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«Stigmatisation and obesity: literature update Stigmatisation and obesity: Literature update February 2015 Published February 2015 by the UK Health ...»

-- [ Page 1 ] --

2015

Stigmatisation and

obesity: literature

update

Stigmatisation and obesity: Literature update

February 2015

Published February 2015 by the UK Health Forum for the Obesity Learning Centre

UK Health Forum,

Fleetbank House,

2-6 Salisbury Square,

London, EC4Y 8JX

The Obesity Learning Centre (OLC) is the nationwide centre for quality assured information for

everyone working in obesity. The OLC sets out to strengthen and support local capacity

and capabilities to treat overweight in children and adults.

The OLC is maintained by the Research Information Services team at the UK Health Forum and works closely with Public Health England.

The Obesity Learning Centre is maintained and provided by the UK Health Forum.

www.obesitylearningcentre.org.uk The UK Health Forum is a charitable alliance of professional and public interest organisations working to reduce the risk of avoidable non-communicable diseases (NCDs) by developing evidence-based public health policy and supporting its implementation through advocacy and information provision.

www.ukhealthforum.org.uk Obesity Learning Centre Literature Update: Stigmatisation and obesity. February 2015 1 Inside this literature update Contents Stigmatisation and obesity: Literature update

February 2015

Inside this literature update

About this literature update

Attitudes towards and perceptions of obesity affecting children and young people

Obesity and stigmatisation in health and care settings

Public perceptions of and attitudes towards obesity

Stigmatization of and discrimination against obese individuals in the workplace

Portrayals of obesity in the media

Effect of stigmatization

Measuring stigmatization

Self-perception and self-stigmatization in obese individuals

Obesity stigmatization and public health planning

Further reading

Appendix: Search strategy

PubMed & Cochrane Library MeSH search strategy

Google Scholar search strategy

Search record

Obesity Learning Centre Literature Update: Stigmatisation and obesity. February 2015 2 About this literature update This literature update has been designed and carried out by qualified information professionals at the UK Health Forum in order to provide an update on published literature on the topic of stigmatization issues relating to obesity. This topic has been selected for the final update in this series in order to highlight the importance of understanding the impact of stigma on people who are obese, not just in terms of their own mental health and well-being, but also their access to services and experience of discrimination, and the influence of public perceptions on policy making.

The search carried out to prepare this update was not a systematic literature search, and was carried out purely for the purposes of delivering a brief update on the named topic. The aim of this update is to highlight open access research on the named topic. The body of the document contains links to open access research, while the ‘Further reading’ section contains details of content accessible by subscription only. If you require a comprehensive update on the named topic you are advised to carry out a systematic search using a full range of appropriate databases.

Readers should note that absence of evidence does not indicate absence of effect. The area covered by this update is an area where the amount and level of available evidence is still developing. This update focuses on peer reviewed and commercially published research, with some unpublished or ‘grey’ non-commercially produced literature such as government reports, policy documents, or publications produced by organisations such as charities and NGOs. If you require a comprehensive update on grey literature for the named topic you are advised to include grey literature sources in your search.

The UK Health Forum produces a weekly news and grey literature update service and eLibrary called Prevention Information and Evidence. This eLibrary contains obesity and nutrition grey

literature and is available from the Obesity Learning Centre website:

http://www.obesitylearningcentre.org.uk/resources/prevention-information-evidence/

To assist the reader the results of the search have been presented in themes as follows:

Attitudes towards and perceptions of obesity effecting children and young people  Obesity and stigmatisation in health and care settings  Public perceptions of and attitudes towards obesity  Stigmatization of and discrimination against the obese in the workplace  Portrayals of obesity in the media  Effect of stigmatization  Measuring stigmatization  Self-perception and self-stigmatization in obese individuals  Obesity stigmatization and public health planning 

–  –  –

Attitudes towards and perceptions of obesity affecting children and young people ANESBURY, T. & TIGGEMANN, M. 2000. An attempt to reduce negative stereotyping of obesity in children by changing controllability beliefs. Health Educ Res, 15, 145-52.

