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Despite the high prevalence of weight bias among fitness professionals, few resources are currently available to educate fitness professionals about weight bias and no systematic review of weight bias interventions has been conducted among this population. This paper therefore reviewed extant weight bias interventions for fitness professionals to inform future weight bias-reduction initiatives. Seven reports comprising six studies were identified from inception until April 2024. Findings showed small to large improvements in explicit weight bias, particularly on the weight control/blame component. No improvements were observed in implicit weight bias. The results show an urgent need to bridge the gap between the resources currently available in the fitness industry and those developed by the scientific community and to develop novel multifaceted interventions that draw from multiple theories of attitude and behavior change to effectively tackle weight bias among fitness professionals. [ABSTRACT FROM AUTHOR]

Among the few interventions that exist to decrease weight stigma in exercise settings, none include a long-term follow-up to assess if changes are sustained. The aim of this study was to assess if a weight stigma intervention that showed success in improving fat attitudes among university recreation center professionals had sustained effects after three months, compared to a control group. Participants were 46 university recreation center professionals who took the Fat Attitudes Assessment Toolkit before completing a two-hour self-paced online intervention or control course, after course completion, and at a three-month follow-up. At follow-up, participants in the intervention group showed significant improvement in total fat attitudes, F (2, 88) = 7.94, p <.001, η2p = 0.15 and in fat acceptance, F (2, 88) = 4.25, p =.017, η2p = 0.09. Future studies should further develop interventions and assess results in larger samples and after longer periods of time. [ABSTRACT FROM AUTHOR]

Exercise professionals often hold anti-fat attitudes, which contribute to weight stigma and discrimination in physical activity contexts. This study examined the effects of an online weight stigma intervention on exercise professionals' attitudes toward fatness. Participants were 105 exercise professionals who were employed at least part-time at university recreation centers in the United States. In this randomized controlled trial, participants were randomized into an intervention online course to decrease weight stigma or a control online course to learn about communication techniques to enhance motivation for physical activity. Attitudes about fatness were assessed at pre- and post-course using the Fat Attitudes Assessment Toolkit (FAAT). There were significant increases in the fat acceptance composite score in the intervention group compared to the control group, suggesting recreation center staff who completed the intervention WIT FITS course experienced more positive evaluations of fat people as a result of the intervention. [ABSTRACT FROM AUTHOR]

Objectification theory posits that puberty is likely to be a critical stage for experiencing body shame. Past research on experiences during puberty has largely focused on the association between pubertal timing (i.e., the onset of the process of physical maturation and sexual development) and physical and/or psychological health problems among adolescent girls, whereas less research has considered pubertal tempo (i.e., the rate of physical maturation and sexual development during puberty) among girls and boys and its association with body image variables. Using growth curve models, the present study examined whether pubertal tempo and pubertal timing predicted body shame at three equidistant data collection time-points over a two-year period in a sample of 755 early adolescent boys and girls from Spain (377 girls and 378 boys; Mage = 11.49; SD = 0.67 at Time 1). Although participants, particularly boys, showed a decline in body shame in their transition to adolescence, early maturing girls (i.e., body hair, skin changes, breast growth, and menstruation) were especially vulnerable to experiencing body shame. Boys with a slower rate of pubertal change in body hair and facial hair (beard) growth were also vulnerable to experiencing body shame. Findings showed the different role that pubertal timing and tempo appeared to have among boys and girls in predicting body shame and, in line with the gendered deviation hypothesis, suggests important gender differences in experiencing atypical pubertal development for body image. [ABSTRACT FROM AUTHOR]

Background Weight stigma (devaluation due to body weight) in healthcare is common and influences one's engagement in healthcare, health behaviors, and relationship with providers. Positive patient–provider relationships (PPR) are important for one's healthcare engagement and long-term health. Purpose To date, no research has yet investigated whether weight bias internalization (self-stigma due to weight; WBI) moderates the effect of weight stigma on the PPR. We predict that weight stigma in healthcare is negatively associated with (i) trust in physicians, (ii) physician empathy, (iii) autonomy and competence when interacting with physicians, and (iv) perceived physician expertise. We also predict that those with high levels of WBI would have the strongest relationship between experiences of weight stigma and PPR outcomes. Methods We recruited women (N = 1,114) to complete a survey about weight stigma in healthcare, WBI and the previously cited PPR outcomes. Results Weight stigma in healthcare and WBI were associated with each of the PPR outcomes when controlling for age, BMI, education, income, race, and ethnicity. The only exception was that WBI was not associated with trust in physicians. The hypothesis that WBI would moderate the effect of weight stigma in healthcare on PPR outcomes was generally not supported. Conclusions Overall, this research highlights how weight stigma in healthcare as well as one's own internalization negatively impact PPRs, especially how autonomous and competent one feels with their provider which are essential for one to take an active role in their health and healthcare. [ABSTRACT FROM AUTHOR]

Exposure therapy has been examined as a treatment for eating disorders, but research has yet to determine how to adapt these approaches for those in larger bodies who experience weight stigma. This case study reports on the use of values-based exposure interventions to reduce body dissatisfaction and body-related concerns in a woman with binge eating disorder in a larger body. We used a values-based approach to mirror and body image exposure that focused on fear tolerance and valued actions, as opposed to belief disconfirmation or habituation-based approaches to exposure, which may invalidate weight stigmatizing experiences. The client was a white cisgender woman in her late 20's with binge eating disorder and major depressive disorder enrolled in trial of Transdiagnostic Network-Informed Personalized Treatment for eating disorders. Symptoms were assessed at pre-, mid-, post-treatment and one-month follow-up. The client was highly satisfied with treatment and experienced clinically significant reductions in eating disorder symptoms and shape and weight concerns. Decreases in body dissatisfaction, feeling fat, and overvaluation of weight and shape were large. Clinical impairment decreased, and quality of life increased. A detailed description of the approach to body image exposure for those in larger bodies is provided. Using a values-based approach to body image exposures may help account for weight stigma experienced by those in larger bodies while decreasing avoidance of personally meaningful experiences, body dissatisfaction, and eating disorder symptoms. [ABSTRACT FROM AUTHOR]

Background: A significant portion of youth with anorexia nervosa (AN) or atypical anorexia nervosa (AAN) have history of 'overweight/obesity' (i.e., body mass index ≥ 85th percentile for age-and-sex) prior to the onset of the eating disorder (ED) diagnosis, but research on this population remains limited. The present study used semi-structured interviews to explore themes related to triggers of weight loss, treatment, and recovery among youth with AN/AAN and history of 'overweight/obesity,' and their parents. Method: The sample included eleven youth and parent dyads (Median [IQR] age of youth = 16.0 (1.5) years, 90.9% female, 90.9% White, 27.3% Hispanic) who were evaluated for an ED in a multidisciplinary ED program at a pediatric hospital between November 2020 and April 2021. Nine youth and separately, nine parents of these 11 dyads completed semi-structured interviews with the research team. Seven matched pairs of patients and parents completed demographic surveys and study interviews. Interviews were recorded, transcribed, and coded by four research team members using a reflexive thematic approach. Results: Weight stigma was the most frequently reported theme for a trigger for weight loss that led to the onset for developing AN/AAN by both youth and parents. Regarding barriers to recovery, themes from more than a half of youth included uncertainty of weight goals in treatment and feeling they are "not sick enough." Notable themes for attitudes towards treatment from most parents included general agreement with clinician recommendations, but also an uncertainty of weight restoration goals and a belief that their child need to have a "normal" weight. Conclusion: These results highlighted how the majority of interviewed youth with history of 'overweight/obesity' reported weight stigma as both a trigger for the development of AN/AAN as well as a barrier to recovering. Internalized weight stigma among parents may influence their attitudes towards weight restoration as a treatment goal where these youth and parents may experience uncertainty of weight goals in treatment. This study demonstrated triggers and barriers to treatment that may be unique to youth with ED and history of 'overweight/obesity' and more research is needed to address weight stigma in multidisciplinary ED treatment for this understudied population. [ABSTRACT FROM AUTHOR]

The study replicates a preliminary report from 2019 on therelationship between body image and persistence. Purpose: The aim of our study was to analyze the associations between body image, persistence, and body weight stereotypes. Patients and methods: A total of 750 individuals were recruited for the study. The research was carried out in computer labs. The procedure consisted of psychological questionnaires (Persistence Scale, The Body Esteem Scale, Perceived Weight Stigma Questionnaire, Weight Bias Internalization Scale, Hospital Anxiety and Depression Scale, Formal Characteristics of Behavior – Temperament Inventory, and NEO-PI-R) and The Maze Test (a computer tool). After completing the Simple Maze Test, saliva samples were collected. Next, the subjects proceeded to the laboratory where anthropometric and body composition measurements were taken. The hormone levels (cortisol and dehydroepiandrosterone) in the collected saliva samples were analyzed via ELISA to determine stress. Results: Body image and persistence are related variables. They are associated with the internalization of stereotypes and perceived stigma related to body weight. These associations are differentially shaped according to sex and the regularity of body weight. In women, a stronger association of these variables with body image was observed, while in men, the relationship with body image was weaker, with a stronger association shown by perceived weight-related stigma. In the group of participants with a BMI<18.5, there was no significant association between the internalization of stereotypes and the analyzed variables. This relationship appeared in the group of subjects with a normal body weight and was strongest in the group of participants who were overweight or obese. Perceived weight-related stigma was most strongly associated with body image in the group with BMI<18.5 kg/m2 and with persistence in the group with BMI>25 kg/m2. Conclusion: Body-related stigma affects not only overweight and obese individuals and its mechanisms may be shaped differently. [ABSTRACT FROM AUTHOR]

