There is a well-established link between peer victimization and social anxiety disorder (SAD). Additionally, rates of bullying are significantly higher in obese compared to normal-weight individuals. However, social anxiety (SA) has not yet been examined in the context of weight, weight bias, and social rejection. This study examined the relationship between SA and weight in undergraduate women (N = 186). It aimed to determine whether implicit weight bias moderated the relationship between body mass index (BMI) and SA. In addition, it explored the interactive effects of SA, BMI, and body image salience on emotional response to exclusion in a social ostracism paradigm (Cyberball). Participants answered questions pertaining to SA and stigmatizing attitudes toward overweight/obesity and completed an implicit association test about weight. One week later, they played Cyberball, completing state measures of affect before and after the game. Although rates of clinically elevated SA did not differ significantly across normal-weight, overweight, and obese women, implicit weight bias did moderate the relationship between BMI and SA. The 3-way interaction of BMI, SA, and body image salience did not significantly predict post-exclusion state measures. However, body image salience moderated the relationship between SA and post-exclusion anxiety as well as between BMI and post-exclusion anxiety. Findings from this study shed light on the role of body weight in the experience of SA. Results suggest that higher BMI is associated with higher SA for those with high, but not low implicit weight bias. In addition, individuals with elevated SA are particularly reactive to exclusion if their bodies are visible to others. / Psychology

Obesity research remains a high priority worldwide, given the sustained high levels of obesity (body mass index ≥30 kg/m2) and class III obesity (body mass index ≥40 kg/m2) across many demographic groups. One component of obesity research is the study of how diet can contribute to obesity, and thus it is crucial to evaluate how existing dietary assessment methods perform for people with obesity, and to develop or refine methods to enhance their accuracy. Researchers should be prepared to include more individuals with obesity and class III obesity, a growing demographic, in studies that assess dietary intake. With the inclusion of these groups, it is vital to consider the potential impact of weight bias and weight stigma on dietary research. Weight bias is negative attitudes and stereotypes about people with obesity, while weight stigma is how these attitudes collectively devalue people with obesity, which could result in acts of discrimination. This dissertation: 1) defined the issues of weight bias and weight stigma, and how they affect dietetics practice, including research, 2) determined the representation of participants with class III obesity in studies validating self-reported measures of dietary assessment using doubly-labeled water, and 3) explored how weight bias and weight stigma might impact misreporting of energy intake among people with overweight and obesity. Findings include that: 1) weight bias and weight stigma are important issues when working with people with obesity, and dietetics professionals can address these in many areas of practice; 2) in studies validating self-reported dietary assessment methods using doubly-labeled water, people with class III obesity are underrepresented, and thus the validity of existing methods to assess diet among people with class III obesity requires further research; 3) in a sample of participants with self-reported overweight and obesity, previous experiences of weight stigma were common, though internalized weight bias, weight bias toward others, and experiences of weight stigma were not predictive of the validity of energy intake reporting. Researchers should consider the potential impact of weight stigma on recruitment, retention, and participant experience when working with participants with obesity. / Doctor of Philosophy / One part of obesity research is the study of how food intake can contribute to obesity. It is crucial to evaluate how well existing methods perform that measure what and how much people eat, especially in people with obesity. As obesity levels rise, researchers should be prepared to include more people with obesity (body mass index ≥30 kg/m2) and class III obesity (body mass index ≥40 kg/m2) in studies that measure dietary intake. When including people with obesity in studies, it is important to consider the potential impact of weight bias and weight stigma on nutrition research. Weight bias is the idea of negative attitudes and stereotypes about people with obesity, while weight stigma is how these attitudes collectively devalue people with obesity. This dissertation 1) defined the issues of weight bias and weight stigma, and how they affect dietetics practice, including nutrition research, 2) determined the representation of people with class III obesity in studies testing the accuracy of methods collecting information about food intake and 3) explored how weight bias and weight stigma might affect how accurately people with overweight and obesity report the number of calories that they eat. This work found: 1) weight bias and weight stigma are important emerging issues when working with people with obesity, and dietetics professionals can address weight bias and weight stigma in many areas of practice; 2) in studies testing the accuracy of measures that collect food information, people with class III obesity are underrepresented, and more research is needed to determine how accurate these measures are in this group; and 3) in a group of people with overweight and obesity, previous experiences of weight stigma were common, though internalized weight bias, weight bias toward others, and experiences of weight stigma did not predict how well a person reported their calorie intake. Future studies should include more people with class III obesity. Researchers should consider how weight stigma might affect a person's willingness to participate in nutrition studies. Minimizing weight stigma in research may decrease participation barriers for people with obesity in research about nutrition, weight, and health.

