1
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Kramer EB, Pietri ES, Bryan AD. Reducing anti-fat bias toward the self and others: a randomized controlled trial. J Eat Disord 2024; 12:46. [PMID: 38637889 PMCID: PMC11025213 DOI: 10.1186/s40337-024-00994-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 03/01/2024] [Indexed: 04/20/2024] Open
Abstract
Despite strong evidence linking anti-fat bias directed toward others with markers of self-directed anti-fat bias, there is a dearth of theory-based research examining the cognitive pathways underlying this relationship, and existing bias-reduction intervention efforts have thus far been conducted with exclusive focus on one domain or the other. Cognitive dissonance (CD)-based interventions have been identified as viable for reducing anti-fat bias directed toward the self and others. However, no study has yet examined whether the effects of these domain-specific interventions (e.g., anti-fat bias towards the self) extend to anti-fat bias in the non-targeted domain (e.g., anti-fat bias towards others). The present study aimed to address these gaps in the literature by comparing effects of brief CD-based interventions targeting anti-fat bias directed toward either the self or others on measures of anti-fat bias. Participants (N = 197, female-identifying undergraduates) were randomized to a writing activity prompting cognitive dissonance about either self-directed or other-directed anti-fat bias, or a bias-consistent control condition. Results indicated that participants in the CD intervention conditions showed significantly greater reductions in both explicit self- and other-directed anti-fat biases than those in the control condition, but results did not significantly differ across CD conditions. This supports the potential utility of interventions simultaneously targeting anti-fat bias in both domains and provides insight into the cognitive pathways underlying these related forms of bias.
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Affiliation(s)
- Emily B Kramer
- Department of Psychology and Neuroscience, University of Colorado Boulder, Muenzinger D244, 345 UCB, Boulder, CO, 80309-0345, USA.
| | - Evava S Pietri
- Department of Psychology and Neuroscience, University of Colorado Boulder, Muenzinger D244, 345 UCB, Boulder, CO, 80309-0345, USA
| | - Angela D Bryan
- Department of Psychology and Neuroscience, University of Colorado Boulder, Muenzinger D244, 345 UCB, Boulder, CO, 80309-0345, USA
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2
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Raffoul A, Andrade L, Acton RB, Lee KM, Burns KE, Godin KM, Hanning RM. Acceptability of an Online Module Addressing Weight Bias: Perspectives and Attitudes of Undergraduate Health Students and Instructors. CAN J DIET PRACT RES 2023; 84:43-48. [PMID: 36413414 DOI: 10.3148/cjdpr-2022-028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Weight bias and discrimination are highly pervasive and harmful to Canadians with higher weights. Researchers and practitioners who deliver, evaluate, and advise on dietary and weight-related interventions may inadvertently perpetuate weight bias through their work; however, trainees in these fields rarely have access to weight bias education within their applied health programs. This study evaluated the acceptability of an online educational weight bias module developed for undergraduate students enrolled in health courses. The intervention included a pre-recorded 20-minute online module with prompts for reflection or discussion, a self-assessment quiz, as well as a separate module and range of resources for instructors. Overall, 211 students from applied health courses and 4 instructors completed an online survey querying the module's delivery, impact, and relevance. Students agreed that the module provided useful information (82%), was easy to understand (97%), and was the right length (75%), but reported wanting more interactivity and engagement with the content. Instructors found the module engaging and useful and expressed interest in additional resources and support for weight bias education. Future research should explore the impact of weight bias education on students' weight-related attitudes and perceptions as well as feasibility and relevance of online features such as multimedia tools.
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Affiliation(s)
- Amanda Raffoul
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA.,Department of Pediatrics, Harvard Medical School, Boston, MA
| | - Lesley Andrade
- School of Public Health Sciences, University of Waterloo, Waterloo, ON
| | - Rachel B Acton
- School of Public Health Sciences, University of Waterloo, Waterloo, ON
| | - Kirsten M Lee
- School of Public Health Sciences, University of Waterloo, Waterloo, ON.,School of Global Health, York University, Toronto, ON
| | - Kathleen E Burns
- School of Public Health Sciences, University of Waterloo, Waterloo, ON
| | - Katelyn M Godin
- School of Public Health Sciences, University of Waterloo, Waterloo, ON
| | - Rhona M Hanning
- School of Public Health Sciences, University of Waterloo, Waterloo, ON
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3
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Ambwani S, Elder S, Sniezek R, Goeltz MT, Beccia A. Do media portrayals and social consensus information impact anti-fat attitudes and support for anti-weight discrimination laws and policies? Body Image 2021; 39:248-258. [PMID: 34655859 DOI: 10.1016/j.bodyim.2021.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 09/20/2021] [Accepted: 09/27/2021] [Indexed: 10/20/2022]
Abstract
Although weight stigma and discrimination are associated with increased body dissatisfaction and eating disorder risk, reduced opportunities, and poorer well-being, there are few legal protections for such discrimination in the U.S. We addressed one barrier to enacting protective legislation - public attitudes toward anti-weight discrimination laws - by assessing the impact of media representations of fatness and information about peer attitudes. Using a 2 × 2 experimental design, participants (N = 525) completed baseline assessments of political conservatism and weight bias and were randomly assigned to view fat-negative or fat-positive media content that was ostensibly supported or not supported by their peers, followed by questionnaires assessing fat phobia and legislative attitudes. Two-way ANCOVAs controlling for baseline weight bias and political conservatism indicated a significant effect for media framing, with greater fat phobia and less support for anti-discrimination laws and policies among those who viewed the fat-negative frame; however, effects for ostensible peer support and interaction effects were not significant. These preliminary findings suggest that efforts to shift media rhetoric may enhance support for anti-weight discrimination laws. Future research should investigate other barriers to anti-discrimination legislation and estimate their impact on body dissatisfaction, eating disorder risk, and other indicators of population health.
