Geographic patterns of implicit age bias and associations with state-level health outcomes across the United States

Negative attitudes toward aging are pervasive in society and may be detrimental to people's health as they become older. Older people tend to report feeling significantly younger than their chronological age, often as a way of psychologically distancing themselves from the stigma of old age. However, attitudes and behaviors toward aging may differ across regional contexts. We examined associations among state-level patterns of bias against older adults and state-level health outcomes across the United States. Data from 803,009 respondents (ages: 15–94) across 50 U.S. states (and the District of Columbia) revealed geographic variation in implicit age bias. Higher state-level implicit age bias was associated with poorer state-level health outcomes among adults ages 65+. Older adults living in states high in implicit age bias showed greater age-group dissociation compared to older adults living in states low in implicit age bias. Findings highlight potential consequences of implicit age bias and invite further research on the long-term health implications of individual age-group dissociation in response to regional age bias.     

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

Objective: The objective of this research was to compare the effects of different causal attributions for overweight and obesity, among individuals with overweight and obesity, on weight-related beliefs, stigmatising attitudes and policy support.

Design: In Study 1, an online sample of 95 US adults rated the extent to which they believed various factors caused their own weight status. In Study 2, 125 US adults read one of three randomly assigned online passages attributing obesity to personal responsibility, biology, or the ‘food environment.’ All participants in both studies were overweight or obese.

Main outcome measures: All participants reported beliefs about weight loss, weight-stigmatising attitudes, and support for obesity-related policies.

Results: In Study 1, biological attributions were associated with low weight-malleability beliefs and blame, high policy support, but high internalised weight bias. ‘Food environment’ attributions were not associated with any outcomes, while ‘personal responsibility’ attributions were associated with high prejudice and blame. In Study 2, participants who received information about the food environment reported greater support for food-related policies and greater self-efficacy to lose weight.

Conclusion: Emphasising the role of the food environment in causing obesity may promote food policy support and health behaviours without imposing the negative consequences associated with other attributions.     

Childhood obesity and social stigma: What we know and what we don't know

Evidence for the development of social stigma associated with body build in childhood, specifically obesity, was critically reviewed. Although there is overwhelming evidence to suggest that children hold a positive stereotype toward a mesomorph (normal) build when compared to other builds, and that this preference increases with age, studies have not convincingly shown a negative stereotype toward the endomorph or obese body build. Furthermore, the belief that obese children are generally discriminated against is without empirical verification. Specifically, it is unclear from the various empirical studies that examine self-esteem and body image, that the psychological consequences of obesity are debilitating. Studies which have noted disturbances in self-concept and body image have sampled clinical populations (youngsters seeking medically supervised reduction); and those studies which have examined nonclinical populations have not found psychological difficulties. Finally, potential moderators such as facial attractiveness × body build interactions, situational contexts, and degree of obesity are examined and new research directions are discussed.     

Influence of Siblings on Child Health Behaviors and Obesity: A Systematic Review

Family structure plays an important role in childhood obesity but the association between having siblings and childhood obesity is not well established. The purpose of this systematic review was to examine the relationship between sibling factors and child health behaviors and child obesity. CINAHL, Cochrane Reviews, PsycINFO and PubMed were searched to identify relevant publications between 2000 and 2016. Of 141 identified studies, 22 peer-reviewed, primary research reports satisfied inclusion criteria and were included in the review. Findings indicated that children without siblings are more likely to be overweight or obese. Having fewer siblings was associated with decreased physical activity, inadequate sleep, and unhealthy dietary habits. The relationship between the number of siblings and childhood obesity persisted over time. All but two studies reported an association between birth order and childhood obesity. Youngest siblings were at a higher risk of becoming overweight or obese than their older siblings. Overall, the findings emphasize the importance of sibling factors in the development of childhood obesity. Further studies are needed to understand the dynamics underlying the effect of siblings on child’s health-related behaviors in order to develop effective childhood obesity prevention programs. Healthcare professionals should focus on family structure and at-risk children when intervening to prevent childhood obesity.     

