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Sonnenblick RM, Liu J, Riddle DR, Manasse SM, Forman EM, Juarascio AS. Behavioral weight loss treatment for adults with binge-eating disorder: A qualitative analysis of patients' perspectives and experiences. Int J Eat Disord 2024. [PMID: 38867446 DOI: 10.1002/eat.24234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 05/16/2024] [Accepted: 05/16/2024] [Indexed: 06/14/2024]
Abstract
OBJECTIVE Understanding the perspectives of behavioral weight loss (BWL) participants could inform whether, how, and for whom BWL should be offered. METHOD All 126 participants in a clinical trial of BWL for adults with binge-eating disorder (BED) and overweight/obesity were contacted about a qualitative study. 45 participants, 11 of whom had dropped out of the parent study, completed qualitative interviews. The interview guide was developed using data from a survey of providers who offer Health at Every Size and other weight-neutral lifestyle interventions. Questions were phrased to invite even the most negative responses. Questions focused on participants' experiences of weight stigma during treatment, perceptions of BWL's calorie and WL goals, and opinions of BWL and weight-neutral interventions. RESULTS We identified four themes using thematic analysis: (1) BWL did not perpetuate weight stigma. (2) Calorie and WL goals did not exacerbate participants' binge eating. (3) Patients should have the right to pursue any treatment that aligns with their personal goals. (4) BWL can improve participants' overall health. DISCUSSION BWL participants with BED and overweight/obesity want others to have access to a program that can reduce both weight and binge eating. Participants emphasized that no treatment works for everyone, and they all agreed that BWL had not perpetuated weight stigma. Fewer than 20% of participants considered the program's calorie and WL goals to be harmful; most participants viewed those goals as achievable and helpful, and many asserted that their participation in BWL had improved their overall health. PUBLIC SIGNIFICANCE We interviewed adults with binge-eating disorder and overweight/obesity who had participated in a behavioral weight loss (BWL) program. Our participants wanted others in their position to have access to BWL because it aims to reduce both weight and binge-eating frequency. Efforts should be made to provide patients, clinicians, and policymakers with the knowledge that supervised, evidence-based BWL is an effective and desired treatment choice for this population.
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Affiliation(s)
- Ross M Sonnenblick
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA
- Center for Weight, Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
| | - Jianyi Liu
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA
- Center for Weight, Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
| | - Devyn R Riddle
- Center for Weight, Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
| | - Stephanie M Manasse
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA
- Center for Weight, Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
| | - Evan M Forman
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA
- Center for Weight, Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
| | - Adrienne S Juarascio
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA
- Center for Weight, Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
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Råheim M, Moltu C, Natvik E. Living the dream - but not without hardship: stories about self-directed weight transformation from severe obesity. Psychol Health 2024; 39:631-650. [PMID: 35765935 DOI: 10.1080/08870446.2022.2090562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 05/26/2022] [Accepted: 06/11/2022] [Indexed: 10/17/2022]
Abstract
DESIGN In-depth interviews were conducted with eight women and two men, aged 27 to 59 years, who had carried out self-directed WL from SO for 5 years or more. TWO THEMES RAN ACROSS THE STORIES fear of weight-regain, and food and emotion. We performed a case-based narrative analysis of especially rich interviews that illustrate these. Results pointed to persistently cultivating new competencies, establishing new eating habits, re-establishing old physical-training habits, and forming new relational bonds. Participants reinvented themselves and their lives. However, the stories are not all about transformation, but also about new and old health problems. CONCLUSION The study directs attention to 'different obesities', not only to initial weight from which WL takes place, but also linked to the experiential horizons that the persons embody from childhood on. Furthermore, there was no way back in the present stories, always haunted in the wake of the lost weight. A double burden imposed on the person with obesity related to meta-stories in society deepens the understanding of this imperative: being vulnerable health-wise and exposed to stigmatization.
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Affiliation(s)
- M Råheim
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - C Moltu
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Førde, Norway
- The Center of Health Research, District General Hospital of Førde, Førde, Norway
| | - E Natvik
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Førde, Norway
- The Center of Health Research, District General Hospital of Førde, Førde, Norway
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Lucibello KM, Goldfield GS, Alberga AS, Leatherdale ST, Patte KA. Exploring the association between internalized weight bias and mental health among Canadian adolescents. Pediatr Obes 2024:e13118. [PMID: 38676448 DOI: 10.1111/ijpo.13118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 02/15/2024] [Accepted: 03/03/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Internalized weight bias (IWB) has been identified as a correlate of higher depressive and anxiety symptoms in adolescents with higher weights. However, there has been limited investigation into how IWB relates to positive mental health and whether these associations differ across genders. OBJECTIVES To examine the associations between IWB and mental health (depression, anxiety, flourishing) in adolescents with higher weights, and to test the potential moderating role of gender. METHODS Canadian adolescents with higher weights (N = 7538, 60% boys, 36% girls, 4% gender diverse, ages 12-19) from the COMPASS study completed a survey during the 2021-2022 school year. Data were analysed using generalized linear models. RESULTS Highest IWB and poorest mental health were noted within gender diverse adolescents, followed by girls then boys. Gender moderated the relationship between higher IWB and higher depression, higher anxiety and lower flourishing, with the strongest relationships noted among girls. CONCLUSION IWB interventions should be tailored to gender subgroups that may be particularly vulnerable to maladaptive mental health outcomes associated with IWB. System-level changes that mitigate perpetuation of weight bias and discrimination which lead to IWB are also essential, particularly for girls.
