The stigma of obesity in the general public and its implications for public health - a systematic review

Abstract

BackgroundUp to this date, prevalence rates of obesity are still rising. Aside from co-morbid diseases, perceived discrimination and stigmatization leads to worsen outcomes in obese individuals. Higher stigmatizing attitudes towards obese individuals may also result in less support of preventive and interventive measures. In light of the immense burden of obesity on health care systems and also on the individuals' quality of life, accepted and subsidized preventive measures are needed. Policy support might be determined by views of the lay public on causes of obesity and resulting weight stigma. This study seeks to answer how representative samples of the lay public perceive people with obesity or overweight status (stigmatizing attitudes); what these samples attribute obesity to (causal attribution) and what types of interventions are supported by the lay public and which factors determine that support (prevention support).MethodsA systematic literature search was conducted. All studies of representative samples reporting results on (a) stigmatizing attitudes towards overweight and obese individuals, (b) causal beliefs and (c) prevention support were included.ResultsOnly 7 articles were found. One study reported prevalence rates of stigmatizing attitudes. About a quarter of the population in Germany displayed definite stigmatizing attitudes. Other studies reported causal attributions. While external influences on weight are considered as well, it seems that internal factors are rated to be of higher importance. Across the studies found, regulative prevention is supported by about half of the population, while childhood prevention has highest approval rates. Results on sociodemographic determinants differ substantially.ConclusionsFurther research on public attitudes toward and perception of overweight and obesity is urgently needed to depict the prevailing degree of stigmatization. Introducing a multidimensional concept of the etiology of obesity to the lay public might be a starting point in stigma reduction.

Public beliefs about the causes of obesity and attitudes towards policy initiatives in Great Britain

“…Population-based surveys in Denmark, Germany, Australia and the USA have also shown less public support for regulation and taxation (13)(14)(15)(16) . One explanation for the low support for more intensive government intervention may be the perceived causes of overweight and obesity (17) . The pervasive stereotypes and stigma surrounding obesity may mean that it is still seen as 'the person's own fault', leading to objections against public expenditure because the condition is perceived to be 'self-inflicted'.…”

Guideline Recommended Medical Therapy for Cardiovascular Diseases in the Obese: Insights From the Veterans Affairs Clinical Assessment, Reporting, and Tracking (CART) Program

“…This incongruence in care patterns across medical disciplines is likely multifactorial. One potential reason is likely the aforementioned hesitance to undergo evaluation and care due to perceived stigma against the obese and overweight from the healthcare system and practitioners,2, 4, 8, 35, 36 resulting in fewer opportunities to establish and optimize medical therapy. As referral for PCI ensures contact with the healthcare system, this may explain the differences from prior analyses.…”

Physical disgust, germ aversion and antifat attitudes: the mediational effect of perceived controllability of weight

“…It is important to remark that some investigations have showed that antifat attitudes do not help obese people to have a healthy life and that the stigmatization of obese individuals has important implications for public health policies (see for a review: Sikorski et al, 2011). For these reasons, we believe that it is especially important to analyze which are the roots of the prejudice toward obese individuals.…”