Disgust predicts prejudice and discrimination toward individuals with obesity

How Can Debiasing Research Aid Efforts to Reduce Discrimination?

PUBLIC ABSTRACT

Scientists studying intergroup biases are often concerned with lessening discrimination (unequal treatment of one social group versus another), but many interventions for reducing such biased behavior have weak or limited evidence. In this review article, we argue one productive avenue for reducing discrimination comes from adapting interventions in a separate field-judgment and decision-making-that has historically studied "debiasing": the ways people can lessen the unwanted influence of irrelevant information on decision-making. While debiasing research shares several commonalities with research on reducing intergroup discrimination, many debiasing interventions have relied on methods that differ from those deployed in the intergroup bias literature. We review several instances where debiasing principles have been successfully applied toward reducing intergroup biases in behavior and introduce other debiasing techniques that may be well-suited for future efforts in lessening discrimination.

Emotional relevance and prejudice: testing the differentiated effect of incidental disgust on prejudice towards ethnic minorities

Negative emotions such as disgust or anger influence the evaluation of minorities and amplify prejudice, stereotypes, and discrimination behaviors towards them. However, new discoveries suggest that these spillover effects might be more specific in the sense that the bias might occur only if the emotions are specific to the affect that is generally evoked by that particular minority, i.e. anger increases prejudice towards anger-relevant groups, and disgust towards disgust-relevant groups. Our study aimed to examine, the specificity of the spillover effects, namely the importance of emotion's relevance to the prejudice towards out-groups. To test this hypothesis, we investigated the influence of incidental disgust on the evaluation of two minorities, one that is usually associated with disgust (the Roma minority) and one usually associated with anger (the Hungarian minority). We used a 2 × 2 between-subjects experimental design where we manipulated the emotion experienced by the participants (disgust versus neutral) and the target they evaluated (Romani or Hungarian minority). We tested the effects of these manipulations on three aspects of prejudice toward the target group: cognitive, affective, and behavioral. The results support the specificity of the spillover effect, by showing that incidental disgust increased prejudice only towards the disgust-relevant target, namely the Roma minority, and that the intensity of this emotion experienced by the participants mediates this effect. Moreover, incidental disgust increased not only the negative emotions associated with the Romani (i.e., the affective component) but also the negative cognitions associated with them and the desire to maintain an increased social distance (i.e., behavioral prejudice). These findings highlight the importance of emotions' relevance in bias toward minorities and provide a starting point for future anti-discrimination interventions.

Effects of Disease Threat and Attitude Similarity on Willingness to Help: The Mediating Role of Disgust

The current research tested the hypothesis that an increase in perceived disease vulnerability would create more feelings of disgust and a reduced willingness to help persons with dissimilar attitudes. To test these hypotheses, two studies were performed. In the first study, 173 university undergraduates indicated their willingness to help a target person who held similar or dissimilar attitudes. Then the participants' feelings of disgust about helping, and perceived vulnerability to disease were measured. In the second study, 127 university undergraduates read materials designed to make a disease threat or a non-disease threat salient then indicated their willingness to help a target person with similar or dissimilar attitudes. As predicted a concern about disease and attitude similarity interacted to influence willingness to help and this effect was mediated by feelings of disgust.

Pandemic and prejudice: Revisiting Bogardus’s social distance concept in a time of COVID-19

This study examined when the realistic threat of COVID-19 leads to prejudicial social distancing. American participants reported social distancing preferences from Chinese or Italian people (out-group target) after viewing increasing or decreasing COVID-19 case numbers (threat level) in China or Italy (threat relevance). On the Bogardus Social Distance Scale, there was support for a disease avoidance hypothesis: greater social distancing preferences were expressed under higher than under lower relevant threats. Responses on a bespoke COVID-19 Social Distance Scale, however, supported an a priori prejudice hypothesis: greater social distancing preferences were expressed toward a Chinese than toward an Italian out-group. Moreover, responses on a separate bespoke Modern Social Distance Scale supported a complex prejudice hypothesis: greater social distancing preferences were expressed toward Chinese than toward Italian out-groups under higher than under lower threat, regardless of threat relevance. These findings suggest that the threat of COVID-19 may enable prejudice expression accompanied by the rationale of disease avoidance.

