the images in combination with other messages because simply using the nonstigmatizing images is likely not enough.
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Affiliation(s)
- Tanya R Berry
- Faculty of Kinesiology, Sport, and Recreation University of Alberta Edmonton Alberta Canada
| | - Maxine Myre
- Faculty of Kinesiology, Sport, and Recreation University of Alberta Edmonton Alberta Canada
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Myre M, Berry TR, Ball GDC, Hussey B. Motivated, Fit, and Strong-Using Counter-Stereotypical Images to Reduce Weight Stigma Internalisation in Women with Obesity. Appl Psychol Health Well Being 2019; 12:335-356. [PMID: 31714033 DOI: 10.1111/aphw.12187] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 08/30/2019] [Accepted: 10/16/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND This study aimed to use implicit retraining to change automatic associations between body size and physical activity (PA) in women with obesity to reduce weight bias internalisation (WBI). METHODS A Solomon-square experimental design was used to determine the effect of a four-week online implicit retraining intervention on WBI (primary measure) and PA attitudes, self-efficacy, and self-reported behaviour (secondary measures). The intervention was a visual probe task pairing counter-stereotypical images of active individuals with obesity with positive PA-related words. In qualitative telephone interviews, a sub-sample of participants provided feedback and recommendations for using counter-stereotypical images in PA promotion. RESULTS Women completed the intervention (n = 48) or a control task (n = 55). Results of a RM-ANOVA showed no interaction or main effect of group on WBI. A main effect of time demonstrated that both groups had reduced WBI between pre-test and post-test, through to one-week follow-up. There were no differences between groups or over time for PA attitudes, self-efficacy, or behaviour. Women who completed interviews (n = 16) discussed several benefits and drawbacks of using counter-stereotypical images. CONCLUSION Implicit retraining did not reduce WBI but qualitative findings support the use of counter-stereotypical PA images.
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Abstract
PURPOSE OF REVIEW This review aims to evaluate current research findings relevant to weight stigmatization, to acknowledge the deleterious impact it has on the health of the paediatric population and to provide insight to optimize future guidelines for the treatment of individuals with overweight and obesity. RECENT FINDINGS Obesity prevalence continues to rise in the USA with estimates in children from ages 2-19 years of 18.5%, an all-time high. With the increase in obesity, there has been a concomitant increase in weight stigma, which affects both youth and general population across varied levels of socioeconomic status and body sizes. SUMMARY Weight stigma is a contributing phenomenon to the current obesity epidemic, as individuals with stigmatized experiences (weight-based teasing, bullying, victimization) have increased risks for acquiring adverse health outcomes that encompass the physical, behavioural and psychological. Weight stigma can also lead affected individuals to internalize such experiences which decrease their overall quality of life. Sources of stigma may come from peers, family, educators, media, as well as healthcare professionals, as highlighted in this review. Efforts to establish prevention and treatment strategies for weight stigma may generate further traction to help improve global obesity rates. VIDEO ABSTRACT.
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Affiliation(s)
- Carl J. Palad
- New York Medical College, Valhalla, New York, Massachusetts, USA
| | | | - Fatima Cody Stanford
- Massachusetts General Hospital, MGH Weight Center, Department of Medicine-Division of Endocrinology- Neuroendocrine, Department of Pediatrics-Division of Endocrinology, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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Johnstone G, Grant SL. Weight stigmatisation in antiobesity campaigns: The role of images. Health Promot J Austr 2018; 30:37-46. [PMID: 29956413 DOI: 10.1002/hpja.183] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 06/26/2018] [Indexed: 01/21/2023] Open
Abstract
ISSUE ADDRESSED Antiobesity campaigns may inadvertently stigmatise individuals with obesity via the use of images that portray negative obesity stereotypes. This study investigated the impact of images on weight stigma using mock antiobesity campaigns featuring different types of images. METHODS Participants (N = 240) were randomly assigned to one of four campaign conditions: stereotypical images, counter-stereotypical images, neutral images, or no images. All four conditions used the same nonstigmatising message text. Participants indicated their attitudes towards being in social situations (desired social distance) with the target featured in the images, or individuals with obesity (no images), rated the target or individuals with obesity on various traits, and indicated to what extent the campaign was motivating and stigmatising. RESULTS Analysis of variance revealed that the stereotypical images were rated as the most stigmatising and were also associated with higher negative and lower positive trait ratings of the target and more desired social distance from the target. Neutral images generally produced the least weight stigma. CONCLUSION It is important to consider the impact of antiobesity campaign images that depict common obesity stereotypes. Developing, testing and disseminating nonstigmatising campaigns is important to reduce stigma and better engage individuals with antiobesity public health messages. SO WHAT?: Weight stigma has negative consequences for physical and psychological health, which may undermine obesity intervention efforts. Stereotypical images that blame individuals for their weight reinforce obesity stigma and are likely to be in-effective in increasing healthier behaviour and reducing obesity. The development of effective antiobesity campaigns should be a public health priority.
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Affiliation(s)
| | - Sharon L Grant
- Swinburne University of Technology, Hawthorn, Vic., Australia
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Vadiveloo M, Mattei J. Perceived Weight Discrimination and 10-Year Risk of Allostatic Load Among US Adults. Ann Behav Med 2017; 51:94-104. [PMID: 27553775 PMCID: PMC5253095 DOI: 10.1007/s12160-016-9831-7] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Discrimination promotes multisystem physiological dysregulation termed allostatic load, which predicts morbidity and mortality. It remains unclear whether weight-related discrimination influences allostatic load. PURPOSE The aim of this study was to prospectively examine 10-year associations between weight discrimination, allostatic load, and its components among adults 25-75 years in the Midlife Development in the US Biomarker Substudy. METHODS Participants with information on weight discrimination were analyzed (n=986). At both timepoints, participants self-reported the frequency of perceived weight discrimination across nine scenarios as "never/rarely" (scored as 0), "sometimes" (1), or "often" (2). The two scores were averaged and then dichotomized as "experienced" versus "not experienced" discrimination. High allostatic load was defined as having ≥3 out of 7 dysregulated systems (cardiovascular, sympathetic/parasympathetic nervous systems, hypothalamic pituitary axis, inflammatory, lipid/metabolic, and glucose metabolism), which collectively included 24 biomarkers. Relative risks (RR) were estimated from multivariate models adjusted for sociodemographic and health characteristics, other forms of discrimination, and BMI. RESULTS Over 41% of the sample had obesity, and 6% reported weight discrimination at follow-up. In multivariable-adjusted analyses, individuals who experienced (versus did not experience) weight discrimination had twice the risk of high allostatic load (RR, 2.07; 95 % CI, 1.21; 3.55 for baseline discrimination; 2.16, 95 % CI, 1.39; 3.36 for long-term discrimination). Weight discrimination was associated with lipid/metabolic dysregulation (1.56; 95 % CI 1.02, 2.40), glucose metabolism (1.99; 95 % CI 1.34, 2.95), and inflammation (1.76; 95 % CI 1.22, 2.54), but no other systems. CONCLUSIONS Perceived weight discrimination doubles the 10-year risk of high allostatic load. Eliminating weight stigma may reduce physiological dysregulation, improving obesity-related morbidity and mortality.
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Affiliation(s)
- Maya Vadiveloo
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, 02881, USA
| | - Josiemer Mattei
- Department of Nutrition, Harvard T. H. Chan School of Public Health, 665 Huntington Ave, Bldg 2, Boston, MA, 02115, USA.
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