Witnessing that the appearance of female trainers has been regarded as a potential cause of appearance-based discrimination and a source of bodily capital, this study examined the influence of female trainers' appearance on the process of occupational socialization. We invited eight research participants for in-depth interviews, including female trainers, Pilates instructors, and male fitness center owners with training experience. We followed the grounded theory analysis method to derive meaningful insights from the collected data. The results indicate that the physical appearance of female trainers had various effects on their perceived value as bodily capital during the preparatory and adaptation periods. However, it became a constraining factor during the conflict period as they experienced bodily changes in their late 20s. Eventually, their physical appearance hindered female trainers from maintaining their careers and decreased the percentage of female trainers who reached maturity period. Ultimately, the culture of lookism had a mixed impact on women's occupational socialization, revealing its discriminatory undertones. Although some women profited from the culture, lookism disadvantaged others. Finally, we suggested that a possible solution would be the enactment of the anti-discrimination law for better protection. [ABSTRACT FROM AUTHOR]

Summary Polycystic ovary syndrome (PCOS) is an endocrine disorder affecting 10–13% of reproductive‐aged women. Lifestyle management through diet and physical activity changes can improve reproductive, metabolic, and psychological comorbidities. The aim of this systematic review is to understand the barriers and facilitators to lifestyle changes from the perspective of people with PCOS and health care professionals (HCP) using the theoretical domains framework and capability, opportunity, motivation, and behavior model. Six databases were systematically searched for qualitative, quantitative, and mixed‐methods studies to 22nd September 2022. Quantitative outcomes from quantitative and mixed‐methods studies were narratively synthesized and all studies were thematically analyzed. Sixty‐eight papers met the eligibility criteria. HCP education on lifestyle management in PCOS was viewed by all to be inadequate, impacting the quality of care and health outcomes. Lifestyle advice delivered by a multidisciplinary team, including dietitians, was identified as a key component for change. All agreed that there was a need for individualized and PCOS‐specific lifestyle advice. Weight stigma was identified as negatively impacting both those in larger and smaller bodies with PCOS, reducing the quality of care and affecting self‐perception and mental health. People with PCOS perceived that lifestyle management was overly focused on weight loss and fertility, independent of their own personal motivations and goals. Systemic changes, including increasing HCP education on lifestyle management and multidisciplinary collaboration, focusing on lifestyle advice that meets individual needs, and reducing the use of weight‐centric care are necessary for long‐term sustainable changes and improvements in health outcomes in people with PCOS. [ABSTRACT FROM AUTHOR]

Lookism encompasses discrimination based on a person's physical appearance. In a society where lookism is prevalent, the question arises concerning the impact of the fear of lookism on one's well‐being. To address this issue, we assessed the fear of anticipated appearance discrimination by constructing a new Fear of Lookism Scale (FLS). By testing 400 Japanese participants, we developed a three‐factor seven‐item scale and confirmed its convergent validity by establishing significantly positive correlations among its subscales (exclusion/devaluation, romantic rejection and insult) and related measures (physical appearance perfectionism and social appearance anxiety) in Study 1. In Study 2a, we gathered data from 312 Japanese participants to assess the scale's test–retest reliability. In Study 2b, combining data from 401 American participants with data from Study 2a, we verified FLS measurement invariance in the United States and Japan. Japanese participants scored higher on the FLS than Americans, particularly for exclusion/devaluation and insult. Across cultures, romantic rejection and insult were positively associated with physical appearance perfectionism, which, in turn, decreased subjective happiness through impacting self‐esteem (or increased loneliness) and increased subjective happiness through impacting self‐esteem (or decreased loneliness) respectively. [ABSTRACT FROM AUTHOR]

Background: Weight stigma is defined as negative misconception and stereotypes associated with weight, and it is commonly experienced during pregnancy. Weight stigma during pregnancy may be sourced from trusted close relationships including family members, partners, and friends. Social support is a necessary psychosocial factor for optimal health and wellbeing throughout pregnancy, and weight stigma sourced from these integral relationships may negatively affect health outcomes. The purpose of this study was to assess the impact of weight stigma from close others on maternal health outcomes. Methods: A survey was administered via Qualtrics to pregnant women (≥ 13 weeks, residence within the United States or Canada, ≥ 18 years old, singleton pregnancy). During pregnancy, participants completed questionnaires identifying whether they had experienced weight stigma from a close relationship (i.e., family, partners, or friends), how often, and relationship quality scales for each source. At three months postpartum, they were surveyed about their pregnancy outcomes including gestational diabetes, gestational hypertension, preeclampsia, chronic pain, anxiety/depression. They also completed the Edinburgh Postpartum Depression Scale (EPDS), and a linear regression was performed with frequency of weight stigma. Logistic regressions were performed between frequency of weight stigma and health outcomes. If significant, relationship quality was tested as a potential mediator. Significance was accepted as p < 0.05. Results: 463 participants completed both surveys of which 86% had experienced weight stigma from close others. Frequency of weight stigma was significantly associated with chronic pain (β = 0.689, p < 0.001), and anxiety/depression (β = 0.404, p = 0.005). The relationship between frequency of weight stigma in pregnancy and chronic pain was mediated by quality of all relationships. Family relationship quality mediated between frequency of weights stigma and anxiety/depression. Frequency of weight stigma was significantly associated with depression symptom severity measured by the EPDS (β = 0.634, p < 0.001). Conclusion: These findings underscore the issue of weight stigma and show that experiencing this from trusted close others is associated with poor health outcomes like chronic pain. Advocacy efforts to mitigate weight stigma in pregnancy and strengthen close relationships to improve maternal health and wellbeing is warranted. [ABSTRACT FROM AUTHOR]

Background: Weight stigma among healthcare professionals is associated with negative health impacts on patients, yet there are few effective strategies to combat weight stigma among health professional learners. The Body Advocacy Movement-Health (BAM-Health) is a novel group-based, peer-led stigma reduction intervention for health professional students that targets weight stigma across intrapersonal, interpersonal, and structural levels. The present study (1) assesses short-term impacts of BAM-Health participation on intrapersonal and interpersonal weight bias compared to an informational brochure control condition and (2) explores the feasibility and acceptability of BAM-Health among a sample of health professional students. Methods: Sixty-seven health professional students participated in BAM-Health (n = 34) or received an informational brochure about weight stigma (n = 33). Participants completed validated self-report surveys assessing internalized weight/ appearance concerns and interpersonal weight stigma prior to their assigned intervention (baseline), immediately following intervention (post-intervention), and four weeks after intervention (follow-up). Baseline to post-intervention and baseline to follow-up effect sizes on each measure were calculated. At post-intervention, participants completed feedback surveys for thematic assessment. Results: BAM-Health participation had a large baseline to post-intervention effect on internalized weight/ appearance concerns that diminished slightly at follow-up (Cohen's d = -0.88; d = -0.62). Receipt of the informational brochure had a small effect on internalized weight/ appearance concerns (d = -0.27); however, these changes were not sustained at follow-up (d = 0.04). BAM-Health participation resulted in reductions in interpersonal obesity stigma and anti-fatness with small effect sizes (d = -0.32; d = -0.31). The effect on obesity stigma was slightly amplified at follow-up (d = -0.43); however, decreases in anti-fatness were not sustained (d = -0.13). The brochure condition failed to demonstrate effects on anti-fatness (d = 0.13, d = 0.14) or obesity stigma (d = -0.12; d = -0.12) at either time point. Between-session attrition rates of 4.5%, favorable quantitative ratings on post-session acceptability surveys, and free responses demonstrating appreciation of the virtual group environment and session activities reflect feasibility and acceptability of BAM-Health. Conclusions: BAM-Health is a novel peer-led intervention that aims to reduce weight stigma among health professional students. BAM-Health met feasibility benchmarks and received positive feedback from participants, demonstrating acceptability and indicating interest among health professional students in analyzing and reducing weight stigma in their personal lives and careers. The intervention led to promising decreases in internalized and interpersonal weight stigma at post-intervention, some of which were sustained at follow-up. However, lack of effect on internalized weight/ appearance concerns measures may indicate that BAM-Health participants are more likely to reject weight stigma directed toward others following intervention, while maintaining thin ideals for themselves. Further investigation of BAM-Health with a larger sample and continued program development is warranted. Plain English Summary: Weight stigma refers to negative attitudes or harmful behaviors directed toward oneself (internalized weight stigma) or others (interpersonal weight stigma) on the basis of body weight. Structural weight stigma refers to policies or norms that harm people who have higher body weights. Weight stigma in healthcare in particular can contribute to negative physical and emotional health outcomes among patients. To examine strategies to mitigate weight stigma in healthcare, health professional students at a large university in the United States – including students in medical, nursing, and physical therapy programs – participated in the Body Advocacy Movement-Health (BAM-Health), a program created to decrease weight stigma in this population. Participants completed surveys prior to and after BAM-Health that indicated modest reductions in internalized and interpersonal weight stigma four weeks after completion of the intervention, whereas those in the comparison arm did not demonstrate sustained changes in measures of weight stigma. Furthermore, participants indicated that they enjoyed involvement in BAM-Health and found it useful both personally and professionally. Future research with larger, more diverse sample sizes is necessary to determine whether BAM-Health is effective at reducing weight stigma among health professional students and whether it improves quality of care for patients in larger bodies. [ABSTRACT FROM AUTHOR]