Pseudo-Contamination and Memory: Is There a Memory Advantage for Objects Touched by "Morphologically Deviant People"?

Memory plays an important role in the behavioral immune system (BIS; Schaller in Psychological Inquiry, 17(2), 96-101, 2016a), a proactive immune system whose ultimate function is to make organisms avoid sources of contamination. Indeed, it has been found that objects presented next to sick people are remembered better than objects shown next to healthy people-representing a contamination effect in memory. In the present studies, we investigated this memory effect in relation to "pseudo-contaminated" sources, that is to say, people exhibiting cues ultimately evoking the threat of contamination but objectively posing no such threat in terms of disease transmission. Common objects were shown next to photographs of people having three kinds of morphological deviations-obesity (study 1), scars and burns (study 2), strange eyes (study 3)-or no morphological deviation. Contrary to our expectations, we found that "pseudo-contaminated objects" were not remembered better than "non-contaminated objects," whereas discomfort ratings of the idea of touching the same objects were clearly higher with morphologically deviant people. Memory mechanisms do not seem to be mobilized by "pseudo-contamination" sources which are not directly related to infection risk.

"Feeling fat," disgust, guilt, and shame: Preliminary evaluation of a mediation model of binge-eating in adults with higher-weight bodies

"Feeling fat" is a subjective state that theoretically contributes to the maintenance of binge eating (BE). However, feeling fat, and its relation to BE among individuals with higher-weight bodies, has been infrequently studied. This study proposes a momentary-level model in which negative moral emotion states (disgust, guilt, shame) mediate the association between feeling fat and binge eating. In this study, 50 adults with higher-weight bodies (MBMI=40.3 ± 8.5 kg/m2; 84% female) completed a two-week ecological momentary assessment protocol, which measured experiences of feeling fat, emotion states, and binge-eating behavior. Univariate generalized linear mixed models (GLMM) evaluated the momentary associations among levels of feeling fat at Time 1, emotion states at Time 2, and binge eating at Time 2, controlling for Time 1 emotion states. GLMM results suggest that increases in each emotion from Time 1 to Time 2 mediated the association between Time 1 feeling fat and Time 2 binge eating. When modeled simultaneously within one multivariate multilevel structured equation model, disgust appeared to drive the relation between feeling fat and binge eating, over and above guilt and shame. Although preliminary, findings suggest increases in negative moral emotions, particularly disgust, mediate the feeling fat-binge eating association in adults with higher-weight bodies.

The Double Bind of Communicating About Zoonotic Origins: Describing Exotic Animal Sources of COVID-19 Increases Both Healthy and Discriminatory Avoidance Intentions

Many novel diseases are of zoonotic origin, likely including COVID-19. Describing diseases as originating from a diverse range of animals is known to increase risk perceptions and intentions to engage in preventative behaviors. However, it is also possible that communications depicting use of exotic animals as food sources may activate stereotypes of cultures at the origin of a disease, increasing discriminatory behaviors and disease stigma. We used general linear modeling and mediation analysis to test experimental data on communications about zoonotic disease origins from the critical first two months leading up to the declaration of a global pandemic. Results suggest that communications about potential familiar food origins (pigs) affected people's risk perceptions, health behaviors, and COVID-19 stigma compared to more exotic food sources (e.g., snakes). Participants (N = 707) who read descriptions of exotic origins viewed the virus as riskier and reported stronger intentions to engage in preventative behaviors than those who read about familiar origins (pigs). However, reading exotic origin descriptions was also associated with stronger intentions to avoid Asian individuals and animal products. These results are critical for both theory and public policy. For theory, they are the first to experimentally demonstrate that zoonotic origin descriptions can impact intentions to engage in discriminatory behaviors for cultures viewed as the origin of a novel infectious disease. For policy, they offer clear, actionable insights on how to communicate about risks associated with a novel zoonosis while managing the potential impact on discriminatory behaviors and stigma.

