A qualitative analysis of people’s experiences with weight-based discrimination

Gerend, Mary A.; Patel, Shefali; Ott, Nicholas; Wetzel, Karen; Sutin, Angelina R.; Terracciano, Antonio; Maner, Jon K.

doi:10.1080/08870446.2021.1921179

Cited by 20 publications

(12 citation statements)

References 37 publications

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“…Different manifestations of discrimination have been described, including offensive or disparaging comments, negative assumptions about capability and intelligence, actions of exclusion or disregard, and lack of environmental accommodations. 32 It is additionally important to highlight that while bias may not have been overtly intended by clinicians, bias can still be perceived and experienced by patients and families and exact deleterious effects on their care experiences and overall well‐being. Future work should ascertain which behaviors and features of decision support interactions with clinicians are being observed as indicative of bias, which can help guide targets for interventions.…”

Section: Discussionmentioning

confidence: 99%

“…A related question is how exactly did respondents note this negative impact in the actions and behaviors of the decision support received from the healthcare team? Different manifestations of discrimination have been described, including offensive or disparaging comments, negative assumptions about capability and intelligence, actions of exclusion or disregard, and lack of environmental accommodations 32 . It is additionally important to highlight that while bias may not have been overtly intended by clinicians, bias can still be perceived and experienced by patients and families and exact deleterious effects on their care experiences and overall well‐being.…”

Section: Discussionmentioning

confidence: 99%

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Bias reported by family caregivers in support received when assisting patients with cancer‐related decision‐making

et al. 2022

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Background Family caregivers play an increasing role in cancer treatment decision‐making. We examined bias reported by family caregivers in the support they and their patient received from their healthcare team when making these decisions, including associations with distress. Methods Analysis of 2021 national survey data of family caregivers of patients with cancer ( N = 2703). Bias experienced in decision support was assessed with the item: “Have you felt that the support you and the person with cancer have received for making cancer‐related decisions by your doctor or healthcare team has been negatively affected by any of the following?” Check‐all‐that‐apply response options included: age, race, language, education, political affiliation, body weight, insurance type or lack of insurance, income, religion, sexual orientation, and gender/sex. Chi‐square and regression analyses assessed associations between bias and caregiver distress (GAD‐2, PHQ‐2). Results Of 2703 caregiver respondents, 47.4% ( n = 1281) reported experiencing ≥1 bias(es) when receiving decision support for making cancer‐related decisions. Bias was more prevalent among younger caregivers, males, transwomen/men or gender non‐conforming caregivers, racial/ethnic minorities, and those providing care over a longer time period. The odds of having high anxiety (GAD‐2 scores ≥ 3) were 2.1 times higher for caregivers experiencing one type of bias (adjusted OR, 2.1; 95% CI, 1.6–2.8) and 4.2 times higher for caregivers experiencing ≥2 biases (adjusted OR, 4.2; 95% CI, 3.4–5.3) compared to none. Similar results were found for high depression scores (PHQ‐2 scores ≥ 3). Conclusions Nearly half of caregivers involved in their care recipients' cancer‐related decisions report bias in decision support received from the healthcare team. Experiencing bias was strongly associated with high psychological distress.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Bias reported by family caregivers in support received when assisting patients with cancer‐related decision‐making

et al. 2022

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“…Weight-related stigma includes a wide variety of stages, going from repeated mocking and mobbing to harassment and hostility [13,14]. In addition, people affected by obesity report experiencing undesired attention, social rejection, and discrimination [15].…”