Access full text: http://www.ncbi.nlm.nih.gov/pubmed/10751373 Aim: The purpose of the present study was to investigate whether changing children's beliefs about the controllability of obesity would reduce their negative attitudes toward fat people.





The participants were 74 children from Grades 4-6, 42 in the experimental group and 32 in the control group. The experimental group were presented with a brief intervention which focussed on the uncontrollability of weight.

Conclusion: The study found that the intervention was successful in reducing the amount of controllability that children assigned to obesity, but was not successful in reducing negative stereotyping of the obese among the experimental group compared to the control group.

These results indicate that while children's beliefs about the controllability of obesity can be changed, reducing their negative stereotyping is more difficult.

BELL, S. K. & MORGAN, S. B. 2000. Children's attitudes and behavioral intentions toward a peer presented as obese: does a medical explanation for the obesity make a difference? J Pediatr Psychol, 25, 137-45.

Access full text: http://jpepsy.oxfordjournals.org/content/25/3/137.full.pdf Aim: To examine the effect of information on children's attitudes and behavioral intentions toward a peer presented as obese.

Conclusion: Ratings were generally more favorable for the average-weight than for the obese condition. However, provision of medical information had a positive effect on attitudes toward the obese peer only for younger children and a negative effect on willingness of older children to share academic activities with the peer. Boys and girls showed more positive behavioral intentions toward the same-sex target child regardless of obesity condition. Information explaining obesity has a minimal positive effect on children's attitudes and behavioral intentions toward a peer presented as obese.

BURMEISTER, J. M., KIEFNER, A. E., CARELS, R. A. & MUSHER-EIZENMAN, D. R. 2013. Weight bias in graduate school admissions. Obesity (Silver Spring), 21, 918-20.

Access full text: http://www.ncbi.nlm.nih.gov/pubmed/23784894 Aim: Whether weight bias occurs in the graduate school admissions process is explored here.

Specifically, we examined whether body mass index (BMI) was related to letter of recommendation quality and the number of admissions offers applicants received after attending in-person interviews.

Conclusion: Higher BMI significantly predicted fewer post-interview offers of admission into Obesity Learning Centre Literature Update: Stigmatisation and obesity. February 2015 4 psychology graduate programs. Results also suggest this relationship is stronger for female applicants. BMI was not related to overall quality or the number of stereotypically weightrelated adjectives in letters of recommendation. Surprisingly, higher BMI was related to more positive adjectives in letters. The first evidence that individuals interviewing applicants to graduate programs may systematically favor thinner applicants is provided here. A conscious or unconscious bias against applicants with extra body weight is a plausible explanation.

Stereotype threat and social identity threat are also discussed as explanations for the relationship between BMI and interview success.

DAVISON, K. K. & BIRCH, L. L. 2004. Predictors of fat stereotypes among 9-year-old girls and their parents. Obes Res, 12, 86-94.

Access full text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2530916/ Aim: To assess familial links in fat stereotypes and predictors of stereotypes among girls and their parents.

Conclusion: Girls and parents exhibited fat stereotypes. Fathers who were more educated and had a higher family income were more likely to endorse fat stereotypes, as were mothers and fathers with a high investment in their physical appearance. Although no associations were found between girls' and parents' fat stereotypes, girls were more likely to endorse fat stereotypes when interactions with parents and peers focused on body shape and weight loss.

Girls were also more likely to endorse fat stereotypes when they reported higher levels of maladaptive eating attitudes. No associations were found between weight status and fat stereotypes.

EDMUNDS, L. D. 2005. Parents' perceptions of health professionals' responses when seeking help for their overweight children. Fam Pract, 22, 287-92.

Access full text: http://www.ncbi.nlm.nih.gov/pubmed/15772121 Aim: The aim was to explore parents' perceptions of help-seeking experiences with health professionals.