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Affiliation(s)
| | - Gary S Goldfield
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
| | - Angela S Alberga
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Scott T Leatherdale
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Karen A Patte
- Department of Health Sciences, Brock University, St. Catharines, ON, Canada
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Cerdeña JP, Tsai JW, Warpinski C, Rosencrans RF, Gravlee CC. Racial, Gender, and Size Bias in a Medical Graphical Abstract Gallery: A Content Analysis. Health Equity 2023; 7:631-643. [PMID: 37786527 PMCID: PMC10541937 DOI: 10.1089/heq.2023.0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2023] [Indexed: 10/04/2023] Open
Abstract
Introduction Graphical abstracts may enhance dissemination of scientific and medical research but are also prone to reductionism and bias. We conducted a systematic content analysis of the Journal of Internal Medicine (JIM) Graphical Abstract Gallery to assess for evidence of bias. Materials and Methods We analyzed 140 graphical abstracts published by JIM between February 2019 and May 2020. Using a combination of inductive and deductive approaches, we developed a set of codes and code definitions for thematic, mixed-methods analysis. Results We found that JIM graphical abstracts disproportionately emphasized male (59.5%) and light-skinned (91.3%) bodies, stigmatized large body size, and overstated genetic and behavioral causes of disease, even relative to the articles they purportedly represented. Whereas 50.7% of the graphical surface area was coded as representing genetic factors, just 0.4% represented the social environment. Discussion Our analysis suggests evidence of bias and reductionism promoting normative white male bodies, linking large bodies with disease and death, conflating race with genetics, and overrepresenting genes while underrepresenting the environment as a driver of health and illness. These findings suggest that uncritical use of graphical abstracts may distort rather than enhance our understanding of disease; harm patients who are minoritized by race, gender, or body size; and direct attention away from dismantling the structural barriers to health equity. Conclusion We recommend that journals develop standards for mitigating bias in the publication of graphical abstracts that (1) ensure diverse skin tone and gender representation, (2) mitigate weight bias, (3) avoid racial or ethnic essentialism, and (4) attend to sociostructural contributors to disease.
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Affiliation(s)
- Jessica P. Cerdeña
- Department of Family Medicine, Middlesex Health, Middletown, Connecticut, USA
- Institute for Collaboration on Health, Implementation, and Policy (InCHIP), University of Connecticut, Storrs, Connecticut, USA
- Department of Anthropology, University of Connecticut, Storrs, Connecticut, USA
| | - Jennifer W. Tsai
- Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Chloe Warpinski
- Department of Anthropology, University of Florida, Gainesville, Florida, USA
- MD-PhD Training Program, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Robert F. Rosencrans
- Medical Scientist Training Program, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Clarence C. Gravlee
- Department of Anthropology, University of Florida, Gainesville, Florida, USA
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Rupp K, McCoy SM. Understanding Health Behaviors, Weight Perceptions, and Body Appreciation of Young Adult Women Engaged in the Body Positivity Movement. Womens Health Issues 2023; 33:551-559. [PMID: 37330399 DOI: 10.1016/j.whi.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 05/03/2023] [Accepted: 05/10/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND The body positivity movement on social media is thought to foster body appreciation, but pervasive societal concern persists about the body positivity movement and the body image, health behaviors, and "normalization of obesity" of young adult women. PURPOSE This study explored the relationship between engagement in the body positivity movement on social media and weight status, body appreciation, body dissatisfaction, and the health behaviors of intuitive eating and physical activity in young adult women (18-35 years). METHODS Participants (N = 521; ∼64% engaged in body positivity content on social media) were recruited using Qualtrics online panels for this cross-sectional survey during February 2021. Outcomes included weight status, weight consideration, weight perception, body appreciation, body dissatisfaction, physical activity, and intuitive eating. Logistic and linear regression models adjusted for age, race, ethnicity, education level, and household income were used to assess the association between engagement in the body positivity movement and specified outcomes. RESULTS Engagement with body positivity content was associated with greater body dissatisfaction (β = 2.33, t(519) = 2.90 p = .017), body appreciation (β = 0.26, t(519) = 2.90 p = .004), and greater likelihood of reporting high amounts of physical activity (odds ratio = 2.28; p < .05) relative to nonengaged peers; these associations remained significant after further adjustment for weight status. Body positivity engagement was not associated with weight status, weight perception, or intuitive eating. CONCLUSIONS Engagement in the body positivity movement is associated with higher body dissatisfaction and body appreciation in young adult women, which suggests they may be drawn to and engage in the body positivity movement as a protective or coping mechanism for body dissatisfaction.
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Affiliation(s)
- Kristie Rupp
- Department of Health and Movement Sciences, Southern Connecticut State University, New Haven, Connecticut.
| | - Stephanie M McCoy
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, Mississippi
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Loor JM, Mullins CR, Smith JE. Examination of ecological validity of intuitive eating. Appetite 2023; 188:106761. [PMID: 37421977 DOI: 10.1016/j.appet.2023.106761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 06/14/2023] [Accepted: 06/25/2023] [Indexed: 07/10/2023]
Abstract
BACKGROUND Intuitive eating, which involves following internal cues of hunger and satiety to guide eating choices, would be better understood if studied at the individual momentary level instead of globally or cross-sectionally. The current study employed ecological momentary assessment (EMA) to examine the ecological validity of a popular intuitive eating measure, the Intuitive Eating Scale (IES-2). METHOD College males and females completed a baseline assessment of trait levels of intuitive eating as measured by the IES-2. Participants then followed a seven-day EMA protocol where they completed brief smart phone assessments about intuitive eating and related constructs while in their natural daily environments. Participants were asked to complete recordings before and after eating about their state level of intuitive eating at that moment. RESULTS Among 104 participants, 87.5% were female, mean age was 24.3, and mean BMI was 26.3. Baseline trait level intuitive eating was significantly correlated with state level intuitive eating reported across EMA recordings, with some evidence suggesting that correlations were stronger before eating compared to after eating. Intuitive eating generally was related to less negative affect, fewer eating restrictions, and more anticipated taste enjoyment before eating, as well as less guilt and regret after eating. DISCUSSION Individuals who reported high trait levels of intuitive eating also reported following their internal cues for hunger and satiety and had less guilt, regret, and negative affect surrounding eating in their naturalistic environments, thereby supporting the ecological validity of the IES-2.
