Dissertation
Weight stigma: prevalence and associated health consequences
University of Iowa
Doctor of Philosophy (PhD), University of Iowa
Autumn 2019
DOI: 10.17077/etd.005251
Abstract
Weight stigma is a pervasive problem that has been linked to poor physical and psychological health outcomes, particularly for persons labeled as obese. Despite its attention, little responsibility has been placed on the role of causal misattributions and inappropriate interventions that contribute to the stress brought on by weight stigma. In this paper, we propose a comprehensive model to describe the complex relationship between weight stigma, causal misattributions for obesity, and interventions in a stressful environment that ultimately leads to adverse health outcomes. We propose that causal misattributions and ineffective interventions are key components of the stressful environment created by weight stigma and up to this point, have been neglected in weight stigma research.
Weight stigma, the mistreatment of individuals due to their body size, is a well-documented problem, however, has yet to remain a healthcare priority. Weight stigma can lead to injustice and inequity in employment, healthcare services, educational opportunities and subsequently have a negative impact on health. Current prevalence estimates for weight stigma are grossly misrepresented, likely due to inadequate methods of estimating prevalence. The purpose of this study was to determine the prevalence of the two types of weight stigma, weight self-stigma and enacted weight stigma, in a large, diverse sample of adults. This cross-sectional study included 3,821, primarily non-Hispanic, white adults (86%; N=3304) at least 18 years of age who completed an electronic survey that measured the two types of weight stigma, weight self-stigma and enacted weight stigma and the belief about personal responsibility for obesity. Weight self-stigma was measured using the Weight Bias Internalization Scale (WBIS)and enacted weight stigma was measured using a series of five questions. Relevant contextual factors included demographic characteristics, body mass index (BMI), and belief about obesity. The prevalence of weight self-stigma was 24% (N=912) and the overall prevalence of enacted weight stigma ranged from 15 to 56%, depending on the question. Overall, women and individuals identifying as other genders reported higher levels of both weight self-stigma and enacted weight stigma. Eighty percent of our sample believed that obesity is under personal control (N=2964), or that individuals are personally responsible for their weight and that contributed to weight self-stigma. Our study provides a comprehensive description of the prevalence of weight stigma and associations according to demographic, body weight, and belief about personal responsibility for obesity.
Persons labeled as obese are stigmatized because of their weight and subject to ridicule, discrimination, teasing, or bullying. This mistreatment may affect health and has been linked to poor physical and psychological health outcomes. The purpose of this study was to determine the relationship between weight stigma and health including outcomes, behavior, and utilization. This cross-sectional study had 3,821 participants who completed an electronic survey measuring weight self-stigma (Weight Bias Internalization Scale), enacted weight stigma (five question series), obesity related disease outcomes, health behavior (dieting and exercise), and healthcare utilization (avoidance, delayed care and disregarded medical concerns). In our sample, we had 80% female (N=3055), 86% (N=3304) non-Hispanic White, and the majority aged 18-44 (72%; N=2750). This is the first study to report significant associations between weight stigma and multiple disease outcomes including hypertension, hyperglycemia, thyroid disorder, overweight or obesity, chronic pain, infertility, anxiety, depression, eating disorders, arthritis, and hyperlipidemia or hypercholesterolemia. Weight stigma was significantly associated with health behaviors include dieting or intense exercise for weight loss and use of over the counter medications for weight loss. Delayed or avoidance of care and having a medical concern disregarded due to weight was also significantly associated with weight stigma.
Details
- Title: Subtitle
- Weight stigma: prevalence and associated health consequences
- Creators
- April Bachinski Prunty
- Contributors
- M Kathleen Clark (Advisor)Melissa Lehan-Mackin (Committee Member)Patricia Groves (Committee Member)Helena Laroche (Committee Member)Sharon Tucker (Committee Member)Stephanie Edmonds (Committee Member)
- Resource Type
- Dissertation
- Degree Awarded
- Doctor of Philosophy (PhD), University of Iowa
- Degree in
- Nursing
- Date degree season
- Autumn 2019
- DOI
- 10.17077/etd.005251
- Publisher
- University of Iowa
- Number of pages
- xiii, 167 pages
- Copyright
- Copyright 2019 April Bachinski Prunty
- Language
- English
- Description illustrations
- color illustrations
- Description bibliographic
- Includes bibliographical references (pages 158-167)
- Public Abstract (ETD)
Weight stigma is the mistreatment, teasing, bullying, or discrimination against an individual because of their body size. Weight stigma can be experienced in the workplace, educational settings, and in healthcare and has been documented in children as young as three years old. To reduce weight stigma, it is important we understand how many people have experienced weigh stigma and how it has affected their health.
We accomplished three things in this study. First, we used current information to develop a figure that explains how weight stigma can cause stress and affect health. This figure includes important information for healthcare providers and others who may influence the delivery of care, public health, or education of others.
Second, we looked at how many people, and who, have experienced weight stigma and third, we looked at how weight stigma can affect health. Some of the health outcomes included high blood pressure, high blood sugar, pain, anxiety, and depression. We also looked at the effect of weight stigma on dieting and exercise behaviors and whether or not individuals delay or avoid seeking healthcare because of fear of weight stigma. We found that weight stigma was common among many people and may lead to adverse health outcomes, influence health behavior, and lead to healthcare avoidance or delayed care.
- Academic Unit
- Nursing
- Record Identifier
- 9983779698202771
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