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

Social and Personality Psychology Compass

Volumn 9, Issue 6, 2015, Pages 255-268

  Hunger, Jeffrey M ^a   Major, Brenda ^a   Blodorn, Alison ^a   Miller, Carol T ^b  

^a UNIVERSITY OF CALIFORNIA   (United States)

^b UNIVERSITY OF VERMONT   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

EID: 84930399217     PISSN: None     EISSN: 17519004     Source Type: Journal    
DOI: 10.1111/spc3.12172     Document Type: Article

References (94)

1. Adam, T. C., & Epel, E. S. (2007). Stress, eating, and the reward system. Physiology & Behavior, 91, 449-458. doi: 10.1016/j.physbeh.2007.04.011
2. Amy, N. K., Aalborg, A., Lyons, P., & Keranen, L. (2006). Barriers to routine gynecological cancer screening for White and African-American obese women. International Journal of Obesity, 30, 147-155. doi: 10.1038/sj.ijo.0803105
3. Anderson, D. A., & Wadden, T. A. (2004). Bariatric surgery patients' views of their physicians' weight-related attitudes and practices. Obesity Research, 12, 1587-1595. doi: 10.1038/oby.2004.198
4. Almeida, L., Savoy, S., & Boxer, P. (2011). The role of weight stigmatization in cumulative risk for binge eating. Journal of Clinical Psychology, 67, 278-292. doi: 10.1002/jclp.20749
5. Andreyeva, T., Puhl, R. M., & Brownell, K. D. (2008). Changes in perceived weight discimination among Americans, 1995-1996 through 2004-2006. Obesity, 16(5), 1129-1134. doi: 10.1038/oby.2008.35
6. Ata, R. N. & Thompson, J. K., (2010). Weight bias in the media: A review of recent research. Obesity Facts, 3, 41-46.
7. Bacon, L., & Aphramor, L. (2011). Weight science: Evaluating the evidence for a paradigm shift. Nutrition Journal, 10, 1-13. doi: 10.1186/1475-2891-10-9
8. Basu, S. (2008). F2-isoprostanes in human health and diseases: From molecular mechanisms to clinical implications. Antioxidants & Redox Signaling, 10, 1405-1434. doi: 10.1089/ars.2007.1956
9. Baumeister, R. F., & Leary, M. R. (1995). The need to belong: Desire for interpersonal attachments as a fundamental human motivation. Psychological Bulletin, 117, 497-529. doi: 10.1037/0033-2909.117.3.497
10. Bayer, R. (2008). Stigma and the ethics of public health: Not can we but should we. Social Science & Medicine, 67, 463-472. doi: 10.1016/j.socscimed.2008.03.017
11. Bjorntorp, P. (2001). Do stress reactions cause abdominal obesity and comorbidities? Obesity Reviews, 2, 73-86. doi: 10.1046/j.1467-789x.2001.00027.x
12. Blascovich, J., & Mendes, W. B., (2010). Social psychophysiology and embodiment. In S. T. Fiske & D. T. Gilbert (Eds.), The Handbook of Social Psychology (5th edn). (pp. 194-227). New York: Wiley.
13. Blodorn, A., Major, B., Hunger, J.M., & Miller, C.T. (2014). Expecting to be rejected: A mechanism underlying the negative psychological effects of weight-based social identity threat. Unpublished manuscript.
14. Brewis, A. A. (2014). Stigma and the perpetuation of obesity. Social Science & Medicine, 118, 152-158.doi: 10.1016/j.socscimed.2014.08.003.
15. Brochu, P. M., & Dovidio, J. F. (2014). Would you like fries (38n) with that? Menu labeling mitigates the impact of weight-based stereotype threat on food choice. Social Psychological and Personality Science, 5, 414-421. doi: 10.1177/1948550613499941
16. Boyes, A. D., & Latner J. D. (2009). Weight stigma in existing romantic relationships. Journal of Sex& Marital Therapy, 35, 282-293. doi: 10.1080/00926230902851280
17. Callahan, D. (2013a). Obesity: Chasing an elusive epidemic. Hastings Center Report, 43, 40-43. doi: 10.1002/hast.114
18. Callahan D. (2013b). Children, stigma, and obesity. JAMA Pediatrics, 167, 791-792. doi: 10.1001/jamapediatrics.2013.2814.
