Measurement of attitudes toward obese people among a Canadian sample of men and women

A new scale for examining attitudes toward obese people had 44 items selected from previously published scales designed to indicate attitudes toward obese people. Reliability analysis yielded a Cronbach coefficient alpha of .92 for the total sample. A factor analysis yielded four factors. Employing the Body Mass Index as an indicator of obesity, the attitudes of 239 men and women were examined. Women were significantly more positive than men in their attitude toward obese people. When examining Body Mass Index as a factor, comparisons of obese and nonobese women indicated obese women were more positive on the Diet and Exercise factor of the scale. Suggestions for improvement and research are offered.     

Comparison of Body Mass Index by self-reported versus measured height and weight

This study compared differences between self-reported and measured height and weight and subsequent Body Mass Index. College students (N=62) were asked to complete a health questionnaire as accurately as possible. Height and weight were self-reported without the knowledge that these variables would be subsequently measured. Self-reported and measured heights, weights, and calculated Body Mass Indexes were statistically compared. Analysis indicated that measured height was significantly less than self-reported height for men, but weight was not significantly different. Calculated Body Mass Index for men was not significantly different, however, self-reported Body Mass Index resulted in placement in the Normal range (18.5 to 24.9) category and measured Body Mass Index placement in the Overweight category (25.0 to 29.9). Women's self-reported and measured heights were not significantly different; however, self-reported weight was significantly less than measured. Further, significantly different Body Mass Indexes were found for women. It was concluded that self-reported height and weight might be viewed with caution in Body Mass Index assessment for convenience samples of college-age subjects.     

Behaviour change among overweight and socially disadvantaged adults: A longitudinal study of the NHS Health Trainer Service

Social disadvantage is associated with being overweight, a poor diet and physical inactivity. The NHS Health Trainer Service (HTS) is a national initiative designed to promote behaviour change among socially disadvantaged people in England and Wales. This study reports pre–post changes in Body Mass Index (BMI), associated behaviours and cognitions among service users who set dietary or physical activity goals during a 12-month period (2008–2009; N?=?4418). Sixty-nine percent of clients were from the two most deprived population quintiles and 94.7% were overweight or obese. Mean BMI decreased from 34.03 to 32.26, with overweight/obesity prevalence decreasing by 3.7%. There were increases in fruit and vegetable consumption, reductions in fried snack consumption, increases in frequency of moderate or intensive activity and gains in self-efficacy and perceived health and wellbeing. Clients with higher BMI, poorer diet or less activity at baseline achieved greater change. Findings suggest that the NHS HTS has the potential to improve population health and reduce health inequalities through behaviour change.     

Individual differences and weight bias: Do people with an anti-fat bias have a pro-thin bias?

While levels of weight bias vary among individuals, it is not clear why one person possesses stronger anti-fat attitudes than another person. This investigation examined whether individual differences commonly associated with greater anti-fat bias are also associated with a greater preference for thinness among people of varying levels of weight. Young adults (62% women; 84% Caucasian) recruited from psychology classes (N = 308) rated four male and female figures with approximate BMIs of 18.5, 25, 30, and 40, on measures of dislike and personality characteristics and completed measures assessing weight controllability, attitudes toward the obese, and perceptual reliance. Greater negative attitudes, weight controllability beliefs, and perceptual reliance were positively associated with greater dislike and negative personality attributes among obese/severely obese figures, but inversely related among low normal weight figures. Individuals who judge others based on physical features or who view obesity as controllable evidence greater weight bias and a stronger preference for thin body types.     

Weight Bias Internalization and Psychosocial,Physical, and Behavioral Health: A Meta-Analysis of Cross-Sectional and Prospective Associations