Summary We conducted a systematic review and meta‐analysis to determine the efficacy of interventions aimed at reducing weight bias in healthcare students, and to explore factors that may impact intervention success. A systematic review and random‐effects meta‐analyses were conducted by including studies that examined the efficacy of weight bias reduction interventions for healthcare students. Of the 3463 journal articles and dissertations screened, 67 studies (within 64 records) met inclusion criteria, with 35 studies included in the meta‐analyses (explicit = 35, implicit [and explicit] = 10) and 32 studies included in the narrative synthesis (explicit = 34, implicit [and explicit] = 3). Weight bias interventions had a small but positive impact, g = −0.31 (95% CI = −0.43 to −0.19, p < 0.001), in reducing students' explicit weight bias but there was no intervention effect on implicit weight bias, g = −0.12 (95% CI = −0.26 to 0.02, p = 0.105). There was considerable heterogeneity in the pooled effect for explicit bias (I2 = 74.28, Q = 132.21, df = 34, p < 0.001). All subgroup comparisons were not significant (p > 0.05) and were unable to explain the observed heterogeneity. Narrative synthesis supported meta‐analytic findings. The small but significant reduction of explicit weight bias encourages the continued testing of interventions, irrespective of variation in individual intervention components. Contrarily, reductions in implicit weight bias may only be possible from a large societal shift in negative beliefs and attitudes held towards people living in larger bodies. [ABSTRACT FROM AUTHOR]

Despite strides toward gender equality in the workforce, women continue to face significant challenges, including the "glass ceiling" and the "leaky pipeline", partially stemming from low occupational self-confidence. This study examined whether a climate of lookism leads to workplace mistreatment, undermining employees' perceptions of job competence and career potential, with a focus on gender differences. Using a cross-sectional design, data from 699 Italian workers (42.8% male, 56.3% female) were analyzed through multi-group structural equation modeling. The model explored relationships between lookism climate, workplace incivility, imposter syndrome, and perceived employability. The results revealed a full serial mediation for women; lookism climate was positively related to workplace incivility, which in turn was related to imposter syndrome, negatively impacting perceived employability. For men, no serial mediation was found; lookism climate was directly related to both incivility and imposter syndrome, with no significant relationship between the two. Like women, men experienced a negative relationship between imposter syndrome and perceived employability, yet this relationship was stronger for men. This study highlights that identifying and addressing workplace climates that foster subtle mistreatment can prevent larger issues like the leaky pipeline, suggesting targeted organizational-level intervention and prevention strategies can enhance job competence perceptions and career potential for both genders. [ABSTRACT FROM AUTHOR]

Body-related shame – operationalised as feeling inadequate about one's appearance, fitness, function, and bodily behaviours – is an emotional experience with particular relevance to athletes given the evaluative, social, and achievement-oriented nature of sport. To date, in-depth explorations of athletes' body-related shame have been scarce and have had a restricted focus on the domain of bodily appearance. Exploring body-related shame is particularly important for women, given consistent evidence for the gendered experience of shame contextualised to the body. As such, the present study explored the phenomenological experiences of body-related shame in women athletes. Sixteen purposefully sampled women athletes aged 18–26 with a history of body preoccupation were recruited to participate in two semi-structured interviews separated by a week-long reflective journaling exercise. Participants shared experiences of body-related shame related to appearance, health behaviours, training, and performance in the sport context. Using reflexive thematic analysis, researchers identified five themes that highlighted women athletes' experiences of body-related shame. Themes included (a) striving to be a worthy athlete; (b) conflicting body ideals and changing roles in sport; (c) the objectified sport body; (d) anti-fatness as the bedrock of sport; (e) shame resistance and athletic invincibility. Results from this study highlight the unique factors that contribute to body-related shame among women athletes from a variety of sport backgrounds and provide preliminary insight to inform the measurement of body-related shame and potential individual and systems-level interventions to improve the emotional well-being of women athletes. [ABSTRACT FROM AUTHOR]

Introduction: The Australian‐led 2023 International evidence‐based guideline for the assessment and management of polycystic ovary syndrome was based on best available evidence, clinical expertise and consumer preference. It followed best practice, involved extensive evidence synthesis and applied relevant frameworks across evidence quality, feasibility, acceptability, cost and implementation. Thirty‐nine societies and organisations covering 71 countries were engaged. The evidence in the assessment and management of polycystic ovary syndrome (PCOS) has generally improved in the past five years, but remains of low to moderate quality. The technical evidence report, 52 systematic reviews and analyses (approximately 6000 pages) underpin 77 evidence‐based and 54 consensus recommendations, with 123 practice points. Main recommendations: Changes include: refinement of individual diagnostic criteria, a simplified diagnostic algorithm and inclusion of anti‐Müllerian hormone levels as an alternative to ultrasound in adults only, and differentiation of adolescent and adult criteria;strengthening the recognition of broad features of PCOS including metabolic effects, cardiovascular disease, dermatological symptoms, sleep apnoea, a high prevalence of psychological features and a high risk of adverse pregnancy outcomes;emphasising the poorly recognised, diverse burden of disease, the vital need for greater health professional education, evidence‐based patient information, improved models of care, shared decision making and research efforts to improve patient experience;maintained emphasis on healthy lifestyle, emotional wellbeing and quality of life, with awareness and consideration of weight stigma; andemphasising evidence‐based medical therapy and cheaper and safer fertility management. Changes in management as a result of this guideline: The 2023 guideline is approved by the National Health and Medical Research Council and provides clinicians and patients with clear advice on best practice in a common and neglected condition, based on the best available evidence, expert multidisciplinary input and consumer preferences. It provides vital, extensive patient and provider resources to enhance evidence‐based care. The full guideline is available at www.monash.edu/medicine/mchri/pcos/guideline. [ABSTRACT FROM AUTHOR]

Background: Mistreatment of individuals due to their body size or weight stigma has been described as a source of stress and as a deterrent for engagement in the healthcare system. Efforts to reduce weight stigma have included curricular interventions to reduce weight bias among future healthcare professionals. However, few studies have examined students' observations of weight stigma and subsequent socialization to healthcare environmental norms. Aims: The purpose of this study is to evaluate observed weight stigma among pre‐licensure nursing students and recent graduates during clinical rotations and its effect on the perceived ability to provide respectful care to people in larger bodies. Materials and Methods: A cross‐sectional, descriptive study was conducted from February to March 2023. Participants answered questions related to personal weight bias (Fat Phobia Scale), observations of weight stigma, and perceived ability to provide respectful care. Results: Ninety‐one participants completed the survey, of whom half (n = 48) held a high level of weight bias. A quarter of participants (n = 23) reported that they engaged in weight stigma behaviors and a quarter (n = 24) of participants observed weight stigma behaviors from two or more healthcare professional roles. Almost one‐third (n = 10) of participants who observed weight stigma behaviors perceived that it impacted their ability to provide respectful care to patients in larger bodies. Conclusions: These findings describe that weight stigma enacted by multiple healthcare professional roles is observed by nursing students during clinical rotations and is perceived to impact their ability to provide respectful care. Efforts to improve healthcare professionals' sensitivity to the effects of weight bias and weight stigma should include addressing the role of socialized norms on weight bias among future healthcare professionals. [ABSTRACT FROM AUTHOR]

Objective: Individuals with obesity face unique challenges when visiting healthcare providers, including inadequate equipment. These negative care experiences, often exacerbated by weight stigma, frequently lead to mistrust and reluctance to seek future care. Currently, few instruments exist to ensure that an ambulatory clinic is welcoming to patients with obesity. The following clinical environment checklist was created with an aim to identify weaknesses in accommodating individuals of size. Methods: A checklist of equipment considered ideal for the care of patients with obesity was developed through a comprehensive review of the literature and feedback from office staff. Eight ambulatory clinics within an urban Midwest setting were assessed, focusing on their accommodations for patients with obesity. Feedback from clinic staff was incorporated to further refine the checklist. Results: Common equipment deficiencies included extra‐large blood pressure cuffs, wheelchair‐accessible scales, 2XL gowns, and adequate seat dimensions in the waiting area. Healthcare workers reported moral distress for their patients when unable to provide proper care due to these limitations. Newly constructed clinics exhibited better‐equipped facilities for patients with obesity. Conclusions: Many clinics lack proper equipment to accommodate patients with obesity, resulting in negative care experiences. This clinical environment checklist can identify problem areas and provide solutions to create more welcoming environments, encouraging future care‐seeking behaviors. [ABSTRACT FROM AUTHOR]

