Weight stigma from romantic partners: Its relations with maladaptive and adaptive coping and depressive symptoms

Social devaluation of being overweight is common in daily life, but little is known about the weight stigma in romantic relationships. The present study investigated the roles of maladaptive and adaptive coping strategies in the relation between the experience of weight stigma in romantic relationships and depressive symptoms in men and women, respectively. Analyses of gender differences and structural equation modeling yielded several findings. First, while men and women experienced similar levels of weight stigma from their romantic partners, women were more likely to use exercise avoidance, disengagement coping, and reappraisal coping strategies, and to exhibit more depressive symptoms than men. Second, men who experienced weight stigma tended to cope with it through exercise avoidance and disengagement coping, which were related to greater depressive symptoms. Men also coped with weight stigma adaptively via reappraisal coping, which was additionally associated with more positive affect. Third, the relation between the experience of weight stigma and depressive symptoms in women was only explained by using disengagement coping. These findings extend the understanding of weight stigma to a specific context and provide some insight that future interventions to reduce the impacts of weight stigma should be tailored accordingly for men and women.

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

OBJECTIVES

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

METHOD

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

RESULTS

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

CONCLUSION

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

Differences in weight stigma between gay, bisexual, and heterosexual men

Gay and bisexual men may experience more weight stigma than heterosexual men; however, research is limited. We examined differences in experienced weight discrimination, weight bias, and internalized weight bias in two studies: the first comprising gay (n = 351), bisexual (n = 357), and heterosexual (n = 408) men, and the second comprising gay (n = 614) and bisexual (n = 123) men. In Study 1, bisexual men reported experiencing more weight discrimination than gay (r = .07) and heterosexual (r = .08) men. Bisexual (Glass' Δ = 0.41) and gay (Δ = 0.37) men reported greater internalized weight bias than heterosexual men. Heterosexual men reported more weight bias than gay (Cohen's d = 0.35) and bisexual (d = 0.46) men. In Study 2, gay men reported more internalized weight bias than bisexual men (d = 0.26). Sexual orientation did not moderate the relationships of weight stigma with either body dissatisfaction or psychological quality of life. Among gay and bisexual men, experiencing weight discrimination predicted diminished psychological quality of life through internalized weight bias and body dissatisfaction. Our research emphasizes the importance of assessing weight stigma among sexual minorities and suggests bisexual men might be particularly vulnerable to weight stigma.

Overlooked and Understudied: Health Consequences of Weight Stigma in Men

OBJECTIVE

A substantial amount of literature has suggested that weight stigma impairs health. Evidence on gender differences in weight stigma has been mixed, but studies of weight stigma within men have been primarily absent from the literature.

METHODS

In two samples of men recruited nationally from across the United States (N = 1,753), participants completed self-report measures assessing their height, weight, demographics, weight stigma (experienced and internalized), psychological well-being (depression), health behaviors (sleep, alcohol, smoking, binge eating, dieting, physical activity), and self-rated health.

RESULTS

Regression analyses showed that, independent of race, socioeconomic status, and BMI, experienced weight stigma and weight bias internalization among men were associated with poor health, including greater depressive symptoms, increased dieting, lower self-reported health, and increased odds of binge eating. Neither internalized nor experienced weight stigma was consistently associated with physical activity, smoking, drinking, or trouble sleeping.

CONCLUSIONS

These findings suggest that both experienced and internalized weight stigma are associated with several indices of poor health in men. It may be informative for future work to examine how men cope with weight stigma, particularly if certain coping responses to stigma involve behaviors that contribute to poorer health.

Social deprivation, gender and obesity: multiple stigma? Results of a population survey from Germany

OBJECTIVES

Individuals with obesity are subject to stigmatisation, resulting in discrimination. Studies focusing on obesity stigma often do not account for social conditions that also may be associated with stigmatisation. Following an intersectional approach, social categories such as gender and socioeconomic status (SES) can interact and form a basis for multiple stigma. The present study analyses differences in public obesity stigma depending on gender and SES, as well as possible interdependencies between these social categories.

DESIGN

Representative cross-sectional telephone survey.