Public health campaigns might not be universally helpful and could have detrimental consequences. The current investigation explored the effects of obesity prevention campaigns. Their impact was assessed using an experiment in which participants were randomized to view either weight focused obesity prevention campaigns or obesity prevention campaigns that did not use weight related terms. Results demonstrated that compared with campaigns without weight related terminology, weight focused campaigns increased negative perceptions of obesity and decreased self-efficacy for health behavior change. No differences in body satisfaction, thin-ideal internalization, state anxiety, or frequency of positive health behaviors were found based on the type of campaign viewed. Finally, exposure to both types of campaigns increased internalization of the thin-ideal. This study demonstrates that weight focused prevention messages pose serious public health consequences. Obesity prevention campaigns should refrain from using weight-related terminology and instead emphasize the positive health consequences of a healthy diet and physical activity.

Reducing rates of overweight and obesity in children remains a prominent public health priority. Parents have been shown to be a major influence on their children’s weight-related behaviors and weight status, but limited research has been devoted to exploring the factors that lead parents to select certain weight-related parenting practices over another. Past research has demonstrated a link between weight stigma (i.e., prejudicial attitudes or discriminatory behavior targeted at individuals who carry excess weight) and an individual’s own weight-related behaviors and outcomes, but no study has examined how parental levels of weight stigma may affect weight-related parenting practices. The primary objective of this study was to examine the cross-sectional associations between parental levels of weight-based stigmatization with parental feeding practices and parental support for physical activity. Responses were collected on Amazon’s Mechanical Turk website for n = 406 parents who 1) had at least one child aged 5-10 and 2) perceived themselves to be overweight or obese. After adjusting for relevant covariates, parental weight stigma was shown to be significantly associated with restrictive feeding practices, verbal modeling of eating behaviors, unintentional modeling of eating behaviors, child unhealthy snack consumption, and explicit modeling of physical activity (all ps < .05). A priori exploratory mediation analysis identified concern about child weight as a significant mediator between weight stigma and parental feeding practices. A discussion of the potential limitations of this study, future directions of research, and implications of these findings are included.

Fear and stigmatization are often used to motivate overweight individuals to engage in healthy behaviors, but these strategies are often counterproductive and can lead to undesirable outcomes. In the present study, I examined the impact of weight-based stigma on cognitive ability (i.e., inhibitory control) and food selection (i.e., calories selected) in individuals who consider themselves to be overweight. I predicted that participants higher in perceived weight stigma would perform more poorly on an inhibitory control task and order more calories on a menu task when they read about discrimination against the overweight versus discrimination against a self-irrelevant out-group. Additionally, I expected that inhibitory control would mediate the relationship between perceived weight stigma and calories ordered for participants who read about discrimination against the overweight, but not for control participants. Participants completed online prescreen measures assessing whether or not they considered themselves to be overweight and their perceptions of weight stigma. Those individuals who considered themselves overweight were then invited into the laboratory to complete tasks to (1) manipulate weight-based discrimination, (2) measure inhibitory control, and (3) measure food selection. As predicted, participants higher in perceived weight stigma performed more poorly on the inhibitory control task and ordered more calories when they read about discrimination against the overweight, but not when they read about discrimination against an out-group. Conversely, inhibitory control did not mediate the relationship between perceived weight stigma and number of calories ordered by participants. Importantly, the present findings provide evidence that perceptions of weight stigma are critical in our understanding of the impact of weight discrimination. Additionally, these results have theoretical and practical implications for both understanding and addressing the psychological and physical consequences of weight-based stigma.

Weight stigma has negative psychological and physical consequences including anxiety, depression, suicidal ideation, eating disorders, and lower quality of life. The purpose of this cross-sectional study was to explore the relationships between weight stigma, ethnic identity, and acculturation in Latinas. The intersectional theory provided the framework for this study. A sample of 154 Latinas over the age of 18 living in the United States or 1 of its territories was gathered through social media, a fat acceptance organization, and a research participant pool. The online survey consisted of 3 psychometric tools-Modified Weight Bias Internalization Scale, Multi-Group Ethnic Identity Measure-Revised, and the Abbreviated Multidimensional Acculturation Scale. Descriptive, correlational, and regression analyses were conducted. Results from this study indicated that ethnic identity was not significantly related to weight stigma and that acculturation to either the U.S. or culture of origin did not significantly interact with ethnic identity to predict weight stigma. This study was focused on a vulnerable population experiencing weight stigma, and provides the professional community with culturally relevant data on weight stigma in Latinas, information on weight stigma reduction interventions, and contributions to policy and paradigm changes about body diversity.

Over the last few decades, the prevalence of overweight and obesity has increased dramatically, with increased interest in the issue of stigmatization of overweight and obese people. The theoretical part of this thesis summarizes the existing knowledge in this area and describes the form of weight stigma in various areas of life - in the work area, in medical care and in the media. Foreign studies claim that weight stigma is not only present in these and other areas of life, but that it has various negative effects on the psyche and health of a stigmatized individual. Although research in this area is at an early stage, there is already evidence of a relationship of weight stigma and pathological eating behavior, affective disorders or negative body image. However, psychological intervention and therapy offer satisfactory tools to work with the stigmatization theme. The weight stigma is not a topic in the Czech Republic, despite its expanding abroad. The research carried out within the empirical part of the thesis is an initial attempt to map out the phenomenon of stigmatization of overweight and obese people in the Czech environment. For the purpose of the thesis, a questionnaire was drawn up and subsequently used in experimental design. The questionnaire investigated whether the assessment of...