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Affiliation(s)
- Suman Ambwani
- Department of Psychology, Dickinson College, United States.
| | - Scott Elder
- Department of Psychology, Dickinson College, United States
| | | | | | - Ariel Beccia
- Clinical and Population Health Research Program, Graduate School of Biomedical Sciences, University of Massachusetts Medical School, United States; Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, United States
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4
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Meaney T, Rieger E. Integrating cognitive dissonance and social consensus to reduce weight stigma. Body Image 2021; 37:117-126. [PMID: 33647827 DOI: 10.1016/j.bodyim.2021.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 02/03/2021] [Accepted: 02/07/2021] [Indexed: 10/22/2022]
Abstract
Weight stigma is pervasive and has a range of deleterious effects. Among the most promising approaches for modifying this form of stigma are cognitive dissonance and social consensus. Due to their theoretical connection, this study tested the effects of an experimental manipulation of cognitive dissonance blended with social consensus for targeting weight stigma. It also added to research investigating the effects of cognitive dissonance on weight stigma by investigating a broader range of stigma measures. Participants were university students aged 18-35 years (N = 98) who were randomly allocated to one of four experimental conditions: blended cognitive dissonance, standard cognitive dissonance, blended control or standard control. Stigma measures included the perceived characteristics of, affective reactions towards, social avoidance of, and blameworthiness attributed to a higher-weight individual, and general weight stigma. Results showed that those in the cognitive dissonance conditions reported significantly lower weight stigma than those in the non-dissonance, control conditions. Moreover, those in the blended cognitive dissonance condition with higher in-group identification reported less negative affective reactions than those with lower in-group identification. The results provide consistent support for cognitive dissonance as an approach for reducing weight stigma and some additive support for an integrated cognitive dissonance and social consensus approach.
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Affiliation(s)
- Tomas Meaney
- Research School of Psychology, Australian National University, Canberra, Australia
| | - Elizabeth Rieger
- Research School of Psychology, Australian National University, Canberra, Australia.
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5
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Aniulis E, Sharp G, Thomas NA. The ever-changing ideal: The body you want depends on who else you're looking at. Body Image 2021; 36:218-229. [PMID: 33401202 DOI: 10.1016/j.bodyim.2020.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 12/06/2020] [Accepted: 12/06/2020] [Indexed: 01/26/2023]
Abstract
The body positivity movement-celebrating bodies beyond the thin ideal-has gained traction on social media. In an online study of North American women, we aimed to determine how ideal body perceptions shift based on the presentation of more diverse body types. In Study 1, women (n = 115, aged 19-75) responded to arrays of bodies ranging from primarily small to primarily large bodies, selecting the body closest to their ideal body. Results showed that the BMI of the ideal body increased as the body sizes in the array increased. Participants were also less likely to select an underweight ideal when viewing larger bodies. In Study 2, women responded to arrays with either primarily small (n = 132, aged 20-68) or primarily large (n = 130, aged 20-75) bodies. Results suggested that ideal body perceptions only shifted around current societal standards, and not to extremes. The participants presented with the larger-bodied arrays were more likely to select a normal weight ideal body than those who saw the smaller-bodied arrays. Results suggest ideal body size is malleable, and shifting toward a more diverse perception of the ideal body is achievable with increased exposure beyond the thin ideal.
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Affiliation(s)
- Ellie Aniulis
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia.
| | - Gemma Sharp
- Monash Alfred Psychiatry Research Centre, Monash University, Melbourne, Australia
| | - Nicole A Thomas
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
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6
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Breithaupt L, Trojanowski P, Fischer S. Implicit and Explicit Anti-Fat Attitude Change Following Brief Cognitive Dissonance Intervention for Weight Stigma. Obesity (Silver Spring) 2020; 28:1853-1859. [PMID: 32845087 DOI: 10.1002/oby.22909] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 04/27/2020] [Accepted: 05/11/2020] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Research has demonstrated that explicit anti-fat attitudes decrease immediately following a brief cognitive dissonance-based intervention targeting weight stigma. The current study explores changes in explicit and implicit anti-fat attitudes immediately following a cognitive dissonance-based weight stigma intervention and 1 week after. METHODS College students (N = 156) were randomly assigned to a control or dissonance weight stigma intervention. Weight stigma attitudes were assessed at three time points, and participants completed a measure of values at baseline. Participants in the dissonance condition were told that they had anti-fat attitudes that were inconsistent with their values, whereas participants in the control group were told that their attitudes aligned with their values. All participants reviewed feedback at a follow-up visit before completing explicit and implicit weight stigma assessments a final time. RESULTS Individuals in the dissonance condition reported statistically significant decreases in explicit attitudes from Visit 1 to Visit 3. In contrast, there was not a significant condition by time interaction on implicit attitudes. CONCLUSIONS This study provides support for cognitive dissonance-based interventions to reduce explicit, but not implicit, anti-fat attitudes following repeated exposure to dissonance induction.
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Affiliation(s)
- Lauren Breithaupt
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Paige Trojanowski
- Department of Psychology, George Mason University, Fairfax, Virginia, USA
| | - Sarah Fischer
- Department of Psychology, George Mason University, Fairfax, Virginia, USA
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7
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Appearance-focused media use as a moderator of the relationship between fear of fat and weight bias: an exploratory study. Eat Weight Disord 2020; 25:643-648. [PMID: 30859464 DOI: 10.1007/s40519-019-00666-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 03/01/2019] [Indexed: 10/27/2022] Open
Abstract
PURPOSE Previous research has found that fear of fat, or the fear of gaining weight, is fairly common within both normative and clinical populations. Similarly, weight bias, or biased attitudes directed at obese individuals, has been found across multiple segments of society. A common link shared between fear of fat and weight bias is the inherent emphasis on anti-fat feelings. Previous research has demonstrated an anti-fat bias within media content. Therefore, the purpose of the current research is to examine exposure to appearance-focused media as a moderator of the relationship between fear of fat and weight bias. METHODS One hundred and eighty-seven female participants (Mage = 21.05, MBMI = 22.60) were administered a battery of assessments, including the Goldfarb Fear of Fat Scale and the Universal Measure of Bias of Fat Scale. Participants were also asked to report their frequency of exposure to appearance-focused media (TV and magazines). RESULTS Results of this study suggest that appearance-focused media partially moderated the relationship between fear of fat and weight bias. CONCLUSIONS This suggests the messages portrayed by the media may be strengthening the relationship between fear of gaining weight and discrimination directed at obese individuals. Understanding this relationship has important implications for reducing weight stigma. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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8
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Wilson RE, Marshall RD, Murakami JM, Latner JD. Brief non-dieting intervention increases intuitive eating and reduces dieting intention, body image dissatisfaction, and anti-fat attitudes: A randomized controlled trial. Appetite 2020; 148:104556. [PMID: 31901439 DOI: 10.1016/j.appet.2019.104556] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 11/20/2019] [Accepted: 12/09/2019] [Indexed: 10/25/2022]
Abstract
This study developed and examined a brief dissonance-based non-dieting intervention designed to help college women reject unhealthy dieting behaviors, accept their bodies, and increase healthy eating. Participants included 94 female university students (mean age = 20.6 years; mean BMI = 23.8 kg/m2), randomly assigned either to the non-dieting intervention condition or a brochure control condition. The intervention consisted of two 90-120 min interactive group sessions designed to engender the rejection of dieting, increase body acceptance, and develop healthy eating skills. Assessment measures were collected at baseline, post-treatment, and one-month follow-up. The group sessions produced significant improvements in the intervention group compared to the control group on measures of dieting intention, intuitive eating, body image dissatisfaction, eating concerns, and anti-fat attitudes. These effects were sustained at one-month follow-up. There were also overall improvements over time in dietary intake and mental health-related quality of life across conditions. This study extends the research on non-dieting approaches by using a brief, dissonance-based structure and by applying the intervention to a young adult sample that included participants of normal weight. The findings here indicate that a non-dieting approach is acceptable and feasible, and can result in improvements in eating and weight-related behaviors, in young adult women.