PARTICIPANTS

692 randomly selected adults (≥ 18 years) in Germany.

METHODS

Different vignettes were presented, depicting a lawyer (male/female) or a janitor/cleaner (male/female) with obesity. Following the vignette, different components of stigma were assessed: (1) fat phobia, (2) emotional reactions to a person with obesity and (3) desire for social distance. Associations between gender, SES and stigma components were tested in multiple linear regression analyses.

RESULTS

A low SES in the obesity vignette (janitor/cleaner) was significantly associated with higher fat phobia scores as well as desire for social distance, compared with the vignette with a person with obesity and a high SES (lawyer). Being a male with obesity was significantly associated with more pronounced negative emotional reactions and greater desire for social distance. There were no significant interaction effects between gender and SES.

CONCLUSIONS

Results support the hypothesis of multiple stigma. Being male or of low SES was significantly associated with more pronounced negative attitudes in the German public. Following the concept of intersectionality, our findings indicate that obesity stigma can exacerbate pre-existing inequalities. This needs to be considered in development and implementation of prevention and anti-stigma measures.

The impact of obesity on perceived patient-centred communication

OBJECTIVE

Patient-provider communication has been found to be less patient centred, on average, with patients who are members of stigmatized or minority groups. Obesity is a stigmatized condition, and thus, people with obesity may experience less patient-centred communication (PCC). The objective of this study was to assess the association between patient body mass index (BMI) and self-reported quality of PCC experienced over a 12-month period and whether that relationship differed for men and women.

METHODS

Data collected for the National Cancer Institute's Health Information National Trends Survey were analysed. Respondents who reported a BMI ≥ 18.5 kg/m2 and indicated having seen a healthcare provider outside of an emergency room in the last 12 months were included. PCC was measured using a validated six-item scale. Multivariate logistic regression was used to model the odds of reporting PCC greater than the sample median.

RESULTS

Compared with people with normal weight BMIs, no associations were found between overweight (odds ratio [OR] = 0.84, p = 0.17), class I & II obesity (OR = 0.94, p = 0.68) or class III obesity (OR = 0.86, p = 0.47) and PCC. There was a significant interaction (p = 0.015) such that for men, but not women, higher BMI was associated with less PCC.

CONCLUSION

Unlike evidence that women experience more weight stigma, in the healthcare domain, men may be at elevated risk of experiencing communication influenced by weight stigma.

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.

Gender differences in the relationship of weight-based stigmatisation with motivation to exercise and physical activity in overweight individuals

Weight stigma is related to lower levels of motivation to exercise in overweight and obesity. This study explored the nature of the relationship between stigma, motivation to exercise and physical activity while accounting for gender differences. Participants were 439 adults with overweight and obesity (mean body mass index = 32.18 kg/m2, standard deviation = 4.09 kg/m2). Females reported significantly more frequent stigma experiences than males. Mediation models found a conditional direct effect of weight stigma for males, with higher frequency of stigma experiences related to higher levels of walking and vigorous physical activity. A conditional indirect effect was found for females for walking, moderate and vigorous levels of physical activity, with higher weight stigma related to lower autonomous motivation, and lower levels of physical activity. Findings suggest that males and females are affected differently by weight-stigma experiences.

A sympathetic nervous system evaluation of obesity stigma

The portrayal of obesity in the media is often one of negativity. Consequently, it may generate an increase in stigma. Obesity stigma, a form of social discrimination, is responsible for many of the negative psychological and physiological effects on individual wellness. These effects not only impact individual health, but also affect the economy, and ultimately, societal wellness. In an attempt to examine the influence of the media on obesity stigma, this study tested the hypothesis that positive priming would lead to a reduction in obesity stigma. To further our understanding of this relationship, we: 1) examined the role of priming on physiological measures (e.g. salivary alpha amylase and skin conductance) in 70 college students by introducing positive and negative media images of individuals with obesity, and 2) assessed psychological measures (e.g. perceived stress, need to belong, and self-esteem, and Body Mass Index). After the priming manipulation, participants read a vignette depicting the discrimination of an individual with obesity and answered subsequent questions assessing participants' attributional blame of obesity. Results of this study revealed that priming affects physiological responding to obesity stigmatization. In conclusion, these findings suggest that incorporating positive media images of individuals with obesity may be an effective tool for reducing stigma and the various physiological consequences associated with it, which in turn, can enhance societal health and wellness.

