Weight Bias and Stigma: Public Health Implications and Structural Solutions

Pearl, Raymond

doi:10.1111/sipr.12043

Cited by 163 publications

(146 citation statements)

References 209 publications

(304 reference statements)

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“…These programs should be specifically aimed at the PT practitioners [13]. Furthermore, within PT/health care settings, regulations should be enforced [47] in order to create physical environments that are suitable for individuals with obesity. Such environments should include appropriately sized equipment and attire (e.g., beds, wheelchairs, appropriate gowns, etc.…”

Section: Discussionmentioning

confidence: 99%

Weight Stigmatization among Physical Therapy Students and Registered Physical Therapists

2020

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Introduction: Weight stigmatization is reflected in anti-fat attitudes and stereotypical perceptions of people who are overweight; it has been demonstrated to be prevalent in many segments of society across multiple countries. Studies examining the prevalence of weight stigmatization use different research tools, which can hinder inter-study comparisons. There is also evidence indicating weight stigmatization among registered physical therapists, although its magnitude differs between studies. Limited information exists regarding the attitudes and beliefs of physical therapy (PT) students toward individuals with obesity. Examining weight stigmatization among PT students is particularly important for developing appropriate educational interventions that may influence the professional lives of future physical therapists. Objective: This study aims to characterize and compare the stigmatizing attitudes and beliefs of PT students and certified physical therapists regarding people with obesity in Israel. Its secondary objective is to translate three weight stigmatization questionnaires into Hebrew and determine their psychometric properties. Methods: A cross-sectional, anonymous, and computerized self-report survey was completed by 285 certified physical therapists (average age 39.6 ± 10.1 years) and 115 PT students (average age 26.4 ± 4.9 years). The study used three validated weight stigma questionnaires employed in earlier studies to determine different aspects of weight stigmatization: the Fat Phobia Scale (short form; FPS), Anti-Fat Attitudes (AFA) questionnaire, and Beliefs about Obese People (BAOP). These questionnaires were translated into Hebrew and their psychometric properties ascertained. Results: Similar to the original English versions, the translated versions of the three question-naires demonstrated good internal consistency (Cronbach's α values of FPS = 0.77; AFA = 0.75; BOAP = 0.59). The three questionnaires showed a low correlation. No significant difference was noted in the FPS and AFA scores between groups, reflecting that both demonstrated average weight stigmatization (FBS in both groups: average score of 3.6 out of 5; AFA therapists: 3.3 ± 1.2, students: 3.0 ± 1.2 out of 9). However, significant between-group differences were observed for BOAP, which examines beliefs regarding individuals' control over their weight (therapists: 16.4 ± 5.6, students: 18.0 ± 5.7 out of 48; p < 0.01). Conclusion: Student and certified physical therapists demonstrate average levels of weight stigmatization, as reflected in the FPS and AFA scores. Nevertheless, compared to certified physical therapists, physical therapist students believe more strongly that obesity cannot be controlled by the individual. The students' beliefs could affect their clinical judgment and behavior as health care professionals in the future. Therefore, anti-fat attitudes and stereotypical perceptions should be addressed and remediated early using educational interventions during the study period.

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Section: Discussionmentioning

confidence: 99%

Weight Stigmatization among Physical Therapy Students and Registered Physical Therapists

2020

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“…Substantial research has demonstrated that weight stigma and discrimination are pervasive, global issues 7,8 . Weight stigma has been documented in multiple societal domains, including the workplace, education, healthcare settings, and within families 9,10 . Stigma has persisted despite the markedly increased prevalence of obesity in recent decades.…”

Section: Summary Of Evidencementioning

confidence: 99%

Joint international consensus statement for ending stigma of obesity

Rubino

Puhl

Cummings

et al. 2020

Nat Med

695

605

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People with obesity commonly face a pervasive, resilient form of social stigma. They are often subject to discrimination in the workplace as well as in educational and healthcare settings. Research indicates that weight stigma can cause physical and psychological harm, and that affected individuals are less likely to receive adequate care. For these reasons, weight stigma damages health, undermines human and social rights, and is unacceptable in modern societies. To inform healthcare professionals, policymakers, and the public about this issue, a multidisciplinary group of international experts, including representatives of scientific organizations, reviewed available evidence on the causes and harms of weight stigma and, using a modified Delphi process, developed a joint consensus statement with recommendations to eliminate weight bias. Academic institutions, professional organizations, media, public-health authorities, and governments should encourage education about weight stigma to facilitate a new public narrative about obesity, coherent with modern scientific knowledge.

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“…A large body of evidence suggests that people with obesity are highly stigmatized and experience high levels of discrimination (Pearl, ; Roehling, Roehling, & Wagstaff, ; Rudolph, Wells, Weller, & Baltes, ; Vanhove & Gordon,). The more excess weight a person carries, the greater the discrimination experienced (Roehling, Roehling, & Pichler, ).…”

Section: Introductionmentioning

confidence: 99%

Is obesity treated like a contagious disease?

Tapp

Oaten

Stevenson

et al. 2019

J Applied Social Pyschol

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The behavioral avoidance of people with obesity is well documented, but its psychological basis is poorly understood. Based upon a disease avoidance account of stigmatization, we tested whether a person with obesity triggers equivalent self‐reported emotional and avoidant‐based responses as a contagious disease (i.e., influenza). Two hundred and sixty‐four participants rated images depicting real disease signs (i.e., person with influenza), false alarms (i.e., person with obesity), person with facial bruising (i.e., negative control), and a healthy control for induced emotion and willingness for contact along increasing levels of physical proximity. Consistent with our prediction, as the prospect for contact became more intimate, self‐reported avoidance was equivalent in the influenza and obese target conditions, with both significantly exceeding reactions to the negative and healthy controls. In addition, participants reported greatest levels of disgust toward the obese and influenza target conditions. These results are consistent with an evolved predisposition to avoid individuals with disease signs. Implicit avoidance occurs even when participants know explicitly that such signs—here, obese body form—result from a noncontagious condition. Our findings provide important evidence for a disease avoidance explanation of the stigmatization of people with obesity.

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Weight Bias and Stigma: Public Health Implications and Structural Solutions

Cited by 163 publications

References 209 publications

Weight Stigmatization among Physical Therapy Students and Registered Physical Therapists

Weight Stigmatization among Physical Therapy Students and Registered Physical Therapists

Joint international consensus statement for ending stigma of obesity

Is obesity treated like a contagious disease?

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