Rebecca L. Pearl

Positive Media Portrayals of Obese Persons: Impact on Attitudes and Image Preferences

OBJECTIVE The purpose of this research was to assess the impact of nonstereotypical, positive media portrayals of obese persons on biased attitudes, as well as propose a change in media practices that could reduce public weight bias and consequent negative health outcomes for those who experience weight stigma. METHOD Two online experiments were conducted in which participants viewed either a stigmatizing or a positive photograph of an obese model. In Experiment 1 (N = 146), participants viewed a photograph of either a Caucasian or African American obese woman; in Experiment 2 (N = 145), participants viewed either a Caucasian male or female obese model. Multiple linear regression models were used to analyze outcomes for social distance attitudes toward the obese models depicted in the images, in addition to other negative attitudes and image preferences. RESULTS Participants who viewed the stigmatizing images endorsed stronger social distance attitudes and more negative attitudes toward obese persons than participants who viewed the positive images, and there was a stronger preference for the positive images than the stigmatizing images. These results were consistent regardless of the race or gender of the obese model pictured. CONCLUSION The findings indicate that more positive media portrayals of obese individuals may help reduce weight stigma and its associated negative health outcomes.

Weight bias internalization, depression, and self-reported health among overweight binge eating disorder patients.

This study aimed to examine the relationship between internalization of weight bias, which has been linked to specific negative mental health outcomes, and overall mental and physical health among overweight patients with binge eating disorder (BED). The role of depressive symptoms as a potential mediator in this relationship was also tested.

Measuring internalized weight attitudes across body weight categories: validation of the modified weight bias internalization scale.

The purpose of this research was to validate a modified version of the Weight Bias Internalization Scale (WBIS-M) that is applicable to individuals across different body weight statuses. One hundred forty-eight men and women completed an online survey that included the WBIS-M and relevant measures of psychopathology. Results indicated that the WBIS-M had high internal consistency and strong construct validity. The WBIS-M also demonstrated significant correlations with body image, eating pathology, self-esteem, and symptoms of anxiety and depression, and was associated with these outcomes distinctly from antifat attitudes and body mass index. Implications for the use of this scale in diverse samples are discussed.

Obesity and Public Policy

There is a pressing need to reduce both the prevalence and impact of obesity. This review begins with a discussion of the roles of treatment and prevention. Two overriding issues, weight bias and the addictive nature of food, are covered because of their importance not only to the individuals affected but also to public policy. We then cover promising policy areas in which changes can be implemented to support healthy behaviors: school policy, food marketing, food labeling and packaging, and taxes on unhealthy foods. The roles of the food industry and federal, state, and local governments are also discussed.

Differential effects of weight bias experiences and internalization on exercise among women with overweight and obesity

This study investigated the effects of experiences with weight stigma and weight bias internalization on exercise. An online sample of 177 women with overweight and obesity (Mage = 35.48 years, MBMI = 32.81) completed questionnaires assessing exercise behavior, self-efficacy, and motivation; experiences of weight stigmatization; weight bias internalization; and weight-stigmatizing attitudes toward others. Weight stigma experiences positively correlated with exercise behavior, but weight bias internalization was negatively associated with all exercise variables. Weight bias internalization was a partial mediator between weight stigma experiences and exercise behavior. The distinct effects of experiencing versus internalizing weight bias carry implications for clinical practice and public health.

Clinical correlates of the weight bias internalization scale in a sample of obese adolescents seeking bariatric surgery.

