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Healing From Weight Stigma in Community: A Thematic Analysis of a Group Intervention for Large-Bodied Individuals

Psychotherapy
Authors:
Lisa M. Brownstone
Lisa M. Brownstone
Lisa M. Brownstone
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Devin A. Kelly
Devin A. Kelly
Devin A. Kelly
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Erin N. Harrop
Erin N. Harrop
Erin N. Harrop
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Hannah Norling at University of Denver
Hannah Norling
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Abstract

Discrimination against and negative beliefs about large-bodied individuals, known as weight stigma, is pervasive and harmful. While previous research has focused on the negative consequences of weight stigma, the present study aims to highlight the lived experience of large-bodied individuals while also exploring the process of healing from harmful experiences of weight stigma. Ten adult (9/10 White, 8/10 cisgender women), large-bodied individuals recruited via snowball sampling through a nonprofit, grassroots, eating disorder advocacy organization participated in a 10-week, counselor-facilitated support group with the shared goal of healing from the impact of weight stigma. Researchers used reflexive thematic analysis to analyze video recordings and transcripts of group sessions to answer the following question: how did participants make sense of their weight stigma experiences and engage with the process of healing in community? Four primary themes were generated: (a) Community is Essential, (b) Storying, (c) Deprogramming and Changing Mindset, and (d) Expansive Healing. These results underscore the impact of weight stigma in the lives of large-bodied individuals and provide insight into how clinicians might support such individuals engaging in collective healing from these painful experiences.
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Healing From Weight Stigma in Community: A Thematic
Analysis of a Group Intervention for Large-Bodied Individuals
Lisa M. Brownstone
1
, Devin A. Kelly
1
, Erin N. Harrop
2
, Hannah N. Norling
1
, L. P. Palazzolo
1
,
Orphea Wright
1
, and Emily Tiede
1
1
Department of Counseling Psychology, Morgridge College of Education, University of Denver
2
Graduate School of Social Work, University of Denver
Discrimination against and negative beliefs about large-bodied individuals, known as weight stigma, is
pervasive and harmful. While previous research has focused on the negative consequences of weight stigma,
the present study aims to highlight the lived experience of large-bodied individuals while also exploring the
process of healing from harmful experiences of weight stigma. Ten adult (9/10 White, 8/10 cisgender
women), large-bodied individuals recruited via snowball sampling through a nonprofit, grassroots, eating
disorder advocacy organization participated in a 10-week, counselor-facilitated support group with the
shared goal of healing from the impact of weight stigma. Researchers used reflexive thematic analysis to
analyze video recordings and transcripts of group sessions to answer the following question: how did
participants make sense of their weight stigma experiences and engage with the process of healing in
community? Four primary themes were generated: (a) Community is Essential, (b) Storying, (c)
Deprogramming and Changing Mindset, and (d) Expansive Healing. These results underscore the impact of
weight stigma in the lives of large-bodied individuals and provide insight into how clinicians might support
such individuals engaging in collective healing from these painful experiences.
Clinical Impact Statement
Question: How do large-bodied individuals heal from systemic weight stigma in group psychotherapy?
Findings: Findings suggest that the process of healing from weight stigma includes story-telling,
community-building, fostering a systemic lens, and bolstering self-advocacy skills. Meaning:
Relational-cultural theory, radical healing, and group psychotherapy may be useful when supporting
large-bodied psychotherapy clients in healing from experiences of weight stigma. Next Steps: Future
research should explore how self-determination and advocacy can be fostered for clients who have
experienced weight stigma, as well as how peer- and clinician-facilitated, self-sustaining versions of a
group intervention like this may support clients.
Keywords: weight stigma, community healing, weight inclusive, fat acceptance, disordered eating
Discrimination and prejudice against large-bodied individuals,
known as weight stigma, is pervasive and harmful to physical,
emotional, and social health (e.g., Pearl & Schulte, 2021). First
arising during European colonization as a way to signal social
distinctions in race, class, and gender hierarchies (Stanley & Hicks,
2023;Strings, 2019), weight stigma stereotypes large-bodied
individuals as unintelligent, unlikable, lazy, and immoral (e.g.,
Daníelsdo´ttir et al., 2010;Latner & Stunkard, 2003;Lieberman
et al., 2012;O’Brien et al., 2013;Puhl & Brownell, 2003). Given the
colonial history of associating larger body sizes with “sensuality,
This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
This article was published Online First October 19, 2023.
Lisa M. Brownstone https://orcid.org/0000-0002-9164-7621
Devin A. Kelly https://orcid.org/0000-0002-6635-726X
Erin N. Harrop https://orcid.org/0000-0002-0933-1098
Hannah N. Norling https://orcid.org/0000-0001-9336-6498
L. P. Palazzolo https://orcid.org/0000-0002-8724-8070
Lisa M. Brownstone and Devin A. Kelly hold shared first authorship on
this article.
The authors have no conflicts of interest to disclose.
Lisa M. Brownstone played a lead role in supervision and an equal role in
data curation, formal analysis, investigation, methodology, project adminis-
tration, resources, validation, writing–original draft, and writing–review and
editing. Devin A. Kelly played an equal role in conceptualization, data
curation, formal analysis, investigation, methodology, project administration,
resources, validation, writing–original draft, and writing–review and editing.
Erin N. Harrop played a supporting role in formal analysis, investigation,
resources, and writing–review and editing. Hannah N. Norling played a
supporting role in formal analysis, investigation, project administration, and
visualization and an supporting role in writing–original draft and writing–
review and editing. L. P. Palazzolo played a supporting role in formal analysis,
project administration, writing–original draft, and writing–review and editing.
Orphea Wright played a supporting role in investigation, writing–original
draft, and writing–review and editing. Emily Tiede played a supporting role in
conceptualization and investigation.
Correspondence concerning this article should be addressed to Lisa M.
Brownstone, Department of Counseling Psychology, Morgridge College
of Education, University of Denver, 1999 East EvansAvenue, Denver, CO
80208-1700, United States. Email: lisa.brownstone@du.edu
Psychotherapy
© 2023 American Psychological Association 2023, Vol. 60, No. 4, 455–466
ISSN: 0033-3204 https://doi.org/10.1037/pst0000509
455
... Aligned with weight-affirming approaches, psychological interventions can focus on helping large-bodied individuals heal from the deleterious effects of internalized weight stigma (Brownstone et al., 2021;Brownstone et al., 2023;Pearl et al., 2020). Internalized weight stigma is defined as "the awareness, agreement, and self-application of negative weight stereotypes, along with consequent self-devaluation or decrements in self-worth due to weight" (Pearl & Puhl, 2018, p. 1141. ...
... Furthermore, it is likely that group members can reframe their narratives about weight stigma through the social learning and the sharing of personal stories (Yalom & Leszcz, 2020) that empower them to dismantle weight stigma with a more informed and compassionate perspective. Lastly, in this study, facilitators incorporated group discussions about systemic power and oppression, which possibly enabled group members to recognize the broader societal forces perpetuating weight stigma so that they make shifts from selfblame to systemic attribution (Brownstone et al., 2023). ...
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... During the final three sessions (Sessions 8, 9, and 10), participants discuss ways to combat weight stigma by curating intentional social media spaces, developing joyful relationships with movement, and engaging in antiweight stigma discourse with others in their lives. See Brownstone et al. (2023) for an in-depth discussion of the content of these groups. Participants completed research measures remotely by responding to a survey that was emailed to them after each session. ...
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