Social interactions of obese and nonobese women

Interpersonal difficulties in obesity: A systematic review and meta-analysis to inform a rejection sensitivity-based model

Obesity is associated with difficulties due to stigma and loneliness. These impact negatively on individuals' quality of life and behaviour change efforts. Increased sensitivity to others' negative feedback might play a role in the maintenance of these difficulties and could be addressed in psychological interventions. We conducted a systematic review of interpersonal difficulties in individuals with obesity, across the lifespan. We investigated early interpersonal adversity (i.e. frequency of teasing/bullying), perceived interpersonal stress and quality of social life, based on a rejection sensitivity model. The databases PubMed, Web of Knowledge and AGRIS, Embase, Medline and PsychINFO were searched for published peer-reviewed journal articles (1980-June 2018). Thirty-two studies met inclusion criteria. Results from the meta-analyses (n = 16 studies) indicated that overweight/obese individuals reported more frequent experiences of teasing/bullying, greater interpersonal stress and poorer quality of social life than healthy weight individuals. Findings in the systematic review aligned to this evidence. Psychological interventions targeting increased sensitivity to negative interpersonal feedback could improve interpersonal functioning and, in turn, eating behaviours in individuals with obesity.

A Reconceptualization of How We Study Issues of Racial Prejudice

This article shows that when confronted with a problem as complex as racial prejudice, researchers cannot afford to limit themselves to studying prejudice from the perspective of Whites. Many argue that in the research that does focus on Blacks and prejudice, Blacks are studied primarily in terms of their reactions to prejudice. This article challenges researchers to examine how Blacks' racial attitudes and behaviors influence intergroup dynamics between Whites and Blacks. Four areas of research in the prejudice and stereotyping literature that could be used to study Blacks' role in understanding racial prejudice are discussed. Moreover, the implications of studying Blacks in these 4 areas are explored.

Promoting the “Social” in the Examination of Social Stigmas

This review highlights the value of empirical investigations examining actual interactions that occur between stigmatizers and targets, and is intended to stimulate and help guide research of this type. We identify trends in the literature demonstrating that research studying ongoing interactions between stigmatizers and targets is relatively less common than in the past. Interactive studies are challenging, complex, and have variables that are sometimes more difficult to control; yet, they offer unique insights and significant contributions to understanding stigma-related phenomena that may not be offered in other (e.g., self-report) paradigms. This article presents a conceptual and empirical overview of stigma research, delineates the unique contributions that have been made by conducting interactive studies, and proposes what can be further learned by conducting more of such research.

Interpersonal Concerns in Social Encounters between Majority and Minority Group Members

Dyadic interactions between Whites and Blacks were examined. Whites' concern about appearing prejudiced was manipulated by informing Whites that it was extremely important not to be prejudiced during the interaction. Blacks' concern about being the target of prejudice was manipulated by informing them that their dyadic partner was prejudiced against Blacks. The findings show that these two concerns differentially impacted individuals' own and their partner's experiences in the interaction. Specifically, Whites who tried not to be prejudiced experienced more anxiety and enjoyed the interaction less, but were liked more by their Black partner. Additionally, Blacks who believed their partner was prejudiced enjoyed the interaction more, and their White partner experienced less anxiety and enjoyed the interaction more. The implications of these findings for interpersonal intergroup encounters are discussed.

Elementary School Students' Perceptions of Overweight Peers

Obesity is a growing epidemic in the United States. Children who are overweight tend to participate in fewer activities, to withdraw from social situations, and to be less physically active than their normal-weight peers. Additionally, they have lower self-image and often suffer from depression. Research on children's perceptions of overweight peers has been sparse, with the few completed studies tending to focus on adolescents. In the current study, participants were asked to listen to four stories, two involving females and two involving males. Following each story, the children were presented with obese and nonobese target pictures and asked to match the two gender-specific pictures of children with the “nice” and “mean” characters from the story. Results show an overall main effect, indicating that the number of “nice” responses given to nonobese target figures was significantly greater than the number given to obese target figures. No gender effects were observed.