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Affiliation(s)
- Jamie M Loor
- University of New Mexico Health Sciences Center, MSC08-4506, Albuquerque, NM 87131-0001, United States.
| | - Chloe R Mullins
- University of New Mexico, Department of Psychology, MSC03-2220, Albuquerque, NM 87131-0001, United States.
| | - Jane Ellen Smith
- University of New Mexico, Department of Psychology, MSC03-2220, Albuquerque, NM 87131-0001, United States.
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Loor JM, Mullins CR, Pacheco C, VanderJagt H, Smith JE. A qualitative exploration of perceived barriers and facilitators to following an intuitive eating style. Eat Behav 2023; 49:101744. [PMID: 37178460 DOI: 10.1016/j.eatbeh.2023.101744] [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: 11/23/2022] [Revised: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Intuitive eating involves following internal cues of hunger and satiety to guide eating choices as opposed to responding to external signals, strong emotions, or dietary rules. This style of eating has consistently been shown to be related to better physical and psychological health indicators, and more interventions are being designed and studied to promote this eating style. The current study aimed to identify anticipated facilitators and barriers to following this style of eating among a group of college students enrolled in a larger study of intuitive eating. METHOD Following a week of tracking their current eating as part of a larger study, college students read a description of intuitive eating. They then answered three open-ended questions about following intuitive eating including facilitators, barriers, and perceived ability to follow long term. Responses were coded using thematic analysis to identify themes across responses. RESULTS Among 100 participants, 86 % were female, 46 % were Hispanic (41 % non-Hispanic White, 13 % other race/ethnicity), mean age was 24.3 years, and mean body mass index was 26.2. The most commonly anticipated participant-reported facilitators of intuitive eating were being in touch with the body's needs and hunger cues, positive perceptions of intuitive eating, and health considerations. The most commonly anticipated barriers were logistical constraints (e.g., busyness and mealtimes), difficulty with hunger cues and reactions to food, and negative perceptions of intuitive eating. The majority of participants (64 %) would consider following this style of eating long term. DISCUSSION This study provides information that can be used to improve efforts aimed at promoting intuitive eating to college students, including marketing intuitive eating interventions, and clarifying misunderstandings of its key tenets that might serve as barriers.
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Affiliation(s)
- Jamie M Loor
- University of New Mexico Health Science Center, Albuquerque, NM, United States.
| | - Chloe R Mullins
- Department of Psychology, University of New Mexico, Albuquerque, NM, United States
| | - Catalina Pacheco
- Department of Psychology, University of New Mexico, Albuquerque, NM, United States
| | - Hayley VanderJagt
- Department of Psychology, University of New Mexico, Albuquerque, NM, United States
| | - Jane Ellen Smith
- Department of Psychology, University of New Mexico, Albuquerque, NM, United States
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Mensinger JL, Shepherd BF, Schapiro S, Aware Y, Brochu PM, Calogero RM, Tylka TL. Mediating effects of a weight-inclusive health promotion program on maladaptive eating in women with high body mass index. Eat Behav 2023; 49:101730. [PMID: 37121132 DOI: 10.1016/j.eatbeh.2023.101730] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 02/14/2023] [Accepted: 04/17/2023] [Indexed: 05/02/2023]
Abstract
Research shows that individuals with a body mass index (BMI) over 30 have experienced an 11-fold increase in restrictive eating and a 7-fold increase in binge eating since the 1990s. Most health promotion programs for higher-weight individuals have not been developed with the high eating disorder risk for this population in mind. The purpose of current study was to test two hypothesized mechanisms underlying improvement in maladaptive eating patterns shown in a weight-inclusive health promotion program designed for women with BMIs at or above 30. Participants (N = 40) were primarily White (93 %), 30-45 years old (M = 39.83, SD = 4.34) with BMIs ranging from 30 to 45 kg/m2 (M = 37.42, SD = 3.58). Using the MEMORE macro, we tested a parallel mediation model hypothesizing that internalized weight stigma and intuitive eating would explain improvements on two subscales from the Three-Factor Eating Questionnaire-R18 after a 6-month program. Total effects of the program on uncontrolled (b = -3.76, SE = 0.64, p < .0001) and emotional eating (b = -1.79, SE = 0.34, p < .0001) were significant. The indirect effects (IE) of internalized weight stigma on uncontrolled eating (IE = 1.59, SE = 0.79, 95 % CI = 0.46, 3.49) and emotional eating (IE = 0.67, SE = 0.40, 95 % CI = 0.11, 1.68) were also significant. Likewise, the IEs of intuitive eating on uncontrolled eating (IE = 2.09, SE = 0.70, 95 % CI = 0.60, 3.38) and emotional eating (IE = 1.03, SE = 0.43, 95 % CI = 0.08, 1.82) were significant. These findings indicate that weight-inclusive health promotion programs that directly address weight bias and eating according to cues from the body may help higher-weight individuals improve maladaptive eating patterns via reductions in internalized weight stigma and increases in intuitive eating.