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Affiliation(s)
- Rebecca E Wilson
- Department of Preventive Medicine, Rush University, 1700 W. Van Buren St., Suite 470, Chicago, IL, 60612, USA
| | - Rachel D Marshall
- Department of Psychology, University of Hawai'i at Mānoa, 2500 Campus Road, Honolulu, HI, 96822, USA.
| | - Jessica M Murakami
- VA Pacific Islands Healthcare System, 459 Patterson Road, Honolulu, HI, 96819, USA
| | - Janet D Latner
- Department of Psychology, University of Hawai'i at Mānoa, 2500 Campus Road, Honolulu, HI, 96822, USA
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9
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Irmansyah I, Susanti H, James K, Lovell K, Idaiani S, Imah S, Hargiana G, Keliat BA, Utomo B, Colucci E, Brooks H. Civic engagement and mental health system strengthening in Indonesia: a qualitative examination of the views of health professionals and national key stakeholders. BMC Psychiatry 2020; 20:172. [PMID: 32295558 PMCID: PMC7161291 DOI: 10.1186/s12888-020-02575-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 03/30/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Mental health services in Indonesia are developing rapidly in response to national and global health policy to support people living with psychosis. This presents a unique opportunity for civic engagement, the active involvement of patients, carers and communities in mental health care, to shape emergent services. In-depth explorations of the views of professionals and other key stakeholders in mental health care on the use of civic engagement in Indonesia are lacking which contributes to a limited understanding of its potential in this regard. The study aimed to explore contemporary professionals' and other key stakeholders' perspectives on the current use of and potential for civic engagement to strengthen mental health systems in Indonesia. METHODS Qualitative interviews were undertaken and analysed using thematic analysis underpinned by a critical realist approach. Eighteen multi-disciplinary professionals and lay health workers involved in mental health care in Jakarta and Bogor and 10 national key stakeholders were recruited. RESULTS Despite high levels of awareness of and support for civic engagement amongst mental health professionals and policy makers combined with a nascent grass roots movement, analysis revealed unstructured and insufficient mechanisms for civic engagement which resulted in ad-hoc and mostly superficial levels of involvement activity. Civic engagement was thought to require a marked shift in existing practices as well as organisational and societal cultures. Challenging stigma is a key feature of civic engagement and our analysis highlights the relevance of social contact methods which are locally and culturally contextualised in this regard. Our findings point to a need to expand current definitions of civic engagement which focus on indivdiual enablement to ones that also encompass environmental and organisational enablement to optimise the future use of civic engagement in mental health settings. CONCLUSIONS Key mental health stakeholders have identified that central aspects of Indonesian culture are well aligned to the ethos of civic engagement which has the potential to facilitate the enactment of recent global health policy. However, full realisation is likely to be impeded by prevailing paternalistic cultures in mental health services and high levels of stigma and discrimination towards those with mental illness in Indonesia without intervention.
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Affiliation(s)
- Irman Irmansyah
- National Institute of Health Research and Development, Jakarta, Indonesia.,Marzoeki Mahdi Hospital, Bogor, Indonesia
| | - Herni Susanti
- Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Karen James
- Centre for Health and Social Care Research, Faculty of Health, Social Care and Education, Kingston and St Georges, London, UK
| | - Karina Lovell
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Sri Idaiani
- National Institute of Health Research and Development, Jakarta, Indonesia
| | - Soimah Imah
- National Institute of Health Research and Development, Jakarta, Indonesia
| | - Giur Hargiana
- Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | | | | | | | - Helen Brooks
- Department of Health Services Research, Institute of Population Health Sciences, University of Liverpool, Room B112, Waterhouse Building Block B, Liverpool, UK.