Compensating for Stigma: Obese and Nonobese Women's Reactions to Being Visible

The hypothesis that obese women compensate for the prejudice of others was tested by having obese and nonobese women converse by telephone with someone who they believed, correctly or incorrectly, could or could not see them. Partners rated obese women's social skills negatively when the women were visible (thus activating the partners' prejudice) but thought they were not. Obese women rated themselves as more likable and socially skilled than nonobese women did when the women thought they were visible to female partners. Judges' ratings of the women's contribution to the conversation indicated that there were no obvious differences in the impressions created by their verbal or nonverbal behaviors. Results support the hypothesis that obese women who were aware of the need to compensate for their partners' reactions to their appearance were able to do so.

Do Parents Discriminate Against their Heavyweight Daughters?

In a 1991 study, the author found that females were less likely to receive support from their parents for college education if they were fatter than average. This effect is replicated for female undergraduates (n = 576); no effect emerged for males (n = 450). Controlling for income, ethnicity, family size, and number of children attending college did not change the results. The selection bias against fat women was strongest for daughters of political conservatives, a group previously found to endorse antifat attitudes. This suggests that parents' attitudes may lead to discrimination within families. To demonstrate that this may be due to parents' bias, data from a representative sample of high school seniors (n = 3,386) showed no association between politics, weight, and predictors of college attendance, including grade point average, self-rated intelligence and ability, college aspirations, and health. The evidence accumulates that parents are discriminating against their own heavyweight daughters.

Culture, Ideology, and Antifat Attitudes

Research on antifat attitudes in the United States has shown the position of antifat attitudes in an ideological network and the importance of attributions of control to prejudice against fat people. To test the role of blame and ideology in antifat prejudice, the authors compared attitudes among students in the United States and Mexico. Mexican students were significantly less concerned about their own weight and more accepting of fat people than were U.S. students. Antifat attitudes in the United States were part of a social ideology that holds individuals responsible for their life outcomes and may derive from attributions of controllability over life events. Attributions of controllability were significantly less important in Mexico for predicting antifat attitudes, and antipathy toward fat people showed no evidence of being part of an ideological network. Prejudice toward fat people in the United States appears to have a significant ideological component.

Expecting To Be the Target of Prejudice: Implications for Interethnic Interactions

Two studies investigated the implications of ethnic minorities’ prejudice expectations for their affective and behavioral outcomes during interethnic interactions. In both studies, the more ethnic minorities expected Whites to be prejudiced, the more negative experiences they had during interethnic interactions. This finding held true for chronic prejudice expectations in a diary study of college roommates (Study 1) and for situationally induced prejudice expectations in a laboratory interaction (Study 2). In Study 2, the authors extended this work to examine the relationship between ethnic minorities’ prejudice expectancies and their White partners’ psychological experience during interethnic interactions. Consistent with predictions, the more ethnic minorities expected Whites to be prejudiced, the more their White partners had positive experiences during interethnic interactions. These divergent experiences of ethnic minorities and Whites have important implications for the psychological success of interactions between members of these groups.

Body Weight and the Quality of Interpersonal Relationships

We investigate whether underweight, normal-weight, overweight, and obese Americans differ in their evaluations of positive and negative aspects of their interpersonal relationships. Analyses are based on data from the Midlife Development in the United States (MIDUS) study, a survey of more than 3,000 adults ages 25 to 74 in 1995. We find no significant differences across the body mass index (BMI) categories in the quality of relationships with friends, coworkers, and spouses. Severely obese persons report significantly higher levels of strain and lower levels of support in their family relationships. This pattern, however, is contingent upon one's adolescent body weight. Among persons who were of “normal” weight at age 21, current BMI is not associated with relationship quality. For persons who were overweight at age 21, the level of social support received from family during adulthood declines as adult BMI increases. Implications for stigma theory are discussed.