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Affiliation(s)
- Janell L Mensinger
- Department of Clinical and School Psychology, Nova Southeastern University, 3301 College Ave, 1073 Maltz, Fort Lauderdale, FL 33314, United States of America.
| | - Benjamin F Shepherd
- Department of Clinical and School Psychology, Nova Southeastern University, 3301 College Ave, 1073 Maltz, Fort Lauderdale, FL 33314, United States of America.
| | - Stevie Schapiro
- Department of Clinical and School Psychology, Nova Southeastern University, 3301 College Ave, 1073 Maltz, Fort Lauderdale, FL 33314, United States of America.
| | - Yashvi Aware
- Department of Clinical and School Psychology, Nova Southeastern University, 3301 College Ave, 1073 Maltz, Fort Lauderdale, FL 33314, United States of America.
| | - Paula M Brochu
- Department of Clinical and School Psychology, Nova Southeastern University, 3301 College Ave, 1073 Maltz, Fort Lauderdale, FL 33314, United States of America.
| | - Rachel M Calogero
- Department of Psychology, Western University, Westminster Hall, Office 321, London, ON N6K 5C2, Canada.
| | - Tracy L Tylka
- Department of Psychology, The Ohio State University, 170F Morrill Hall, 1465 Mt. Vernon Avenue, Marion, OH 43302, United States of America.
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Quinn N, Zeglin RJ, Boggs C, Glusenkamp H, Rule M, Hicks-Roof K, Terrell KR. Sex at every size: A content analysis of weight inclusivity in sexual functioning research. Body Image 2022; 43:420-428. [PMID: 36345080 DOI: 10.1016/j.bodyim.2022.10.010] [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: 04/25/2022] [Revised: 10/10/2022] [Accepted: 10/20/2022] [Indexed: 11/16/2022]
Abstract
Sexual functioning research has been slow to address sizeism within its volumes. Much of the sexual health science has adopted a weight normative model rather than a weight inclusive model. The purpose of this study was to, through systematic literature review, describe the sexual functioning research landscape with respect to weight inclusivity. The review included three databases (Google Scholar, Medline and Ebsco) between 2010 and 2020. Each article was double coded for weight inclusivity and sexual functioning. Sixty-seven articles met the criteria and were included in analysis. The articles, overall, only endorsed weight inclusive tenets 16 % of the time. Articles were most weight inclusive when discussing sexual satisfaction (22.5 %). Meanwhile, when discussing sexual arousal, the articles were the least weight inclusive (16.7 %). These findings suggest there is needs to be greater education and intention for sex educators, therapists, and clinicians, to explore and enhance body positivity and sexual health.
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Mensinger JL. Traumatic stress, body shame, and internalized weight stigma as mediators of change in disordered eating: a single-arm pilot study of the Body Trust® framework. Eat Disord 2022; 30:618-646. [PMID: 34634212 DOI: 10.1080/10640266.2021.1985807] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
To enhance access to evidence-based treatment it is increasingly important to evaluate scalable virtual programs that support the needs of those struggling with disordered eating. This study described a scientifically grounded, trauma-informed framework known as Body Trust,® and aimed to pilot test the preliminary effectiveness and mechanisms of change in a Body Trust® program to improve disordered eating. Using quality outcomes data, we examined 70 mostly white (87%) female-identifying (97%) individuals enrolled in a 6-module online program based in the Body Trust® framework (Mage = 45.5 ±10.9; MBMI = 33.7 ±8.0). Putative mediators included traumatic stress, internalized weight stigma, and body shame. Outcomes were objective and subjective binge episodes, overvaluation of weight and shape, and eating concerns. Generalized estimating equations were applied to determine pre-to-post changes. We applied Montoya's MEMORE macro, the joint-significance test, and calculated 95% Monte Carlo confidence intervals to assess mediation. Significant pre-to-post improvements with medium to large effect sizes were detected for all outcomes and mediators (ps<.008). All hypothesized mechanisms supported mediation. Using the Body Trust® framework shows early promise for alleviating disordered eating symptoms through targeting traumatic stress, body shame, and internalized weight stigma. Given the program's use of mindfulness techniques, future research should test target mechanisms like interoception.
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Affiliation(s)
- Janell L Mensinger
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, United States
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11
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Talumaa B, Brown A, Batterham RL, Kalea AZ. Effective strategies in ending weight stigma in healthcare. Obes Rev 2022; 23:e13494. [PMID: 35934011 PMCID: PMC9540781 DOI: 10.1111/obr.13494] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 12/11/2022]
Abstract
Weight stigma impacts negatively healthcare quality and hinders public health goals. The aim of this review was to identify strategies for minimizing weight bias among healthcare professionals and explore future research directions. An electronic search was performed in PubMed, PsycINFO and Scopus (until June 2020). Studies on weight stigma reduction in healthcare students, trainees and professionals were assessed based on specific inclusion and exclusion criteria. A narrative synthesis was undertaken to analyze emerging themes. We identified five stigma reduction strategies in healthcare: (i) increased education, (ii) causal information and controllability, (iii) empathy evoking, (iv) weight-inclusive approach, and (v) mixed methodology. Weight stigma needs to be addressed early on and continuously throughout healthcare education and practice, by teaching the genetic and socioenvironmental determinants of weight, and explicitly discussing the sources, impact and implications of stigma. There is a need to move away from a solely weight-centric approach to healthcare to a health-focused weight-inclusive one. Assessing the effects of weight stigma in epidemiological research is equally important. The ethical argument and evidence base for the need to reduce weight stigma in healthcare and beyond is strong. Although evidence on long-term stigma reduction is emerging, precautionary action is needed.