Coinciding with widespread efforts to address obesity, weight bias internalization (a process of self-devaluation wherein individuals apply weight-biased stereotypes to themselves) has gained increased attention as a robust correlate of poor health outcomes. The present meta-analysis aimed to provide the largest quantitative synthesis of associations between weight bias internalization and health-related correlates. Studies that provided zero-order correlations for cross-sectional or prospective associations between weight bias internalization and physical, psychosocial, and behavioral health correlates were included in the meta-analysis. Meta-regression determined whether these associations differed based on demographic (sex/gender, race, age), anthropometric (body mass index), and study-level (publication status, sample type, study quality) moderators. Data for 149 (sub)samples were identified that included between 14 and 18,766 participants (M sample size = 534.96, SD = 1,914.43; M age = 34.73, SD = 12.61, range = 9.95–65.70). Results indicated that greater weight bias internalization was concurrently associated with worse psychosocial (e.g., negative and positive mental health, social functioning), physical (e.g., BMI, weight maintenance, health-related quality of life [HRQoL]), and behavioral health (e.g., disordered eating behaviors, healthy eating, physical activity) across most constructs, with effects ranging from small to very large in magnitude. Preliminary evidence also suggested that greater weight bias internalization was subsequently associated with less weight loss and increased negative mental health. Notable variations in the nature and magnitude of these associations were identified based on the health-related correlate and moderator under consideration. These findings indicate that weight bias internalization is linked to multiple adverse health-related outcomes and provide insight into priorities for future research, theory building, and interventions in this area.     

Relations among premorbid weight,referral weight,and psychological test scores for patients with anorexia nervosa

The purpose of this study was to test the hypothesis that, in anorexia nervosa, patients with a low premorbid weight are associated with a low weight at referral and that premorbid weight, referral weight, and weight loss are associated with mood states. The changes of Body Mass Index from premorbid to referral, the duration of illness, and the psychological scores on the Profile of Mood States and the Cornell Medical Index-Health Questionnaire were examined in 49 anorexia nervous patients. Body Mass Index at referral of patients with lower premorbid Body Mass Index was significantly lower than that of patients with higher premorbid level. For patients with a larger relative decrease, scores on depressive mood were lower. These findings suggested that in anorexia nervosa patients, lower premorbid Body Mass Index was associated with lower Body Mass Index at referral, and that the patients with higher relative decrease in Body Mass Index might be satisfied with their weight loss.     

Effects of a 12-month pedometer walking program on gait, body mass index, and lower extremity function in obese women

This study evaluated the effects of a self-reported pedometer-walking program on gait, lower extremity function, and Body Mass Index for 33 obese women, ages 31-65 years (M = 48.0, SD = 8.0) and whose initial average Body Mass Index was 40.30 +/- 9.60 kg/m2. During the 12-mo. intervention participants wore pedometers and reported the number of daily steps walked. Body Mass Index, three gait parameters, steps/day, and lower extremity function were taken over 3-mo. intervals. All participants increased in gait velocity, % single-leg support, and lower extremity function, and decreased in Body Mass Index over time. Those whose steps/day increased by 2000 over 6 mo. had significantly faster velocities and longer step lengths than those whose steps/day did not increase. The 1-yr. walking program stimulated changes in gait, Body Mass Index, and lower extremity function for these obese women. Ultimately, these changes may reduce the risk of falls for this group of women.     

Body Image and Depression in Women With Early and Late Onset Obesity

Three groups of women (N = 27 in each group) were compared: women of normal weight and asymptomatic for eating disorders (M = 125.5 lb); women with early onset obesity—before 13 years (M = 182.4 lb); and women with adult onset obesity—17 years or over (M = 172.4 lb). Subjects (M age = 40.7 years) were obtained through church and business groups. Body image and depression were assessed, respectively, by three scales of the Body-Self Relations Questionnaire (Winstead & Cash, 1983) and by the Beck Depression Inventory (Beck, 1967). The combined group of obese subjects rated their bodies as less fit than normal weight subjects (p<.01). However, there were no other significant differences between obese and normal weight subjects. Also, no significant differences were found between the early and late onset groups. Results showed that (a) there is a subpopulation of obese women who are relatively satisfied with their bodies and whose psychological adjustment is no different from that of other women, and that (b) an early onset of obesity does not necessarily have more serious psychological consequences than late onset.     