Background: Weight stigma is prevalent within healthcare settings and is an aspect of the lived experience of people living with obesity. There is international evidence of weight stigma in the dental setting, where currently there is also evidence indicating limited training amongst dental professionals regarding obesity or obesity‐related stigma. There has been Australian research and none have included dental support staff. Aims: This cross‐sectional survey aimed to assess stigmatizing attitudes and beliefs of dental professionals (registered general dentists, oral health therapists) and support staff (dental assistants, dental receptionists) working in private and public regional practices in New South Wales and specialists in Special Needs Dentistry across Australia toward people living with obesity. Methods: An anonymous electronic validated survey was administered through REDCap™ to assess stigmatizing attitudes and beliefs held amongst respondents in relation to people living with obesity. Results: Fifty‐three participants completed the survey (n = 33 clinicians, n = 20 support staff). The majority 47/53 (88.7%) held positive attitudes toward people living with obesity. Of the clinicians, 15/33 (45.5%) reported 1 hour or less and 14/33 (42.4%) reported two to 5 hours of obesity‐related education. 14/20 (70%) of the support staff reported no prior education or training about obesity. Of responses reflecting weight stigma, only three clinicians reported negative reactions toward the appearance, or discomfort during examination, of a patient with obesity, or a perception of laziness, compared with normal weight individuals. A higher proportion 4/20 (20%) of support staff reported responses indicating negative attitudes for people with obesity compared with normal weight individuals. Conclusion: Survey responses reflected evidence of weight stigma in both dental professionals and support staff. Professional development targeting weight stigma reduction in the dental setting is needed for both clinicians and support staff. [ABSTRACT FROM AUTHOR]

Aims Methods Results Conclusions To examine associations between weight self‐stigma and healthy diet or physical activity, and potential moderating effects of self‐esteem, diabetes self‐efficacy, and diabetes social support, among adults with type 2 diabetes.Diabetes MILES‐2 data were used, an Australian cross‐sectional online survey. Participants with type 2 diabetes who considered themselves overweight, and reported concern about weight management (N = 726; 48% insulin‐treated), completed the Weight Self‐Stigma Questionnaire (WSSQ; total score and subscales: self‐devaluation, fear of enacted stigma), measures of diabetes self‐care (diet, exercise), and hypothesised psychosocial moderators (self‐esteem, diabetes self‐efficacy, and diabetes social support). Adjusted linear regression tested associations and interaction effects, separately by insulin treatment status.Greater weight self‐stigma (WSSQ total) was associated with less optimal dietary self‐care (both groups: β = −0.3), and with a lower level of exercise (non‐insulin only: β = −0.2; all p < 0.001). All hypothesised moderators were negatively associated with weight self‐stigma (range r = −0.2 to r = −0.5). Positive associations were identified between the hypothesised moderators and self‐care behaviours (strongest between diet and diabetes self‐efficacy, r = > 0.5). No significant interaction effects were observed.This study provides novel evidence of negative associations between weight self‐stigma and self‐care behaviours among adults with type 2 diabetes. Weight self‐stigma is a demonstrated barrier to self‐care behaviours in type 2 diabetes cohorts. Acknowledgement and strategies to address weight self‐stigma are needed in clinical care and health programmes. [ABSTRACT FROM AUTHOR]

Background: Perceived weight stigma (PWS) and internalized weight stigma (IWS) are both associated with psychological distress and food addiction (FA). Using the previously proposed 'cyclic obesity/weight-based stigma' (COBWEBS) model, the present study extended the framework to investigate the mediating effects of IWS and psychological distress in the association between PWS and FA among young adults. Given that individuals who are overweight/have obesity have different vulnerabilities, this population was separately analyzed alongside the total study population. Methods: An online survey comprising the Perceived Weight Stigma Scale, Weight Bias Internalization Scale (WBIS), Depression, Anxiety and Stress Scale-21 (DASS-21), and modified Yale Food Addiction Scale Version 2 was completed by 601 participants (59.6% females; mean age 29.3 years [SD = 6.07]). A total of 219 participants were categorized as being overweight/having obesity. Results: A direct correlation was found between PWS and FA (standardized coefficient [β] = 0.28, p < 0.001) among both populations, and was mediated by IWS and psychological distress (β [95% CI] = 0.03 [0.01, 0.05] for WBIS score and 0.10 [0.06, 0.14] for DASS-21 score) among the total participants, but only mediated by psychological distress among participants who were overweight/had obesity (β [95% CI] = 0.14 [0.06, 0.24]). Conclusions: The results demonstrated novel perspectives by showing the direct association between PWS and FA and the mediating roles of IWS and psychological distress. Treatment strategies such as psychological acceptance and psychoeducation could be used to reduce weight stigma, which could have positive downstream benefits of ameliorating FA. Future research may seek to study strategies for reducing weight stigma and psychological distress, to investigate their efficacy in improving disordered eating. Plain English summary: The present study proposed a model to understand the association between weight stigma and food addiction with the following considerations: (i) subdividing weight stigma into perceived weight stigma and internalized weight stigma; and (ii) adding psychological distress in the association between weight stigma and food addiction. Analysis was carried out on two populations of young adults: the total sample, and participants who were overweight/had obesity. The results supported the direct association between perceived weight stigma and food addiction among both samples. This association was mediated by internalized weight stigma and psychological distress among the total participants, but only mediated by psychological distress among participants who were overweight/had obesity. The findings provided novel evidence regarding the effect of perceived weight stigma, as well as the mediating roles of internalized weight stigma and psychological distress in the development of food addiction. Such findings might be implemented into strategies aimed at reducing food addiction. [ABSTRACT FROM AUTHOR]

Background: Both the causes and consequences of childhood obesity can be complex. To provide healthcare that is suitably tailored to the specific needs of children with obesity integrated care is required. The objective of this study was to explore the perceived barriers and facilitators of healthcare professionals (HCPs) in providing integrated care for children with obesity, to support them in tailoring the healthcare approach. Methods: In this qualitative study, semi-structured in-depth interviews were conducted with 18 healthcare professionals with experience in childhood obesity care; pediatricians, youth healthcare nurses and a youth healthcare physician. A two-phased thematic content analysis was performed: an inductive analysis with open and selective coding and a deductive analysis with axial coding using the patient-centered care model by Stewart. Results: Overall, the healthcare professionals defined the etiology of obesity as complex, and experienced the integrated care as complicated. The results fit into the four theme-structure of the patient-centered care model, with the integrated care system as an additional fifth theme. The main barriers were perceived within the sub-themes of illness and healthcare experiences, and sensitivity over talking about weight-related issues. The main facilitators were perceived within the sub-themes of conducting a biomedical, psychosocial and lifestyle assessment, tailoring the approach to families' situation and investing in a family-professional relationship. Weight stigma appeared to be an underlying barrier for healthcare professionals that impacted, both explicitly and implicitly, upon all themes. Conclusions: Healthcare professionals providing integrated care for children with obesity, experience this type of care as complicated and comprising many barriers and facilitators regarding the four themes of the patient-centered care model and the fifth theme of the integrated care system. This paper demonstrates the patient-centered care model could prove helpful structuring a tailored approach within integrated care. This approach supports healthcare professionals in adopting a broad perspective towards individual and environmental factors and investing in the relationship, with respect to the sensitivity and complexity of childhood obesity. [ABSTRACT FROM AUTHOR]

While studies about attention cues influencing empathy for pain have been reported, it is still unclear what pain reactivity in individuals with implicit weight stigma, whether and how the attention cues have an influence on empathy for pain in individuals with implicit weight stigma as well as its potential contributions to understanding empathy processes and developing interventions for weight stigma. Here, using the Single Category Implicit Association Test (SC-IAT), twenty-five participants were randomly selected to provide different stimulus conditions (e.g. the painful pictures). The event-related potential (ERP) and behavioral data were recorded when they were required to judge whether stimuli would be painful/ attractive or not to explore the impact of attention cues on empathy for pain in individuals with implicit weight stigma. Behavioral results showed participants responded slower to the thin body picture than the fat body picture. Moreover, top–down attention influences the late cognitive processing stage component P3 and LPC. Specifically, relative to pain judgment task, the fat body picture elicited larger P3 amplitudes than the thin body picture. In addition, relative to pain judgment task, the fat body picture elicited larger LPC amplitudes than the thin body picture; relative to the attractiveness judgment task, the thin body picture elicited larger LPC amplitudes than the fat body picture. These findings revealed that empathy for pain among college students with weight implicit stigma was influenced by top-down attention to attention cues, and presented evidence for the empathy deficits of individuals with implicit weight stigma who might avoid negative emotion when viewing other people's bodies. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Methods Results Discussion Weight bias toward individuals with higher body weights in healthcare settings is associated with adverse health behaviors, reduced healthcare utilization, and poor health outcomes. The purpose of this integrative review was to explore: (1) What has been measured and described regarding perinatal care providers' and students' weight bias toward pregnant, birthing, and postpartum individuals with higher body weights? (2) What has been measured and described regarding pregnant, birthing, and postpartum individuals' experiences of weight bias? (3) What is the association of experiences of weight bias with perinatal and mental health outcomes among pregnant, birthing, and postpartum individuals?We conducted a systematic search in CINAHL, PubMed, and PsycINFO databases to identify relevant research publications related to the Medical Subject Headings (MeSH) terms weight prejudice (and related terms) and pregnancy (and related terms). The review was guided by the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA), Johns Hopkins Nursing Evidence‐Based Practice model for study quality determination, and the Whittemore and Knafl integrative review framework for data extraction and analyses.Twenty‐two publications met inclusion criteria, representing six countries and varying study designs. This review found pervasive sources of explicit weight bias in the perinatal period, including care providers and close relationships. Experiences of weight bias among pregnant and postpartum individuals are associated with adverse perinatal and mental health outcomes.The findings address a knowledge gap regarding a summary of literature on weight bias in the perinatal period and elucidate its prevalence as well as its negative influence on perinatal and mental health outcomes. Future research efforts on this topic must examine the nature and extent of perinatal care providers' weight bias by demographic factors and explore its association with clinical decision‐making and perinatal and mental health outcomes. [ABSTRACT FROM AUTHOR]

