Weight perception among US adults predicts cardiovascular risk when controlling for body fat percentage

2020

Pediatric Obesity

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Summary Background Research shows that explicit (reported) and implicit (unconscious) bias are distinct constructs varying by socioecological context. Implicit bias better predicts poor health outcomes related to chronic psychosocial stress. Objectives Variation in fat bias was identified in two populations of adolescents in Indiana counties with relatively high (Lawrence) and low (Monroe) obesity prevalence. Methods Adolescents (n = 185) aged 14‐18 years were recruited October 2017‐2018. Explicit fat bias was measured using the Attitudes Towards Obese Persons (ATOP) scale. Implicit fat bias was measured using the obesity attitude implicit association test (IAT). Results Both samples scored high on the ATOP, indicating more positive reported attitudes towards persons with obesity, and scores did not differ between counties (P > .05) after adjusting for age, sex, ethnicity, and BMI‐for‐age percentile. Both samples demonstrated unconscious anti‐fat bias, with Monroe exhibiting significantly higher IAT scores (ie, greater anti‐fat bias) than Lawrence after controlling for confounders (P = .039). Conclusion Differences between explicit and implicit fat‐bias were observed. Both samples reported positive attitudes towards obesity but also demonstrated unconscious anti‐fat bias. Unconscious anti‐fat bias was significantly higher in the county with lower prevalence of obesity, suggesting epidemiological context may influence implicit fat bias. Higher obesity prevalence may reduce unconscious anti‐fat bias in a population or, alternatively, lower obesity prevalence may increase such bias.

Section: Discussionmentioning

confidence: 99%

Implicit and explicit fat bias among adolescents from two US populations varying by obesity prevalence

2020

Pediatric Obesity

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“…Some have argued that this shift in perceived weight status may have negative consequences if it decreases weight loss efforts (Yaemsiri et al, 2011). Conversely, others have argued that being satisfied with one's own weight improves health behaviors and life satisfaction (Blake et al, 2013), and perceiving one's own weight as "about right" rather than "overweight" has been associated with lower cardiovascular risk after controlling for body fat percentage (Cullin & White, 2020). Such changes in perceptions around body fat could be indicative of shifts in social norms in response to the steady rise in average weight status in the US.…”

Section: Obesity Prevalence and Views Of Fatmentioning

confidence: 99%

Biological normalcy and body fat: Obesity prevalence, fat stigma, and allostatic load among late adolescents and young adults

American Journal of Biological Anthropology

2023

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Objectives: Biological normalcy provides a framework to assess tensions between clinical definitions of "normal," statistical norms, and normative beliefs. A prevailing cultural belief is obesity directly causes poor health, but research has demonstrated consequences of fat stigma. Previous research linked fat stigma and allostatic load (AL) in adults, but this has not been demonstrated in youth, and the role of obesity prevalence is unknown. This study assesses the relationship between fat stigma and AL among youth from counties varying by obesity prevalence.Materials and methods: Undergraduates from 38 counties across the US state of Indiana (n = 175) were recruited. Fat stigma was measured using the brief stigmatizing situations inventory (SSI). AL was calculated using eight biomarkers representing cardiovascular, metabolic, and immune function. Poisson regression assessed relationships of interest and adjusted for potential confounding. An interaction term and stratified analyses were used to assess moderation.Results: SSI was not statistically associated with obesity prevalence (RR = 0.96, p = 0.173) but did statistically significantly predict AL (RR = 1.019, p = 0.045) when adjusting for confounders. Obesity prevalence moderated the relationship between SSI and AL (RR = 0.993, p = 0.001).Discussion: Results suggest that fat stigma, regardless of body fat percentage, is associated with physiologic wear and tear on the late adolescent body, and that exposure to obesity during earlier adolescence moderates this relationship. Those most at risk for high AL reported high fat stigma and lived in counties with relatively low obesity prevalence during earlier adolescence, suggesting vulnerability to fat stigma may be heightened where obesity is less common.

“…Weight perception may also be related to body size norms and health. Research has indicated that as the prevalence of obesity has increased over the past several decades, so has the likelihood of US adults (Johnson‐Taylor et al, 2008; Maynard et al, 2006) and adolescents (Lu et al, 2015) falling into overweight and obese BMI categories to perceive their own weight as “about right” rather than “overweight.” Furthermore, a recent study found that US adults who perceived their own weight as “about right” had a reduced 10‐year risk of experiencing a cardiovascular event compared to those perceiving their own weight as “overweight,” regardless of body fat percentage (Cullin & White, 2020). Thus, weight perception has been associated with health outcomes independent of body fat itself.…”

Section: Introductionmentioning

confidence: 99%

What is normal body weight? Perceptions around “average” and “healthy” body weight among adolescents in Indiana

2021

American J Hum Biol

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Objectives Biological normalcy is a framework that investigates relationship(s) between statistical norms and normative views/beliefs around particular traits. This study assessed the relationships between perceptions of average body weight, healthy body weight, and weight status among adolescents. Methods Adolescents recruited in southcentral Indiana, United States (n = 123) completed online questionnaires for demographics and body weight perceptions. Silhouettes from the Stunkard Figure Rating Scale measured perceived weight status, perceived average body weight, and perceived healthy body weight. Height and weight were measured to calculate body mass index‐for‐age percentiles. A subsample (n = 11) provided descriptions of “average,” “healthy,” and “normal” bodies during semi‐structured interviews. Results As perceived average body weight increased, selections of “healthy” silhouettes shifted downward, with smaller female silhouettes being marked healthy more often and larger male silhouettes being marked healthy less often. Additionally, perceived weight status was positively associated with perceptions around average body weight and lowest body weight perceived to be healthy for female and male silhouettes. Qualitative data demonstrated significant overlap in adolescents' descriptions of “average,” “healthy,” and “normal” bodies as well as dual meanings for the term “normal” in adolescents' views of body weight. Conclusions Perceived weight status appears to play a role in adolescents' conceptualizations of average and healthy body weight. Additionally, Qualitative and quantitative data indicated that perceived body weight norms were associated with normative perceptions around what healthy bodies look like. This study demonstrates relationships between statistical norms and normative views around body weight, underscoring the duality in how body weight is understood to be “normal” among adolescents.