Sex Differences in Obesity and Mental Health

PURPOSE OF REVIEW

The purposes of this study were to examine the relationships between obesity and a wide range of mental health issues and to identify where sex differences exist and may vary across disorders.

RECENT FINDINGS

Research on sex differences in the relationship between obesity and psychiatric disorders is more abundant in some areas, such as depression and eating disorders, than others, such as anxiety, trauma, and substance use. However, for most of the disorders, their relationships with obesity and sex are complex and are usually moderated by additional variables. Thus, studies that find stronger relationships for women between depression and obesity cross-sectionally do not tell the whole story, as longitudinal studies suggest that this relationship may also be present among men, particularly when confounders are considered. For those with eating disorders, men and women with obesity are fairly equally affected, and weight and shape concerns may play a role in maintaining these behaviors for both sexes. Weight stigma, though, seems to have worse consequences for women than men with obesity. Sex differences exist in relation to the associations between mental health and obesity. However, these differences vary by disorder, with disorder-specific moderators playing a role, such as age for depressive disorders, comorbid depression for anxiety disorders, and weight and shape concerns for eating disorders. More work is needed to understand if sex differences play a role in the relationship between obesity and anxiety, trauma, and substance use disorders.

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

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

Who responds to financial incentives for weight loss? Evidence from a randomized controlled trial

There is a paucity of evidence on the heterogeneous impacts of financial incentives on weight loss. Between March 2010 and January 2012, in a randomized controlled trial, we assigned 700 obese persons to three experimental arms. We test whether particular subgroups react differently to financial incentives for weight loss. Two treatment groups obtained a cash reward (€150 and €300 with 237 and 229 participants, respectively) for achieving an individually-assigned target weight within four months; the control group (234 participants) was not incentivized. Participants and administrators were not blinded to the intervention. We find that monetary rewards effectively induced obese individuals to reduce weight across all subgroups. However, there is no evidence for treatment-effect heterogeneity for those groups that were incentivized. Among those who were in the €300 group, statistically significant and large weight losses were observed for women, singles, and those who are not working (all above 4 kg in four months). In addition, the magnitude of the reward matters only for women and migrants. The effectiveness of financial incentives to reduce weight nevertheless raises sensitive ethical issues that should be taken into consideration by policymakers.

Stigmatisation of a formerly obese young female

BACKGROUND

Weight loss does not necessarily decrease the negative appraisal of a formerly overweight individual. Since past weight history tends to be disclosed in several contexts, this study aims to investigate whether negative appraisals are gender-specific and if they are modulated by the evaluators' own BMI.

METHODS

202 young adults (106 male and 96 female) viewed a picture of a young attractive female (target) accompanied by one of two statements about her past weight (overweight (OW) or always kept a normal weight (NW)), and then rated her using the Fat Phobia Scale (FPS).

RESULTS

Female evaluators rated the target with the OW statement more negatively than the target with the NW statement. In contrast, males exposed to the OW statement rated the target as having fewer emotional/psychological problems and being less stupid/uncreative. BMI only influenced ratings in males, where those with higher BMI ascribed more negative attributes to the target with the NW statement than the OW statement.

CONCLUSION

Information on weight history impacts upon the appraisal of peers. These effects are dependent on gender and BMI. Knowing that a young female was overweight triggered negative evaluations from females but did not appear to impact the judgment of males.

Explanatory models of obesity of inner-city African-American adolescent males

The purpose of this phenomenological inquiry was to construct an explanatory model of illness in inner-city African-American adolescent males using Kleinman's Explanatory Model of Illness as a framework. Thirteen males were enrolled in this study. In-depth, semi-structured interviews were used to explore adolescents' perspectives regarding the nature, cause, prevention and responses to obesity; their perception of self; and meanings they attach to obesity with particular emphasis on existing attitudes, expectations, and values. Data analysis was achieved through a process of inductive content analysis. Findings, future research and clinical implications are discussed.