Assessment of interpersonal skills in obese women with binge eating disorder

Based upon interpersonal theory that suggests an association between binge eating disorder (BED) and interpersonal problems, the present study examined empathy and other social skills of obese women with BED. The findings showed that five social skills were statistically associated with the chance of presenting BED. Obese women with less assertiveness, lower ability to express feelings, lower capacity to deal with strangers, lower ability to understand the perspective of others, and with higher levels of distress in interpersonal situations had a higher probability of presenting the diagnosis of BED. These results highlight an association between social skills deficits and BED.

Differences in the desire to eat in children and adults in the presence of an obese eater

Previous research has shown that the desire to eat foods decreases in adults in the presence of an obese eater compared to a normal-weight eater. This study investigated whether or not this decrease in eating desire was observed in younger children in the same way as in adults. Children aged 5 and 8 years old, as well as adults, were presented with photographs of liked and disliked foods presented either alone or with normal-weight and obese eaters expressing three different emotions--pleasure, disgust, and neutrality--toward these food products. The results showed that the eater's weight status had a greater effect on the adults' desire to eat than on that of the children. Adults were influenced by the eater's weight status, regardless of the facial expression or the food category. Compared to adults, the impact of the eater's weight status on the children's desire to eat depended on the emotional facial expression and the children's food preferences. Thus, when children did not like the foods, their eating desire was negatively influenced by the eater's obese status, as was that of adults. On the other hand, when children liked the food products, the eater's weight status had no effect on their eating desire. They were more influenced by the eater's facial expressions. Thus, an expression of pleasure increased the desire to eat the liked foods in the younger children, whereas an expression of disgust decreased it. These results are discussed in terms of the high sensitivity of young children to emotional facial expressions.

Employing immersive virtual environments for innovative experiments in health care communication

OBJECTIVE

This report reviews the literature for studies that employ immersive virtual environment technology methods to conduct experimental studies in health care communication. Advantages and challenges of using these tools for research in this area are also discussed.

METHODS

A literature search was conducted using the Scopus database. Results were hand searched to identify the body of studies, conducted since 1995, that are related to the report objective.

RESULTS

The review identified four relevant studies that stem from two unique projects. One project focused on the impact of a clinician's characteristics and behavior on health care communication, the other focused on the characteristics of the patient. Both projects illustrate key methodological advantages conferred by immersive virtual environments, including, ability to maintain simultaneously high experimental control and realism, ability to manipulate variables in new ways, and unique behavioral measurement opportunities.

CONCLUSION

Though implementation challenges exist for immersive virtual environment-based research methods, given the technology's unique capabilities, benefits can outweigh the costs in many instances.

PRACTICE IMPLICATIONS

Immersive virtual environments may therefore prove an important addition to the array of tools available for advancing our understanding of communication in health care.

Application of virtual reality methods to obesity prevention and management research

There is a great need for empirical evidence to inform clinical prevention and management of overweight and obesity. Application of virtual reality (VR) methods to this research agenda could present considerable advantages. Use of VR methods in basic and applied obesity prevention and treatment research is currently extremely limited. However, VR has been employed for social and behavioral research in many other domains where it has demonstrated validity and utility. Advantages of VR technologies as research tools include the ability to situate hypothetical research scenarios in realistic settings, tight experimental control inherent in virtual environments, the ability to manipulate and control any and all scenario elements, and enhanced behavioral measurement opportunities. The means by which each of these features could enhance obesity prevention and management research is discussed and illustrated in the context of an example research study. Challenges associated with the application of VR methods, such as technological limitations and cost, are also considered. By employing experimental VR methods to interrogate clinical encounters and other health-related situations, researchers may be able to elucidate causal relationships, strengthen theoretical models, and identify potential targets for intervention. In so doing, researchers stand to make important contributions to evidence-based practice innovation in weight management and obesity prevention.

