Weight Bias and Anti-Fat Attitudes: Sources, Impacts, and Prevention Methods

The number of overweight and obese individuals in the United States has steadily increased over the last decade (CDC, 2012). According to the Food Research and Action Center, over two-thirds of adults in the United States are either overweight or obese (2010). The Academy of Nutrition and Dietetics (2013) states that individuals who are overweight fall within a body mass index range of 25-29.9 and individuals who are obese fall within a body mass index range of 30 and above. Meanwhile, the social environment places a heavy emphasis on dieting and the importance of being thin (Brownell, 1991). Despite the increasing rates of overweight and obese populations, weight based prejudice, also known as weight bias, is still broadly prevalent within our society (Diedrichs & Barlow, 2011).

Weight bias can include negative attitudes, beliefs, and discrimination toward overweight and obese individuals (Puhl & Heuer, 2009). The engagement of such attitudes or beliefs can result in the perception of such individuals as lesser or devalued human beings and can lead to these individuals being treated differently than those of a more ‘acceptable’ weight. The concept of weight bias is closely linked to “antifat attitudes,” or the negative thoughts, feelings, and assumptions individuals possess regarding overweight or obese individuals (Crandall, 1994). These assumptions often involve stereotyping overweight individuals as “lazy,” “undisciplined,” or “unintelligent” (Schwartz, Chambliss, Brownell, Blair, & Billington, 2003).

Weight bias often occurs in places where overweight individuals might assume they would be free from judgment, including within the health system, college admissions process, and during the hiring process (Teachman & Brownell, 2001; Canning & Mayer, 1966; Rothblum, Brand, Miller, & Oetjen, 1990). Biases from health care professionals can influence the type of care an overweight or obese individual may receive, while biases from university admissions professionals and hiring employers can result in individuals not being accepted for university or employment positions.

Negative associations and connotations can have negative impacts on overweight or obese individuals. These negative impacts include both physical and emotional implications for the effected individual, including the internalization of negative stereotypes (Puhl, Moss-Racusin, & Schwartz, 2007; Friedman, Reichmann, Costanzo, Zelli, Ashmore, & Musante, 2005). Puhl, Moss-Racusin, and Schwartz (2007) note that sometimes when overweight or obese individuals are subjected to weight bias, individuals may often experience body dissatisfaction, depression, or changes in eating behaviors and physical activity patterns. Non-overweight or non-obese individuals may comment that subjecting overweight or obese individuals to such biases is a motivational factor for weight loss. However, past research conflicts with this claim (Wang & Lobstein, 2006; Puhl & Heuer, 2009).

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Antifat attitudes and weight bias can be assessed using questionnaire methods of which individuals will base their agreements upon given statements or figures (O’Brien, Latner, Halberstadt, Hunter, Anderson, & Caputi, 2008). Other assessment measures have included the Implicit Associations Test (IAT). The IAT can be completed in order to determine if an individual makes an association between words such as “good” and “skinny” or “bad” and “fat” (Greenwald, McGhee, & Schwartz, 1998). Other measures of such attitudes include the use of the Antifat Attitudes Test (AFAT). The AFAT involves individuals to assess their attitudes regarding obese individuals on a five-point Likert scale with options ranging from strongly disagree to strongly agree (Chambliss, Finley, & Blair, 2004).

Due to the detrimental effects of weight bias among overweight or obese populations reduction efforts are critical. These efforts are critical in order to allow for equal treatment for all individuals, regardless of weight (Carels, Burmeister, Oehlhof, Hinman, LeRoy, Bannon, Koball, & Ashrafloun, 2013). Puhl, Moss-Racusin, Schwartz, and Brownell (2008) suggest using education about obesity etiologies, the inaccuracy of weight-based stereotypes, and the difficulty of weight-loss when addressing weight biases as tactics to reduce weight-based stereotyping and discrimination.

The purpose of this paper is to identify common sources of weight bias and antifat attitudes, elaborate upon the experiences of weight bias among overweight and obese individuals, and examine bias reduction efforts. This topic is particularly important in a society that is constantly grappling with issues of body size. Such a focus on obesity has resulted in the establishment of a divide between normal-sized individuals and overweight and obese individuals. This divide emphasizes how overweight or obese individuals are undesirable and must cross-over to normal weight populations.

Sources of Weight Bias

Health Care Professionals

An ironic source of weight bias stems from the individuals, whose jobs include addressing the problems of the overweight and obese with suspended judgment, include health care professionals and health care students. The prevalence of weight bias among health care professionals can be detrimental to overweight or obese individuals. These attitudes can create uncomfortable settings which can prevent overweight or obese individuals from seeking out the necessary treatments (Schwartz, Chambliss, Brownell, Blair, & Billington, 2003). Schwartz, Chambliss, Brownell, Blair, and Billington (2003) noted that even health care professionals whose specialties consisted of treating obese patients possessed beliefs suggesting their patients were to blame for their obesity. After administered an IAT, the professionals frequently made associations between obese people and words such as “lazy” or “stupid.” Schwartz, Chambliss, Brownell, Blair, and Billington (2003) suggested that a perception of obese individuals being lazy can result in health care professionals blaming obese individuals.

Health care students were also found to engage in weight bias. Chambliss, Finley, and Blair (2004) found that exercise science students, individuals whom are training to work with clients and address the clients’ physical fitness, were found to exhibit weight biases. The students’ overall IAT scores indicated that they did not score high on explicit measures for biases. However, according to the students AFAT results, the students did admit to endorsing certain stereotypes and antifat beliefs regarding overweight and obese individuals.Continued on Next Page »