Would You Like Fries (380 Calories) With That? Menu Labeling Mitigates the Impact of Weight-Based Stereotype Threat on Food Choice

Policies that focus on self-regulation are being implemented to reduce obesity. One policy is menu labeling, the provision of calorie information on restaurant menus, which has evidenced mixed results. To illuminate the role of psychological processes, we examined the effect of weight-based stereotype threat on food choice as a function of body mass index (BMI). In Study 1, participants under stereotype threat ordered food containing more calories from a conventional menu that did not present calorie information as BMI increased, whereas no association between BMI and calories was found in the control (no threat) condition. In Study 2, participants under stereotype threat ordered more calories from a conventional menu as BMI increased, whereas no association between BMI and calories was found among participants who ordered from a calorie menu, demonstrating that menu labeling eliminated the stereotype threat effect. Theoretical and practical implications for stereotype threat and policy interventions are discussed.

Disgust sensitivity, obesity stigma, and gender: contamination psychology predicts weight bias for women, not men

Recent research has established a link between disgust sensitivity and stigmatizing reactions to various groups, including obese individuals. However, previous research has overlooked disgust's multiple evolved functions. Here, we investigated whether the link between disgust sensitivity and obesity stigma is specific to pathogen disgust, or whether sexual disgust and moral disgust--two separate functional domains--also relate to negative attitudes toward obese individuals. Additionally, we investigated whether sex differences exist in the manner disgust sensitivity predicts obesity stigma, whether the sexes differ across the subtypes of obesity bias independent of disgust sensitivity, and last, the association between participants' BMI and different subtypes of obesity stigma. In study 1 (N = 92), we established that obesity elicits pathogen, sexual, and moral disgust. In study 2, we investigated the relationship between these types of disgust sensitivity and obesity stigma. Participants (N = 387) reported their level of disgust toward various pathogen, sexual, and moral acts and their attitudes toward obese individuals. For women, but not men, increased pathogen disgust sensitivity predicted more negative attitudes toward obese individuals. Men reported more negative general attitudes toward obese individuals whereas women reported greater fear of becoming obese. The sexes also differed in how their own BMI related to the subtypes of obesity stigma. These findings indicate that pathogen disgust sensitivity plays a role in obesity stigma, specifically for women. Defining the scope of disgust's activation in response to obesity and its relationship with other variables can help identify possible mechanisms for understanding and ultimately alleviating prejudice and discrimination.

Testing the norm to fat talk for women of varying size: what's weight got to do with it?

"Fat talk" is the conversational phenomenon whereby people berate their bodies in social circles. This study assessed whether norms of fat talk differ for overweight versus average-weight women. Sixty-three women read a script depicting a fat talk situation during which an overweight or average-weight target woman engaged in positive or negative body talk. Regardless of the target's weight, participants perceived it to be more typical and less surprising if she engaged in negative body talk (fat talk) rather than positive body talk. Furthermore, fat talk from either weight group did not affect the likeability of the target, but women, overweight or of average weight, who engaged in positive talk were perceived to have more socially desirable personality characteristics.

The influence of body weight on social network ties among adolescents

Evidence of negative stereotypes, prejudice and discrimination towards obese individuals has been widely documented. However, the effect of a larger body size on social network ties or friendship formations is less well understood. In this paper, we explore the extent to which higher body weight results in social marginalization of adolescents. Using data from a nationally representative sample of adolescents, we estimate endogeneity-corrected models including school-level fixed effects that account for bi-directionality and unobserved confounders to ascertain the effect of body weight on social network ties. We find that obese adolescents have fewer friends and are less socially integrated than their non-obese counterparts. We also find that such penalties in friendship networks are present among whites but not African-Americans or Hispanics, with the largest effect among white females. These results are robust to common environmental influences at the school-level and to controls for preferences, risk attitudes, low self-esteem and objective measures of physical attractiveness.