Weight stigma is described as prejudice and discrimination concerning body weight. People stigmatized by their body weight report worse physical and mental health and, consequently, poor psychosocial functioning. Research has shown a high prevalence of weight stigma among health professionals. However, less is known about weight stigma among healthcare undergraduate students. In this vignette study, we assessed weight stigma in 217 healthcare students, who filled sociodemographic and weight stigma measures, and read one of three vignettes at random, each one with a hypothetical patient which differs only in terms of body weight (underweight, healthy weight, and overweight). Then, participants answered ten questions/statements about patient characteristics described in the vignette to assess the influence of body weight on stigmatizing beliefs. Weight stigma was found in 39.44% of healthcare students. Moreover, weight stigma was higher among men, healthy weight people, and Physical Therapy students. This experimental study showed more negative attitudes in participants exposed to the patient with overweight and underweight vignettes compared to those exposed to the healthy weight patient vignette. Due to the known impacts of weight stigma, efforts are needed to address this issue during the training of healthcare undergraduate students. [ABSTRACT FROM AUTHOR]

Background: Weight stigma refers to the social rejection, discrimination, and ideological devaluation of individuals because of body size and is a direct result of weight bias and anti-fat attitudes. Individuals with higher weight may be less likely to seek healthcare due to weight stigma, and if or when they do present for care, medical providers with weight bias may fail to provide high quality care. Little, however, is known about the intersectionality of weight stigma and perceptions of healthcare interactions as experienced by individuals who also binge eat. Methods: Community-based adults completed online self-report questionnaires regarding generalized weight stigma (Attitudes Towards Obese Persons1), healthcare interaction quality (Patient Perceptions of Healthcare Provider Interaction Quality; PPH), and disordered eating (Eating Disorder Examination-Questionnaire) via Amazon's Mechanical Turk platform. For this cross-sectional study, participants were categorized by the presence and absence of regular binge episodes. Pearson's correlations, T-tests, ANOVA/ANCOVA, and a multivariate regression were used to examine relationships among demographic variables, weight stigma, disordered eating, and the PPH. Results: Participants (N = 648) primarily identified as female (65.4%) and White, non-Hispanic (72.7%). Participants' average age and body mass index (BMI) were 37.5 (SD = 12.3) years old and 27.3 (SD = 6.9) kg/m2, respectively. Higher healthcare provider interaction quality ratings (PPH) were significantly related to lower BMI (r(648)=-0.098,p = 0.012), less weight stigma (r(648) = 0.149,p < 0.001), and identifying as a woman (t(514) = 2.09, p = 0.037, Cohen's d = 0.165) or White, non-Hispanic (t(646)=-2.73, p = 0.007, Cohen's d=-0.240). Participants reporting regular binge eating endorsed significantly worse perceptions of healthcare provider quality than those who did not, even after accounting for BMI, F(1, 645) = 8.42, p = 0.004, η2 = 0.013. A multivariate linear regression examining the PPH as dependent, and weight stigma and binge eating as independent, variable/s, was significant even after accounting for covariates (sex, race, BMI), F(95, 640) = 7.13,p < 0.001, R2 = 0.053 (small effect). Conclusions: More negative experiences with healthcare providers was associated with worse weight stigma, higher BMI, regular binge eating and overall disordered eating, and for participants identifying as male or a Person of Color. These data have implications for non-clinical community populations and are particularly important as experiencing poorer quality of interactions with healthcare providers may decrease individuals' likelihood of seeking needed care for both disordered eating and health-related concerns. Trial Registration: N/A. Plain English summary: Weight stigma refers to the discrimination towards individuals because of body size. Individuals who identify as a Person of Color and who experience binge eating may experience additional discrimination, resulting in barriers to receiving healthcare. To examine these relationships, a community-based sample (N = 648) completed health- and eating-related questionnaires online. Participants who had higher weight rated their perceptions of their interactions with healthcare providers as lower quality. People of Color and men reported lower quality of perceptions of their healthcare provider interactions compared to White, non-Hispanic and female participants, respectively. Participants reporting less weight stigma also reported more positive interactions with their healthcare providers. Participants who reported regular binge eating episodes reported worse quality of interactions with their healthcare providers compared to those who did not report regular binge eating, regardless of their weight. Participants endorsing more stigmatizing views of individuals with higher weight and those reporting regular binge eating were more likely to report poorer perceived quality of interactions with healthcare providers, regardless of their weight, race/ethnicity, or sex. These findings are of particular importance as experiencing poor quality interactions with healthcare providers may be a barrier to receiving needed healthcare. [ABSTRACT FROM AUTHOR]

Background Little is known about weight stigma in sexual minority women, and even less is known about weight stigma in those who have attained substantial weight loss and maintenance. Purpose This study examined weight stigma experiences and internalization in sexual minority women from the National Weight Control Registry (NWCR) who had lost ≥30 pounds and maintained this weight loss for ≥1 year, and compared weight stigma levels between sexual minority women versus heterosexual women in the NWCR. Methods NWCR participants completed an electronic survey. Women who identified as a sexual minority (n = 64; 98% White; M BMI = 29 ± 8; M age = 47 ± 13) and heterosexual women matched on body mass index (BMI), age, and race (n = 64; 98% White; M BMI = 28 ± 7; M age = 51 ± 13) were included. Participants completed assessments of experienced and internalized weight stigma. Results Generalized linear models showed that a significantly larger proportion of sexual minority women in the NWCR reported experiencing weight stigma in the past year (24.2%) compared with heterosexual women (4.7%; p <.05). Furthermore, sexual minority (vs. heterosexual) women reported significantly higher levels of internalized weight stigma (p <.001), and a greater proportion of sexual minority women (35%) reported clinically significant internalized weight stigma relative to heterosexual women (2%; p <.001). Conclusions Sexual minority women are at greater risk for experienced and internalized weight stigma than their heterosexual counterparts among women who have attained significant long-term weight loss. It is critical to expand research on weight stigma in sexual minority women. [ABSTRACT FROM AUTHOR]

Body weight has a long history of functioning as a symbol of one's beauty, social status, morality, discipline, and health. It has also been a standard inflicted much more intensely on women than men. While US culture has long idealized thinness for women, even at risky extremes, there is growing evidence that weight standards are broadening. Larger bodies are becoming more visible and accepted, while desire for and approval of a thin ideal has diminished. However, the continued widespread prevalence of anti-fat attitudes and stigma leaves uncertainty about just how much weight standards are changing. This study used an online survey (n = 320) to directly compare evaluations of thin, fat, and average size women through measures of negative stereotypes, prejudicial attitudes, and perceptions about quality of life. Results indicated that, as hypothesized, thin women were perceived less favorably than average weight women. However, fat women were perceived less favorably than both average and thin women. Men were harsher than women in their evaluations of only fat women. Additionally, participants being underweight or overweight did not produce an ingroup bias in their evaluations of underweight and overweight targets, respectively. That is, participants did not rate their own group more favorably, with the exception of overweight participants having lower prejudice toward overweight targets. These findings add to the emerging evidence that women's weight standards are in transition, marked by an increasingly negative perception of thin women, though not necessarily growing positivity toward fat women. This evidence further points toward the need for more extensive research on attitudes of people across the entire weight spectrum. [ABSTRACT FROM AUTHOR]

Taking the Mamá Fit memes and other social media eruptions as a starting point and delving deeper into popular print media, this chapter traces the racialized and gendered practices that constitute fitness in El Salvador in a diasporic context. Importantly, the word fit is now often expressed in English, captured in the names of commercial gyms and diet advertisements; the use of this word signals an important cultural change in conventional understandings of the body in a Spanish-speaking society. By charting the emergence of this new health/beauty norm in a transnational domain, this chapter explores the relationship between shifting patterns of gendered body discipline and changes in El Salvador's location within the global political economy. This chapter argues that fitness discourse has become a subtle, but powerful, conduit for coloniality during a renegotiation of the meaning of gender to fit a neoliberal reality. The argument ends by pointing in the direction of future research to explore how this discourse is experienced in embodied practice with potentially contradictory impacts in Salvadoran society. [ABSTRACT FROM AUTHOR]

