Article

Le rôle de la stigmatisation dans la symptomatologie dépressive de femmes françaises en surpoids ou en situation d’obésité

Authors:
To read the full-text of this research, you can request a copy directly from the authors.

Abstract

Introduction. – Despite the high prevalence of depressive symptoms among women being overweight orhaving obesity, the role of stigma and causal attributions in the expression of these symptoms in Frenchwomen has been largely under-explored to date. Objective. – The aim of this research is to study the role of internalized stigmatization, stigmatizingexperiences and causal attribution in the intensity of depressive symptoms in overweight and obeseFrench women. Method. – These four variables were measured in 160 French women being overweight or having obesity. Results. – Our analyses highlight positive correlations between stigmatizing experiences, internalizedstigmatization and depressive symptomatology. It is important to note that stigmatizing experiencesseem to play a more preponderant role than internalized stigmatization in the expression of depressivesymptoms. Conclusion. – For women with significant depressive symptoms, it appears essential to integrate inter-ventions aimed at reducing their level of stigma. Moreover, from a preventive perspective, it also seemsessential to promote campaigns in France aimed at reducing the stigmatization in this population

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the authors.

ResearchGate has not been able to resolve any citations for this publication.
Article
Full-text available
Sensitivity of public discourses over social media platforms has been largely discussed in the recent past and considered one of the reasons that have led to widespread weight stigmatization. This article examines existing work on the biological, psychological and sociological consequences of weight stigmatization resulting from online conversations over social media. Articles were identified through EBSCO Discovery Service. Independent extraction of articles was conducted using predefined search data fields to synthesize prior works on biological, psychological and sociological correlates of weight stigma. Our findings have revealed psychological correlates to be most frequently identified with weight stigma than with biological and sociological correlates. Some correlations with gender and ethnicity have also been identified in previous studies; however, these studies are limited in their data acquisition and in use of analytic techniques. While there is widespread social media attention on the increasing overweight and obese population, the current research on weight stigmatization and interventions to tackle online stigmatization are not yet properly elucidated.
Article
Full-text available
Behavioral treatment is an approach used to help individuals develop a set of skills to achieve a healthier weight. It is more than helping people to decide what to change; it is helping them identify how to change. The behavior change process is facilitated through the use of self-monitoring, goal setting, and problem solving. Studies suggest that behavioral treatment produces weight loss of 8–10% during the first 6 mo of treatment. Structured approaches such as meal replacements and food provision have been shown to increase the magnitude of weight loss. Most research on behavioral treatment has been conducted in university-based clinic programs. Although such studies are important, they tell us little about the effectiveness of these approaches in settings outside of specialized clinics. Future research might focus more on determining how these behavioral techniques can be best applied in a real-world setting.
Article
Full-text available
BACKGROUND Although the rising pandemic of obesity has received major attention in many countries, the effects of this attention on trends and the disease burden of obesity remain uncertain. METHODS We analyzed data from 68.5 million persons to assess the trends in the prevalence of overweight and obesity among children and adults between 1980 and 2015. Using the Global Burden of Disease study data and methods, we also quantified the burden of disease related to high body-mass index (BMI), according to age, sex, cause, and BMI in 195 countries between 1990 and 2015. RESULTS In 2015, a total of 107.7 million children and 603.7 million adults were obese. Since 1980, the prevalence of obesity has doubled in more than 70 countries and has continuously increased in most other countries. Although the prevalence of obesity among children has been lower than that among adults, the rate of increase in childhood obesity in many countries has been greater than the rate of increase in adult obesity. High BMI accounted for 4.0 million deaths globally, nearly 40% of which occurred in persons who were not obese. More than two thirds of deaths related to high BMI were due to cardiovascular disease. The disease burden related to high BMI has increased since 1990; however, the rate of this increase has been attenuated owing to decreases in underlying rates of death from cardiovascular disease. CONCLUSIONS The rapid increase in the prevalence and disease burden of elevated BMI highlights the need for continued focus on surveillance of BMI and identification, implementation, and evaluation of evidence-based interventions to address this problem. (Funded by the Bill and Melinda Gates Foundation.)
Article
Full-text available
Purpose: The Weight Self-Stigma Questionnaire (WSSQ) was recently developed to assess the internalization of weight stigma among English-speaking overweight and obese adults. The objective of the present study was to develop and examine the psychometric properties of a French version of the WSSQ, as well as its applicability to adolescents. Methods: The sample comprised 156 overweight and obese adolescents (81 boys, 75 girls, M age = 16.31). The factor validity and the convergent validity of the French version of the WSSQ were examined using a confirmatory factor analysis and a structural equation model, respectively. Results: The a priori two-factor structure of the WSSQ and the composite reliability of its subscales (self-devaluation and fear of enacted stigma) were supported. Convergent validity analyses revealed that both WSSQ subscales were significantly and (a) negatively correlated with measures of self-esteem and physical appearance, and (b) positively correlated with measures of anxiety, depression, fear of negative appearance evaluation, and eating-related pathology (fear of getting fat, eating-related control, food preoccupation, vomiting-purging behaviors, and eating-related guilt subscales). However, no significant relation was found between the WSSQ subscales and body mass index. Conclusion: These results suggest that the French version of the WSSQ has acceptable psychometric properties and can be used to assess weight self-stigma among overweight and obese adolescents.
Article
Full-text available
Weight self-stigma is a promising target for innovative interventions seeking to improve outcomes among overweight/obese individuals. Preliminary research suggests acceptance and commitment therapy (ACT) may be an effective approach for reducing weight self-stigma, but a guided self-help version of this intervention may improve broad dissemination. This pilot open trial sought to evaluate the potential acceptability and efficacy of a guided self-help ACT intervention, included coaching and a self-help book, with a sample of 13 overweight/obese individuals high in weight self-stigma. Results indicated a high degree of program engagement (77% completed the intervention) and satisfaction. Participants improved on outcomes over time including weight self-stigma, emotional eating, weight management behaviors, health-related quality of life, and depression. Although not a directly targeted outcome, participants improved on objectively measured weight, with an average of 4.18 pounds lost over 7 weeks, but did not improve on self-reported weight at 3-month follow-up. Processes of change improved over time, including psychological inflexibility, valued action and reasons to lose weight. Coaching effects indicated greater retention and improvements over time with one coach vs. the other, suggesting characteristics of coaching can affect outcomes. Overall, these results provide preliminary support for the acceptability and efficacy of a guided self-help ACT program for weight self-stigma. Implications of these results and how to address clinical challenges with guided self-help are discussed.