Experiences of weight stigmatization: a review of self-report assessment measures

BACKGROUND

Overweight and obese persons are vulnerable to frequent stigmatization and discrimination because of their weight. Despite widespread prejudice towards obese persons, many questions remain regarding the nature, extent, and impact of weight-based stigmatization experienced by so many people. However, improving our knowledge in this area will only be as good as the measures we have to study this phenomenon. Our paper is the first to provide a comprehensive summary of published quantitative self-report measures available for assessing experiences of weight stigmatization in children and adults.

METHODS

This review examined 22 measures of self-reported weight stigmatization and highlights the strengths and limitations of existing assessment.

RESULTS

Existing measures contain a number of limitations and have been assessed in samples lacking diversity. Improvements in measurement are needed to achieve a clearer understanding of the nature and extent of self-perceived weight stigmatization and to develop measures that accurately reflect this type of stigmatization.

CONCLUSIONS

Specific directions for future research that will help improve measurement of self-perceived weight stigmatization and advance this area of study are highlighted.

The Effects of Playing with Thin Dolls on Body Image and Food Intake in Young Girls

This study experimentally tested the effects of playing with thin dolls on body image and food intake in 6- to 10-year-old Dutch girls (N = 117). Girls were randomly assigned to play with a thin doll, an average-sized doll, or Legos in a no doll control condition. After 10 min, they participated in a taste-test and completed questionnaires about body image. No differences were found between conditions for any of the body image variables. However, girls who played with the average-sized doll ate significantly more food than girls in other exposure conditions. Although no support was found for the assumption that playing with thin dolls influences body image, the dolls directly affected actual food intake in these young girls.

Comprehensive review of obesity and psychological considerations for treatment

Although obesity is considered to be a medical condition, psychosocial variables influence its development, course, and treatment. To date, obesity research focuses heavily on the associated physical problems and the identification of effective treatments. While an array of behavioral, pharmacological and surgical treatments has been developed, their ability to demonstrate long-term weight losses is not convincing. Thus, there has been a shift towards the identification of psychological and social factors that may assist in the prediction of successful treatments, most notably in the surgical treatment of obesity. As a result, less emphasis has been placed on post-treatment psychosocial influences. As the treatment of obesity becomes increasing multidimensional, the need for attention to psychosocial factors and the involvement of mental health providers increases. For the allied or mental health provider, a comprehensive understanding of obesity's physical, psychological and social basis is vital to ensure proper assessment or treatment, as it is warranted.

Individual differences and weight bias: Do people with an anti-fat bias have a pro-thin bias?

While levels of weight bias vary among individuals, it is not clear why one person possesses stronger anti-fat attitudes than another person. This investigation examined whether individual differences commonly associated with greater anti-fat bias are also associated with a greater preference for thinness among people of varying levels of weight. Young adults (62% women; 84% Caucasian) recruited from psychology classes (N=308) rated four male and female figures with approximate BMIs of 18.5, 25, 30, and 40, on measures of dislike and personality characteristics and completed measures assessing weight controllability, attitudes toward the obese, and perceptual reliance. Greater negative attitudes, weight controllability beliefs, and perceptual reliance were positively associated with greater dislike and negative personality attributes among obese/severely obese figures, but inversely related among low normal weight figures. Individuals who judge others based on physical features or who view obesity as controllable evidence greater weight bias and a stronger preference for thin body types.

Perceived interpersonal mistreatment among obese Americans: do race, class, and gender matter?

OBJECTIVE

We examine the extent to which body weight affects three types of perceived interpersonal mistreatment, and evaluate whether these patterns vary by race, social class, and gender in a large sample of American men and women.

METHODS AND PROCEDURES

We use data from the first wave (1995) of the Midlife Development in the United States (N = 3,511), a survey of persons aged 25-74, to contrast underweight, normal weight, overweight, obese I, and obese II/III persons' reports of three types of perceived interpersonal mistreatment: disrespectful treatment; harassment/teasing; and being treated as if one has a character flaw. We assess whether these relationships are contingent upon one's gender, race, and occupational status. We control for possible confounding influences, including physical and mental health.