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10
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Pearl RL, Wadden TA, Bach C, Gruber K, Leonard S, Walsh OA, Tronieri JS, Berkowitz RI. Effects of a cognitive-behavioral intervention targeting weight stigma: A randomized controlled trial. J Consult Clin Psychol 2020; 88:470-480. [PMID: 31971410 DOI: 10.1037/ccp0000480] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To test the effects of a cognitive-behavioral intervention for weight bias internalization (WBI; i.e., self-stigma) combined with behavioral weight loss (BWL). METHOD Adults with obesity and elevated WBI were randomly assigned to BWL alone or combined with the Weight Bias Internalization and Stigma Program (BWL + BIAS). Participants attended weekly group meetings for 12 weeks, followed by 2 biweekly and 2 monthly meetings (26 weeks total). Changes at Week 12 on the Weight Bias Internalization Scale (WBIS) and Weight Self-Stigma Questionnaire (WSSQ) were the principal outcomes, with changes at Week 26 assessed as secondary outcomes. Other outcomes included changes in mood, body image, eating behaviors, self-monitoring, and weight. RESULTS Seventy-two participants were randomized (84.7% female, 66.7% Black, mean age = 47.1 ± 11.5 years) Linear mixed models showed no significant differences between the BWL + BIAS and BWL groups in WBIS changes at Week 12 (-1.3 ± 0.2 vs. -1.0 ± 0.2) or week 26 (-1.5 ± 0.2 vs. -1.3 ± 0.2). BWL + BIAS participants had greater reductions in WSSQ total scores at Week 12 (p = .03), with greater changes on the self-devaluation subscale at Weeks 12 and 26 (p ≤ .03). BWL + BIAS participants reported significantly greater benefits on measures of eating and self-monitoring. Percent weight loss at Week 26 did not differ significantly between groups (BWL + BIAS = -4.5 ± 1.0%, BWL = -5.9 ± 1.0%, p = .28). CONCLUSION A psychological intervention for WBI produced short-term reductions in some aspects of weight self-stigma in persons with obesity. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Rebecca L Pearl
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania
| | - Thomas A Wadden
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania
| | - Caroline Bach
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania
| | - Kathryn Gruber
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania
| | - Sharon Leonard
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania
| | - Olivia A Walsh
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania
| | - Jena S Tronieri
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania
| | - Robert I Berkowitz
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania
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11
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Wylie TAF, Shah C, Connor R, Farmer AJ, Ismail K, Millar B, Morris A, Reynolds RM, Robertson E, Swindell R, Warren E, Holt RIG. Transforming mental well-being for people with diabetes: research recommendations from Diabetes UK's 2019 Diabetes and Mental Well-Being Workshop. Diabet Med 2019; 36:1532-1538. [PMID: 31177573 PMCID: PMC6899580 DOI: 10.1111/dme.14048] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/06/2019] [Indexed: 12/23/2022]
Abstract
AIMS To identify key gaps in the research evidence base that could help to improve the mental well-being of people with diabetes, and to provide recommendations to researchers and research funders on how best to address them. METHODS A 2-day international research workshop was conducted, bringing together research experts in diabetes and in mental health, people living with diabetes and healthcare professionals. RESULTS The following key areas needing increased financial investment in research were identified: understanding the mechanisms underlying depression; understanding the multifactorial impact of social stigma; improving the language used by healthcare professionals; supporting people who find it difficult to engage with their diabetes; supporting significant others; supporting people with diabetes and eating disorders; improving models of care by learning from best practice; the potential benefits of screening and managing diabetes distress in routine diabetes care pathways; primary prevention of mental health issues at the time of diagnosis of diabetes; establishing the effectiveness of diabetes therapies on mood and other mental health issues; and understanding the impact of current diabetes technologies on mental health. Research recommendations as to how to address each of these priority areas were also developed. CONCLUSIONS This inaugural position statement outlines recommendations to address the urgent unmet need related to the mental well-being of people living with diabetes, and calls on the research community and funders to develop research programmes and strategies to reduce this need.
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Affiliation(s)
- T. A. F. Wylie
- Diabetes UKWells Lawrence House, 126 Back Church LaneLondonUK
| | - C. Shah
- Diabetes UKWells Lawrence House, 126 Back Church LaneLondonUK
| | | | - A. J. Farmer
- Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordUK
| | - K. Ismail
- Department of Psychological MedicineInstitute of Psychiatry, Psychology and NeurosciencesKing's College LondonLondonUK
| | - B. Millar
- Diabetes UK Clinical Studies Group MemberUniversity of EdinburghEdinburghUK
| | - A. Morris
- Diabetes UKWells Lawrence House, 126 Back Church LaneLondonUK
| | - R. M. Reynolds
- Centre for Cardiovascular ScienceQueen's Medical Research InstituteUniversity of EdinburghEdinburghUK
| | - E. Robertson
- Diabetes UKWells Lawrence House, 126 Back Church LaneLondonUK
| | - R. Swindell
- Diabetes UK Clinical Studies Group MemberUniversity of EdinburghEdinburghUK
| | - E. Warren
- Diabetes UK Clinical Studies Group MemberUniversity of EdinburghEdinburghUK
| | - R. I. G. Holt
- Human Development and Health, Faculty of MedicineUniversity of SouthamptonUK
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12
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Lin S, Stutts LA. Impact of exposure to counterstereotypic causality of obesity on beliefs about weight controllability and obesity bias. PSYCHOL HEALTH MED 2019; 25:730-741. [PMID: 31397587 DOI: 10.1080/13548506.2019.1653484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Individuals with obesity often report experiencing prejudice and discrimination due to their weight. Past research on obesity bias reduction strategies have yielded mixed results. The present study investigated the effectiveness of manipulating information about weight controllability in reducing obesity bias. Participants (N = 350) were randomly assigned into one of three conditions: counterstereotypic, stereotypic, or control. Each condition consisted of four short vignettes. The counterstereotypic condition provided an uncontrollable explanation of obesity (e.g., genetics) in each vignette describing a person with obesity, while the stereotypic condition emphasized lifestyle choices as the main cause of obesity. The control condition included a vignette in which weight was not addressed. Participants completed questionnaires about weight controllability and obesity bias pre- and post-exposure. There was a significant interaction between time and condition on beliefs about weight controllability and obesity bias. Participants in the counterstereotypic condition increased in belief about the uncontrollability of weight and decreased in obesity bias, while participants in the stereotypic condition decreased in belief about the uncontrollability of weight and increased in obesity bias. Obesity bias reduction strategies that utilize information about weight controllability can be effective. However, perpetuating stereotypic causes of obesity can worsen the problem.