Prevalence of obesity in Switzerland 1992-2007: the impact of education, income and occupational class

Prevalence of excess weight varies substantially by socioeconomic position (SEP). SEP can be defined with different indicators. The strength of the association of SEP with excess weight differs by SEP indicator, between populations and over time. We examined the prevalence of overweight and obesity (body mass index 25-29.9 and ≥30 kg m(-2) ) in Switzerland by educational level, household income tertile and occupational class (three categories for each indicator). Self-reported data stem from four cross-sectional population surveys including 53 588 persons aged between 25 and 74 years. The overall prevalence of overweight increased between 1992 and 2007 from 37.4% to 41.4% in men and from 18.8% to 21.9% in women. Obesity prevalence increased from 7.2% to 9.7% in men and from 5.4% to 8.6% in women. Inequalities were calculated with multivariable logistic regression. Inequalities were larger in women than in men and for obesity than for overweight. However, overweight and obesity inequalities did not significantly change over time, despite overall increasing prevalence. Although all SEP indicators were independently associated with excess weight, the association was strongest with education, particularly in women. Programmes and policies aimed at preventing excess weight should target individuals with low education early in life.

Medical student bias and care recommendations for an obese versus non-obese virtual patient

OBJECTIVE

This study examined the independent effect of a patient's weight on medical students' attitudes, beliefs and interpersonal behavior toward the patient, in addition to the clinical recommendations they make for her care.

DESIGN

A total of 76 clinical-level medical students were randomly assigned to interact with a digital, virtual female patient who was visibly either obese or non-obese.

METHODS

Interactions with the patient took place in an immersive virtual (virtual reality) clinical environment that allowed standardization of all patient behaviors and characteristics except for weight. Visual contact behavior was automatically recorded during the interaction. Afterward, participants filled out a battery of self-report questionnaires.

RESULTS

Analyses revealed more negative stereotyping, less anticipated patient adherence, worse perceived health, more responsibility attributed for potentially weight-related presenting complaints and less visual contact directed toward the obese version of a virtual patient than the non-obese version of the patient. In contrast, there was no clear evidence of bias in clinical recommendations made for the patient's care.

CONCLUSION

Biases in attitudes, beliefs and interpersonal behavior have important implications because they can influence the tone of clinical encounters and rapport in the patient-provider relationship, which can have important downstream consequences. Gaining a clear understanding of the nature and source of weight bias in the clinical encounter is an important first step toward the development of strategies to address it.

Body Size and Social Self-Image among Adolescent African American Girls: The Moderating Influence of Family Racial Socialization

Social psychologists have amassed a large body of work demonstrating that overweight African American adolescent girls have generally positive self-images, particularly when compared with overweight females from other racial and ethnic groups. Some scholars have proposed that elements of African American social experience may contribute to the maintenance of these positive self-views. In this paper, we evaluate these arguments using data drawn from a panel study of socio-economically diverse African American adolescent girls living in Iowa and Georgia. We analyze the relationship between body size and social self-image over three waves of data, starting when the girls were 10 years of age and concluding when they were approximately 14. We find that heavier respondents hold less positive social self-images but also find that being raised in a family that practices racial socialization moderates this relationship.

What determines well-being in obesity? Associations with BMI, social skills, and social support

OBJECTIVE

Theory and research suggest that the stigma associated with obesity has an impact on the development of social skills and social relationships which may be related to subjective well-being. The main objective was to clarify the associations between BMI (kg/m2), social skills, social support and subjective well-being in a sample of obese subjects.

METHODS

Cross-sectional study of 226 obese adults (75 females and 151 males) from the general population between the ages of 19 and 74 [mean (SD), 46.9 (13.7) years]. Mean (SD) BMI of the subjects was 36 (5.3).