Section: Introductionmentioning

confidence: 99%

Weight stigma speaks Italian, too

Muscogiuri¹,

Barrea

Verde³

et al. 2022

J Endocrinol Invest

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Purpose Weight stigma is the negative weight related attitudes and beliefs towards individuals because of their overweight or obesity. Subjects with obesity are often victim of weight-related stigma resulting in a significant negative social consequence. As obesity epidemic is growing so fast, there is urgency to act on weight-stigma related social consequences being potentially serious and pervasive. This study investigated experiences, interpersonal sources, and context of weight stigma in Italy in a sample of adult subjects with obesity. Methods An online questionnaire was distributed to respondents via a snowball sampling method among subjects with obesity belonging to Italian Associations for people living with obesity aged 18 years and above. Results Four hundred and three respondents (47.18 ± 9.44 years; body mass index (BMI) 33.2 ± 8.48 kg/m2) participated to the study. Most respondents were females (94.8%). The age first dieted was 15.82 ± 7.12 years. The mean period of obesity was 27.49 ± 11.41 years. Frequency analyses reported that stigmatizing situations were experienced by 98% of participants: 94.82% during adulthood, 89.88% during adolescence and 75.39% during childhood. Verbal mistreatments (92.43%) was the most reported stigmatizing situation, strangers (92.43%) were the most common interpersonal sources of stigma and public settings (88.08%) were the most common location of stigma. Conclusions Identifying strategies acting on the identified weight stigma targets could contribute to reduce weight stigma and thus to result in important implications for obesity treatment in Italy.

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“…Weight stigma (social devaluation due to body weight) toward highweight individuals is a multinational problem which is steadily increasing in prevalence (Charlesworth & Banaji, 2019;. Individuals experience stigma and discrimination in many situations across everyday life (e.g., healthcare, education, workplace, and restaurants) and from varied sources including family members, friends, and coworkers (Gerend et al, 2022;Puhl et al, 2021).…”

mentioning

confidence: 99%

“…Weight stigma (social devaluation due to body weight) toward high-weight individuals is a multinational problem which is steadily increasing in prevalence (Charlesworth & Banaji, 2019; Puhl et al, 2015). Individuals experience stigma and discrimination in many situations across everyday life (e.g., healthcare, education, workplace, and restaurants) and from varied sources including family members, friends, and coworkers (Gerend et al, 2022; Puhl et al, 2021). Weight bias internalization (WBI; weight self-stigma) is another manifestation of societal weight stigma, which involves self-stereotyping and devaluing the self because of one’s body weight (Austen et al, 2021; Durso & Latner, 2008).…”

mentioning

confidence: 99%

Constant vigilance: The impact of weight stigma, vigilance, and internalization on maladaptive eating behaviors.

Wetzel,

Himmelstein

2023

Health Psychology

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Objective: Weight stigma (social devaluation because of weight) and weight bias internalization (self-stigma due to weight) have been independently implicated in maladaptive eating, which ultimately contributes to poor cardiometabolic health. Additionally, vigilance (being on the lookout for social devaluation) is connected to stress, poor sleep, and depression. Most research considers these factors separately but establishing how these variables interact with one another is essential to understanding their cumulative impact on health behaviors. Method: Using a diverse national panel of adults in the United States (N = 1,051), this study tested several statistical moderated mediations in which weight stigma was both directly associated with maladaptive eating and indirectly associated with maladaptive eating via vigilance. We simultaneously examined whether the relationship between weight stigma and vigilance was moderated by self-stigma. Results: Results indicated that experiencing weight stigma was directly related to each of the maladaptive eating behaviors (eating to cope, restrictive dieting frequency, and binge eating). Weight stigma was also indirectly related to each eating behavior through vigilance; this indirect relationship was stronger among those with high levels of weight bias internalization, compared to those with low levels of weight bias internalization. Race moderated the relationship between weight stigma and vigilance, such that participants identifying as Black had a stronger relationship between them. Conclusions: These results provide support for a theoretical model which explains how weight stigma, self-stigma, and vigilance interact with one another to produce negative health behaviors and highlight the importance of further investigation of vigilance in the context of weight stigma. Public Significance StatementPoor treatment due to someone's body weight leads to increases in disordered eating such as restricting food, eating to cope, and binge eating. This study finds that one reason this might be happening is chronic stress and worry over the possibility of being treated poorly in the future. This is especially likely if somebody already thinks about themselves poorly because of their body weight.

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A qualitative analysis of people’s experiences with weight-based discrimination

Cited by 20 publications

References 37 publications

Bias reported by family caregivers in support received when assisting patients with cancer‐related decision‐making

Bias reported by family caregivers in support received when assisting patients with cancer‐related decision‐making

Weight stigma speaks Italian, too

Constant vigilance: The impact of weight stigma, vigilance, and internalization on maladaptive eating behaviors.

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