The constantly rising prevalence of overweight and obesity requires intensive research not only in terms of physiological and medicinal aspects but also with regard to psychological factors that increase the burden associated with obesity and can hinder health maintenance or health improvements as suggested by previous studies. Work on weight discrimination among dietitians and nutritionists towards individuals with obesity and overweight was reviewed showing that, despite having knowledge about causation and consequences of obesity, health care professionals are not free of having negative attitudes towards individuals with obesity. Findings of empirical analyses revealed the impact of weight discrimination by general practitioners or internists while recommending bariatric surgery or referring patients with obesity to a surgeon, lowering the possibility for patients with obesity and associated comorbidities of gaining adequate health care services and sufficient obesity treatment. In a second study, the impact of weight discrimination on the desire to lose weight was investigated, demonstrating the pervasive effects of weight stigma on possible treatment outcomes or decision making with regard to obesity treatment. In conclusion, weight discrimination and stigmatization can be seen as having detrimental effects on individuals and therefore bias should be addressed especially within the health care setting to reduce stigma as being a barrier towards health and well-being. This work aims to reveal the consequences of weight-based stigmatization on the treatment of obesity from two different angles: the patient and the health care professional.:List of Figures IV Glossary of Terms V Bibliographic Description VI 1. Introduction - 1 - 1.1 The Psychosocial Side of Obesity - 1 - 1.2 Weight-based Stigmatization and Discrimination - 2 - 1.3 Obesity and Stigma within Health Care Settings - 8 - 2. Stigmatization in Health Care - A Literature-Based Analysis - 11 - 2.1 Dietitians and Nutritionists: Stigma in the Context of Obesity – A Systematic Review - 12 - 3. Quantitative Analyses based on the Current State of Research - 29 - 3.1 Weight-related Stigmatization as Determinant of Recommendation and Referral Behavior of Physicians - 31 - 3.2 Weight-related discrimination and desired body weight. - 42 - 4. Discussion - 57 - 4.1 Connecting Existing Literature to the Empirical Results - 58 - 4.2 Future Research on Weight Stigma and possible Implications - 62 - 4.3 Conclusion - 64 - Summary - 65 - References - 72 - Appendix - 80 - Appendix A - Declaration - 80 -

Weight bias and weight stigmatization are independent risk factors for poor health, and are brought up within health promotion, as focus areas when it comes to interventions targeting body weight (WHO, 2017; Pearl, 2018). Discourses within the society, can either reinforce weight bias and weight stigmatization towards people in larger bodies, or disrupt them. A gap in the literature exists, when it comes to health professionals and their means of communicating health on social media platforms, such as Instagram. This gap was the inspiration for the present study. The study sought to critically examine the discourses communicated by doctors and registered dietitians on the social media platform Instagram. With the specific focus of examining their presentation of body weight and health, the manifestations of roles and the discourses presented. The study was based on the theory of social semiotics, using critical multimodal discourse analysis, that include elements from the critical discourse analysis framework, by Fairclough (2010) (Machin &amp; Mayr, 2012). The study found that the chosen health professionals generally presented weight bias and presented body weight as a sum of individual choices, as well as body weight as a personal responsibility. The health professionals used both visual and verbal techniques, to establish authority and power, and were generally promoting health as a commodity, as well as using their own body to promote the thin ideal. The strongest discourses present were those of healthism, paternalism and aesthetics defining health, findings that are supported within the literature, when looking at other health promoting entities, such as personal trainers.  The study brought forth important implications within health communication on social media platforms, thus that healthism is an area that is important to educate health professionals within, as well as there being basis to further investigate this notion. The study also brought  forth important considerations for ethics and validity within this type of research.

Past research shows that weight-related teasing is linked to binge eating, but little is known about the individual risk factors that render certain people more vulnerable than others. The current study examined three potential risk factors for binge eating in response to weight-related teasing: weight stigmatization experiences, weight bias internalization, and emotion dysregulation. The current study empirically investigated how these factors interacted to predict concurrent binge eating behavior through a self-report questionnaire and eating behavior in a laboratory following exposure to a weight stigma vignette. First, it was hypothesized that higher levels of weight stigmatization and emotion dysregulation would be associated with higher levels of binge eating, which was consistent with the results of a multiple linear regression analysis. Second, it was predicted that higher levels of weight stigmatization and emotion dysregulation would predict greater quantities of cookie consumption during a bogus taste test following exposure to a weight stigma vignette. The hypothesis was not supported by a multiple linear regression. Third, we posited that weight bias internalization would moderate the relationship between weight stigmatization and emotion dysregulation on disordered eating, such that higher levels of weight bias internalization would be associated with higher levels of binge eating. This was not supported by a hierarchical regression analysis. Overall, the results highlight variables pertinent to the relationship between weight stigma and binge eating. Future research should test the model in clinical samples to see if it is more relevant to people with more severe levels of eating pathology.