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.     

Weighed Down by Stigma: How Weight‐Based Social Identity Threat Contributes to Weight Gain and Poor Health

Weight stigma is pervasive, and a number of scholars argue that this profound stigma contributes to the negative effects of weight on psychological and physical health. Some lay individuals and health professionals assume that stigmatizing weight can actually motivate healthier behaviors and promote weight loss. However, as we review, weight stigma is consistently associated with poorer mental and physical health outcomes. In this article, we propose a social identity threat model elucidating how weight stigma contributes to weight gain and poorer mental and physical health among overweight individuals. We propose that weight‐based social identity threat increases physiological stress, undermines self‐regulation, compromises psychological health, and increases the motivation to avoid stigmatizing domains (e.g., the gym) and escape the stigma by engaging in unhealthy weight loss behaviors. Given the prevalence of overweight and obesity in the US, weight stigma thus has the potential to undermine the health and wellbeing of millions of Americans.     

Impact of perceived consensus on stereotypes about obese people: a new approach for reducing bias.

In 3 experiments, the authors tested the effect of perceived social consensus on attitudes toward obese people. Participants completed self-report measures of attitudes toward obese people prior to and after manipulated consensus feedback depicting attitudes of others. In Study 1 (N=60), participants decreased negative and increased positive stereotypes after learning that others held more favorable attitudes toward obese people. In Study 2 (N=55), participants improved attitudes when they learned about favorable attitudes of obese people from an in-group versus an out-group source. In Study 3 (N=200), a consensus approach was compared with other stigma reduction methods. Social consensus feedback influenced participants' attitudes and beliefs about causes of obesity. Providing information about the uncontrollable causes of obesity and supposed scientific prevalence of traits also improved attitudes.     

Derogating obese individuals: the role of blame,contempt, and disgust

Weight stigma is pervasive and has profound negative consequences for obese individuals. The attribution‐emotion approach of stigmatization holds that blame attributions relate to derogation stigmatized groups indirectly through anger and pity. Other research suggests that disgust is related to weight stigma. In the present studies, we investigate whether contempt is a reliable predictor of biases against obese individuals. Study 1 (N = 297) shows that contempt partially mediates the relation between blame and both prejudice and support for weight related discrimination policies. Studies 2 and 3 (total N = 406) added disgust and show that both contempt and disgust relate to social distance and prejudice. Contempt mediated the relation between blame and negative reactions toward obese individuals, even after controlling for other emotions, while disgust only mediated these relations in Study 2. Anger and pity did not show this mediating role, but pity was moderately associated with weight bias. Contempt is likely to play an important role in how people react to members of this stigmatized group.     

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.     

Self‐Stigma,Mental Health Literacy,and Health Outcomes in Integrated Care

The authors describe research on the self‐stigma of mental illness and help seeking, mental health literacy, and health outcomes in an integrated care medical center. Results revealed that self‐stigma of mental illness and self‐stigma of seeking help had an inverse relationship with mental health literacy. No statistically significant relationships were found between health outcomes, either type of self‐stigma, and mental health literacy. The authors discuss these and other findings and offer research and counseling implications.     

Pre-service teachers’ implicit and explicit attitudes toward obesity influence their judgments of students

Obese children experience disadvantages in school and discrimination from their teachers. Teachers’ implicit and explicit attitudes have been identified as contributing to these disadvantages. Drawing on dual process models, we investigated the nature of pre-service teachers’ implicit and explicit attitudes, their motivation to respond without prejudice, and how attitudes influence their judgments of an obese student. Results showed that implicit anti-obesity bias might stem from an implicit positivity toward thinness rather than from an implicit negativity toward obesity. Explicit attitudes were mixed: positive attitudes toward achievement, a dislike of obese persons, and neutral attitudes concerning blame and health responsibility emerged. Implicit and explicit attitudes affected judgments of language proficiency and intelligence: pre-service teachers with more positive attitudes judged the obese student more favorably. The results of multiple regression analyses suggest that attitudes might exert a greater influence when pre-service teachers must draw inferences to derive the judgment.     