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Affiliation(s)
- Sara Lin
- Health and Human Values Department, Davidson College , Davidson, NC, USA
| | - Lauren A Stutts
- Health and Human Values Department, Davidson College , Davidson, NC, USA
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13
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Cassone S, Rieger E, Crisp DA. Reducing anorexia nervosa stigma: an exploration of a social consensus intervention and the moderating effect of blameworthy attributions. J Ment Health 2019; 29:506-512. [PMID: 30862256 DOI: 10.1080/09638237.2019.1581326] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background: Research suggests that blameworthy attributions towards individuals with anorexia nervosa are common, which in turn elicit more stigmatising attitudes towards those with the disorder. The social consensus approach has been found to reduce stigmatising attitudes in various domains and, as such, is a promising avenue to pursue for ameliorating stigma in anorexia nervosa.Aims: The present study primarily sought to investigate the effectiveness of a social consensus approach in reducing stigma towards individuals with anorexia nervosa. The study also examined if blameworthy attributions were associated with change in stigma.Method: An experimental design was employed, where female undergraduate students (N= 126) completed self-report measures that assessed anorexia nervosa stigma at baseline (Time 1) and 6-10 days after allocation to one of two conditions: social consensus and control (Time 2).Results: The social consensus intervention was more effective than the control condition in reducing stigmatising attitudes on measures assessing affective reactions (p= 0.025) and characteristics attributed to a target with anorexia nervosa (p < 0.001). Level of blame-based attributions did not moderate change in stigma.Conclusions: Results suggest that a social consensus intervention is promising irrespective of the endorsement of blameworthy attributions.
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Affiliation(s)
- Sarah Cassone
- Research School of Psychology, Australian National University, Canberra, Australia
| | - Elizabeth Rieger
- Research School of Psychology, Australian National University, Canberra, Australia
| | - Dimity A Crisp
- Faculty of Health, Centre for Applied Psychology, University of Canberra, Canberra, Australia
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Tamul DJ, Hotter JC. Exploring Mechanisms of Narrative Persuasion in a News Context: The Role of Narrative Structure, Perceived Similarity, Stigma, and Affect in Changing Attitudes. COLLABRA: PSYCHOLOGY 2019. [DOI: 10.1525/collabra.172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Two exploratory studies demonstrate, for the first time, that narrative persuasion can diminish the stigma attached to social groups featured in journalistic narratives. Study 1 shows narrative format improves stigma toward Syrian refugees indirectly through narrative engagement, perceived similarity, and meaningful affect. Decreases in stigma also improved attitudes toward refugees. Study 2 replicates these findings against a separate participant pool, an additional story topic, and compares changes in engagement, stigma, and attitude to a non-narrative fact sheet and a control condition. A preregistered third study seeks to validate the finding that narratives can elicit destigmatization and disentangle the roles of story exemplars from story structure.
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Affiliation(s)
- Daniel J. Tamul
- Department of Communication, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, US
| | - Jessica C. Hotter
- Department of Communication, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, US
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15
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Pötzsch A, Rudolph A, Schmidt R, Hilbert A. Two sides of weight bias in adolescent binge-eating disorder: Adolescents' perceptions and maternal attitudes. Int J Eat Disord 2018; 51:1339-1345. [PMID: 30584662 DOI: 10.1002/eat.22982] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 10/26/2018] [Accepted: 10/27/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Adolescents with binge-eating disorder (BED) are suffering from weight teasing and, as found in adult BED, are likely to internalize weight bias. Weight teasing by mothers accounts for psychopathology in overweight (OW), but stigmatization sources are largely unknown in BED. This study sought to address weight bias in adolescents with OW and BED by examining adolescents' perceived parental weight teasing and weight bias internalization in relation to their eating disorder psychopathology and maternal stigmatizing attitudes and beliefs. METHOD Adolescents with OW and BED (BED; n = 40) were compared to a socio-demographically matched group with OW only and a normal-weight control group (NW; each n = 25). They filled out the Perception of Teasing Scale, with parents as the source of teasing, the Weight Bias Internalization Scale and the Eating Disorder Examination-Questionnaire. Their mothers filled out the Attitudes Toward and Beliefs about Obese Persons Scales. RESULTS Significantly higher perceived parental weight teasing and weight bias internalization were found in BED compared to OW and NW. Maternal stigmatizing attitudes and beliefs did not differ significantly between groups and were not correlated with adolescents' perceptions of being stigmatized. Perceived parental weight teasing was associated with adolescents' eating disorder psychopathology, however, this association was fully mediated by weight bias internalization. DISCUSSION Results indicate that adolescents with OW and BED perceive weight teasing in families. As we found no significant association between adolescents' perceptions of being stigmatized and maternal stigmatizing attitudes, future research should examine parent-child interaction or implicit measures of stigmatizing attitudes.
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Affiliation(s)
- Anne Pötzsch
- Departments of Medical Psychology and Medical Sociology and Psychosomatic Medicine and Psychotherapy, Leipzig University Medical Center, Integrated Research and Treatment Center Adiposity Diseases, Leipzig, Germany
| | - Almut Rudolph
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Ricarda Schmidt
- Departments of Medical Psychology and Medical Sociology and Psychosomatic Medicine and Psychotherapy, Leipzig University Medical Center, Integrated Research and Treatment Center Adiposity Diseases, Leipzig, Germany
| | - Anja Hilbert
- Departments of Medical Psychology and Medical Sociology and Psychosomatic Medicine and Psychotherapy, Leipzig University Medical Center, Integrated Research and Treatment Center Adiposity Diseases, Leipzig, Germany
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Yan Y, Rieger E, Shou Y. Reducing the stigma associated with anorexia nervosa: An evaluation of a social consensus intervention among Australian and Chinese young women. Int J Eat Disord 2018; 51:62-70. [PMID: 29197118 DOI: 10.1002/eat.22808] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 11/13/2017] [Accepted: 11/18/2017] [Indexed: 12/29/2022]
Abstract
OBJECTIVE This study examined the effectiveness of a social consensus intervention in reducing stigma toward individuals with anorexia nervosa (AN) among women from Australia and mainland China. Moreover, the different predictions of informational/normative social influence theory and the social identity approach in terms of the effectiveness of the social consensus intervention were investigated. METHOD Participants were female students from the Australian National University (n = 97) and Central China Normal University (n = 76) who reported their levels of stigma toward a fictional character with AN before and after receiving normative information regarding the attitudes of others toward people with AN. Three experimental conditions of normative information were utilized: in-group, out-group, and neutral. RESULTS Chinese participants reported higher levels of baseline stigma across all measures than Australian participants. Social consensus was effective in reducing most types of AN stigma, and supported the social identity approach in that improvements in attitudinal, affective, and behavioral aspects of stigma were significantly greater for participants in the in-group (but not the out-group) versus the neutral condition. The effectiveness of the social consensus approach was not moderated by nationality. DISCUSSION A social consensus approach holds potential as an additional strategy for reducing AN stigma, with its benefits extending across diverse cultural settings. Such an approach would entail ensuring that positive messages regarding people with AN are delivered by members of a valued in-group.