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Affiliation(s)
- Britta Talumaa
- Division of Medicine, University College London, London, UK
| | - Adrian Brown
- Division of Medicine, University College London, London, UK.,Centre for Obesity Research, University College London, London, UK.,Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital NHS Trust, London, UK.,UCLH Biomedical Research Centre, National Institute of Health Research, London, UK
| | - Rachel L Batterham
- Division of Medicine, University College London, London, UK.,Centre for Obesity Research, University College London, London, UK.,Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital NHS Trust, London, UK.,UCLH Biomedical Research Centre, National Institute of Health Research, London, UK
| | - Anastasia Z Kalea
- Division of Medicine, University College London, London, UK.,Institute of Cardiovascular Science, University College London, London, UK
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Faragó F, Savoy S, Sanchez EA, Khaleghi N, Evans L, Adams EL, Palomino E. Gender Typicality, Pressure to Conform to Gender Norms, and Anti-Fat and Appearance Stereotypes in Girls. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:2183-2198. [PMID: 35471679 DOI: 10.1007/s10508-021-02252-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 11/23/2021] [Accepted: 11/25/2021] [Indexed: 06/14/2023]
Abstract
This mixed-methods study investigated the relation among gender identity (i.e., self-perceived gender similarity to girls and boys; self-perceived parental and peer pressure to conform to gender norms) and stereotyping about weight (i.e., anti-fat stereotypes), weight change, and appearance in 83 girls ages 6-9 (Mage = 7.60 years, SD = .85; 65% White, 16% Mixed/Other, 11% Black, 8% Latina) in the U.S. Stereotypes about weight change were assessed with open-ended responses (i.e., qualitatively), and the rest of the constructs were assessed with closed-ended responses (i.e., quantitatively). There was a positive association between pressure from parents to conform to gender norms and appearance stereotypes, and between pressure from peers and negative stereotypes about the fat and thin figures. Girls who were more gender typical, or more similar to girls, were more likely to endorse appearance stereotypes. There was no significant relation among stereotypes about weight change and gender identity. Many girls deemed the fat figure as unattractive, physically restrained, unhealthy, and likely to be bullied and believed that the fat figure should change back to look like a thinner figure. Most girls were aware that exercising, eating healthy, and dietary restriction can lead to weight loss and that food consumption and lack of exercise can lead to weight gain. Findings suggest that certain aspects of weight (anti-fat) and appearance stereotypes are closely linked to gender identity in girls, whereas other aspects of weight stereotypes (e.g., stereotypes about weight change) are so pervasive that they are common in most girls, regardless of their gender identity.
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Affiliation(s)
- Flóra Faragó
- School of Human Sciences, Human Development and Family Studies, Stephen F. Austin State University, SFA Station, P. O. Box 13014, Nacogdoches, TX, 75962, USA.
| | - Sarah Savoy
- Department of Psychology, Stephen F. Austin State University, Nacogdoches, TX, USA
| | - Emily A Sanchez
- Department of Psychology, Stephen F. Austin State University, Nacogdoches, TX, USA
| | - Neusha Khaleghi
- Department of Psychology, Stephen F. Austin State University, Nacogdoches, TX, USA
| | - Lauren Evans
- Department of Psychology, Stephen F. Austin State University, Nacogdoches, TX, USA
| | - Emily L Adams
- Human Services and Educational Leadership, Stephen F. Austin State University, Nacogdoches, TX, USA
| | - Edgar Palomino
- Human Services and Educational Leadership, Stephen F. Austin State University, Nacogdoches, TX, USA
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13
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Myre M, Glenn NM, Berry TR. Experiences of Size Inclusive Physical Activity Settings Among Women With Larger Bodies. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2022:1-10. [PMID: 35344473 DOI: 10.1080/02701367.2021.1983515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 09/17/2021] [Indexed: 06/14/2023]
Abstract
Purpose: Size inclusive physical activity settings may help mitigate the impact of physical activity-related weight stigma. In this interpretive description study, we aimed to understand how women with larger bodies experienced size inclusive physical activity settings. The study was informed by a settings-based approach to health promotion. Method: We interviewed nine women with larger bodies who participated in size inclusive physical activity and used an inductive approach to analyze the data. Findings: At the individual level, size inclusion was experienced as an enhancement of well-being, self-worth, and belonging. This was closely tied to the interpersonal level, whereby weight-neutral practices used by fitness instructors and lack of judgment from other exercisers contributed to experiences of size inclusion. At the organizational level, the organization's culture, marketing, programs, and physical spaces could enhance or limit inclusion and participation. However, weight stigma was prevalent in women's experiences outside the physical activity setting. Conclusion: We provide recommendations to improve size inclusion in physical activity settings.
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14
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First do no harm: reconsidering our approach to weight in primary care. Br J Gen Pract 2022; 72:102-103. [PMID: 35210233 PMCID: PMC8884442 DOI: 10.3399/bjgp22x718565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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15
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Osa ML, Siegel J, Meadows A, Elbe C, Calogero RM. Stigmatizing effects of weight status on lay perceptions of eating disorder-related distress. Eat Disord 2022; 30:99-109. [PMID: 33393452 DOI: 10.1080/10640266.2020.1855571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The present study examined how weight status would affect lay perceptions of a White female student presenting signs of eating disorder-related distress. We recruited a mixed-gender, weight-diverse U.S. community sample through Mechanical Turk (N = 130; 49.2% female) to complete an online survey. Participants were randomly assigned to one of two conditions in which they read a personal statement section of a college application revealing eating disorder-related distress from a student who was either 'overweight' or 'underweight.' Participants evaluated the student on need for support, behavioural prescriptions for eating and exercise, and personal qualities. Although participants recognized a serious mental health concern in both conditions, they were more likely to prescribe eating disorder behaviors to the higher weight student. Findings suggest that weight stigma may bias lay perceptions of and even reinforce an eating disorder when exhibited by higher weight individuals.