Depression affects several aspects of life, including socioeconomic status, relationships, behavior, emotions, and overall health. The etiology of depression is complex and influenced by various factors, with obesity emerging as a significant contributor. This narrative review aims to investigate the factors associated with the development of depression, with a particular focus on the role of obesity. The literature search was conducted on PubMed, Embase, and PsycINFO from May to July 2024. The review highlights the impact of environmental and socioeconomic conditions; lifestyle choices, including physical activity and dietary habits; stress; traumatic experiences; neurotransmitter imbalances; medical and psychological conditions; hormone fluctuations; and epigenetic factors on depression. A key emphasis is placed on the inflammatory processes linked to obesity, which may drive the bidirectional relationship between obesity and depression. The findings suggest that obesity is associated with an increased risk of depression, potentially due to chronic inflammation, neurochemical dysregulation, and the emotional and social challenges related to weight stigma and obesity management. Understanding these interconnected factors is important for developing targeted interventions to address both obesity and depression, leading to improved quality of life for those affected. [ABSTRACT FROM AUTHOR]

Ravasio (2023) recently presents an interesting discussion of strategies to deal with lookism. He categorizes strategies into revisionary and redistributive ones and argues for a case against the former. This note is a critical response to both the taxonomy and the evaluation. I argue that the taxonomy needs to be improved and that the case against revisionary strategies cannot be maintained. [ABSTRACT FROM AUTHOR]

In this paper, we draw upon a study exploring how COVID-19 and social isolation impacted young people's (aged 13–18) experiences of online sexual and gendered risks and harms in England during nationwide lockdowns and upon their return to school. We explore the complexities, tensions and ambiguities in youth navigating algorithmised feeds on social media apps such as TikTok and content featuring idealised cis-gendered, heterosexualised feminine and masculine embodiment. Young people repeatedly witness hateful and abusive comments that are algorithmically boosted. We argue that this toxic content normalises online hate in the form of body shaming and sexual shaming, developing the concept of the postdigital to analyse the offline, affective, embodied and material dimensions of online harm, harassment and abuse. We also explore young people's direct experiences of receiving harmful comments, including girls' and gender and sexuality-diverse youth's experiences of body and sexual shaming, as well as boys' experiences of fat shaming; which, in many instances, we argue must be classified as forms of image-based abuse. Using our postdigital lens, we argue that the ways heteronormative, cis-gendered masculine and feminine embodiment are policed online shapes behaviour and norms in young people's everyday lives, including in and around school, and that better understanding and support around these issues is urgently needed. [ABSTRACT FROM AUTHOR]

Background: Reducing weight stigma in healthcare is critical to supporting and improving the health of people living with overweight or obesity and decreasing the risk of adverse patient outcomes. We were invited as stigma researchers to participate in an online workshop alongside community members, healthcare professionals and policymakers to codesign guidance for reducing weight stigma in healthcare. This workshop prompted us to reflect on why and how weight stigma should be addressed in healthcare, and to provide recommendations for healthcare professionals and policymakers to reduce weight stigma in healthcare. Objective: This paper presents our reflections and recommendations for addressing weight stigma in healthcare following the codesign workshop. Discussion: Recommendations include targeting individual healthcare professionals and involving clear, practical guidelines and training that leverage the notions of 'do no harm', improving practice and recognising biases. Importantly, such strategies must be couched in broader structural approaches to weight stigma reduction. [ABSTRACT FROM AUTHOR]

Background: Pregnant women with obesity face heightened focus on weight during pregnancy due to greater risk of medical complications. Closer follow-up in maternety care may contribute to reduce risk and promote health in these women. The aim of this study was to gain a deeper insight in how pregnant women with obesity experience encounters with healthcare providers in maternity care. How is the received maternity care affected by their weight, and how do they describe the way healthcare providers express attitudes towards obesity in pregnancy? Methods: We conducted in-depth interviews with 14 women in Trøndelag county in Norway with pre-pregnancy BMI of ≥ 30 kg/m2, between 3 and 12 months postpartum. The study sample was strategic regarding age, relationship status, education level, obesity class, and parity. Themes were developed using reflexive thematic analysis. The analysis was informed by contextual information from a prior study, describing the same participants' weight history from childhood to motherhood along with their perceptions of childhood quality. Results: This study comprised of an overarching theme supported by three main themes. The overarching theme, Being pregnant with a high BMI: a vulnerable condition, reflected the challenge of entering maternity care with obesity, especially for women unprepared to be seen as "outside the norm". Women who had grown up with body criticism and childhood bullying were more prepared to have their weight addressed in maternity care. The first theme, Loaded conversations: a balancing act, emphasizes how pregnant women with a history of body criticism or obesity-related otherness proactively protect their integrity against weight bias, stigma and shame. The women also described how some healthcare providers balance or avoid weight and risk conversations for the same reasons. Dehumanization: an unintended drawback of standardized care makes apparent the pitfalls of prioritizing standardization over person-centered care. Finally, the third theme, The ambivalence of discussing weight and lifestyle, represent women's underlying ambivalence towards current weight practices in maternity care. Conclusions: Our findings indicate that standardized weight and risk monitoring, along with lifestyle guidance in maternity care, can place the pregnant women with obesity in a vulnerable position, contrasting with the emotionally supportive care that women with obesity report needing. Learning from these women's experiences and their urge for an unloaded communication to protect their integrity highlights the importance of focusing on patient-centered practices instead of standardized care to create a safe space for health promotion. [ABSTRACT FROM AUTHOR]

Background: Individuals with higher weight (overweight or obesity) may experience social stigma due to their weight. Weight stigma can be internalized with adverse health effects. Internalized weight stigma is relevant across different weight categories, but no validated weight-neutral measure of internalized weight bias currently exists in Norway. The current study aimed to examine the validity of a Norwegian translation of the Modified Weight Bias Internalization Scale. Methods: A Norwegian translation of the Modified Weight Bias Internalization Scale (WBIS-M) was administered in an adult Norwegian sample (N = 315, of which 251 women) ranging from self-reported "very underweight" to "very overweight". Results: A confirmatory factor analysis was conducted on 11 of the original 11 items in the WBIS-M. Based on previous factor analyses with this scale, we expected a one-factor model. One of the items related to competence showed poor model fit, and concern was raised around possible item ambiguity partway through the study. Two versions of this item were therefore tested, neither of which yielded an acceptable fit. After exclusion of this item, the results showed high loadings for the remaining 10 items on one factor with a high internal consistency (α = 0.94). Convergent validity was approached by looking at the relationship between answers on the WBIS-M, self-perceived weight, and items on overall health and psychological/emotional state. Conclusion: The 10-item Norwegian version of the WBIS-M shows sound psychometric properties and can be used to measure internalized weight bias in a weight-neutral fashion in a Norwegian-speaking population. Internalized weight bias was correlated with psychological/emotional state and overall health, with those reporting more internalized weight bias also reporting that they felt worse. This relationship was stronger for women than men in our sample and was partially dependent on weight. The women also showed higher internalized weight bias than the men. Future studies should include more male participants and explore alternative versions of the missing item related to competence. Plain English summary: Individuals with higher weight may experience social stigma due to their weight. This can include encountering beliefs that people of higher weight lack willpower or are not as smart or valuable as others. Stigma related to weight can then be internalized, leading to weight bias internalization, which is when people start to believe in weight-related stigma about themselves. A Norwegian translation of the modified weight bias internalization scale (WBIS-M) was answered by a Norwegian sample. A confirmatory factor analysis was conducted to determine whether the scale had a single-factor structure. The results showed that 10 of the original 11 items fit well, but one item related to the experience of competence should be removed. Once this item was removed, the scale had good statistical properties, indicating that internalized weight bias can be measured by the 10 items of the Norwegian WBIS-M. Internalized weight bias was related to how well people were feeling psychologically and health-wise, with those reporting more internalized weight bias also reporting that they felt worse. This relationship was stronger for women than men in our sample. Future studies should include more male participants and explore further versions of the competence item. [ABSTRACT FROM AUTHOR]

Fat microaggressions are microlevel social practices in the form of commonplace everyday indignities that insult fat people and have been documented anecdotally and qualitatively. However, no psychometrically validated scale exists for measuring fat microaggressions, despite decades of microaggression research demonstrating their negative health associations. This research describes the development and construct validation of the Fat Microaggressions Scale across four studies. Study 1 focused on item development through a systematic review, qualitative analysis of Tweets using #fatmicroaggressions, and a Delphi review. Study 2 (N = 343) determined that a four-factor structure was appropriate in an online community sample of fat adults. Study 3 (N = 410) confirmed the factor structure in a new online sample of fat adults and provided initial evidence of construct validity. Study 4 (N = 197) found evidence of test–retest reliability and demonstrated additional construct validity. Our findings offer a newly validated quantitative measure of fat microaggressions and an initial framework for naming and categorizing these experiences, which may be used to advance the study of fat microaggressions. [ABSTRACT FROM AUTHOR]

In this multi‐professional review, we will provide the in‐depth knowledge required to work in the expanding field of obesity treatment. The prevalence of obesity has doubled in adults and quadrupled in children over the last three decades. The most common treatment offered has been lifestyle treatment, which has a modest or little long‐term effect. Recently, several new treatment options—leading to improved weight loss—have become available. However, long‐term care is not only about weight loss but also aims to improve health and wellbeing overall. In the era of personalized medicine, we have an obligation to tailor the treatment in close dialogue with our patients. The main focus of this review is new pharmacological treatments and modern metabolic surgery, with practical guidance on what to consider when selecting and guiding the patients and what to include in the follow‐up care. Furthermore, we discuss common clinical challenges, such as patients with concurrent eating disorder or mental health problems, and treatment in the older adults. We also provide recommendations on how to deal with obesity in a non‐stigmatizing way to diminish weight stigma during treatment. Finally, we present six microcases—obesity treatment for persons with neuropsychiatric disorders and/or intellectual disability; obesity treatment in the nonresponsive patient who has "tried everything"; and hypoglycemia, abdominal pain, and weight regain after metabolic surgery—to highlight common problems in weight‐loss treatment and provide personalized treatment suggestions. [ABSTRACT FROM AUTHOR]

