Weight stigma experiences and self-exclusion from sport and exercise settings among people with obesity

Abstract

Background A central strategy to tackle the health risks of obesity is regular physical activity (PA), exercising and participating in sports. However, people with obesity regularly experience weight-related stigma and discrimination in sport and exercise settings. Research has indicated that they often cope with such experiences by simply excluding themselves from sport and exercise. Meanwhile, self-exclusion as a coping strategy has not been fully understood and it remains unclear to what extent self-exclusion from PA settings is accompanied by general inactivity among people with obesity. The goal of this interview study was to determine to what extent physical inactivity among adults with obesity is the result of weight stigma-induced self-exclusion in and from sport and PA settings. Methods We conducted semi-structured interviews with thirty adult men and women with obesity (average BMI: 40.64) and asked them about experiences with their body, weight stigma and coping behaviours in sport and exercise settings across their lifespans. Employing constant comparative analysis and a thematic network approach, we analysed the interview data to identify the most common reasons for and different strategies of self-exclusion. Results Participants reported that they excluded themselves from sport and exercise settings due to traumatic weight stigma experiences, self-discrimination and fear of stigma, using a variety of strategies. Exposure to discrimination was prevented by selectively avoiding certain settings or strategically frequenting them at certain times only, but also by exercising in ‘safe’ spaces, e.g. at home. Furthermore, people with obesity reported strategically managing their social relations in order to avoid stigmatising reactions by others in exercise settings, for example by exercising individually and avoiding social PA. Most notably, our results strongly indicate that not all self-excluding coping strategies result in less exercising. Conclusions In order to successfully promote physical activity among people with obesity, the various forms of self-exclusion should be taken into account as pathways of stigma regarding physical activity. People with obesity may exclude themselves from certain PA settings, yet could still be exercising on their own or in other ways. One focus of public health strategies should thus be directed at the potentially socially isolating effects.

Spanish validation of the Modified Weight Bias Internalization Scale (WBIS-M) for adolescents

“…Weight stigma has been associated with psychological distress [3], poorer mental health [4], disordered eating and unhealthy eating behaviours [5], substance use [6], more physiological stress [7], reduced motivation to engage in physical activity [8], additional barriers to weight loss maintenance [9], reduced healthcare seeking behaviour [10], and a higher risk for suicidality and mortality [11,12].…”

Obesity Stigma: Causes, Consequences, and Potential Solutions

“…Counter to traditional public health beliefs that social pressure encourages people with obesity to lose weight [ 25 ], ironically, evidence suggests that obesity stigma actually increases the risk of obesity. Obesity stigma may be associated with increased difficulty of losing weight and medication non-adherence and people with obesity may exclude themselves from some exercise settings [ 102 , 104 ]. Pearl and Puhl’s systematic review found that obesity self-stigma is associated with worse dietary adherence and reduced motivation and self-efficacy to complete health-promoting behaviours [ 105 •].…”

Representaciones sociales del exceso de peso en adultos chilenos: Una aproximación desde el análisis del discurso

“…En este sentido, desde estudios en psicología y psicología de la salud se ha demostrado que la obesidad aparece a menudo acompañada del estigma de peso (Spahlholz, Baer, Konig, Riedel y Luck, 2016;Thedinga, Zehl y Thiel, 2021), fenómeno que se ha asociado a un aliciente para lograr un peso corporal reducido, basándose en la suposición que la vergüenza provocada por la estigmatización, motivaría a cambiar el comportamiento y lograría la reducción de peso a través de dietas autodirigidas y aumento del ejercicio físico (Rubino, Puhl y Dixon, 2020). Sin embargo, tanto estudios observacionales como aquellos experimentales, muestran que esas estrategias pueden surtir el efecto contrario y, en cambio, pueden inducir a evitar el ejercicio, consumir alimentos poco saludables y aumentar el comportamiento sedentario, llevando a una mala salud metabólica, mayor aumento de peso y reducción de la calidad de vida (Puhl y Suh, 2015).…”