RESULTS

In the total sample, obese I and obese II/III persons report significantly higher levels of all three types of perceived mistreatment (compared to normal weight persons), even when demographic, socioeconomic status, and health characteristics are controlled. Among black men, however, obese II/III persons report significantly lower levels of all three types of perceived mistreatment, compared to their normal weight peers. Among both men and women, obese professional workers report significantly more perceived interpersonal mistreatment, compared to obese persons of lower socioeconomic status.

DISCUSSION

These findings reveal the ways that intersecting social identities may shape obese Americans' perceptions of stigmatizing interpersonal encounters.

Gender, Excessive Body Weight, and Psychological Well-Being in Adulthood

We examined gender differences in the association between body mass index (BMI) and psychological well-being. Regression analysis involving 3,251 adults indicated that gender moderated the BMI–psychological well-being link. In follow-up analyses, higher BMI predicted lower psychological well-being only among women. When participants were categorized into 5 BMI groups, women reported lower psychological well-being than men in the overweight and obese I groups, but no gender differences were observed in the more seriously obese or normal-weight groups. Also, among women, all 4 groups with higher-than-normal BMI had lower psychological well-being than normal-weight women; for men, no significant differences were found across the 5 groups. These findings are discussed in relation to research on stigma theory and gender-differentiated cultural norms regarding weight.

Perceptions of weight discrimination: prevalence and comparison to race and gender discrimination in America

OBJECTIVE

Limited data are available on the prevalence and patterns of body weight discrimination from representative samples. This study examined experiences of weight/height discrimination in a nationally representative sample of US adults and compared their prevalence and patterns with discrimination experiences based on race and gender.

METHOD AND PROCEDURES

Data were from the National Survey of Midlife Development in the United States, a 1995-1996 community-based survey of English-speaking adults aged 25-74 (N=2290). Reported experiences of weight/height discrimination included a variety of institutional settings and interpersonal relationships. Multivariate regression analyses were used to predict weight/height discrimination controlling for sociodemographic characteristics and body weight status.

RESULTS

The prevalence of weight/height discrimination ranged from 5% among men to 10% among women, but these average percentages obscure the much higher risk of weight discrimination among heavier individuals (40% for adults with body mass index (BMI) of 35 and above). Younger individuals with a higher BMI had a particularly high risk of weight/height discrimination regardless of their race, education and weight status. Women were at greater risk for weight/height discrimination than men, especially women with a BMI of 30-35 who were three times more likely to report weight/height discrimination compared to male peers of a similar weight.

DISCUSSION

Weight/height discrimination is prevalent in American society and is relatively close to reported rates of racial discrimination, particularly among women. Both institutional forms of weight/height discrimination (for example, in employment settings) and interpersonal mistreatment due to weight/height (for example, being called names) were common, and in some cases were even more prevalent than discrimination due to gender and race.

Confronting and coping with weight stigma: an investigation of overweight and obese adults

OBJECTIVE

This study examined experiences of weight stigmatization, sources of stigma, coping strategies, psychological functioning, and eating behaviors in a sample of 2671 overweight and obese adults.

RESEARCH METHODS AND PROCEDURES

The total sample was partitioned into two subsamples for investigation. Sample I was comprised of 2449 adult women, and Sample II was a matched sample of adult men and women (N = 222) that was disaggregated to investigate gender differences. Both samples completed an online battery of self-report questionnaires measuring frequency of weight stigmatization and coping responses to deal with bias, the most common sources of the bias, symptoms of depression, self-esteem, attitudes about weight and obesity, and binge eating behaviors.

RESULTS

Experiences of weight stigmatization, in many forms and across multiple occasions, was common in both samples. A variety of coping strategies were used in response. More frequent exposure to stigma was related to more attempts to cope and higher BMI. Physicians and family members were the most frequent sources of weight bias reported. No gender differences were observed in types or frequency of stigmatization. Frequency of stigmatization was not related to current psychological functioning, although coping responses were associated with emotional well-being.

DISCUSSION

These findings raise questions about the relationship between stigma and psychological functioning and have important implications for obesity treatment and stigma reduction intervention efforts, both of which are discussed.