Article
Full-text available
Childhood obesity is one of the most serious public health challenges of the 21st century with far-reaching and enduring adverse consequences for health outcomes. Over 42 million children <5 years worldwide are estimated to be overweight (OW) or obese (OB), and if current trends continue, then an estimated 70 million children will be OW or OB by 2025. The purpose of this review was to focus on psychiatric, psychological, and psychosocial consequences of childhood obesity (OBy) to include a broad range of international studies. The aim was to establish what has recently changed in relation to the common psychological consequences associated with childhood OBy. A systematic search was conducted in MEDLINE, Web of Science, and the Cochrane Library for articles presenting information on the identification or prevention of psychiatric morbidity in childhood obesity. Relevant data were extracted and narratively reviewed. Findings established childhood OW/OBy was negatively associated with psychological comorbidities, such as depression, poorer perceived lower scores on health-related quality of life, emotional and behavioral disorders, and self-esteem during childhood. Evidence related to the association between attention-deficit/hyperactivity disorder (ADHD) and OBy remains unconvincing because of various findings from studies. OW children were more likely to experience multiple associated psychosocial problems than their healthy-weight peers, which may be adversely influenced by OBy stigma, teasing, and bullying. OBy stigma, teasing, and bullying are pervasive and can have serious consequences for emotional and physical health and performance. It remains unclear as to whether psychiatric disorders and psychological problems are a cause or a consequence of childhood obesity or whether common factors promote both obesity and psychiatric disturbances in susceptible children and adolescents. A cohesive and strategic approach to tackle this current obesity epidemic is necessary to combat this increasing trend which is compromising the health and well-being of the young generation and seriously impinging on resources and economic costs.
Article
Full-text available
Background Korea has the highest suicide rate in the OECD and is one of the few OECD countries whose suicide rates have not decreased in recent years. To address these issues, we investigated the effects of weight control failure on suicidal ideation in the overweight and obese populations. Methods We performed a cross-sectional study using data from the Korea National Health and Nutrition Examination Survey (2008–2012) consisting of 6621 individuals 40 years of age or older. Logistic regression analysis was used to identify the relationship between weight control failure and suicidal ideation in the overweight and obese populations. Results A total of 6621 participants were analyzed in this study (overweight group: 2439; obese group: 4182). Among them, weight control failure (weight gain with weight loss efforts) was experienced in 962 obese (males 16.3 %, females 29.6 %) and 412 overweight individuals (males 9.1 %, females 23.4 %). Weight control failure was significantly associated with suicidal ideation in obese females (OR = 1.70, 95 % CI 1.21–2.39), but this association was not significant in obese males or in either sex of the overweight group. Conclusions Findings from this study suggest that weight control failure is associated with an increased risk of suicidal ideation among obese women. Furthermore, intervention programs that aim to address the prevalence of suicide, especially for obese women, are needed.
Article
Full-text available
Objective The Stigmatizing Situations Inventory (SSI) is one of the most commonly used measures of weight stigma experiences but may be impractical for some researchers because of its length (50 items). The present report describes the development and validation of a brief version of the SSI that could be used as a more efficient tool for assessing experiences with weight stigma. Methods In stage 1, data from three existing studies (total n = 257) were used to create two 10‐item versions of the SSI. One version was primarily based on items that showed the highest item‐total correlations, and the second version maintained the content coverage of the original measure by including one item (the one with the highest item‐total correlation) from each of 10 subscales of the SSI. Stage 1 also provided a test of the convergent validity of these brief measures. In stage 2, four new samples (total n = 832) provided an independent test of the reliability and validity of the brief measures. Results The brief SSIs showed good reliability across all samples. Furthermore, the magnitude of the correlations between the brief versions of the SSI and other associated constructs was comparable with the magnitude of the correlations between those constructs and the full SSI. Conclusions The brief versions of the SSI are reliable and valid measures of stigmatizing experiences that provide a more efficient means of capturing stigma experiences without sacrificing the reliability and validity of the original measure.
Article
Full-text available
Explore the relation between body mass index (BMI) and cardiovascular disease, and the influence of optimal medical therapy (OMT) on this relationship. Patients from the REACH cohort, an international, prospective cohort of patients with or at high risk of atherosclerosis with documentation of potential confounders, including treatments and risk factors, were followed up to 4 years (n = 54 285). Patients were categorized according to baseline BMI (ranging from underweight to Grade III obesity). Optimal medical therapy was defined as the use of the four cardioprotective medication classes (statins, ACE inhibitors/angiotensin II receptor blockers, β-blockers, and antiplatelet agents). The main outcomes were all-cause mortality, cardiovascular (CV) mortality, and CV events. In primary and secondary prevention, a reverse J-shaped curve best described the relationship between BMI categories and the incidence of the various outcomes. In secondary prevention, the highest adjusted risks were observed for underweight patients (1.97, P < 0.01, and 1.29, P = 0.03, for CV mortality and CV events) and the lowest HRs were observed, respectively, in Grade II and Grade III obese patients (0.73, P < 0.01 and 0.80, P < 0.01). The proportion of patients on OMT increased with BMI from 10.1 to 36% (P < 0.001). The apparent CV protection conferred by obesity persisted in patients receiving OMT. An obesity paradox was observed in both primary and secondary CV prevention patients. The intensity of use of evidence-based preventive medications does not account for the paradoxical CV protection associated with obesity. At extremes of BMI, further interventions beyond OMT may be needed to reduce CV risk. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.