AbstractObjective:Method:Results:Conclusions:Informed by the person-environment fit theory, this preliminary study examined if a fit between a group member’s treatment experience and their working therapy context (other group members’ aggregated treatment experiences) were related to their level of motivation within a group treatment for healing from internalized weight stigma.We examined the relationship between two types of within-member and between-member’s group cohesion, working alliance, and motivation. Specifically, we utilized the Actor-Partner Interdependence Model to operationalize the impact of actor’s within-member cohesion and alliance (personal changes over time) and between-member cohesion and alliance (individual differences) as well as partner’s within-member cohesion and alliance (contextual changes over time) and between-member cohesion and alliance (contextual differences) on group members’ motivation. This study utilized self-report data from 26 group members who participated in three online weight stigma psychotherapy groups.For cohesion, results suggested that the relationship between partner within-member cohesion and motivation was larger for members who reported low cohesion across all the sessions compared to the other members of their group. Additionally, an individual group member who perceived a group session more cohesive than they did on average, reported increased motivation in that session, and this relationship was stronger for members who on average perceived their group less cohesive than other group members. Lastly, session-level alliance was more strongly associated with an individual member’s motivation in that session when the other group members reported higher group alliance on average.These findings underscore the significance of member-group fit in group therapy and the reciprocal impact of individual members and the group on each other’s therapy outcomes. [ABSTRACT FROM AUTHOR]

Objective Research has highlighted the potential adverse effects of weight bias internalization (WBI) on adolescents, but there has been little examination of WBI and sources of weight teasing (family, peers, or both) or across racial/ethnic diversity of adolescents. We aimed to examine the relationship between WBI and sources of weight teasing across sociodemographic characteristics and weight status in a diverse community sample of adolescents. Methods Data were collected from a U.S. sample of 1859 adolescents aged 10–17 years (59% female; 43% White, 27% Black or African American, and 25% Latino). An online questionnaire was used to assess participants' experiences of weight teasing from family members, peers, or both, and their weight status, weight-related goals, WBI, and sociodemographic characteristics. Results Adolescents experiencing weight teasing from both family and peers reported the highest levels of WBI, while those reporting no teasing exhibited the lowest levels. These patterns were observed across sex, race/ethnicity, weight status, and weight goals, and persisted after controlling for depressive symptoms. Notably, family influences played a salient role, with adolescents reporting higher WBI if teased by family only compared to teasing from peers only. Sex and racial differences were also observed in adolescents' experiences with weight-based teasing. Conclusion Our study reveals associations between adolescent weight-based teasing, WBI, and sociodemographic factors. Weight-based teasing, whether from family and peers or from family only, was associated with increased WBI. Interventions targeting weight stigma in youth should not be limited to peer-focused efforts, but should also emphasize supportive family communication. [ABSTRACT FROM AUTHOR]

Objective: Cross‐sectional research has demonstrated that internalized weight stigma (IWS) is associated with less engagement in weight management behaviors, including physical activity. However, limited research has explored longitudinal relationships among IWS, physical activity, and weight loss. This study examined longitudinal associations of changes in IWS, physical activity, and weight and tested whether physical activity mediated the relationship between IWS and weight change. Methods: Individuals with obesity and high IWS (N = 105) participated in a 72‐week behavioral weight loss intervention, with or without a weight stigma intervention. Measures of IWS (Weight Self‐Stigma Questionnaire), physical activity (accelerometry and self‐report), and weight were collected at baseline and weeks 20, 46 and 72. Correlations examined relationships among changes in variables from baseline to all timepoints, controlling for treatment condition. Mediation, controlling for treatment condition, tested whether IWS reductions during the first 20 weeks predicted greater weight loss at weeks 46 and 72 via increased physical activity between weeks 20 and 46 or 72. Results: Decreases in IWS at week 20 were associated with greater week‐20 weight loss (r = 0.265, p = 0.012). Physical activity was not a significant mediator, but greater reductions in IWS at week 20 predicted greater week‐46 weight loss with or without controlling for physical activity (WSSQ: b = 0.30, confidence interval: 0.12, 0.54). Significant associations were not found at week 72. Conclusion: Initial reductions in IWS were associated with greater week‐46 weight loss. Further research should investigate whether reducing IWS early in obesity treatment enhances long‐term outcomes. Clinical trial registration: ClinicalTrials.gov (NCT03704064). [ABSTRACT FROM AUTHOR]

Objective: Commonly used terms like "obese person" have been identified as stigmatizing by those with lived experience. Thus, this study sought to revise a commonly used measure of weight stigmatizing attitudes, the Attitudes Toward Obese Persons (ATOP) scale. Methods: The original terminology in the 20‐item ATOP (e.g., "obese") was compared to a modified version using neutral terms (e.g., "higher weight"). Participants (N = 832) were randomized to either receive the original or modified ATOP. Results: There was a statistically significant difference, with a small effect size (d = −0.22), between the scores of participants who received the original ATOP (M = 69.25) and the modified ATOP (M = 72.85), t(414) = −2.27, p = 0.024. Through principal component analysis, the modified ATOP was best used as a brief, 8‐item unidimensional measure. In a second sample, confirmatory factor analysis verified the fit of the brief, 8‐item factor structure. Conclusions: Findings suggest that a modified, brief version of the ATOP (ATOP‐Heigher Weight; ATOP‐HW) with neutral language is suitable for assessing negative attitudes about higher‐weight people. The ATOP‐HW may slightly underestimate weight stigma compared to the original ATOP, or the language in the ATOP may magnify negative attitudes. Further examination of the terminology used in weight stigma measures is needed to determine how to best assess weight stigma without reinforcing stigmatizing attitudes. The present study's findings suggest that the use of neutral terms in measures of anti‐fat bias is a promising solution that warrants further investigation. [ABSTRACT FROM AUTHOR]

Background and objectives: Psychosocial factors affect individuals' desire for physical activity. A newly developed instrument (Tendency to Avoid Physical Activity and Sport; TAPAS) has been designed to assess the avoidance of physical activity. Considering cultural differences could be decisive factors, the present study aimed to translate and validate the TAPAS into Chinese (Mandarin) for Taiwanese youths, and further cultural comparisons are expected. Methods: Standard translation procedure (i.e., forward translation, back translation, and reconciliation) was used to translate the English TAPAS into the Chinese TAPAS. Following translation, 608 youths (mean [SD] age 29.10 [6.36] years; 333 [54.8%] women) participated in the study via a snowballing sampling method with an online survey. All participants completed the Chinese TAPAS and additional instruments assessing weight stigma and psychological distress. Confirmatory factor analysis (CFA) was used to examine the factor structure of the Chinese TAPAS and multigroup CFA to examine measurement invariance across gender (men vs. women) and weight status (overweight vs. non-overweight). Pearson correlations were used to examine the concurrent validity; independent t-tests between gender groups and weight status groups were used to examine the known-group validity. Results: Consistent with the English version, the Chinese TAPAS was found to have a one-factor structure evidenced by CFA results. The structure was invariant across gender and weight status groups evidenced by multigroup CFA results. Concurrent validity was supported by significant associations with the related constructs assessed (r = 0.326 to 0.676; p < 0.001). Known-group validity was supported by the significant differences in TAPAS total scores between gender and weight status groups (p = 0.004 and < 0.001; Cohen's d = 0.24 and 0.48). Conclusion: The Chinese version of the TAPAS is a valid and reliable instrument assessing individuals' avoidance of physical activity and sports due to underlying psychosocial issues among Taiwanese youths. It is anticipated to be applied within a large Asian population, as well as cross-cultural comparisons, for further explorations in health, behavioral and epidemiological research and practice. [ABSTRACT FROM AUTHOR]