OUTCOME MEASURES

subjective well-being was measured by the Satisfaction With Life Scale (SWLS) and by the Positive And Negative Affect Scales (PANAS). Social support was assessed with scales of the Social Support Questionnaire F-SozU and social skills with a short form of the German Insecurity Questionnaire U-24.

RESULTS

Hierarchical regression analysis showed that social support and social skill measures are relevant predictors of subjective well-being (with both independent and shared influences), while BMI is not. The obese people in our study neither differed from other comparison groups in their subjective well-being, nor did they report greater impairments in social skills or social support.

CONCLUSION

BMI does not seem to be the major determinant of low subjective well-being in obesity. As in healthy controls, subjective well-being is principally associated with social skills and social support.

Prevalence, characteristics, and correlates of teasing experiences among overweight children vs. non-overweight peers

OBJECTIVE

Information regarding the prevalence, nature, sources, and psychosocial correlates of teasing was obtained for overweight (OV) children (10 to 14 years of age) vs. non-overweight (non-OV) peers. It was hypothesized that weight-related teasing would be negatively correlated with self-esteem in specific domains and with enjoyment of physical/social activities and positively correlated with loneliness, bulimic behaviors, body dissatisfaction, and enjoyment of sedentary/isolative activities.

RESEARCH METHODS AND PROCEDURES

Teasing experiences and psychosocial correlates were assessed among OV children from a fitness camp and a demographically similar school sample of non-OV children.

RESULTS

Among the OV children, appearance-related teasing was more prevalent, frequent, and upsetting, involved disparaging nicknames focusing more on weight rather than less stigmatized aspects of appearance, and more often perpetrated by peers in general rather than a specific peer. Degree of teasing within the full sample was significantly associated with higher weight concerns, more loneliness, poorer self-perception of one's physical appearance, higher preference for sedentary/isolative activities, and lower preference for active/social activities, all but the latter association holding up above and beyond actual weight status and demographics. Among OV children, teasing was associated with bulimic behaviors. Associations with type of teasing showed specificity, with weight-related teasing predicting weight and appearance variables and competency-related teasing related to social domain factors.

DISCUSSION

When frequency, intensity, emotional impact, and stigmatized content are examined, findings indicate that teasing is more severe for OV children. Effective interventions are needed to help victims cope with and prevent further weight-related teasing, which may improve peer functioning, enhance weight control efforts, and reduce risk for future eating disturbance.

Habilidades sociais em mulheres obesas: um estudo exploratório

Dentre os aspectos psicológicos associados à obesidade, pode-se destacar a qualidade das relações interpessoais, supondo-se que as pessoas com sobrepeso podem, pelas restrições associadas, possuir déficits em habilidades sociais. Esta pesquisa avaliou, em uma amostra de 29 mulheres obesas mórbidas, seus principais déficits em habilidades sociais gerais e diante de demandas de alimentação; e a influência de características sociodemográficas e outros aspectos cognitivos e motivacionais sobre esses déficits. As mulheres responderam o Inventário de Habilidades Sociais, questões sobre Habilidades Assertivas na Alimentação (HAA) e um Questionário sobre Obesidade. A análise mostrou que as mulheres obesas apresentaram déficits principalmente em HAA, sendo semelhantes à amostra normativa nas habilidades gerais; não houve influência de características sociodemográficas; há aspectos cognitivos e motivacionais importantes a serem considerados na análise.

Measurement of attitudes toward obese people among a Canadian sample of men and women

A new scale for examining attitudes toward obese people had 44 items selected from previously published scales designed to indicate attitudes toward obese people. Reliability analysis yielded a Cronbach coefficient alpha of .92 for the total sample. A factor analysis yielded four factors. Employing the Body Mass Index as an indicator of obesity, the attitudes of 239 men and women were examined. Women were significantly more positive than men in their attitude toward obese people. When examining Body Mass Index as a factor, comparisons of obese and nonobese women indicated obese women were more positive on the Diet and Exercise factor of the scale. Suggestions for improvement and research are offered.