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Affiliation(s)
- Yuwen Yan
- Research School of Psychology, Australian National University, Canberra, Australia
| | - Elizabeth Rieger
- Research School of Psychology, Australian National University, Canberra, Australia
| | - Yiyun Shou
- Research School of Psychology, Australian National University, Canberra, Australia
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17
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Puhl RM, Himmelstein MS, Gorin AA, Suh YJ. Missing the target: including perspectives of women with overweight and obesity to inform stigma-reduction strategies. Obes Sci Pract 2017; 3:25-35. [PMID: 28392929 PMCID: PMC5358077 DOI: 10.1002/osp4.101] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 01/12/2017] [Accepted: 01/13/2017] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE Pervasive weight stigma and discrimination have led to ongoing calls for efforts to reduce this bias. Despite increasing research on stigma-reduction strategies, perspectives of individuals who have experienced weight stigma have rarely been included to inform this research. The present study conducted a systematic examination of women with high body weight to assess their perspectives about a broad range of strategies to reduce weight-based stigma. METHODS Women with overweight or obesity (N = 461) completed an online survey in which they evaluated the importance, feasibility and potential impact of 35 stigma-reduction strategies in diverse settings. Participants (91.5% who reported experiencing weight stigma) also completed self-report measures assessing experienced and internalized weight stigma. RESULTS Most participants assigned high importance to all stigma-reduction strategies, with school-based and healthcare approaches accruing the highest ratings. Adding weight stigma to existing anti-harassment workplace training was rated as the most impactful and feasible strategy. The family environment was viewed as an important intervention target, regardless of participants' experienced or internalized stigma. CONCLUSION These findings underscore the importance of including people with stigmatized identities in stigma-reduction research; their insights provide a necessary and valuable contribution that can inform ways to reduce weight-based inequities and prioritize such efforts.
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Affiliation(s)
- R M Puhl
- Department of Human Development & Family Studies; Rudd Center for Food Policy & Obesity University of Connecticut Hartford CT USA
| | - M S Himmelstein
- Rudd Center for Food Policy & Obesity University of Connecticut Hartford CT USA
| | - A A Gorin
- Department of Psychological Sciences University of Connecticut Storrs CT USA
| | - Y J Suh
- University of Massachusetts Medical School Worcester MA USA
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18
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Alberga AS, Pickering BJ, Alix Hayden K, Ball GDC, Edwards A, Jelinski S, Nutter S, Oddie S, Sharma AM, Russell-Mayhew S. Weight bias reduction in health professionals: a systematic review. Clin Obes 2016; 6:175-88. [PMID: 27166133 DOI: 10.1111/cob.12147] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 03/07/2016] [Accepted: 04/05/2016] [Indexed: 12/26/2022]
Abstract
Innovative and coordinated strategies to address weight bias among health professionals are urgently needed. We conducted a systematic literature review of empirical peer-reviewed published studies to assess the impact of interventions designed to reduce weight bias in students or professionals in a health-related field. Combination sets of keywords based on three themes (1: weight bias/stigma; 2: obesity/overweight; 3: health professional) were searched within nine databases. Our search yielded 1447 individual records, of which 17 intervention studies satisfied the inclusion criteria. Most studies (n = 15) included medical, dietetic, health promotion, psychology and kinesiology students, while the minority included practicing health professionals (n = 2). Studies utilized various bias-reduction strategies. Many studies had methodological weaknesses, including short assessment periods, lack of randomization, lack of control group and small sample sizes. Although many studies reported changes in health professionals' beliefs and knowledge about obesity aetiology, evidence of effectiveness is poor, and long-term effects of intervention strategies on weight bias reduction remain unknown. The findings highlight the lack of experimental research to reduce weight bias among health professionals. Although changes in practice will likely require multiple strategies in various sectors, well-designed trials are needed to test the impact of interventions to decrease weight bias in healthcare settings.
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Affiliation(s)
- A S Alberga
- Werklund School of Education, University of Calgary, Calgary, AB, Canada
| | - B J Pickering
- Werklund School of Education, University of Calgary, Calgary, AB, Canada
| | - K Alix Hayden
- Libraries and Cultural Resources, University of Calgary, Calgary, AB, Canada
| | - G D C Ball
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - A Edwards
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - S Jelinski
- Emergency Strategic Clinical Network, Alberta Health Services, Edmonton, AB, Canada
- Department of Emergency Medicine, University of Alberta, Edmonton, AB, Canada
| | - S Nutter
- Werklund School of Education, University of Calgary, Calgary, AB, Canada
| | - S Oddie
- Applied Research and Evaluation Services, Primary Health Care, Alberta Health Services, Edmonton, AB, Canada
| | - A M Sharma
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - S Russell-Mayhew
- Werklund School of Education, University of Calgary, Calgary, AB, Canada
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Purvis CK, Jones M, Bailey JO, Bailenson J, Taylor CB. Developing a Novel Measure of Body Satisfaction Using Virtual Reality. PLoS One 2015; 10:e0140158. [PMID: 26469860 PMCID: PMC4607468 DOI: 10.1371/journal.pone.0140158] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 09/22/2015] [Indexed: 12/05/2022] Open
Abstract
Body image disturbance (BID), considered a key feature in eating disorders, is a pervasive issue among young women. Accurate assessment of BID is critical, but the field is currently limited to self-report assessment methods. In the present study, we build upon existing research, and explore the utility of virtual reality (VR) to elicit and detect changes in BID across various immersive virtual environments. College-aged women with elevated weight and shape concerns (n = 38) and a non-weight and shape concerned control group (n = 40) were randomly exposed to four distinct virtual environments with high or low levels of body salience and social presence (i.e., presence of virtual others). Participants interacted with avatars of thin, normal weight, and overweight body size (BMI of approximately 18, 22, and 27 respectively) in virtual social settings (i.e., beach, party). We measured state-level body satisfaction (state BD) immediately after exposure to each environment. In addition, we measured participants' minimum interpersonal distance, visual attention, and approach preference toward avatars of each size. Women with higher baseline BID reported significantly higher state BD in all settings compared to controls. Both groups reported significantly higher state BD in a beach with avatars as compared to other environments. In addition, women with elevated BID approached closer to normal weight avatars and looked longer at thin avatars compared to women in the control group. Our findings indicate that VR may serve as a novel tool for measuring state-level BID, with applications for measuring treatment outcomes. Implications for future research and clinical interventions are discussed.