Bodies and Minds: Heavier Weight Targets Are De-Mentalized as Lacking in Mental Agency

Five experiments investigate the hypothesis that heavier weight individuals are denied mental agency (i.e., higher order cognitive and intentional capacities), but not experience (e.g., emotional and sensory capacities), relative to average weight individuals. Across studies, we find that as targets increase in weight, they are denied mental agency; however, target weight has no reliable influence on ascriptions of experience (Studies 1a-2b). Furthermore, the de-mentalization of heavier weight targets was associated with both disgust and beliefs about targets' physical agency (Study 3). Finally, de-mentalization affected role assignments. Heavier weight targets were rated as helpful for roles requiring experiential but not mentally agentic faculties (Study 4). Heavier weight targets were also less likely than chance to be categorized into a career when it was described as requiring mental agency (versus experience; Study 5). These findings suggest novel insights into past work on weight stigma, wherein discrimination often occurs in domains requiring mental agency.

The Impact of Perspective Taking on Obesity Stereotypes: The Dual Mediating Effects of Self-Other Overlap and Empathy

Previous studies have indicated that obese people face many forms of severe prejudice and discrimination in various settings, such as education, employment, and interpersonal relationships. However, research aimed at reducing obesity stereotyping is relatively rare, and prior studies have focused primarily on negative stereotypes. Based on the empathy-altruism hypothesis and self-other overlap hypothesis, this study investigates the impact of perspective taking (PT) on both positive and negative obesity stereotypes and examines the mediating effects of empathy and self-other overlap. A sample of 687 students (191 males and 496 females) at Chinese universities participated by completing self-report questionnaires on trait tendency and evaluation toward obese people. Structural equation modeling and the bootstrap method revealed that self-other overlap (but not empathy) mediated the relationship between PT and negative obesity stereotypes. While self-other overlap and empathy both mediated the relationship between PT and positive obesity stereotypes. These findings address the importance of PT for improving positive and negative obesity stereotypes: specifically, PT promotes psychological merging, and produces empathic concern (EC).

Adults' attitudes toward children, adolescents, and adults who are obese and tax-funded programs to combat obesity

The goals of the present study were to assess (1) adults' patterns of beliefs about and attitudes toward children, adolescents, and adults who are obese and (2) their attitudes toward hypothetical tax-funded programs designed to combat obesity in children, adolescents, and adults. A total of 267 participants, ranging in age from 19 to 88 years old, were recruited through Amazon's Mechanical Turk (MTurk) to participate online in the present study. The participants rated adults who are obese less favorably, and as less malleable, than children or adolescents who are obese. Furthermore, they were less supportive of tax-funded programs designed to combat obesity in adults than children or adolescents. In general, the participants' relatively unfavorable response to adults who are obese appears to be associated with the beliefs that older individuals who are obese are relatively unchangeable and have heightened personal fault for their plight.

Individual differences in avoiding feelings of disgust: Development and construct validity of the disgust avoidance questionnaire

We developed and examined the construct validity of the Disgust Avoidance Questionnaire (DAQ) as a measure of people’s inclination to prevent experiencing disgust (disgust prevention) and to escape from the experience of disgust (disgust escape). In a stepwise item-reduction (Study 1; N = 417) using Exploratory Factor Analysis (EFA) based on a 4-subscale distinction (behavioral prevention, cognitive prevention, behavioral escape, cognitive escape), we selected 17 items from a pool of potential items. In order to incorporate the conceptual overlap between dimensions of disgust avoidance, focus (prevention vs. escape), and strategy (behavioral avoidance vs. cognitive avoidance), we specified an adapted model. In this model, we allowed each item to load on one type of dimension and one type of strategy, resulting in four overlapping factors (prevention, escape, behavioral avoidance, cognitive avoidance). Evaluation of this overlapping 4-factor model (Study 2; N = 513) using Exploratory Structural Equation Modeling (ESEM) and Confirmatory Factor Analysis (CFA) showed promising model fit indices, factor loadings, factor correlations, and reliability estimates for three of the four factors (prevention, behavioral avoidance, cognitive avoidance). Those three subscales also showed good convergent validity. In contrast, the results related to the escape factor may call the suitability of self-report to assess disgust escape into question. In light of the exploratory nature of the project, future examinations of the DAQ’s validity and applicability to more diverse samples are essential. A critical next step for future research would be to examine the DAQ’s criterion validity and the distinctive roles of the DAQ subscales in (clinical) psychological constructs and processes.