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Affiliation(s)
- Maggie L Osa
- Prevention Science Program, Department of Counseling and Human Services, University of Oregon, Eugene, OR, USA
| | - Jaclyn Siegel
- Department of Psychology, Western University, London, Canada
| | - Angela Meadows
- Department of Psychology, Western University, London, Canada
| | - Connor Elbe
- Department of Psychology, Western University, London, Canada
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16
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Meadows A, Barreto M, Dovidio JF, Burke SE, Wittlin NM, Herrin J, Ryn M, Phelan SM. Signaling hostility: The relationship between witnessing weight‐based discrimination in medical school and medical student well‐being. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2021. [DOI: 10.1111/jasp.12847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Angela Meadows
- School of Psychology University of Exeter Exeter UK
- Department of Psychology Western University London Ontario Canada
| | | | - John F. Dovidio
- Department of Psychology Yale University New Haven Connecticut USA
| | - Sara E. Burke
- Department of Psychology Syracuse University Syracuse New York USA
| | | | - Jeph Herrin
- School of Medicine Yale University New Haven Connecticut USA
| | - Michelle Ryn
- Division of Health Care Delivery Research Mayo Clinic Rochester Minnesota USA
| | - Sean M. Phelan
- Division of Health Care Delivery Research Mayo Clinic Rochester Minnesota USA
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17
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Lucibello KM, Vani MF, Koulanova A, deJonge ML, Ashdown-Franks G, Sabiston CM. #quarantine15: A content analysis of Instagram posts during COVID-19. Body Image 2021; 38:148-156. [PMID: 33892438 PMCID: PMC9760216 DOI: 10.1016/j.bodyim.2021.04.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 03/30/2021] [Accepted: 04/03/2021] [Indexed: 10/21/2022]
Abstract
There has been a surge in "quarantine15" social media posts during the self-isolation and lockdowns associated with the COVID-19 global pandemic. Given the influence of other body and weight-centered social media content (e.g., Fitspiration, Fatspiration) on body image and weight stigmatizing thoughts and attitudes, characterizing the features of quarantine15 content is an imperative first step towards understanding its impact on those who view it. Therefore, the present study is a content analysis of quarantine15 content on Instagram. A total of 668 posts were sampled using the hashtag quarantine15, and systematically analyzed for features related to positive and negative body image, as well as weight stigma. The results showed that the posts containing human figures (57.5 %) showcased individuals who were perceived as lower-weight (88.8 %), White (70.3 %), and women (87 %). Approximately one-third (34.4 %) of the images containing individuals were considered objectifying. Posts also perpetuated the controllability of weight through diet (51.5 %) and physical activity (27.5 %), while 46.9 % expressed dislike towards higher-weight bodies. Future experimental research in this area will be important for understanding both the acute and long-term effects of viewing quarantine15 content on body image, weight stigmatizing attitudes and thoughts, and internalized weight stigma.
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Affiliation(s)
| | - Madison F. Vani
- Department of Kinesiology, University of Toronto, Toronto, Ontario, Canada
| | - Alyona Koulanova
- Department of Kinesiology, University of Toronto, Toronto, Ontario, Canada
| | - Melissa L. deJonge
- Department of Kinesiology, University of Toronto, Toronto, Ontario, Canada
| | - Garcia Ashdown-Franks
- Department of Kinesiology, University of Toronto, Toronto, Ontario, Canada,Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Catherine M. Sabiston
- Department of Kinesiology, University of Toronto, Toronto, Ontario, Canada,Corresponding author at: Department of Kinesiology, University of Toronto. 55 Harbord Street, Toronto, Ontario, M5S 2W6, Canada
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18
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Vendemia MA, DeAndrea DC, Brathwaite KN. Objectifying the body positive movement: The effects of sexualizing and digitally modifying body-positive images on Instagram. Body Image 2021; 38:137-147. [PMID: 33887562 DOI: 10.1016/j.bodyim.2021.03.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 03/24/2021] [Accepted: 03/24/2021] [Indexed: 12/13/2022]
Abstract
The body positive movement on social media seeks to challenge narrow conceptualizations of beauty that media outlets traditionally perpetuate and reinforce. Through a 2 × 2 between-subjects online experiment, we examined how the nature and authenticity of body-positive imagery on social media affects female viewers and their evaluations of body-positive content (N = 425, Mage = 35.47, SDage = 13.52). Specifically, participants viewed and reacted to a series of 10 body-positive images of women on social media varying in their degree of sexualization (sexualized vs. non-sexualized) and evidence of digital photo modifications (modification icons vs. no modification icons). A control group that featured landscape images was also included. Results indicate body-positive images that are considered sexualized and are believed to be digitally modified can undercut the movement's intended aims: Participants who viewed body-positive images that were sexualized (vs. non-sexualized) and included photo modification icons (vs. no modification icons) reported greater endorsement of traditional beauty ideals (e.g., thinness) and thought the images were shared for self-serving reasons (e.g., to gain likes/shares/endorsements); these relationships were mediated by the extent to which viewers believed these images were sexualized and digitally modified. Further, results indicate that sexualized body-positive images can instigate sexual objectification of others and oneself. Those who viewed control images (vs. experimental body-positive images) produced significantly fewer sexually objectifying words about others and themselves. Implications for both viewers and producers (e.g., individuals, corporations) of body-positive imagery on social media are discussed in light of objectification theory.
