In the Journals

Weight discrimination persistent for women, adults with extreme obesity

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December 28, 2015

More than half of U.S. adults with obesity report experiencing lifetime discrimination, with women and adults with extreme obesity experiencing more pronounced effects, according to research in Obesity Reviews.

Jenny Spahlholz , MSc , of Leipzig University Medical Center, Germany, and colleagues conducted a meta-analysis of eight studies conducted in the United States and one in Europe that assessed the perception of discrimination among adults with obesity. Sample sizes ranged from 93 to 22,231 adults. All studies were based on self-reports and used psychometrically validated questionnaires. Researchers excluded studies that focused on bullying and its association with body weight, as well as studies that focused on socioeconomic inequalities in obesity. Researchers used random-effects models to calculate pooled prevalence of discrimination based on weight.

Prevalence estimates of perceived discrimination varied across studies. Researchers found a pooled prevalence of perceived weight discrimination of 19.2% among adults with class I obesity (BMI 30-35 kg/m²; 95% CI, 11.7-29.8); 41.8% of adults with a BMI of at least 35 kg/m² experienced discrimination (95% CI, 36.9-46.9).

Findings from nationally representative U.S. samples revealed higher prevalence estimates in adults with a BMI more than 35 kg/m² and in women, according to researchers.

Several studies also revealed significant differences based on sex. One longitudinal study in a National Survey of Midlife Development in the United States (MIDUS) subsample found prevalence ranged between 20.6% for women with class I obesity and 45.4% for women with class II or class III obesity, compared with 6.1% for men with class I obesity and 28.1% for men with class II and class III obesity. Perceived discrimination data were similar for women and men with obesity in the workplace and in health care settings, with women reporting more perceived discrimination than men.

“Women reported more lifetime discrimination, work-related discrimination and health care-related discrimination than men, and women with more extreme obesity reported an even higher degree of perceived weight discrimination than women and men with class I obesity, thus underlying the ‘gendered nature of weight-related discrimination,’” the researchers wrote. “The lower prevalence in perceived weight discrimination among men might reflect a higher acceptance of obesity among men.”

The researchers said several studies did not provide a consistent definition of “perceived weight discrimination;” the term “weight stigmatization” was often used as an umbrella term.

“While some still argue over the accuracy of self-reported discrimination, its relevance in general and its linkage to negative outcomes on mental and physical health have been demonstrated by many studies,” the researchers wrote. – by Regina Schaffer

Disclosure: The researchers report no relevant financial disclosures.

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