Body Image Disturbances and Weight Bias After Obesity Surgery: Semantic and Visual Evaluation in a Controlled Study, Findings from the BodyTalk Project

Purpose

Body image has a significant impact on the outcome of obesity surgery. This study aims to perform a semantic evaluation of body shapes in obesity surgery patients and a group of controls.

Materials and Methods

Thirty-four obesity surgery (OS) subjects, stable after weight loss (average 48.03 ± 18.60 kg), and 35 overweight/obese controls (MC), were enrolled in this study. Body dissatisfaction, self-esteem, and body perception were evaluated with self-reported tests, and semantic evaluation of body shapes was performed with three specific tasks constructed with realistic human body stimuli.

Results

The OS showed a more positive body image compared to HC (p < 0.001), higher levels of depression (p < 0.019), and lower self-esteem (p < 0.000). OS patients and HC showed no difference in weight bias, but OS used a higher BMI than HC in the visualization of positive adjectives (p = 0.011). Both groups showed a mental underestimation of their body shapes.

Conclusion

OS patients are more psychologically burdened and have more difficulties in judging their bodies than overweight/obese peers. Their mental body representations seem not to be linked to their own BMI. Our findings provide helpful insight for the design of specific interventions in body image in obese and overweight people, as well as in OS.

Lack of guilt, shame, and remorse following weight stigma expression: a real-time assessment pilot study

Objective

Weight stigma is pervasive and is associated with negative health and psychological outcomes. Few studies have examined weight stigma perpetration or the emotions individuals experience after perpetrating weight stigma. This study used experience sampling to explore the nature and frequency of weight stigma behaviors and cognitions and moral emotions (shame, guilt, remorse, pride) in the perpetrator following weight stigma perpetration.

Methods

Participants were college students (N = 31, 77.1% female). Participants completed baseline measures of anti-fat attitudes and one week of experience sampling phone prompts assessing: (1) weight stigma behaviors and cognitions and (2) moral emotions. Generalized estimating equation analyses were used to model trajectories of moral emotions after weight stigma events.

Results

Thirty-one participants reported 1,008 weight stigma events over 7.5 days. Feelings of guilt, shame, and remorse decreased after weight stigma perpetration. Individuals also reported feeling less proud after engaging in weight stigma.

Conclusions

Weight stigma occurs frequently as reported by perpetrators. A lack of remorse, guilt, and shame is evident in undergraduates after they express weight stigma; however, individuals in this study also reported feeling less pride after perpetration. This study highlights the need for future studies to explore the expression of weight stigma from the perspective of perpetrators instead of targets. Results highlight the pervasiveness and normative nature of weight stigma perpetration in everyday life and the need to better understand the emotional response following weight stigma perpetration as a potential mechanism of its perpetuation.