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19
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Ganesan A, Carter-Sowell AR. Buffering anti-fat attitudes using contact: The roles of contact quantity, duration, favorability, and intergroup anxiety. Body Image 2021; 38:120-126. [PMID: 33887561 DOI: 10.1016/j.bodyim.2021.03.019] [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: 09/05/2020] [Revised: 03/27/2021] [Accepted: 03/27/2021] [Indexed: 01/25/2023]
Abstract
Decades of intergroup contact research have found that contact with outgroups reduces negative attitudes. Yet, few studies have examined the association between contact and anti-fat attitudes. Furthermore, testing different facets of contact, namely contact quantity versus contact duration, provides more precise theoretical predictions for their effectiveness in this under-tested context. This study examined whether intergroup anxiety was indirectly related to and contact favorability moderated the relationship between contact and anti-fat attitudes, tested through the constructs of contact quantity (i.e., how many individuals interacted with) and contact duration (i.e., how often time was spent). Undergraduates (N = 343; 260 women) based in the United States completed an online survey assessing intergroup contact, contact favorability, intergroup anxiety, and anti-fat attitudes. Analyses of conditional indirect effects showed that longer contact but not more contact reduced intergroup anxiety, which lowered anti-fat attitudes. The indirect paths for both contact types were not conditional upon contact favorability. Contact favorability moderated the association between contact duration and anti-fat attitudes such that longer and more favorable contact lowered anti-fat attitudes. Findings are discussed within the contact hypothesis, and future research should explore the distinct elements of the hypothesis as applicable to anti-fat prejudice in in-person and online contexts.
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Affiliation(s)
- Asha Ganesan
- Department of Psychological & Brain Sciences, Texas A&M University, TX, USA.
| | - Adrienne R Carter-Sowell
- Department of Psychological & Brain Sciences and the Interdisciplinary Critical Studies Program, Texas A&M University, TX, USA
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20
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Mensinger JL, Cox SA, Henretty JR. Treatment Outcomes and Trajectories of Change in Patients Attributing Their Eating Disorder Onset to Anti-obesity Messaging. Psychosom Med 2021; 83:777-786. [PMID: 34267090 PMCID: PMC8428859 DOI: 10.1097/psy.0000000000000962] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 02/05/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Given the increased prevalence of eating disorders (EDs) among individuals higher on the weight spectrum, we aimed to 1) report the prevalence of ED patients in higher levels of care (residential, partial hospitalization, and intensive outpatient) attributing the onset of their ED to anti-obesity messaging, 2) report the most commonly recollected sources of those messages, and 3) determine if those attributing the onset of their ED to anti-obesity messaging a) enter, b) exit, and c) respond to treatment differently from peers who did not. METHODS This retrospective cohort study used data from 2901 patients receiving ED treatment in higher levels of care at a US-based center between 2015 and 2018. Multilevel models examined differences in ED symptoms and trajectories of change over time. NVivo was used to analyze the patients' comments about sources of messages. RESULTS Eighteen percent attributed their ED onset to anti-obesity messaging, 45% did not, and 37% were unsure. Of those providing comments, the most common sources included the following: educational curriculum/school context (45.9%), media/Internet (24.7%), health care (10.4%), family (9%), and peer bullying (3.7%). At admission, patients attributing their ED onset to anti-obesity messaging had more severe ED symptoms than those who did not (γ = 0.463, standard error [SE] = 0.086, p < .001) and those who were unsure (γ = 0.288, SE = 0.089, p < .001); no differences were evident at discharge (p > .483). During phase 2 of treatment, patients attributing their ED onset to anti-obesity messaging improved faster than those who did not (γ = 0.003, SE = 0.001, p = .008) and those who were unsure (γ = 0.003, SE = 0.001, p = .014). CONCLUSIONS Anti-obesity messaging may put vulnerable individuals at risk for EDs. We recommend increasing weight bias training for school personnel and health care professionals. To reduce health disparities, we also suggest the promotion of weight-neutral health-enhancing self-care practices in media and public health campaigns, legislative policies, and health care overall.
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21
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"What can her body do?" Reducing weight stigma by appreciating another person's body functionality. PLoS One 2021; 16:e0251507. [PMID: 33989320 PMCID: PMC8121301 DOI: 10.1371/journal.pone.0251507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 04/27/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Weight stigma is prevalent across multiple life domains, and negatively affects both psychological and physical health. Yet, research into weight stigma reduction techniques is limited, and rarely results in reduced antipathy toward higher-weight individuals. The current pre-registered study investigated a novel weight stigma reduction intervention. We tested whether a writing exercise focusing on body functionality (i.e., everything the body can do, rather than how it looks) of another person leads to reductions in weight stigma. METHOD Participants were 98 women (Mage = 23.17, Range = 16-63) who viewed a photograph of a higher-weight woman, "Anne," and were randomised to complete a writing exercise either describing what "Anne's" body could do (experimental group) or describing her home (active control group). Facets of weight stigma were assessed at pretest and posttest. RESULTS At posttest, the experimental group evidenced higher fat acceptance and social closeness to "Anne" compared with the active control group. However, no group differences were found in attribution complexity, responsibility, and likeability of "Anne". CONCLUSIONS A brief body functionality intervention effectively reduced some, but not all, facets of weight stigma in women. This study provides evidence that functionality-focused interventions may hold promise as a means to reduce weight stigma.
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22
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Horenstein A, Kaplan SC, Butler RM, Heimberg RG. Social anxiety moderates the relationship between body mass index and motivation to avoid exercise. Body Image 2021; 36:185-192. [PMID: 33360475 DOI: 10.1016/j.bodyim.2020.11.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 11/19/2022]
Abstract
Higher weight individuals experience frequent weight-related discrimination, which is associated with exercise avoidance. Exercise is a health behavior with multiple physical and mental health benefits and should be accessible to all. The current study examined another factor that might influence exercise in addition to weight stigma: social anxiety (SA). Given the often public nature of exercise, individuals with SA may feel scrutinized when exercising, which may lead to avoidance. This study examined whether SA moderates the relationship between body mass index (BMI) and exercise and whether SA and its interaction with BMI predict exercise behavior after accounting for weight stigma. We administered an online survey to 603 undergraduates (72 % female, 60 % White). SA was not significantly associated with BMI, but it was positively associated with weight stigma and exercise-avoidance motivation and negatively associated with self-reported exercise. SA moderated the relationship between BMI and exercise-avoidance motivation; individuals with higher BMIs were motivated to avoid exercise, but only if they reported higher SA. This interaction predicted exercise-avoidance motivation after accounting for weight stigma and its interaction with BMI. However, SA did not moderate the relationship between BMI and self-reported exercise. SA may be associated with exercise avoidance among higher weight individuals.