Stigma towards Mental Health Problems during Childhood and Adolescence: Theory,Research and Intervention Approaches

Many children and teenagers living with mental health problems experience stigma from within their peer group, yet this remains an under-researched topic in developmental science and the broader mental health literature. This paper highlights the limitations of adopting measures, concepts and theories that have exclusively emanated from the adult mental health literature. We argue that the social context of children and adolescents is critical in understanding the development and maintenance of stigma towards those with mental health problems, alongside the changing developmental needs and abilities of children and adolescents. In this article we argue that a theory proposed to explain the development of stereotypes and prejudice in childhood has potential as a framework for integrating existing research findings on mental health stigma in childhood and adolescence and providing direction for further research. The need for interventions that are grounded within the developmental science literature and that explicitly state their theory of change are identified as key research priorities for reducing stigma during childhood and adolescence.     

Factors associated with mothers' obesity stigma and young children's weight stereotypes

Parents and children hold negative attitudes about obesity, but little is known about individual differences in obesity stigma. The current study examined authoritarian parenting style, beliefs about the controllability of weight and fear of fat in relation to mothers' dislike of overweight individuals. Factors related to children's weight stereotypes were also investigated. Forty-nine mothers and children (43% girls) participated. Mothers showed more dislike and blame toward adults who are overweight than children who are overweight; parents were most often blamed for children's weight status. Authoritarian parenting and beliefs about controllability were related to mothers' anti-fat attitudes, but fear of fat was not. However, mothers' fear of fat was the best predictor of children's negative stereotypes toward overweight peers. The current study provides some preliminary insight into the role of mothers in children's attitudes about weight. Examining individual difference factors is also useful in planning targeted interventions to lessen obesity stigma.     

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.     

Framing Childhood Obesity: How Individualizing the Problem Affects Public Support for Prevention

Political actors recognize the power of framing problems using personalized examples and causal stories to shape public opinion. Yet little is known about how these frames interact. This research presents the results of three studies designed to investigate the effect of “individualizing” the problem of childhood obesity, in combination with information about causes of obesity, on public support for obesity prevention policies (Studies 1 and 2) and to examine how frequently the news media rely on individual depictions of obese children to portray the problem in actual news coverage (Study 3). Results from two experiments consistently demonstrated that, regardless of how the cause of childhood obesity was framed, when a news report identified an individual obese child, participants were less likely to support prevention policies than when the report described the problem in more general terms. A content analysis indicated that news articles relatively infrequently frame the problem using individualized depictions of a specific child. When specific overweight or obese children were mentioned, news coverage emphasized internal (behavioral and genetic) causes rather than factors external to the child such as neighborhood, economic, or food‐industry factors. Findings underscore the importance of considering attitudes toward a policy's target population when assessing how individual depictions of a policy problem influence public sentiment.     

Effects of obesity, social interactions, and physical environment on physical activity in preschoolers

Examined demographic, environmental, and parent-child interactional correlates of physical activity in a group of 222 preschoolers. Activity levels were assessed with a system that quantified directly observed physical activity in the natural environment. Using regression-modeling procedures, results revealed a significant relationship between (a) child's relative weight, parental weight status, and percentage of time spent outdoors (environment) and (b) children's activity levels. Parental obesity was associated with lower levels of physical activity in children, childhood relative weight was associated with slightly higher levels of physical activity, and more outdoor activity was associated with higher activity levels. Parental participation in children's activities also significantly interacted with levels of parental obesity in predicting activity levels. Those children with a 50% risk for obesity (as defined by both, one, or neither parent being overweight) had small changes in activity across levels of parent-child interaction, whereas those at higher risk for obesity responded with increased activity as parent-child interactions increased. Results are discussed, and the implications of these findings for future intervention efforts are examined.     