Sensitivity to status-based rejection: implications for African American students' college experience

The authors proposed a process model whereby experiences of rejection based on membership in a devalued group can lead people to anxiously expect, readily perceive, and intensely react to status-based rejection. To test the model, the authors focused on race-based rejection sensitivity (RS-race) among African Americans. Following the development and validation of the RS-Race Questionnaire (Studies 1 and 2), the authors tested the utility of the model for understanding African American students' experiences at a predominantly White university (Study 3). Students high in RS-race experienced greater discomfort during the college transition, less trust in the university, and relative declines in grades over a 2- to 3-year period. Positive race-related experiences, however, increased feelings of belonging at the institution among students high in RS-race.

The differential effect of education and occupation on body mass and overweight in a sample of working people of the general population

PURPOSE

To assess whether two indicators of social class, education and occupation, have independent and/or synergistic effects in determining the body mass and overweight.

METHODS

Body mass index (BMI), education, and occupation were assessed in a survey of 1767 men and 1268 women from a representative sample of currently working people of the general population of Geneva, Switzerland. Education and occupation were categorized as low, medium, and high. Overweight was defined as BMI > or = 25 kg/m(2).

RESULTS

The prevalence of overweight was 52.1% in men and 28.7% in women. Men with overweight were more likely to have low education while women with overweight had lower education and lower occupation. Education and occupation were inversely related to BMI in both genders and, in women, had a synergistic effect (p-value for the interaction = 0.03).

CONCLUSIONS

Education and occupation have independent and, in women, synergistic effects on BMI. The two indicators may express different mechanisms through which low social class is related to high body mass.

Behavioral approaches to the problems of obesity

Obesity is a complex and increasingly prevalent disorder that can confer a number of medical, social, and psychological difficulties. As a result, an array of treatment strategies falling under the generic umbrella of "behavior therapy" have been developed and continue to be refined and expanded. In this article, different behavioral approaches to the problems of obesity are outlined and reviewed, specifically, those that target (a) body weight or composition, (b) lifestyle factors and other health-related variables, and (c) related psychological variables such as self-esteem and assertiveness, as well as negative attitudes toward obese persons held by nonobese individuals. For each of these targets of change, approaches to both individual- and group-level interventions are considered. Suggestions for future research and clinical work are offered. Throughout, the importance of conceptualizing obesity as a multifaceted problem is underscored. The necessity for explicit target goals when attempting to modify behavior is also highlighted.

Do obese women have poorer social relationships than nonobese women? Reports by self, friends, and coworkers

Both theory and research suggest that obese women may have relatively poor social relationships even if their self-reports about their relationships do not differ from the reports of nonobese women. Seventy-seven obese and 78 nonobese women completed self-report measures of social anxiety, social self-esteem, social competence, social network size, and perceived social support from friends and family. Friends and coworkers also rated these women on the same measures. The self-reports of obese and nonobese women did not differ significantly on any of these social measures, and ratings from friends and coworkers of obese women were not different from ratings of nonobese women by friends and coworkers. These results suggest that obese women may be able to overcome prejudice against obese people in their relationships with others.

The influence of weight on adolescent self-esteem

Overweight children have traditionally been thought to have lower self-esteem than other children. Prospective data from the California Child Health and Development Studies were used to test this hypothesis by examination of the relationship between body mass index, self-esteem and locus of control while controlling for demographic and baseline psychosocial traits. Principle components and confirmatory factor analysis were used to derive latent constructs for self-esteem, locus of control and other psychosocial factors. A covariance structure model was developed using the results of the confirmatory factor analysis. In this model, adolescent self-esteem, locus of control and body mass index were not related. These findings from prospective data in a non-clinical population suggest that although some subgroups of obese children may be vulnerable for decreased self-esteem, this does not appear to be a significant problem in the general population.