Compassion-Focused Therapy to Reduce Body Weight Shame for Individuals With Obesity: A Randomized Controlled Trial

Adults living in larger bodies (Body Mass Index > 30) often experience body weight shame, are highly self-critical, and are at increased risk for anxiety and depression. To date, there have been no RCTs examining the efficacy of Compassion-Focused Therapy (CFT) to help those experiencing body weight shame. The aim of the current study was to investigate the efficacy of CFT as a 12-session group intervention to reduce body weight shame for individuals living in larger bodies. The study used an RCT design with participants randomized to the CFT (n = 28) or waitlist control (n = 27) condition. Participants in both groups were assessed at pre- and postintervention, with the CFT group alone assessed at 3- and 6-month follow-up intervention. Both self-report and a physiological measure of parasympathetic nervous system activity were used (i.e., heart rate variability). Results indicated that CFT had a significant positive impact at postintervention compared to the control group for body weight shame (internal and external), increasing self-compassion, reducing fears of compassion (self, other, and receiving), reducing self-criticism, and reducing external shame. Although there were no significant group effects at postintervention on depression and anxiety, 66% of participants had clinical improvement on depression in the CFT group compared to 8% in the control group at postintervention. CFT did not shift baseline heart rate variability at postintervention. The evidence from this RCT supports CFT as an efficacious intervention to reduce body weight shame for individuals with obesity.     

Downsizing obesity: On Ancel Keys,the origins of BMI,and the neglect of excess weight as a health hazard in the United States from the 1950s to 1970s

In 1972 Body Mass Index, BMI was put forth by physiologist Ancel Keys in his analysis of Seven Countries Study heart disease epidemiological data as the best available measure of obesity. This work culminated more than 20 years of effort by Keys to discredit the accepted measure of obesity, weight relative to height, along with a major public health campaign in the United States to fight heart disease through weight control. Here, I retrace his campaign to replace weight as a measure of obesity and analyze its methodology and relationship to the broader research field of heart disease epidemiology. I also explore why the epidemiological community accepted BMI despite Keys's failure to demonstrate that either it or adiposity (body fat content), were superior as predictors of heart disease—one of the Seven Countries Study's central aims.     

The Coronary Health Improvement Project (CHIP) for lowering weight and improving psychosocial health

This study extends previous research evaluating the association between the CHIP intervention, change in body weight, and change in psychological health. A randomized controlled health intervention study lasting 4 wk. was used with 348 participants from metropolitan Rockford, Illinois; ages ranged from 24 to 81 yr. Participants were assessed at baseline, 6 wk., and 6 mo. The Beck Depression Inventory (BDI) and three selected psychosocial measures from the SF-36 Health Survey were used. Significantly greater decreases in Body Mass Index (BMI) occurred after 6 wk. and 6 mo. follow-up for the intervention group compared with the control group, with greater decreases for participants in the overweight and obese categories. Significantly greater improvements were observed in BDI scores, role-emotional and social functioning, and mental health throughout follow-up for the intervention group. The greater the decrease in BMI through 6 wk., the better the chance of improved BDI score, role-emotional score, social functioning score, and mental health score, with odds ratios of 1.3 to 1.9. Similar results occurred through 6 mo., except the mental health variable became nonsignificant. These results indicate that the CHIP intervention significantly improved psychological health for at least six months afterwards, in part through its influence on lowering BMI.     

Body Mass Index, suicide, and homicide among inhabitants of the Caribbean Islands

To test the hypothesis that the more overweight and obese a nation, as measured by Body Mass Index, the greater the risk of suicide; mean scores of Body Mass Index for males and females over 15 years of age in 11 Caribbean Islands were not associated with either male or female rates of suicide or homicide with one exception, i.e., when controlling for gross domestic product per capita, mean Body Mass Indices for males were significantly and negatively associated with male rate of homicide.     