Article
Full-text available
Objective: The present study explored the clinical correlates of the Weight Bias Internalization Scale (WBIS). Method: Participants were 656 overweight and obese (mean body mass index (BMI): 34.3 ± 7.7) adults who completed the WBIS and measures of disordered eating behaviors and attitudes via an online survey. Results: Based on both the Eating Disorder Examination Questionnaire (EDE-Q) and Questionnaire on Eating and Weight Patterns – Revised (n = 442), 9.7% and 22.2% of participants were classified into a binge/purge (B/P) and binge eating (BE) group, respectively. WBIS scores were significantly higher among those with binge and/or purge behaviors compared to those without eating pathology, and higher degree of internalized weight bias was predictive of the presence of B/P behaviors (OR = 2.408, 95% CI: 1.727–3.359, p < .001) and BE (OR = 1.459, 95% CI: 1.224–1.739, p < .001). Partial correlations, controlling for BMI, revealed positive correlations between WBIS score and number of weight fluctuations, depression, and all EDE-Q subscales (Restraint, Eating Concern, Shape Concern, and Weight Concern) and a negative correlation with age at overweight onset. Discussion: These novel findings suggest an association between weight bias internalization and clinical eating pathology among overweight adults. The associations between internalization of weight bias and depression, weight instability, and eating pathology have important implications for healthcare providers working with overweight patients.
Article
Full-text available
Although obesity has been widely recognized for its consequences on physical health, its psychological burden in the adult populations of the Middle East remains unclear. This meta-analysis synthesized data from observational studies to investigate the association between obesity and depression among adult populations in Middle Eastern countries. Five bibliographical electronic databases were searched for studies published up to April 2014. Pooled meta-analytic estimates were derived using the random-effect models. Three case-control studies and five cross sectional studies were identified. Meta-analysis showed significant positive associations between obesity and depression across study designs, with an overall effect of OR 1.27 (95% CI 1.11–1.44). The association between obesity and depression was more marked in women than men although that difference was not statistically significant. Other subgroup analysis showed that none of the potential factors including the assessment for obesity or depression, confounder control and study quality had a modification effect on the studied association. Meta-analysis of eight observational studies from five countries of the Middle East suggests an evidence of a positive association between obesity and depression among adult populations, which appeared to be more marked among women. Future research should examine the causal pathways between obesity and depression.
Article
Full-text available
USING AN ETHICAL LENS, THIS REVIEW EVALUATES TWO METHODS OF WORKING WITHIN PATIENT CARE AND PUBLIC HEALTH: the weight-normative approach (emphasis on weight and weight loss when defining health and well-being) and the weight-inclusive approach (emphasis on viewing health and well-being as multifaceted while directing efforts toward improving health access and reducing weight stigma). Data reveal that the weight-normative approach is not effective for most people because of high rates of weight regain and cycling from weight loss interventions, which are linked to adverse health and well-being. Its predominant focus on weight may also foster stigma in health care and society, and data show that weight stigma is also linked to adverse health and well-being. In contrast, data support a weight-inclusive approach, which is included in models such as Health at Every Size for improving physical (e.g., blood pressure), behavioral (e.g., binge eating), and psychological (e.g., depression) indices, as well as acceptability of public health messages. Therefore, the weight-inclusive approach upholds nonmaleficience and beneficience, whereas the weight-normative approach does not. We offer a theoretical framework that organizes the research included in this review and discuss how it can guide research efforts and help health professionals intervene with their patients and community.
Article
Full-text available
Objective: Weight dissatisfaction, defined as discordance between actual and goal weight, may be associated with increased risk for several obesity-related comorbidities. The purpose of the study was to examine the association between weight dissatisfaction and risk of developing Type 2 diabetes. Method: This longitudinal study used data from 9,584 adults enrolled in the Aerobics Center Longitudinal Study. Key variables included multiple measures of measured weight, self-reported goal weight, and incident diabetes. Weight dissatisfaction was defined as being above the median of measured weight minus goal weight. Cox proportional hazards regression estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for diabetes incidence by weight dissatisfaction. Results: HRs for time until diabetes diagnosis revealed that family history of diabetes (HR = 1.46, 95% CI [1.13, 1.90]), age (HR = 1.03, 95% CI [1.02, 1.04]), and weight dissatisfaction (HR = 1.83, 95% CI [1.50, 2.25]) at baseline were statistically significant predictors. Longitudinally, higher risk was observed in individuals who either stayed dissatisfied (HR = 2.98, 95% CI [1.98, 4.48]) or became dissatisfied (HR = 1.51, 95% CI [0.79, 2.89]), compared with those who stayed satisfied. After additional adjustment for BMI, the elevated HR for those who remained dissatisfied compared with those who remained satisfied persisted (HR = 2.85, 95% CI [1.89, 4.31]). Conclusions: Weight dissatisfaction, regardless of BMI, represents a potentially important psychophysiological modifier of the relationships between BMI and risk of Type 2 diabetes, and warrants greater attention in future studies of chronic disease risk.
Data
Full-text available
While slim-body ideals have spread globally in the last several decades, we know comparatively little of any concurrent proliferation of fat-stigmatizing beliefs. Using cultural surveys and body mass estimates collected from 680 adults fromurban areas in 10 countries and territories, we test for cultural variation in how people conceptualize and stigmatize excess weight and obesity. Using consensus analysis of belief statements about obese and fat bodies, we find evidence of a shared model of obesity that transcends populations and includes traditionally fat-positive societies. Elements include the recognition of obesity as a disease, the role of individual responsibility in weight gain and loss, and the social undesirability of fat but also the inappropriateness of open prejudice against fat. Focusing on statements about fat that are explicitly stigmatizing, we find most of these expressed in the middleincome and developing-country samples. Results suggest a profound global diffusion of negative ideas about obesity. Given the moral attributions embedded in these now shared ideas about fat bodies, a globalization of body norms and fat stigma, not just of obesity itself, appears to be well under way, and it has the potential to proliferate associated prejudice and suffering.
Article
Full-text available
The objectives of this study are to enable the use of the concept of locus of control in the treatment of obese subjects and to verify if the presence of an alimentary disorder influences the belief in the weight’s control. The translation and validation in French is also part of the objective. We translated into French Saltzer’s specific scale of Weight Locus of Control (WLOC: weight locus of control) and then examined it’s validity. Then we compared it on general scales of the place of control (IPC of Levenson and SOC-3 of Paulhus). The subjects were both classified according to the presence of eating disorders (ED). A sample of 46 obese women (IMC>30) was tested, 20 of them without ED, and 26 with, associated to the presence ED, according to the criteria of the DSM-IV.The internal validity of WLOC is rather satisfactory. It correlates negatively with internality (IPC), personal control and interpersonal control (SOC-3). ED at the obese subjects are related on the externality of weight control and the externality of personal control. Obese subjects without ED believe more in weight control by themselves and personal control that the obese subjects with ED (Eating Disorders). Finally the scale of weight locus of control (WLOC) remains the most adapted in the treatment and the study of the obese subject.