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Affiliation(s)
- Clare K. Purvis
- PGSP-Stanford Consortium, Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, California, United States of America
| | - Megan Jones
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, California, United States of America
| | - Jakki O. Bailey
- Department of Communication, Stanford University, Stanford, California, United States of America
| | - Jeremy Bailenson
- Department of Communication, Stanford University, Stanford, California, United States of America
| | - C. Barr Taylor
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, California, United States of America
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Star A, Hay P, Quirk F, Mond J. Perceived discrimination and favourable regard toward underweight, normal weight and obese eating disorder sufferers: implications for obesity and eating disorder population health campaigns. BMC OBESITY 2015. [PMID: 26217519 PMCID: PMC4511013 DOI: 10.1186/s40608-014-0032-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background Obesity stigma has been shown to increase binge eating, whilst positive regard for eating disorders (EDs) may increase dietary restriction which can also lead to binge eating and weight gain. In the context of increasing prevalence of both obesity and EDs exploring community attitudes towards these illnesses may uncover new variables worthy of consideration in population health campaigns. The aim of the study was to explore community perceived stigma and conversely favourable regard toward eating disorder (ED) sufferers of varying weight status, and understand how the attitudes of obese individuals may differ from those of non-obese individuals. Data for this purpose were derived from interviews with individuals participating in a general population health survey. Vignettes of an underweight female with Anorexia Nervosa (AN), a normal weight male with an atypical eating disorder (NWED) and an obese female with Binge Eating Disorder (BED) were presented to three randomly selected sub-samples of n = 983, 1033 and 1030 respectively. Questions followed that assessed participants’ attitudes towards and beliefs about the person described in the vignette and their eating behaviours. Results Sixty-six per cent of participants who responded to the obese BED vignette believed that there would be discrimination against the person described (primarily because of her weight). Corresponding figures were for the AN and NWED vignettes were 48% and 35%, respectively. A positive regard for weight-loss or body-image-enhancing ED behaviours was reported ‘occasionally’ or more often by 8.8% of respondents to the AN vignette and by 27.5% of respondents to the NWED vignette. Positive regard for ED behaviours was significantly more likely in obese participants (AN: 15%; NWED: 43%). Conclusion The findings support integrated ED and obesity prevention programs that address weight stigma and the social desirability of ED behaviours in vulnerable individuals.
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Affiliation(s)
- Anita Star
- Private Practice, Albury, 2640 New South Wales Australia ; School of Medicine and Dentistry, James Cook University, Townsville, Queensland 4811 Australia
| | - Phillipa Hay
- School of Medicine and Dentistry, James Cook University, Townsville, Queensland 4811 Australia ; School of Medicine, University of Western Sydney, Locked bag 1797, Penrith, New South Wales 2751 Australia
| | - Frances Quirk
- School of Medicine and Dentistry, James Cook University, Townsville, Queensland 4811 Australia ; School of Medicine, Deakin University, Melbourne, 3125 Victoria Australia ; Research Directorate, Barwon Health, Geelong, 3220 Victoria Australia
| | - Jonathan Mond
- School of Medicine, University of Western Sydney, Locked bag 1797, Penrith, New South Wales 2751 Australia ; Department of Psychology, Macquarie University, Sydney, New South Wales 2129 Australia
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21
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Ruggs EN, Hebl MR, Law C, Cox CB, Roehling MV, Wiener RL. Gone Fishing: I–O Psychologists' Missed Opportunities to Understand Marginalized Employees' Experiences With Discrimination. INDUSTRIAL AND ORGANIZATIONAL PSYCHOLOGY-PERSPECTIVES ON SCIENCE AND PRACTICE 2015. [DOI: 10.1111/iops.12007] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This article focuses attention on research examining workplace discrimination against employees from marginalized groups. We particularly consider the experiences of seven different groups of marginalized individuals, some of which have legal protection and some of which do not but all of whom we feel have been overlooked by the field of industrial–organizational (I–O) psychology. We briefly describe the importance of studying each group and then delineate the brief amount of research that has been conducted. Finally, we make recommendations for I–O psychologists in terms of research and advocacy. Overall, we argue that I–O psychologists are missing an opportunity to be at the forefront of understanding and instigating changes that would result in maximizing the fairness and optimization of these often forgotten employees and their experiences in the workplace.
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Lee M, Ata RN, Brannick MT. Malleability of weight-biased attitudes and beliefs: a meta-analysis of weight bias reduction interventions. Body Image 2014; 11:251-9. [PMID: 24958660 DOI: 10.1016/j.bodyim.2014.03.003] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 02/24/2014] [Accepted: 03/13/2014] [Indexed: 11/16/2022]
Abstract
Weight bias exists across many important life domains, necessitating interventions designed to reduce weight-biased attitudes and beliefs. Though the effectiveness of weight bias interventions has been questioned, to our knowledge no meta-analysis of these interventions has been conducted. This meta-analysis evaluated the impact of weight bias interventions on weight-biased attitudes and beliefs and explored potential moderators. Interventions were eligible if they used an adult sample and a validated measure of weight-biased attitudes, which resulted in the inclusion of 30 studies represented in 29 articles. A random effects approach using inverse weights resulted in a mean effect size estimate of g=-0.33 (lower scores indicate less weight bias) for both attitudes and beliefs. Intervention type, publication type, and population type were not significant moderators but demonstrated noteworthy trends. Results reveal a small, positive effect of weight bias interventions on weight-biased attitudes and beliefs and provide useful information for future interventions.
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Affiliation(s)
- Morgan Lee
- Department of Psychology, University of South Florida, Tampa, FL, United States.
| | - Rheanna N Ata
- Department of Psychology, University of South Florida, Tampa, FL, United States.
| | - Michael T Brannick
- Department of Psychology, University of South Florida, Tampa, FL, United States.