Attitudes Towards Appearance and Body-Related Stigma Among Young Women With Obesity and Psoriasis

The goal of this study was to investigate the role of the subjective assessment of one's body image in the relationship between objective indices of appearance and perceived stigma in young women affected by obesity and psoriasis. These are chronic diseases that decrease one's physical attractiveness and are associated with stigmas related to body defects. A total of 188 women in early adulthood took part in the study (M = 25.58; SD = 2.90), including obese women (n = 54), women suffering from psoriasis (n = 57), and a control group (n = 77). The participants completed the Multidimensional Body-Self Relations Questionnaire, Perceived Stigmatisation Questionnaire, and a socio-demographic questionnaire. Anthropometric data were gathered using a body composition analyzer. Objective parameters of body shape were calculated (WHR and ICO). Subjective assessment of one's body and attitudes towards one's body were found to influence perceived stigma, independently of the condition causing the stigma and of the objective appearance of the participant. This study did not support the existence of a relationship between parameters regarding body shape and sense of stigma, even when subjective body assessment acted as a moderator. At the same time, body mass was a strong predictor of levels of perceived stigma. Women affected with obesity perceived a higher level of stigma than the other groups. The severity of psoriasis did not impact the perceived stigma. Moreover, women with psoriasis assessed their health-as a part of the assessment of their bodies-the highest, which may explain the lower perceived stigma in this group.

Weight Stigmatization among Physical Therapy Students and Registered Physical Therapists

INTRODUCTION

Weight stigmatization is reflected in anti-fat attitudes and stereotypical perceptions of people who are overweight; it has been demonstrated to be prevalent in many segments of society across multiple countries. Studies examining the prevalence of weight stigmatization use different research tools, which can hinder inter-study comparisons. There is also evidence indicating weight stigmatization among registered physical therapists, although its magnitude differs between studies. Limited information exists regarding the attitudes and beliefs of physical therapy (PT) students toward individuals with obesity. Examining weight stigmatization among PT students is particularly important for developing appropriate educational interventions that may influence the professional lives of future physical therapists.

OBJECTIVE

This study aims to characterize and compare the stigmatizing attitudes and beliefs of PT students and certified physical therapists regarding people with obesity in Israel. Its secondary objective is to translate three weight stigmatization questionnaires into Hebrew and determine their psychometric properties.

METHODS

A cross-sectional, anonymous, and computerized self-report survey was completed by 285 certified physical therapists (average age 39.6 ± 10.1 years) and 115 PT students (average age 26.4 ± 4.9 years). The study used three validated weight stigma questionnaires employed in earlier studies to determine different aspects of weight stigmatization: the Fat Phobia Scale (short form; FPS), Anti-Fat Attitudes (AFA) questionnaire, and Beliefs about Obese People (BAOP). These questionnaires were translated into Hebrew and their psychometric properties ascertained.

RESULTS

Similar to the original English versions, the translated versions of the three questionnaires demonstrated good internal consistency (Cronbach's α values of FPS = 0.77; AFA = 0.75; BOAP = 0.59). The three questionnaires showed a low correlation. No significant difference was noted in the FPS and AFA scores between groups, reflecting that both demonstrated average weight stigmatization (FBS in both groups: average score of 3.6 out of 5; AFA therapists: 3.3 ± 1.2, students: 3.0 ± 1.2 out of 9). However, significant between-group differences were observed for BOAP, which examines beliefs regarding individuals' control over their weight (therapists: 16.4 ± 5.6, students: 18.0 ± 5.7 out of 48; p < 0.01).

CONCLUSION

Student and certified physical therapists demonstrate average levels of weight stigmatization, as reflected in the FPS and AFA scores. Nevertheless, compared to certified physical therapists, physical therapist students believe more strongly that obesity cannot be controlled by the individual. The students' beliefs could affect their clinical judgment and behavior as health care professionals in the future. Therefore, anti-fat attitudes and stereotypical perceptions should be addressed and remediated early using educational interventions during the study period.