Article
Full-text available
While lipophilia (a positive perception of fat in the body as well as in the food) seems quasi universal in "traditional" societies, contemporary, affluent societies have become lipophobic. This phenomenon is examined in both historical and socio-anthropological perspective.
Thesis
La problématique de l’excès de poids représente un enjeu de santé publique. En effet, l’obésité, et, en premier lieu, le surpoids, concerneraient (à eux deux) 45% de la population française. Au-delà de facteurs génétiques, hormonaux et socio-économiques, les habitudes de vie des personnes (i.e., alimentation, dépenses énergétiques, etc.) sont souvent mentionnées pour expliquer l’origine d’un telle pathologie. Or, si ces premiers facteurs trouvent un appui scientifique, les habitudes de vie sont, quant à elle, peu documentées et relèveraient davantage du mythe. Néanmoins, les travaux menés en psychologie sociale ont démontré que, parfois, le mythe peut devenir réalité… En effet, les recherches réalisées sur le phénomène de menace du stéréotype ont permis de montrer que les stéréotypes négatifs dont certains groupes sociaux sont la cible peuvent nuire à leurs comportements dans un sens conforme à ces stéréotypes. Plus précisément, par peur de confirmer un stéréotype négatif à l’égard de leur groupe social, des membres peuvent être paradoxalement conduit à émettre des comportements consistants avec ce stéréotype, dans un contexte où ce dernier est saillant et applicable. Le présent travail visait, par conséquent, à mettre en exergue l’impact de la stigmatisation relative au poids sur les conduites alimentaires des personnes en surcharge pondérale vivant en France. Pour ce faire, 633 personnes en surpoids/obèses et 1278 normopondérés ont participé aux six expérimentations (et cinq pré-tests) présentées dans cette thèse. Dans un premier temps, nous nous sommes assurés de l’existence d’une stigmatisation relative au poids en France, et nous nous sommes attachés à étudier son contenu. Dans un second temps, nous nous sommes intéressés au ressenti des personnes obèses face à cette stigmatisation, en terme de vécu, fréquence, stratégies de coping mises en œuvre pour y faire face, bien-être psychologique et comportements de santé (e.g., alimentation, activité physique, etc.). In fine, à travers le phénomène de menace du stéréotype, nous avons examiné les effets de cette stigmatisation relative au poids sur les intentions/comportements alimentaires d’une population normopondérée et en excès de poids. Les résultats de ces études ont, tout d’abord, permis de montrer qu’il existait bien une stigmatisation relative au poids en France. Cette stigmatisation attribuait notamment de mauvaises habitudes alimentaires et un manque d’activités physiques aux individus en excès de poids. Ensuite, nous avons démontré que le vécu de stigmatisation relative au poids de personnes obèses et leurs stratégies de coping adoptées pour y faire face corrélaient avec un faible bien-être psychologique, un fort niveau d’impulsivité et des comportements alimentaires inadaptés. Pour finir, nous avons mis en évidence que, dans certaines situations, cette stigmatisation relative au poids, via le phénomène de menace du stéréotype, conduisait des personnes en surpoids à consommer davantage d’aliments caloriques. Ces résultats sont discutés au regard de la littérature portant sur la menace du stéréotype, notamment auprès des personnes en surpoids. Des pistes de recherches et d’interventions, pour diminuer les effets délétères de la stigmatisation relative au poids et ceux du phénomène de menace du stéréotype qui en résulte, sont également proposées.
Article
Obesity is frequently attributed to causes such as laziness and lack of willpower and personal responsibility. The current study identified causal attributions for obesity among patients seeking bariatric surgery and compared them to those among patients seeking less invasive weight loss treatment (behavioral/pharmacological). The 16-item Causal Attributions for Obesity scale (CAO; rated 1-7) was administered to 102 patients seeking bariatric surgery (sample 1) and 178 patients seeking behavioral/pharmacological weight loss treatment (sample 2). Between-subjects analyses compared CAO ratings for the two samples. Results showed that behavioral factors were the highest-rated attributions in both samples. Sample 1 had higher ratings of biological and environmental factors than did sample 2. Overall, patients seeking bariatric surgery had a more complex conceptualization of obesity than did patients seeking behavioral/pharmacological treatment. Trial registration: NCT02388568.
Article
Points essentiels L’obésité est une maladie caractérisée par un excès de masse grasse. Elle est associée au développement de nombreuses comorbidités. La prévalence mondiale de l’obésité indique un accroissement significatif sur les 30 dernières années. Des résultats récents de 2015 montrent une prévalence globale de 12 % chez les adultes, soit environ 604 millions d’adultes obèses dans le monde. La prévalence de l’obésité a aussi augmenté chez les enfants depuis les années 1980 pour atteindre une prévalence mondiale de 5 %. Les catégories sociales les plus défavorisées ont vu leur prévalence de l’obésité augmenter de façon plus rapide. Citons pour exemple, l’étude française Esteban de 2015, où la prévalence du surpoids et de l’obésité était plus élevée chez les adultes les moins diplômés et chez les enfants dont le représentant légal était sans diplôme.
Article
Objectives Obesity and depression are common conditions in the general public and show a high level of co-morbidity. Both conditions are stigmatized, i.e., associated with negative attitudes and discrimination. Previous research shows that devalued conditions can overlap or combine to produce a layered stigma which is associated with more negative health outcomes than either single devalued condition alone. This study therefore set out to investigate the double stigma of obesity and depression. Methods A telephone-based representative study of the German population was conducted. Vignettes describing women with obesity, depression or both conditions were presented, followed by a set of items on semantic differentials based on previous stigma research of depression (depression stigma DS) and obesity (Fat Phobia Scale FPS). Personal experience with depression and obesity was assessed. Results All comparisons were significant in univariate ANOVA, showing negative attitudes measured by the FPS and the DS to be most pronounced in the double stigma condition. Multivariate analysis, controlling for age, gender, education and personal experience with the stigma condition (e.g. having obesity or depression), show that the double stigma obesity and depression is associated to more negative attitudes on the FPS (b = 0.163, p < 0.001) and the DS (b = 0.154, p = 0.002) compared to the single-stigma condition. Conclusions The magnitude of the layered stigma of obesity and depression may need to be considered in mental health settings when treating the depressed patient with obesity, but likewise in obesity care when treating the obese patient with depression.