Conclusion: Parents went through a complex process of monitoring and self-help approaches before seeking professional help. The responses they received from GPs included: being sympathetic, offering tests and further referrals, general advice which parents were already following, mothers were blamed, or dismissed as "making a fuss", and many showed a lack of interest. Health visitors offered practical advice and paediatric dietitians were very supportive.

Experiences with community dietitians were less constructive.

GREENLEAF, C., MARTIN, S. B. & RHEA, D. 2008. Fighting fat: how do fat stereotypes influence beliefs about physical education? Obesity (Silver Spring), 16 Suppl 2, S53-9.

Access full text: http://www.ncbi.nlm.nih.gov/pubmed/18978764 Aim: The purpose of this study was to examine college students' beliefs about youth obesity, the roles of schools and physical education in addressing obesity, and the training they receive to work with overweight youth.

Conclusion: The importance of youth being normal weight was rated most highly among participants in physical education-related majors and among those who endorsed fat stereotypes. Participants who endorsed fat stereotypes, compared to those who did not, were more likely to believe that all school professionals should be involved in treating childhood obesity. Participants who endorsed fat stereotypes, compared to those who did not, more Obesity Learning Centre Literature Update: Stigmatisation and obesity. February 2015 5 strongly agreed that physical educators should be role models by maintaining normal weight and educating parents on childhood obesity, and PE classes should focus on lifelong fitness.

No group differences in perceived competencies to develop exercise, weight loss, nutritional, and educational programs for overweight youth were found.

GRIFFITHS, L. J. & PAGE, A. S. 2008. The impact of weight-related victimization on peer relationships: the female adolescent perspective. Obesity (Silver Spring), 16 Suppl 2, S39-45.

Access of full text: http://www.ncbi.nlm.nih.gov/pubmed/18978762 Aim: Obesity is associated with undesirable psychological and social consequences. This qualitative study examined the relationship between obesity and victimization, and the impact this has on peer relationships.

Conclusion: Weight-related victimization experiences were common and their impact on peer relationships was complex. Low self-confidence, isolation, and peer anxiety were all identified as resulting from victimization and were all barriers to developing peer relationships.

Participants sought protection from victimization by seeking the "ideal" nonjudgmental empathetic best friend(s) and supportive family members to shield them from negative experiences. However there was also evidence that, while they were guarded with their own feelings, the experience of victimization increased empathy in these obese female adolescents.

KRAIG, K. A. & KEEL, P. K. 2001. Weight-based stigmatization in children. Int J Obes Relat Metab Disord, 25, 1661-6.

Access full text: http://www.nature.com/ijo/journal/v25/n11/full/0801813a.html Aim: To examine sex differences in children's weight-based stigmatization. DESIGN: Schoolbased sample of children evaluating qualities of children of varying weights. SUBJECTS: Thirtyfour children (age, 7-9 y; body mass index (BMI) 12.1-31.2 kg/m2).

Conclusion: Children evaluated drawings of thin children most favorably and drawings of chubby children least favorably. Thin girls were rated more favorably than average or chubby girls, for whom ratings did not differ significantly. Conversely, chubby boys were rated less

favorably than average or thin boys for whom ratings did not differ significantly. CONCLUSION:

These patterns may further explain gender differences in motivation to lose weight.

LATNER, J. D., SIMMONDS, M., ROSEWALL, J. K. & STUNKARD, A. J. 2007. Assessment of obesity stigmatization in children and adolescents: modernizing a standard measure. Obesity (Silver Spring), 15, 3078-85.

Access full text: http://www.ncbi.nlm.nih.gov/pubmed/18198317 Aim: Stigmatization of overweight children is highly prevalent. However, the measurement of stigma has varied widely across studies. An up-to-date version of a commonly used measure of weight-related stigma is needed. scales (VASs).

Conclusion: Rankings of liking of the new figures were highly correlated with rankings of corresponding old figures, especially for overweight figures [boys: rho (77) = 0.72, p 0.001;



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