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Affiliation(s)
- Arielle Horenstein
- Department of Psychology, Temple University, 1701 North 13th Street, Philadelphia, PA, 19122, USA
| | - Simona C Kaplan
- Department of Psychiatry, Cambridge Health Alliance, 1493 Cambridge Street, Cambridge, MA, 02139, USA
| | - Rachel M Butler
- Department of Psychology, Temple University, 1701 North 13th Street, Philadelphia, PA, 19122, USA
| | - Richard G Heimberg
- Department of Psychology, Temple University, 1701 North 13th Street, Philadelphia, PA, 19122, USA.
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23
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Kamody RC, Thurston IB, Burton ET. Adolescent Engagement in a Binge-Eating Behavioral Health Intervention: Influence of Perceptions of Physical Appearance and Locus of Control. CHILDREN-BASEL 2021; 8:children8020102. [PMID: 33546263 PMCID: PMC7913317 DOI: 10.3390/children8020102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/26/2021] [Accepted: 02/01/2021] [Indexed: 01/23/2023]
Abstract
Traditional weight management approaches focused solely on weight loss as a measure of success may lead youth to internalize negative beliefs about their appearance, and feel they have little control over their health. We examined how perceptions of appearance and health-related locus of control (HRLOC) influenced engagement and outcomes in a behavioral health intervention for binge eating. Thirty adolescents aged 14-18 years completed measures of self-perception, HRLOC, and eating behaviors. Half (n = 15) completed baseline assessments only, while the other half participated in a 10-week intervention targeting dysregulated eating behaviors. Analyses revealed negative perceptions of physical appearance and internal HRLOC were higher at baseline among youth who completed the intervention compared to those who completed baseline assessments only. Among those completing the intervention, however, greater internal HRLOC and more positive perception of physical appearance at baseline was associated with greater reduction in objective binge episodes and emotional eating post-intervention. Findings of the present study suggest that while having a more negative perception of one's appearance may initially motivate youth to participate in weight-related interventions, such perceptions can actually lead to poorer health outcomes, and further supports the extant literature on the benefits of interventions that engender positive body image.
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Affiliation(s)
| | - Idia B. Thurston
- Department of Psychological and Brain Sciences, College of Liberal Arts, Texas A&M University, College Station, TX 77843, USA;
- Texas A&M Health Science Center, Department of Health Promotion and Community Health Sciences, School of Public Health, College Station, TX 77843, USA
| | - E. Thomaseo Burton
- Department of Pediatrics, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38103, USA
- Children’s Foundation Research Institute, Le Bonheur Children’s Hospital, Memphis, TN 38103, USA
- Correspondence: ; Tel.: +1-901-287-6884
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24
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Brochu PM, Banfield JC, Dovidio JF. Does a Common Ingroup Identity Reduce Weight Bias? Only When Weight Discrimination Is Salient. Front Psychol 2020; 10:3020. [PMID: 32038393 PMCID: PMC6985568 DOI: 10.3389/fpsyg.2019.03020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 12/20/2019] [Indexed: 11/24/2022] Open
Abstract
Compared to many other forms of social bias, weight bias is pervasive, socially accepted, and difficult to attenuate. According to the common ingroup identity model, strategies that expand group inclusiveness may promote more positive intergroup attitudes and behaviors, particularly when people are aware of unjust treatment of others included within their shared identity. Considering that most people are not aware of the social justice issue of weight discrimination, we hypothesized that a common ingroup identity would be effective in reducing weight bias primarily when unfair weight-based treatment was made salient (i.e., that fat people experience discrimination in employment). Participants were randomly assigned to conditions following a 3 (discrimination salience: weight discrimination, height discrimination, control) × 2 (group identity: common ingroup, control) design and completed an evaluative measure of weight bias. Results revealed a significant interaction, showing that when weight discrimination was salient, participants in the common ingroup identity condition reported less weight bias than participants in the group identity control condition. When a common ingroup identity was emphasized, weight bias was lower when weight discrimination was salient compared to when height discrimination was salient and the control condition in which nothing about discrimination was mentioned. These results were not moderated by participant weight. This study demonstrates that a common ingroup identity can be effective in reducing weight bias if a cue is provided that fat people experience disparate and unjust outcomes in employment. Given the serious consequences of weight bias for health and well-being, and the relative ease of implementing this prejudice-reduction intervention, the common ingroup identity model has potential application for reducing weight bias in a range of real-world settings. However, these findings should be considered preliminary until they are replicated in well-powered and pre-registered future research.
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Affiliation(s)
- Paula M Brochu
- Department of Psychology, Yale University, New Haven, CT, United States.,Department of Clinical and School Psychology, Nova Southeastern University, Fort Lauderdale, FL, United States
| | - Jillian C Banfield
- Department of Psychology, Yale University, New Haven, CT, United States.,Nova Scotia Health Authority, Halifax, NS, Canada
| | - John F Dovidio
- Department of Psychology, Yale University, New Haven, CT, United States
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25
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Brochu PM. Testing the effectiveness of a weight bias educational intervention among clinical psychology trainees. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2020. [DOI: 10.1111/jasp.12653] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Paula M. Brochu
- Department of Clinical and School Psychology Nova Southeastern University Fort Lauderdale FL USA
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