Article
Curbing the worldwide increase in obesity requires upstream social interventions that modify the environment in which obesity emerges. Recent studies have suggested that social capital and networks may influence a person's risk of obesity. Yet, few longitudinal studies have assessed whether social capital and networks reduce obesity risk in adult populations. In this study, the data come from three waves (2008, 2010, and 2013) of the Montreal Neighborhood Networks and Health Aging Panel (N=2606). Self-reported height and weight were used to calculate body mass index (BMI) with obesity defined as a BMI>30. Name and position generator instruments captured network measures of social capital, including: (1) upper reachability, (2) range, (3) diversity and (4) the number of kin ties. Questions on generalized trust and participation were used to assess cognitive and structural dimensions of social capital. Separate random effects logistic regression was used to examine the association among social network characteristics, social capital, and obesity. We found the greater the number of kin ties in a person's network, the greater the risk of obesity (OR: 1.33, 95% CI: 1.08-1.62). Adults with higher network diversity (OR: 0.83, 95% CI: 0.72-0.96) and high generalized trust (OR: 0.52, 95% CI: 0.35-0.77) were at a lower the risk of obesity. The current study confirmed that higher network capital and trust were protective against obesity, while having kin ties was not. Disentangling the multidimensional role that social capital plays can lead to more effective interventions to reduce obesity.
Article
Objective: Considerable evidence has documented links between weight stigma and poor health, independent of weight. However, little research has assessed how individuals cope with weight stigma, and how stigma-specific coping responses contribute to health. The present study examined multiple stigma-specific coping responses as mediators of the relationship between experienced weight stigma and health. Method: A diverse national sample of 912 adults (53.9% female, Mage = 40.33, SD = 15.58) reporting experiences of weight stigma completed questionnaires about stigma, stigma-specific coping responses (i.e., coping with weight stigma via negative affect, maladaptive eating behavior, healthy lifestyle behavior, and exercise avoidance), and health indices including depressive symptoms, physical health, psychological wellbeing, dieting frequency, and self-esteem. Results: Stigma-specific coping responses mediated the relationship between experienced weight stigma and all health indices, though indirect effects of weight stigma on health varied by coping strategy. Weight stigma was indirectly associated with greater frequency of depressive symptoms, lower scores on psychological wellbeing, self-esteem and physical health through coping via negative affect. Weight stigma indirectly contributed to greater frequency of depressive symptoms and dieting, as well as lower self-esteem and poorer physical health through coping via maladaptive eating. Weight stigma was associated with less frequent depressive symptoms, more frequent dieting, better psychological wellbeing, better self-esteem, and better physical health through coping with healthy lifestyle behaviors. Conclusions: These findings suggest that it may be useful to address weight stigma and coping in the context of weight management and obesity treatment programs, to help protect individuals from negative health effects of experiencing weight stigma. (PsycINFO Database Record
Article
In step with the proliferation of Thinspiration and Fitspiration content disseminated in popular web-based media, the fat acceptance movement has garnered heightened visibility within mainstream culture via the burgeoning Fatosphere weblog community. The present study extended previous Fatosphere research by comparing the shared and distinct strategies used to represent and motivate a fat-accepting lifestyle among 400 images sourced from Fatspiration- and Health at Every Size®-themed hashtags on Instagram. Images were systematically analyzed for the socio-demographic and body size attributes of the individuals portrayed alongside content reflecting dimensions of general fat acceptance, physical appearance pride, physical activity and health, fat shaming, and eating and weight loss-related themes. #fatspiration/#fatspo-tagged images more frequently promoted fat acceptance through fashion and beauty-related activism; #healthateverysize/#haes posts more often featured physically-active portrayals, holistic well-being, and weight stigma. Findings provide insight into the common and unique motivational factors and contradictory messages encountered in these fat-accepting social media communities.
Article
This meta-analysis aimed to evaluate the association between childhood and adolescent obesity and depression. We systematically searched PubMed, PsycInfo, EMBASE and Science Direct for studies that compared prevalence of depression and depressive symptoms in normal weight and obese children and adolescents. Observational studies were included if they reported body mass index and assessed depression by validated instruments or diagnostic interviews. Quality assessment was performed using the Newcastle-Ottawa scale. We used the random-effect model to calculate the pooled odds ratios, standard mean differences (SMDs) and subgroup analysis. Findings for a total of 51,272 participants were pooled across 18 studies and examined. Our analyses demonstrated a positive association between childhood and adolescent obesity and depression (pooled odds ratio = 1.34, 95% confidence interval [CI]: 1.1-1.64, p = 0.005) and more severe depressive symptoms (SMD = 0.23, 95% CI: 0.025-0.44, p = 0.028) in the obese groups. Overweight subjects were not more likely to have either depression (pooled odds ratio = 1.16, 95% CI: 0.93-1.44, p = 0.19) or depressive symptoms (SMD = 0, 95% CI: -0.101 to 0.102, p = 0.997). Non-Western and female obese subjects were significantly more likely to have depression and severe depressive symptoms (p < 0.05). In conclusion, obese children and adolescents are more likely to suffer from depression and depressive symptoms, with women and non-Western people at higher risk.
Article
Objective: The aim of this study is to examine whether self-esteem and fear of negative appearance evaluation are significant mediators in the association between weight-related self-devaluation and disordered eating. Method: A sample of obese Canadian women (N = 111, M age = 40.9, SD = 10.2) completed the Weight Self-Stigma Questionnaire (WSSQ), the Rosenberg Self-Esteem Scale (RSES), the Fear of Negative Appearance Evaluation Scale (FNAES), and the Eating Disorder Examination Questionnaire (EDE-Q). Results: Self-esteem mediated the relationship between weight-related self-devaluation and restraint and weight concerns, whereas fear of negative appearance evaluation mediated the relationship with weight, shape and eating concerns. Conclusion: Since, for obese women, self-esteem and fear of negative appearance evaluation are likely to maintain disordered eating, they should be more frequently taken into consideration by researchers, health professionals and public policy stakeholders.