Women With Obesity Are Not as Curvy as They Think: Consequences on Their Everyday Life Behavior

Two studies explore the impact of body size on daily life activities of women with obesity. In the first study, ethnographic techniques (first-person perspective video recordings) and subsequent interviews based on the video recordings were used. Results showed atypical behavior of women with obesity and ex-obese women related to memories of embarrassing experiences regarding personal body size (sitting, passing doors sideways, over-careful navigation in public space, and choosing clothes sizes too large.) Women with obesity seem to behave as if they thought they had a larger body than it actually was. These atypical behaviors are related to memories of embarrassing experiences regarding personal body size and stigma. Overweight women exhibit the same behavior but to a lesser and less systematic degree. In the second study, the represented (imagined) body size was compared to the perceived (in a mirror) body size with digital morphing techniques. In the mirror condition, the perceived image is accurate, while in the absence of a mirror women with obesity overestimate their body size by about 30%. Moreover, overestimation of imagined body size increased according to the weight status. Finally, women who had bariatric surgery had poorer estimates than women who had not. This would result of being continuously reminded of obesity and its stigma by daily embarrassing experiences, by being confronted with an environment designed for normal weight (e.g., narrow seats, turnstiles etc.) that makes obesity salient. We suggest that body size overestimation is a case of accentuation where things that matter are perceived bigger. These results could also been explained by the allocentric lock theory.

Understanding fatness in the public sphere of young students: social representations and emotional response

This study examines how youth collectively represent fatness and determines the emotions it arouses. Understanding how fatness is socially constructed by young people is crucial to create programs that better deal with it. A free association exercise elicited by the word "fatness" was answered by 200 people of the Autonomous Community of the Basque Country (Spain), and the content was analyzed by its lexicon using Alceste software. The results showed that health-related representation of fatness was mostly descriptive, and it was not connected to risky or any emotional response. But fatness was also completely represented as a social pressure issue related to stigmatization and highly correlated with negative emotions, such as sadness, insecurity, embarrassment, anguish, lonesomeness, pity or anger. That is, risky and negative emotions were linked to social non-acceptance, and not with health problems. Thus, the conclusion is that fatness is transmitted from fear and not from a positive construction of the health.

The stigma of clean dieting and orthorexia nervosa

BACKGROUND

Although the stigma of eating disorders such as anorexia has been well established, little is known about the social consequences of "clean dieting" and orthorexia nervosa. In two studies, we examined the social stigma of clean dieting and orthorexia.

METHOD

In Study 1, participants read a vignette describing a woman following a "clean" diet, a woman with anorexia, or a control target (minimal information about the individual). In Study 2, participants read a vignette describing a woman with orthorexia, a woman displaying identical orthorexic behaviors but without the orthorexia label, a woman with anorexia, or a control target. Participants then rated the target individual on a range of measures assessing stereotypes, emotions, and behavioral intentions toward the target.

RESULTS

Study 1 found that the clean-dieting target was evaluated more negatively than the control target on some dimensions, but less negatively than the target with anorexia nervosa. Study 2 found that evaluations of the targets with orthorexia nervosa were more negative than evaluations of a control target, but did not differ from evaluations of the target with anorexia nervosa. Perceptions of the target's control over her behavior were associated with more positive evaluations (Studies 1 and 2), whereas perceptions of blame and responsibility for the condition were associated with more negative evaluations (Study 2).

CONCLUSIONS

Overall, these findings highlight the potential negative social consequences of clean dieting and orthorexia nervosa, and point to perceptions of control and blame as potential mechanisms underlying the stigma of these conditions.

Positioning of Weight Bias: Moving towards Social Justice

Weight bias is a form of stigma with detrimental effects on the health and wellness of individuals with large bodies. Researchers from various disciplines have recognized weight bias as an important topic for public health and for professional practice. To date, researchers from various areas have approached weight bias from independent perspectives and from differing theoretical orientations. In this paper, we examined the similarities and differences between three perspectives (i.e., weight-centric, non-weight-centric (health-centric), and health at every size) used to understand weight bias and approach weight bias research with regard to (a) language about people with large bodies, (b) theoretical position, (c) identified consequences of weight bias, and (d) identified influences on weight-based social inequity. We suggest that, despite differences, each perspective acknowledges the negative influences that position weight as being within individual control and the negative consequences of weight bias. We call for recognition and discussion of weight bias as a social justice issue in order to change the discourse and professional practices extended towards individuals with large bodies. We advocate for an emphasis on social justice as a uniting framework for interdisciplinary research on weight bias.