BMI,age, Mate Value,and Intrasexual Competition in Chilean Women

Attractiveness is the most important component of women intrasexual competition and it certainly has an impact in female’s perceived mate value (i.e., the value of an individual to the opposite sex as a potential mate). In the realm of intrasexual competition women are eager to emphasize their attractiveness and compete with rivals displaying these cues. Accordingly, age is an important feature of women’s appeal to the opposite sex; youth is highly valued by men, and is perceived by women as an important component of their attractiveness. Another trait that is a reliable cue of health and fertility is Body Mass Index (BMI). A large body of literature has associated BMI to female attractiveness. However, more information is necessary about the associations of BMI and age with mate value, and female intrasexual competition. In the present research we report two studies that examined the associations of BMI and age with estimates of self-perceived mate value and intrasexual competition in Chilean women (18–39 years). More specifically, we hypothesized inverse relationships of BMI and age with mate value (N?=?234), and intrasexual competition (N?=?308). We found partial support to our propositions. The results revealed inverse associations between BMI, mate value and mating success, but BMI with intrasexual competition were not related. In contrast, age had a strong and negative effect on intrasexual competition. We discuss our results within the framework of Evolutionary Psychology and consider the central role of attractiveness (estimated from BMI and age) in the mating strategies of women.     

Body mass index in female Spanish Olympic athletes

The purpose of this study was to examine the Body Mass Index of 180 female Spanish Olympic athletes (M age = 27.1 yr., SD = 5.9 yr.) who participate in presentation sports and nonpresentation sports, in comparison with 114 female nonathletes (M age = 20.7, SD = 1.5 yr.). Presentation sports athletes have a profile similar to that of a university student but by age with a lower Body Mass Index. In particular, rhythmic gymnasts have a lower weight and Body Mass Index than other athletes and nonathletes.     

Childhood Overweight and Obesity: Maternal and Family Factors

Treatment programs for childhood overweight and obesity have highlighted the importance of the family in treatment. Considering this, it is surprising that few studies have examined the role of family factors in the development of childhood overweight and obesity. The objective of this study was to examine which family and maternal factors predict increases in weight in boys and girls during middle to late childhood. This study used longitudinal data from the childhood growth and development (GAD) Study. The GAD Study involved 286 healthy weight, overweight and obese children, aged 6–13 years at baseline, who completed baseline, 1-year follow-up and 2-year follow-up assessments. Overweight/obese children were recruited from clinical and community settings. A broad range of maternal and family factors were assessed. Linear mixed models were used to identify which factors predicted child Body Mass Index (BMI) z-scores over time. For community-based children, maternal BMI and single-parent family structure were significant longitudinal predictors of child BMI z-scores. For the clinical participants, low family income was the only significant multivariate predictor of child BMI z-scores. The strong association between child BMI, maternal BMI and family structure confirms the need to target prevention and intervention efforts for childhood overweight and obesity towards families with overweight parents, particularly single-parent families.     

Is severe obesity a form of addiction? Rationale, clinical approach, and controlled clinical trial.

For many, obesity is just a problem of energy input and expenditure: more energy input than expenditure. However, the clinical practice and epidemiological data clearly show that weight control is more complex than expected by this simple equation. This is particularly true in morbid obesity, a form of severe obesity in which a person's Body Mass Index (BMI, kg/m(2)) is over 40. If we compare the definitions and diagnostic criteria for "dependence" and "addiction" with the situation of many severe obese subjects, it is apparent that they match very well. Further, different neurological studies confirm this similarity: both addiction and obesity patients have a deficiency of dopamine receptors. Nevertheless, when we compare many of the actual obesity treatments with the ones used in the area of addictions it is possible to find relevant differences: obesity treatments neither consider different levels of type and intensity of care, nor a multidimensional approach. To overcome these limitations, in this paper we propose a bio-psychosocial approach in which the genetic influence (lack of dopamine receptors) is matched by psychosocial issues (pressure for thinness and diet as main body image dissatisfaction treatment). Further, the paper outlines how this approach may influence the treatment options, by focusing both on the lessons coming from actual addiction treatment and the opportunities offered by virtual reality. Finally, the paper presents and discusses the outcome of a controlled trial, based on the proposed approach, including a 6-month follow-up (211 morbid obese females with a BMI of >40 and a documented history of failures.     

Women and weight: fad and fiction

In this article, I argue that women's concern with body weight is a "fad," when taken in an historical context, and is limited to Western societies. I have presented evidence that the following aspects of weight are myths rather than reality: (a) There are objective definitions of obesity; (b) obesity is prevalent among women; (c) obese people take in more calories than the nonobese; (d) dieting is an effective way to reduce weight; and (e) obesity is related to poor physical health.