Article
Introduction Weight-related stigma is pervasive and often is founded on the assumption that weight is controllable; therefore, those who are overweight and obese are thought to be weakwilled, lazy, and lacking self-control. As targets of weight stigma, over 30% of overweight and obese youth experience weight-related teasing, which is associated with depression, a serious mental health condition that puts young people at risk for myriad of other health problems. To date, little is known about the psychological mechanisms that underlie the teasing–depression relationship. Objective Thus, the purpose of this study was to examine self-esteem and body satisfaction as possible mediators of the association between weight-related teasing and depression among overweight and obese middle school boys and girls. Method Participants included 143 girls and 200 boys in grades 6 through 8 with measured BMIs 85th percentile for age and sex. Demographic information and pubertal development were collected via questionnaire. Height and weight were measured during state mandated school-based physical fitness testing. Participants also completed the Weight/Size Teasing subscale of the Physical appearance Related Teasing Scale, Center for Epidemiological Studies—Depression Scale for Children, General Self-Esteem scale from the Self-Description Questionnaire II, and Body subscale of the Body Parts Satisfaction Scale-Revised (girls)/Body Parts Satisfaction Scale for Men (boys). Results Weight-based teasing was positively related with depression; teasing and depression were inversely associated with self-esteem and body satisfaction. Bootstrap confidence interval mediation models were tested. Self-esteem and body satisfaction mediated the relationship between teasing and depression, with gender, BMI percentile, race, and pubertal status controlled for in the models. Self-esteem accounted for 48% of the total model, body satisfaction accounted for 9% of the total model. Conclusion The results of this study extend previous research by identifying self-esteem and body satisfaction as possible psychological constructs that help to explain the nature of the relationship between weight-related teasing and depression among overweight and obese youth. Results indicated that overweight and obese adolescents, self-esteem and body dissatisfaction may play a role in the extent to which weight-related teasing is associated with depression. Low self-esteem and body dissatisfaction may exacerbate the experience of teasing whereas positive general self-evaluations may protect against the deleterious influence of teasing on depression. Although public health efforts often focus on weight loss and behavior change as a way to enhance mental health, these results suggest that intervening on protective mechanisms may offer an alternative approach. Additional research is needed to determine if and how self-esteem and body satisfaction can be enhanced among overweight and obese youth via interventions in order to reduce the possible influence of teasing on depression.
Article
Objectives: To review the contribution of the Nurses' Health Studies (NHS and NHS II) in addressing hypotheses regarding risk factors for and consequences of obesity. Methods: Narrative review of the publications of the NHS and NHS II between 1976 and 2016. Results: Long-term NHS research has shown that weight gain and being overweight or obese are important risk factors for type 2 diabetes, cardiovascular diseases, certain types of cancers, and premature death. The cohorts have elucidated the role of dietary and lifestyle factors in obesity, especially sugar-sweetened beverages, poor diet quality, physical inactivity, prolonged screen time, short sleep duration or shift work, and built environment characteristics. Genome-wide association and gene-lifestyle interaction studies have shown that genetic factors predispose individuals to obesity but that such susceptibility can be attenuated by healthy lifestyle choices. This research has contributed to evolving clinical and public health guidelines on the importance of limiting weight gain through healthy dietary and lifestyle behaviors. Conclusions: The NHS cohorts have contributed to our understanding of the risk factors for and consequences of obesity and made a lasting impact on clinical and public health guidelines on obesity prevention. (Am J Public Health. Published online ahead of print July 26, 2016: e1-e7. doi:10.2105/AJPH.2016.303326).
Article
Weight self-stigma is conceptualized as a multidimensional concept involving experiences of shame, self-devaluation and the perception of being discriminated against in social situations due to one's weight. It has been associated with experiential avoidance, unhealthy eating behaviours, binge eating and diminish quality-of-life (QoL). The current study aims to explore the mediation effect of weight-related experiential avoidance on the relationship between weight self-stigma and obesity-related QoL in women with and without binge eating (BE). The sample comprised 282 women with overweight or obesity, from which 100 presented BE symptoms. Sample's mean age was 44.24 (SD = 11.30), with a mean BMI of 31.40 (SD = 4.53). Participants completed a set of self-reported measures regarding BE symptoms, weight self-stigma, weight-related experiential avoidance and QoL. Results from path analysis supported the mediation of weight-related experiential avoidance on the relationship between weight self-stigma and QoL, even when controlling for BMI. The model accounted 58% of QoL variance. Furthermore, the multi-group analysis revealed that the model was not invariant for both groups. The analysis of the critical ratios showed that the path from weight-related experiential avoidance to QoL was stronger for the BE group. Also the model only explained 39% of QoL for the group without BE and 65% of QoL for the BE group. This study highlights the pervasive role of weigh self-stigma, particularly fear of being discriminated and weigh-related experiential avoidance on obesity-related quality-of-life, especially for those women with BE. Additionally, it supports that interventions should focus not only in weight loss but also in improving individual's QoL, promoting the development of adaptive emotional regulation strategies.
Chapter
One reason why it is difficult to approach the study of stigma with much confidence is that there are so many kinds. Consider just a short list: old age, paralysis, cancer, drug addiction, mental illness, shortness, being black, alcoholism, smoking, crime, homosexuality, unemployment, being Jewish, obesity, blindness, epilepsy, receiving welfare, illiteracy, divorce, ugliness, stuttering, being female, poverty, being an amputee, mental retardation, and deafness. One of the few common denominators of these characteristics may be that all of them generate ridicule and scorn. However, there is another, more important reason why the study of stigma must be approached cautiously. Conceptualization and use of the term have been so vague and uncritical that one may reasonably ask: What is a stigma? To many, the answer is simply a “flaw,” “shortcoming,” “blemish,” or “taint,” but that answer does little except to imply that stigmas are opprobrious.
Article
It has been said that obese persons are the last acceptable targets of discrimination.1-4 Anecdotes abound about overweight individuals being ridiculed by teachers, physicians, and complete strangers in public settings, such as supermarkets, restaurants, and shopping areas. Fat jokes and derogatory portrayals of obese people in popular media are common. Overweight people tell stories of receiving poor grades in school, being denied jobs and promotions, losing the opportunity to adopt children, and more. Some who have written on the topic insist that there is a strong and consistent pattern of discrimination, 5 but no systematic review of the scientific evidence has been done.
