Stimulating Weight Stigma in Future Experimental Designs on Physical Activity - Development and Pilot Validation of a Video Instrument

Carl, Johannes; Thedinga, Hendrik K.; Zipfel, Stephan; Thiel, Ansgar

doi:10.1159/000487889

Cited by 8 publications

(4 citation statements)

References 47 publications

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“…We have therefore not experienced weight stigmatisation ourselves. However, the team has a research history regarding weight stigma and published several studies on the subject [9,14,62]. Consequently, we are familiar with the subject matter [22].…”

Section: Statement On Positionality Of Research Teammentioning

confidence: 99%

Weight stigma experiences and self-exclusion from sport and exercise settings among people with obesity

2021

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Background A central strategy to tackle the health risks of obesity is regular physical activity (PA), exercising and participating in sports. However, people with obesity regularly experience weight-related stigma and discrimination in sport and exercise settings. Research has indicated that they often cope with such experiences by simply excluding themselves from sport and exercise. Meanwhile, self-exclusion as a coping strategy has not been fully understood and it remains unclear to what extent self-exclusion from PA settings is accompanied by general inactivity among people with obesity. The goal of this interview study was to determine to what extent physical inactivity among adults with obesity is the result of weight stigma-induced self-exclusion in and from sport and PA settings. Methods We conducted semi-structured interviews with thirty adult men and women with obesity (average BMI: 40.64) and asked them about experiences with their body, weight stigma and coping behaviours in sport and exercise settings across their lifespans. Employing constant comparative analysis and a thematic network approach, we analysed the interview data to identify the most common reasons for and different strategies of self-exclusion. Results Participants reported that they excluded themselves from sport and exercise settings due to traumatic weight stigma experiences, self-discrimination and fear of stigma, using a variety of strategies. Exposure to discrimination was prevented by selectively avoiding certain settings or strategically frequenting them at certain times only, but also by exercising in ‘safe’ spaces, e.g. at home. Furthermore, people with obesity reported strategically managing their social relations in order to avoid stigmatising reactions by others in exercise settings, for example by exercising individually and avoiding social PA. Most notably, our results strongly indicate that not all self-excluding coping strategies result in less exercising. Conclusions In order to successfully promote physical activity among people with obesity, the various forms of self-exclusion should be taken into account as pathways of stigma regarding physical activity. People with obesity may exclude themselves from certain PA settings, yet could still be exercising on their own or in other ways. One focus of public health strategies should thus be directed at the potentially socially isolating effects.

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Section: Statement On Positionality Of Research Teammentioning

confidence: 99%

Weight stigma experiences and self-exclusion from sport and exercise settings among people with obesity

2021

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“…This approach is person-centered, focused on specific target groups to identify what is important to them, taking into account not only health needs but also IT skills, socioeconomic context, interoperability, and integration gaps that may influence the adoption of innovative solutions tailored to improve health outcomes. Of note, overweight or obese patients tend to be marginalized and subjected to a real social stigma [ 31 , 73 ], and digital solutions may be useful to overcome psychological factors that prevent obese patients from starting their journey in a lifestyle change [ 74 ]. Indeed, among the twelve personas developed ( Figure 1 ) by Blueprint Partners, five—Rose, Millie, Ben, Antonio, and Matilde developed later ( Figure 2 )—are overweight or obese due to low physical activity, making them at risk for developing diabetes and becoming socially isolated [ 68 ].…”

Section: Methodsmentioning

confidence: 99%

An Innovative Approach to Designing Digital Health Solutions Addressing the Unmet Needs of Obese Patients in Europe

Patalano

Luca

Vogt

et al. 2021

IJERPH

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According to the World Health Organization (WHO), the worldwide obesity rate has tripled since 1975. In Europe, more than half of the population is overweight and obese. Around 2.8 million people die each year worldwide as a result of conditions linked to being overweight or obese. This study aimed to analyze the policies, approaches, and solutions that address the social and health unmet needs of obese patients, at different levels, in order to simulate the definition of an integrated approach, and to provide and share examples of innovative solutions supporting health promotion, disease prevention, and integration of services to improve the collaboration between the different health and care stakeholders involved across the country and in the lives of obese patients. A collaborative approach involving various levels of government and regional experts from different European countries was applied to identify, explore, and evaluate different aspects of the topic, from the innovation perspective and focusing on a European and a regional vision. Currently, people prefer more foods rich in fats, sugars, and salt/sodium than fruits, vegetables, and fiber. This behavior leads to a significant negative impact on their health-related quality of life. Changes in healthcare systems, healthy policy, and approaches to patient care and better implementation of the different prevention strategies between all the stakeholders are needed, taking advantage of the digital transformation of health and care. Such changes can support obese patients in their fight against an unhealthy lifestyle and at the same time reduce healthcare costs.

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“…In Kushner et al ,32 for example, it was shown that “in contrast to empathy and counselling, scaled stereotyping mean scores showed a regression back to baseline over a year”—which, to an even greater degree, supports the need for research to focus on variables that support lasting effects of anti-stereotyping interventions. Regarding future research methods on ‘anti-fat’ attitudes, Carl and colleagues43 suggest the use of a video instrument, which has just been validated within a pilot study.…”

Section: Discussionmentioning

confidence: 99%

Is an obesity simulation suit in an undergraduate medical communication class a valuable teaching tool? A cross-sectional proof of concept study

Herrmann–Werner¹,

Loda²,

Wiesner³

et al. 2019

BMJ Open

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ObjectiveWith the growing prevalence of overweight and obesity, medical students should be prepared to engage in weight management and obesity-related communications in order to prevent patients from having stigmatising experiences. In addition, medical students should have training to reduce anti-fat prejudices.DesignCross-sectional proof of concept study.SettingUniversity Hospital Tuebingen, Germany.Participants246 participants (207 second-year medical students, 13 standardised patients (SPs) and 22 teachers) took part in the study.Primary and secondary outcome measuresThe primary outcome was the assessment of degree of reality of the encounter with the SP wearing an obesity simulation suit (OSS). The secondary outcome was the evaluation of students’ awareness and prejudice against patients with obesity in a simulated role play. Additionally, a description of the advantages and disadvantages when using such a teaching tool is delivered.ResultsThe OSS contributed to a realistic perception of the patient group depicted in a role play according to students, teachers and SPs. OSS body mass index estimation by students, teachers and SPs correctly was over 30 kg/m2—thus in the range of obesity. In a selected subscale of the Anti-Fat Attitudes Test, students showed significantly stronger anti-fat stigmatisation compared with teachers and SPs.ConclusionsAn OSS worn by an SP is a valuable teaching tool to raise awareness about patients with obesity. It gives a realistic picture of the encounter. Stigmatisation was low in general but was especially present in the students. Further research should include intervention studies to address this issue.

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Stimulating Weight Stigma in Future Experimental Designs on Physical Activity - Development and Pilot Validation of a Video Instrument

Cited by 8 publications

References 47 publications

Weight stigma experiences and self-exclusion from sport and exercise settings among people with obesity

Weight stigma experiences and self-exclusion from sport and exercise settings among people with obesity

An Innovative Approach to Designing Digital Health Solutions Addressing the Unmet Needs of Obese Patients in Europe

Is an obesity simulation suit in an undergraduate medical communication class a valuable teaching tool? A cross-sectional proof of concept study

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