Introduction: Patient engagement is essential to achieve long-term goals in obesity management. It is crucial to identify patients' perspectives, misperceptions and unmet educational needs on obesity etiology and treatments, to establish a correct therapeutic alliance between healthcare providers and patients. Methods: Objective: This study, promoted by the regional section of the Italian Obesity Society (SIO Lazio), explores attitudes towards obesity, self-awareness, misperceptions of weight loss strategies, experiences of weight stigma and educational needs of patients living with overweight or obesity. Design and subject: We conducted an anonymous survey among patients who accessed an Obesity Management Centers across the Lazio region of Italy for the first time, from October 2023 to April 2024. Approach: The survey consisted of 27 closedended questions grouped into 4 sections: (1) sociodemographic factors and selfreported anthropometric measures; (2) self-awareness and attitudes towards obesity and weight loss strategies; (3) experiences of obesity-related stigma; (4) knowledge and perceptions of obesity treatment options. Results: A total of 300 patients (67.9% women, aged 49.1 ± 14.4 years) returned completed surveys. Despite the self-reported BMI 35.3 ± 7.0 kg/m2 with three out of four (75.3%) of participants having a BMI ≥ 30 kg/m2, only 49% correctly identified themselves as affected by obesity. Almost one-third of the patients believed that obesity does not imply a genetic predisposition (31.9%) and that it is always secondary to psychological or behavioral disorders (29.7%). Interestingly, 66.7% of the patients declared themselves as completely responsible for their own condition and 39.4% considered obesity always treatable by means of lifestyle interventions. Stigma and weight discrimination in healthcare settings were reported by a substantial portion of patients (31.9%). A perception of inadequate support from the National Healthcare System emerged in most of the interviews (61.9%). Most patients (72.1%) felt they were not sufficiently informed about anti-obesity medications and a relevant part of their knowledge was derived from healthcare providers (57.7%) and social networks (19.1%). Weight loss medications were considered useful (63.2%) or necessary (18.4%) by the majority of patients, but only 60.1% would accept without any hesitation a pharmacologic treatment. The main reasons for refusal of pharmacological treatments were the belief that lifestyle intervention is a sufficient treatment (46.9%), the fear of adverse effects (28.1%) and feeling defeated (12.5%). Similarly, for most of participants bariatric surgery is useful (73.3%) or necessary (13.6%). Conclusion: Despite advancements in obesity research, this study underscores the need to improve patient education and public awareness to optimize the management and treatment of obesity. Addressing misconceptions, stigma, and gaps in knowledge are critical steps towards improving patient outcomes and fostering a supportive healthcare environment. [ABSTRACT FROM AUTHOR]

The article explores the issue of discrimination in dating based on physical appearance, known as aprioristic sexual lookism (ASL). It discusses the moral implications of ASL and whether individuals should reject potential partners solely based on their appearance. The article argues that while there are reasons to avoid ASL, it may not be feasible or respectful to date others out of duty. It emphasizes the importance of addressing dating discrimination through individual conduct and structural and cultural remedies. The text also discusses the social meanings and expectations associated with dating practices and the need for a more egalitarian approach. [Extracted from the article]

Background: Since the first papers focused on internalized weight stigma were published in the mid 2000's, the literature has grown into a robust field that complements existing knowledge on weight stigma. Recently, researchers have documented the need for increased conceptual and measurement clarity, to distinguish internalized weight stigma from body dissatisfaction. Although several systematic reviews have been conducted on portions of the internalized weight stigma literature, no review to date has been conducted examining the entirety of the literature. Objective: The aim of this research was to conduct a systematic scoping review and synthesis of research on internalized weight stigma. Specifically, we sought to examine the broad scope of the literature, terms used to refer to internalized weight stigma, how internalized weight stigma is defined, sample characteristics, and weight-based framings of internalized weight stigma research. Methods: We conducted a single-concept search across six databases (EMBASE, Medline, PsychINFO, PubMed, SCOPUS, and Web of Science) of peer-reviewed papers published in English on internalized weight stigma. Data were extracted for article authors, year published, journal name and type, general article topic(s), study design, study location, sample characteristics, variables measured, paper framing, term used to describe internalized weight stigma, and definition of internalized weight stigma. Results: Of the 931 unique records screened, 376 were identified for inclusion in the scoping review. The majority of internalized weight stigma research is characterized by cross-sectional methods, has been conducted in the US, and has utilized samples of higher weight white women. Further, 40 unique terms were used across the literature to refer to internalized weight stigma, and 19 different components of definitions of internalized weight stigma were identified. The literature is also characterized by a focus on understanding the association between internalized weight stigma and health outcomes with an emphasis on obesity. Conclusions: This scoping review confirms a lack of concept clarity of internalized weight stigma, in part influenced by an inconsistency in definitions of internalized weight stigma across the literature. Considerations are provided for steps to enhance conceptual and measurement clarity. Given the obesity focused framing of much of the research on internalized weight stigma, considerations are also provided for reducing weight-centric approaches to research. Plain english summary: In the early 2000's, researchers began to pay more attention to the potential health impacts of believing societal stereotypes, negative attitudes, and beliefs about higher weight people. When these stereotypes, negative attitudes, and beliefs are directed towards the self, it can have significant consequences for an individual's perceptions of self. This research collected and summarized all existing research published in English on internalized weight stigma. Our results highlighted that researchers do not use consistent terminology to refer to internalized weight stigma and that they do not have a consistent definition of internalized weight stigma. Further, a large proportion of the research is focused on obesity or weight loss, which may unintentionally perpetuate weight stigma in scientific research. We provide several recommendations for researchers to address these challenges in future research on internalized weight stigma as well as recommendations to address other identified gaps in the existing literature. [ABSTRACT FROM AUTHOR]

Background: Deeply engaging with the expertise of those who have experienced or supported someone with an eating disorder can add to a growing body of knowledge about recovery processes. In this qualitative study, we sought to explore and generate nuanced understandings of recovery experiences of people with a lived ED experience (first hand or as a caregiver) who were working as mentors in the field. To do this, we focused on changes that occur in personality, traits, and interests over the course of an eating disorder and into recovery. Method: We conducted semi-structured interviews with 27 people with an eating disorder history, either through personal lived experience (n = 14) or as a caregiver of a loved one with an eating disorder (n = 13). We undertook a reflexive thematic analysis of the data through a critical realist lens. Results: We developed three themes, which illustrate the nonlinearity, relationality, and systemically linked nature of changes across experiences of having and recovering from an eating disorder. The first theme focuses on expansion; participants described how their worlds got bigger as they explored who they were becoming and discovered new ways of living in line with their values. The second theme emphasizes the balance between support and autonomy participants described as important for enabling change to occur across the recovery process. The last theme highlights the ways in which changes throughout the recovery process entwined with systemic factors, including actively pushing back against diet culture and weight stigma. Conclusions: Participants' stories highlight interactions between individual, relational, and societal shifts that occur throughout the course of an ED and into recovery. They support ongoing calls to orient to ED recovery as situated within a broader social milieu, which invites us to build supportive environments to enable expansion and flourishing. Plain English summary: If we wish to better understand eating disorder recovery, it is important to ask those who have lived experience. In this qualitative study, we sought to better understand changes that people experience while they have an eating disorder and into recovery. We conducted interviews with 27 people with an eating disorder history. Participants had either first-hand lived experience or lived experience of supporting someone with an eating disorder, and were working as peer (n = 14) or family (n = 13) mentors supporting others through recovery. We analyzed this data using reflexive thematic analysis. We developed three themes, which together paint a picture of recovery as a non-linear experience that occurs with the support of others. First, participants shared how recovery felt like the world was getting bigger as they discovered a version of themselves that resonated with their values. Second, they discussed the importance of striking a balance between being supported and having autonomy. Finally, participants reflected on how they needed to push back against weight stigma and diet culture as they worked toward recovery. These stories help to illustrate the importance of looking at shifts and changes in recovery to better understand it—including individual shifts, shifts in relationships, and social shifts that can support recovery. [ABSTRACT FROM AUTHOR]

Aims: The Bear subculture is a community of sexual minority men who are distinguished by their preference for muscular or large body build and pronounced body hair in men. Previous studies indicated that Bears experienced weight stigma within and outside the gay community. In this study we focused on body esteem in members of the Bear subculture and explored its associations with anthropological body mass indexes and experiences of weight discrimination. Methods: The study, which included questionnaires and anthropological measurements, involved 64 cisgender sexual minority men from the Polish Bear community. Analyses focused on predictors of body esteem measured with The Body-Esteem Scale, including body mass indexes (e.g., waist circumference) and self-reported exposure to weight discrimination. Results: Every three out of four study participants reported exposure to weight stigma. Greater exposure to weight discrimination predicted lower ratings of one's Physical Attractiveness, Upper Body Strength and Physical Condition. Body mass indexes were significantly and negatively related only to Physical Condition factor. Discussion: Our study confirms previous observations of increased body mass indexes and exposure to weight stigma among Bears. Interestingly, weight discrimination but not body mass indexes consistently and negatively predicted self-assessed body esteem across its all dimensions. Conclusion: Men from the Bear community constitute a population that may be particularly vulnerable to health inequalities due to increased body mass and weight stigma exposure. Health promotion interventions targeting this population should be tailored to Bears' subcultural norms, support healthier lifestyles and effective coping with stigma as opposed to focus on weight loss. [ABSTRACT FROM AUTHOR]

Summary: Perceptions and biases influence how we interact with and experience the world, including in professional roles as researchers. Weight bias, defined as negative attitudes or perceptions towards people that have large bodies, can contribute to weight stigma and discrimination leading to negative health and social consequences. Weight bias is experienced by people living with obesity in media, health care, education, employment and social settings. In research settings, there is potential for weight bias to impact various aspects of qualitative research including the participant‐researcher dynamic in interviews. However, evidence‐based strategies to reduce weight bias in qualitative research interviews have yet to be identified. We discuss how weight bias may influence research interviews and identify several considerations and strategies for researchers to minimize the impact of weight bias. Strategies include practicing reflexivity, planning and conducting interviews in ways that support rapport building, using inclusive language, and considering participatory methods. [ABSTRACT FROM AUTHOR]