Article
Social science research on stigma has grown dramatically over the past two decades, particularly in social psychology, where researchers have elucidated the ways in which people construct cognitive categories and link those categories to stereotyped beliefs. In the midst of this growth, the stigma concept has been criticized as being too vaguely defined and individually focused. In response to these criticisms, we define stigma as the co-occurrence of its components-labeling, stereotyping, separation, status loss, and discrimination-and further indicate that for stigmatization to occur, power must be exercised. The stigma concept we construct has implications for understanding several core issues in stigma research, ranging from the definition of the concept to the reasons stigma sometimes represents a very persistent predicament in the lives of persons affected by it. Finally, because there are so many stigmatized circumstances and because stigmatizing processes can affect multiple domains of people's lives, stigmatization probably has a dramatic bearing on the distribution of life chances in such areas as earnings, housing, criminal involvement, health, and life itself. It follows that social scientists who are interested in understanding the distribution of such life chances should also be interested in stigma.
Article
Although research has consistently documented the prevalence and negative health implications of weight stigma, little is known about the stigma associated with eating disorders. Given that weight stigma is a risk factor associated with disordered eating, it is important to address stigma across the spectrum of eating and weight disorders. The aim of this review is to systematically review studies in the past 3 years evaluating stigma in the context of obesity and eating disorders (including binge eating disorder, bulimia nervosa, and anorexia nervosa). Physical and psychological health consequences of stigma for individuals with obesity and eating disorders are discussed. Recent studies on weight stigma substantiate the unique influence of stigma on psychological maladjustment, eating pathology, and physiological stress. Furthermore, research documents negative stereotypes and social rejection of individuals with eating disorder subtypes, while attributions to personal responsibility promote blame and further stigmatization of these individuals. Future research should examine the association of stigma related to eating disorders and physical and emotional health correlates, as well as its role in health-care utilization and treatment outcomes. Additional longitudinal studies assessing how weight stigma influences emotional health and eating disorders can help identify adaptive coping strategies and improve clinical care of individuals with obesity and eating disorders.
Article
Importance In 2011, the Centers for Medicare & Medicaid Services (CMS) approved intensive behavioral weight loss counseling for approximately 14 face-to-face, 10- to 15-minute sessions over 6 months for obese beneficiaries in primary care settings, when delivered by physicians and other CMS-defined primary care practitioners.Objective To conduct a systematic review of behavioral counseling for overweight and obese patients recruited from primary care, as delivered by primary care practitioners working alone or with trained interventionists (eg, medical assistants, registered dietitians), or by trained interventionists working independently.Evidence Review We searched PubMed, CINAHL, and EMBASE for randomized controlled trials published between January 1980 and June 2014 that recruited overweight and obese patients from primary care; provided behavioral counseling (ie, diet, exercise, and behavioral therapy) for at least 3 months, with at least 6 months of postrandomization follow-up; included at least 15 participants per treatment group and objectively measured weights; and had a comparator, an intention-to-treat analysis, and attrition of less than 30% at 1 year or less than 40% at longer follow-up.Findings Review of 3304 abstracts yielded 12 trials, involving 3893 participants, that met inclusion-exclusion criteria and prespecified quality ratings. No studies were found in which primary care practitioners delivered counseling that followed the CMS guidelines. Mean 6-month weight changes from baseline in the intervention groups ranged from a loss of 0.3 kg to 6.6 kg. In the control group, mean change ranged from a gain of 0.9 kg to a loss of 2.0 kg. Weight loss in both groups generally declined with longer follow-up (12-24 months). Interventions that prescribed both reduced energy intake (eg, ≥ 500 kcal/d) and increased physical activity (eg, ≥150 minutes a week of walking), with traditional behavioral therapy, generally produced larger weight loss than interventions without all 3 specific components. In the former trials, more treatment sessions, delivered in person or by telephone by trained interventionists, were associated with greater mean weight loss and likelihood of patients losing 5% or more of baseline weight.Conclusions and Relevance Intensive behavioral counseling can induce clinically meaningful weight loss, but there is little research on primary care practitioners providing such care. The present findings suggest that a range of trained interventionists, who deliver counseling in person or by telephone, could be considered for treating overweight or obesity in patients encountered in primary care settings.
Article
Research on personality and adiposity has focused primarily on middle-aged and older adults. The present research sought to (a) replicate these associations in a young adult sample, (b) examine whether sex, race, or ethnicity moderate these associations, and (c) test whether personality is associated with the subjective experience of body weight and discrepancies between perceived and actual weight. Participants (N = 15,669; Mage = 29; 53% female; ∼40% ethnic/racial minority) from Wave 4 of the National Longitudinal Study of Adolescent Health completed a Five-Factor Model personality measure and reported their weight, height, and perception of weight category (e.g., overweight); trained staff measured participants’ height, weight, and waist circumference. Conscientiousness was associated with healthier weight, with a nearly 5 kg difference between the top and bottom quartiles. Neuroticism among women and Extraversion among men were associated with higher adiposity. Neuroticism was also associated with misperceived heavier weight, whereas Extraversion was associated with misperceived taller and leaner. The associations were similar across race/ethnic groups. Personality is associated with objective and subjective adiposity in young adulthood. Although modest, the effects are consistent with life span theories of personality, and the misperceptions are consistent with the conceptual worldviews associated with the traits.
Article
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.
Article
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 (M age = 35.48 years, M BMI = 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.
Article
America's war on obesity has intensified stigmatization of overweight and obese individuals. This experiment tested the prediction that exposure to weight-stigmatizing messages threatens the social identity of individuals who perceive themselves as overweight, depleting executive resources necessary for exercising self-control when presented with high calorie food. Women were randomly assigned to read a news article about stigma faced by overweight individuals in the job market or a control article. Exposure to weight-stigmatizing news articles caused self-perceived overweight women, but not women who did not perceive themselves as overweight, to consume more calories and feel less capable of controlling their eating than exposure to non-stigmatizing articles. Weight-stigmatizing articles also increased concerns about being a target of stigma among both self-perceived overweight and non-overweight women. Findings suggest that social messages targeted at combating obesity may have paradoxical and undesired effects.