There's something about obesity: culture, contagion, rationality, and children's responses to drinks "created" by obese children

Theories of the development of obesity stereotypes cannot easily explain the stigma associated with being obese. Evidence that important similarities exist between the symptoms of obesity and contagious illnesses, young children have "theories" of illnesses, and obesity stereotypes are among the earliest that children develop led to the hypothesis that children would find beverages purportedly created by obese children less tasteful and more memorable than beverages created by average weight children. After assignment to two story conditions in which a child became ill after eating an unfamiliar food, Caucasian-American and Chinese 7- and 10-year-olds sampled identically flavored "obese-created" and "average-created" beverages. Taste ratings were lower, ratings of the chances of feeling sick were higher, and memory was superior for obese-created drinks than for average-created drinks, particularly when the character in the story contracted a contagious illness and memory was scored for "gist." Finally, children often created the false memory that the story character was an obese beverage creator. The roles of contagion and magical beliefs are discussed, as are the rationality of children's responses and the relevance of the findings for theories of obesity stereotypes.     

Early executive control and risk for overweight and obesity in elementary school

An emerging literature suggests that poor executive control (EC) may be associated with clinical weight problems, e.g., body mass index (BMI) for age percentile ≥85 in children. However, our understanding of the impact of EC on overweight and obesity in childhood is limited by the lack of longitudinal studies spanning critical developmental periods and assessing EC using comprehensive performance-based batteries. The current study addresses these limitations in a longitudinal examination of 212 children who completed an extensive laboratory-based EC task battery in preschool (age 4 years and 6 months) and were followed through elementary school (Grades 1 through 4) with objective measures of weight status. The logistic regression results indicate that poorer EC in preschool is associated with significantly greater risk for clinical weight problems (either overweight or obese status, as defined by BMI-for-age percentile ≥ 85) in elementary school, controlling for maternal education. EC in preschool was not significantly associated with risk for obese status, specifically (defined by BMI-for-age percentile ≥ 95), but the trend was in the expected direction. The results suggest that early executive abilities are relevant for children’s subsequent health status, with deficits in EC in the critical period of preschool conferring risk for later problems with weight. Based on these findings, early interventions to promote stronger EC may be a promising, yet currently overlooked, component in pediatric obesity prevention efforts.     

对体胖者的社会性偏向：本土化视角的探索

通过三个研究从本土化视角探索人们对体胖者的社会性偏向特征。研究1采用访谈法和问卷法获得了被试对体胖者的刻板印象内容；研究2使用情感温度计和AMP范式对体胖者的外显与内隐偏见进行了测量；研究3通过情境测量对比人们在不同生活情境中对体胖者的行为反应。结果表明，中国被试对体胖者的刻板印象内容提名以高热情特质为主，刻板印象评价呈现低能力为主的特征；人们对体胖者没有外显偏见，但存在一定内隐偏见；社会生活情境中体胖者可能遭遇歧视，对女性体胖者的歧视程度更高。总体上，人们对体胖者的社会性偏向表现出复合性的本土化特征。     

Association between bullying victimization and physical fitness among children and adolescents

Background/ObjectiveThe aim of the study was to analyze the relationship between being bullied and the physical fitness components, and to determine whether a healthy physical fitness level is related with lower victimization in children and adolescents with overweight and obesity compared to unfit overweight/obese peers. Method:The present cross-sectional study included a total of 7,714 youths (9-17 years), categorized as normal-weight or overweight/obese and fit or unfit according to sex-specific handgrip strength and cardiorespiratory fitness (CRF) cut-points. Bullying (physical, verbal, social exclusion, sexual harassment, and cyberbullying) was assessed through the Standard Health Behavior in School-aged Children survey questions. Results:Boys and girls that were categorized as fit (healthy level of CRF) showed lower traditional bullying compared to unfit counterparts. Also, a healthy level of CRF could be a protective factor of traditional bullying among overweight/obese youths compared to unfit overweight/obese peers. Conclusions:CRF is related with lower risk for experiencing traditional bullying in Latino youths with and without obesity, thus emphasizing the role of fitness even among youth with excess of adiposity.