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Cook JE, Purdie-Vaughns V, Meyer IH, Busch JT. Intervening within and across levels: A multilevel approach to stigma and public health. Soc Sci Med 2014; 103:101-109. [DOI: 10.1016/j.socscimed.2013.09.023] [Citation(s) in RCA: 180] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Revised: 06/28/2013] [Accepted: 09/24/2013] [Indexed: 10/26/2022]
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Radice R, Zanin L, Marra G. On the effect of obesity on employment in the presence of observed and unobserved confounding. STAT NEERL 2013. [DOI: 10.1111/stan.12016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Rosalba Radice
- Department of Economics, Mathematics and Statistics; Birkbeck, University of London; London UK
| | | | - Giampiero Marra
- Department of Statistical Science; University College London; London UK
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25
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Hudson E, McGloin A, McConnon A. Parental weight (mis)perceptions: factors influencing parents' ability to correctly categorise their child's weight status. Matern Child Health J 2013; 16:1801-9. [PMID: 22139047 DOI: 10.1007/s10995-011-0927-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
This study investigates parents' ability to correctly classify their child's weight status. The influence of parent and child socio-demographic and lifestyle factors on parental misclassification of their child's weight status is explored. A representative sample of Irish children (aged 5-12 (n = 596) years, aged 13-17 years (n = 441)) and their parents (n = 1885) were recruited to participate in a national dietary survey. Parental perceptions of their child's weight and their own weight were measured. Anthropometric measurements (weight and height) were objectively measured for parents and children. Body Mass Index (BMI) scores were derived and categorised as normal, overweight or obese using standard references. Over 80% of parents of overweight boys and 79.3% of parents of overweight girls reported their child's weight was fine for his/her height and age. Furthermore, 44.4% of parents of obese boys and 45.3% of parents of obese girls felt their child's weight was fine for their height and age. Parents were significantly less likely to be correct about their sons' weight status and more likely to be correct the older the child. Parents were over 86% less likely to be correct about their child's weight if their child was overweight and approximately 59% less likely to be correct if the child was obese, compared to parents of normal weight children. This research suggests that parents are failing to recognise overweight and obesity in their children with factors such as parental weight status, child's age and gender influencing this.
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Affiliation(s)
- Eibhlin Hudson
- School of Economics, Finance and Marketing, RMIT University, Melbourne, Australia
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26
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Abstract
Considerable attention has been given to the behaviors that need to be changed in individuals who are overweight and obese. Much less attention has been given to the behaviors that need to be changed in health care professionals who treat these individuals. Specifically, health care professionals, similar to the general population, have been shown to engage in weight-based discrimination. The impact this may have on patients is discussed.
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Affiliation(s)
- Craig A. Johnston
- Department of Pediatrics-Nutrition, Baylor College of Medicine, Houston, Texas
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27
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Allen PJ, Batra P, Geiger BM, Wommack T, Gilhooly C, Pothos EN. Rationale and consequences of reclassifying obesity as an addictive disorder: neurobiology, food environment and social policy perspectives. Physiol Behav 2012; 107:126-37. [PMID: 22583861 DOI: 10.1016/j.physbeh.2012.05.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Revised: 04/02/2012] [Accepted: 05/06/2012] [Indexed: 01/13/2023]
Abstract
The rapid increase in the prevalence of obesity is a priority for investigators from across numerous disciplines, including biology, nutritional science, and public health and policy. In this paper, we systematically examine the premise that common dietary obesity is an addictive disorder, based on the criteria for addiction described in the Diagnostic and Statistical Manual (DSM) of Mental Disorders of the American Psychiatric Association, version IV, and consider the consequences of such a reclassification of obesity for public policy. Specifically, we discuss evidence from both human and animal studies investigating the effects of various types and amounts of food and the food environment in obese individuals. Neurobiological studies have shown that the hedonic brain pathways activated by palatable food overlap considerably with those activated by drugs of abuse and suffer significant deficits after chronic exposure to high-energy diets. Furthermore, food as a stimulus can induce the sensitization, compulsion and relapse patterns observed in individuals who are addicted to illicit drugs. The current food environment encourages these addictive-like behaviors where increased exposure through advertisements, proximity and increased portion sizes are routine. Taking lessons from the tobacco experience, it is clear that reclassifying common dietary obesity as an addictive disorder would necessitate policy changes (e.g., regulatory efforts, economic strategies, and educational approaches). These policies could be instrumental in addressing the obesity epidemic, by encouraging the food industry and the political leadership to collaborate with the scientific and medical community in establishing new and more effective therapeutic approaches.
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Affiliation(s)
- Patricia J Allen
- Department of Psychology, Tufts University, Medford, MA 02155, USA
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Abstract
Prejudice against those who are perceived as 'fat' or obese (anti-fat prejudice) is rife, increasing, and associated with negative outcomes for those targeted for such treatment. The present review sought to identify and describe published research on interventions to reduce anti-fat prejudice. A systematic search of relevant databases (e.g. PsychInfo, PubMed, Scopus) found 16 published studies that had sought to reduce anti-fat prejudice. Most notable was the lack of research on interventions for reducing anti-fat prejudice. Methodological problems that limit the interpretability of results were identified in the majority of studies found. Interventions employing more rigorous experimental designs provided at best mixed evidence for effectiveness. Although several studies reported changes in beliefs and knowledge about the causes of obesity, reductions in anti-fat prejudice did not typically accompany these changes. Anti-fat prejudice interventions adopting social norm- and social consensus-based approaches appear encouraging but are scarce. The lack of prejudice reduction following most interventions suggests that psychological mechanisms other than, or additional to, those being manipulated may underpin anti-fat prejudice. New directions for researching anti-fat prejudice are suggested. Given the strength of antipathy displayed toward those who are perceived as 'fat' or obese, research in this area is urgently required.
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Affiliation(s)
- Sigrén Daníelsdóttir
- Division of Psychiatry, Landspítali-University Hospital, Reykjavík, Iceland
| | - Kerry S. O'Brien
- School of Psychological Sciences, University of Manchester, UK
- *Dr. Kerry S. O’Brien, School of Psychological Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK, Tel. +44 161 275 2578,
| | - Anna Ciao
- Department of Psychology, University of Hawaii at Manoa, Honolulu, HI, USA
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