Article
Objective: The objective of the study was to evaluate the incidence of eating disorders, including not otherwise specified eating disorders (EDNOS) and subthreshold disorders, inappropriate compensatory behaviors (such as self-induced vomiting, strict dieting, fasting) along with depressive symptoms among young French adult males. Method: The sample was composed of 458 young men in age ranging from 18 to 30 years (mean age=21.9±2.4). The average body mass index was 22.8±3. Participants completed two questionnaires: the Questionnaire for Eating Disorders Diagnoses (Q-EDD) assessing full-criteria eating disorder symptoms based on DSM-IV criteria (i.e. clinical eating disorders) and subthreshold disorders, and the Center for Epidemiological Studies-Depression scale (CES-D) assessing depressive symptoms. Results: Out of the 458 surveyed respondents, eating disorders were reported by approximately 17% of the overall sample, with 1.5% meeting diagnostic criteria for serious clinical disorders, 3% meeting diagnostic criteria for EDNOS and 12% meeting diagnostic criteria for subthreshold disorders. Exercise bulimia represented 1% of the overall sample and binge-eating disorder 2%. The most frequent subthreshold disorder was subthreshold nonbinging bulimia (7%). Participants with eating disorders were equally divided between those desiring weight gain, those desiring weight loss and those wanting to keep their current weight. Participants without eating disorders were more likely to want to gain weight compared to participants with eating disorders (45.5% versus 30% respectively; P<0.05). After controlling for body mass index, 30% of participants tended to perceive themselves as thinner than they actually were and 6% tended to perceive themselves as fatter. Regarding normal-weight participants, 28% perceived themselves as thinner and 8% as fatter than in reality. Overeating episodes were reported by 19% of participants. Binge-eating episodes (recurrent or not) were reported by 8% of young men, including 32% of participants with eating disorders and 3% of participants without eating disorder. Six percent reported repeated binging (at least twice a week for at least once a month). Inappropriate compensatory behaviors were mostly used by participants with eating disorders, except for excessive exercise (34% versus 35% for participants without eating disorders). The most typical compensatory behavior was fasting (11%). According to the cut-off score of 22, 18% of young men had a moderate to severe depressive symptomatology, including 5% of participants who also reported an eating disorder (i.e. 30 participants). A one-way ANOVA was conducted to examine differences in depressive symptoms as a function of eating disorder groups, namely the clinical eating disorders sample (n=22), the subthreshold disorders sample (n=54) and the asymptomatic sample (participants without eating disorder; n=382). Results were statistically significant, (F(2,455)=7.27, P<0.001) and post-hoc tests (Scheffé tests) were used to examine the group differences. The mean CES-D scores for the clinical eating disorders sample (19.45±8.2; P<0.05) and the subthreshold disorders sample (18.15±10.9; P<0.05) were significantly higher than for the asymptomatic sample (14.19±8.9). There was no significant difference between the two eating disorder groups (P>0.05). Discussion: The results demonstrate that a significant proportion of men with eating disorders manifest comorbid depressive symptomatology. These results suggest that EDNOS and subthreshold disorders should be taken into consideration, as they represent 15% of the total sample. Participants reported high rate of excessive exercise and fasting, which could reflect the importance of muscle tone or strategies to increase muscle mass. Further research is necessary in order to better understand male eating behaviors and disorders.
Article
Three studies investigated implicit biases, and their modifiability, against overweight persons. In Study 1 (N = 144), the authors demonstrated strong implicit anti-fat attitudes and stereotypes using the Implicit Association Test, despite no explicit anti-fat bias. When participants were informed that obesity is caused predominantly by overeating and lack of exercise, higher implicit bias relative to controls was produced; informing participants that obesity is mainly due to genetic factors did not result in lower bias. In Studies 2A (N = 90) and 2B (N = 63), participants read stories of discrimination against obese persons to evoke empathy. This did not lead to lower bias compared with controls but did produce diminished implicit bias among overweight participants, suggesting an in-group bias.
Article
Overweight and obesity are considered major public health issues, and many preventive campaigns are designed to prevent unhealthy eating habits among the French. But these campaigns may be ineffective, and even sometimes counterproductive. Firstly, because prevention is a moral enterprise that can lead to stigmatizing targeted people. Secondly, because the ‘merchandization’ of prevention fuels a ‘dietary cacophony’. Thirdly, the medicalisation of overweight/obesity involves some shortcomings: it can prevent us from understanding eating habits, and many general physicians are insufficiently trained to take care of overweight or obese patients.
Article
Objectives The major objective of this study was to explore the relation between frequency, perceived impact of stigmatization and Binge Eating Disorder. Subjects The sample was composed of 160 obese women consulting for assistance with dieting; all of them had a body mass index greater than 30kg/m2 and were 18 to 65 years old. Materials A researcher-designed questionnaire on stigmatization with obesity, the Rosenberg Self-Esteem Scale (RSE), Beck's abridged depression scale, the Body Shape Questionnaire (BSQ), the questionnaire of Eating and Weight Pattern (QEWP-R) were used. Results Stigmatizing did not appear to be more frequent in obese women with BED than without. It was also observed that obese women with BED perceived a stronger overall impact from stigmatizing than those without BED. Obese women manifesting BED were far more likely to be confronted with the following stigmatizing situations: negative comments by others, negative perception by close family members, negative comments from close family members, and limited clothing choice. Impact for the following situations of stigmatization was greater: negative perceptions by other adults, negative perceptions by close family members, a feeling of shame or discomfort coming from loved ones, discrimination in daily life, discrimination in the workplace, and negative attitudes of store employees.
Article
Obesity is not comparable in France and in the United States, from its width, its evolution, its age and gender distribution. Between 1970 and 2000, obesity progressed very quickly in the United States, whereas we can observe a stability in France until the middle of the 1990′s, then a deterioration. For as much, for 30 years, the relations between obesity among women – and more largely corpulence – and social hierarchy have been marked in the two countries: obesity concerns more the people – especially the women – of the working-class categories, the least rich and the least graduate people. With equal corpulence, people of the working-class categories, even if they share some of the standards of thinness, are much less concerned about excesses of weight: the women most touched by obesity belong to the groups where the average corpulence is highest and where the attention to weight is the least strong. A preventive policy of public health concerning the members of theses working-class categories could be a good objective.