The aim of this study was to evaluate psychometric properties and clinical correlates of the Weight Bias Internalization Scale (WBIS) in a sample of obese adolescents seeking bariatric surgery. Sixty five adolescents enrolled in a bariatric surgery program at a large, urban medical center completed psychiatric evaluations, self‐report questionnaires including the WBIS and other measures of psychopathology and physical assessments. The WBIS had high internal consistency (Cronbachs α = 0.92). As in previous research with adults, the one underlying factor structure was replicated and 10 of the original 11 items were retained. The scale had significant partial correlations with depression (r = 0.19), anxiety (r = 0.465), social, and behavioral problems (r = 0.364), quality of life (r = −0.480), and eating (r = 0.579), shape (r = 0.815), and weight concerns (r = 0.545), controlling for BMI. However, WBIS scores did not predict current or past psychiatric diagnosis or treatment or past suicidal ideation. Overall, the WBIS had excellent psychometric properties in a sample of obese treatment‐seeking adolescents and correlated significantly with levels of psychopathology. These findings suggest that the WBIS could be a useful tool for healthcare providers to assess internalized weight bias among treatment‐seeking obese youth. Assessment of internalized weight bias among this clinical population has the potential to identify adolescents who might benefit from information on coping with weight stigma, which in turn may augment weight loss efforts.

Beyond personal responsibility: Effects of causal attributions for overweight and obesity on weight-related beliefs, stigma, and policy support

Objective: The objective of this research was to compare the effects of different causal attributions for overweight and obesity, among individuals with overweight and obesity, on weight-related beliefs, stigmatising attitudes and policy support. Design: In Study 1, an online sample of 95 US adults rated the extent to which they believed various factors caused their own weight status. In Study 2, 125 US adults read one of three randomly assigned online passages attributing obesity to personal responsibility, biology, or the ‘food environment.’ All participants in both studies were overweight or obese. Main outcome measures: All participants reported beliefs about weight loss, weight-stigmatising attitudes, and support for obesity-related policies. Results: In Study 1, biological attributions were associated with low weight-malleability beliefs and blame, high policy support, but high internalised weight bias. ‘Food environment’ attributions were not associated with any outcomes, while ‘personal responsibility’ attributions were associated with high prejudice and blame. In Study 2, participants who received information about the food environment reported greater support for food-related policies and greater self-efficacy to lose weight. Conclusion: Emphasising the role of the food environment in causing obesity may promote food policy support and health behaviours without imposing the negative consequences associated with other attributions.

Do media portrayals of obesity influence support for weight-related medical policy?

OBJECTIVE The purpose of this research was to examine the impact of nonstigmatizing visual portrayals of obesity on support for a discriminatory weight-based medical policy. METHOD Participants read an online news story about a policy to deny fertility treatment to obese women that was accompanied by a nonstigmatizing, stigmatizing, or no image of an obese couple. A balanced discussion of the policy was presented, with information both questioning the policy as discriminatory and supporting the policy because of weight-related medical complications. RESULTS Results revealed that participants who viewed the nonstigmatizing image were less supportive of the policy to deny obese women fertility treatment and recommended the policy less strongly than participants who viewed the stigmatizing image. Furthermore, weaker perceptions of medical risk mediated the effect of the nonstigmatizing image on policy ratings. CONCLUSION The findings indicate that simply eliminating stigmatizing media portrayals of obesity may help reduce bias.

The distinct effects of internalizing weight bias: An experimental study.

Both experiencing and internalizing weight bias are associated with negative mental and physical health outcomes, but internalization may be a more potent predictor of these outcomes. The current study aimed to differentiate between causal effects of experiencing versus internalizing weight bias on emotional responses and psychological well-being. Adults with overweight/obesity (N=260) completed an online experiment in which they were randomly assigned to focus on either the experience or internalization of weight bias, and completed measures of affect, self-esteem, and body dissatisfaction. Results indicated that the Internalization condition led to more negative affect, less positive affect, and lower self-esteem than the Experience condition. The Internalization condition also led to heightened body dissatisfaction among men, but not women. These findings suggest that weight bias internalization may be a stronger predictor of poor mental and physical health than experiences alone, and carry implications for developing weight bias interventions.

Association between weight bias internalization and metabolic syndrome among treatment-seeking individuals with obesity.

Weight stigma is a chronic stressor that may increase cardiometabolic risk. Some individuals with obesity self‐stigmatize (i.e., weight bias internalization, WBI). No study to date has examined whether WBI is associated with metabolic syndrome.