19. Carr, D., & Friedman, M. A. (2005). Is obesity stigmatizing? Body weight, perceived discrimination, and psychological well-being in the United States. Journal of Health and Social Behavior, 46, 244-259. doi: 10.1177/002214650504600303
20. Carr, D., Friedman, M. A., & Jaffe, K. (2007). Understanding the relationship between obesity and positive and negative affect: The role of psychosocial mechanisms. Body Image, 4, 165-177. doi: 10.1016/j.bodyim.2007.02.004
21. Carver, C. S., & Scheier, M. F. (1998). On the Self-Regulation of Behavior. New York: Cambridge University Press.
22. Chang, V. W., Asch, D. A., & Werner, R. M. (2010). Quality of care among obese patients. JAMA, 303, 1274-1281.
23. Chida, Y., & Steptoe, A. (2010). Greater cardiovascular responses to laboratory mental stress are associated with poor subsequent cardiovascular risk status a meta-analysis of prospective evidence. Hypertension, 55, 1026-1032. doi: 10.1161/hypertensionaha.109.146621
24. Cohen, S. (2004). Social relationships and health. American Psychologist, 59, 676-684. doi: 10.1037/0003-066X.59.8.676.
25. Dickerson, S. S., & Kemeny, M. E. (2004). Acute stressors and cortisol responses: A theoretical integration and synthesis of laboratory research. Psychological Bulletin, 130, 355-391. doi: 10.1037/0033-2909.130.3.355
26. Drury, A., & Louis, M. (2002). Exploring the association between body weight, stigma of obesity, and health care avoidance. Journal of the American Academy of Nurse Practitioners, 14, 554-561. doi: 10.1111/j.1745-7599.2002.tb00089.x
27. Durso, L. E., Latner, J. D., & Hayashi, K. (2012). Perceived discrimination is associated with binge eating in a community sample of non-overweight, overweight, and obese adults. Obesity Facts, 5, 869-880. doi: 10.1159/000345931
28. Faith, M. S., Leone, M. A., Ayers, T. S., Heo, M., & Pietrobelli, A. (2002). Weight criticism during physical activity, coping skills, and reported physical activity in children. Pediatrics, 110, e23-e23.
29. Fikkan, J. L., & Rothblum, E. D. (2012). Is fat a feminist issue? Exploring the gendered nature of weight bias. Sex Roles, 66, 575-592. doi: 10.1007/s11199-011-0022-5
30. Haffner, S. M., (2006). The metabolic syndrome: inflammation, diabetes mellitus, and cardiovascular disease. The American Journal of Cardiology, 97, 3-11.
31. Haines, J., Neumark-Sztainer, D., Eisenberg, M. E., & Hannan, P. J. (2006). Weight teasing and disordered eating behaviors in adolescents: Longitudinal findings from Project EAT (Eating Among Teens). Pediatrics, 117, e209-e215. doi: 10.1542/peds.2005-1242
32. Hatzenbuehler, M. L., Keyes, K. M., & Hasin, D. S. (2009). Associations between perceived weight discrimination and the prevalence of psychiatric disorders in the general population. Obesity, 17, 2033-2039. doi: 10.1038/oby.2009.131
33. Hebl, M., & Xu, J. (2001). Weighing the care: Physicians' reactions to the size of a patient. International Journal of Obesity, 25, 1246-1252. doi: 10.1038/sj.ijo.0801681
34. Hilmert, C. J., & Kvasnicka, L. R. (2010). Blood pressure reactivity and emotional responses to stress: Perspectives on cardiovascular reactivity. Social and Personality Psychology Compass, 4, 470-483. doi: 10.1111/j.1751-9004.2010.00275.x
35. Himmelstein, M. S., Incollingo Belsky, A. C., & Tomiyama, A. J. (2014). The weight of stigma: The effects of BMI and perceived body weight on cortisol reactivity to experiencing weight stigma. Obesity, 23, 368-374.
36. Hofmann, W., Schmeichel, B. J., & Baddeley, A. D. (2012). Executive functions and self-regulation. Trends in Cognitive Sciences, 16, 174-180. doi: 10.1016/j.tics.2012.01.006
37. Hunger, J. M., & Major, B. (2015). Weight stigma mediates the association between BMI and self-reported psychological and physical health. Health Psychology, 34, 172-175. doi: 10.1037/hea0000106
38. Hunger, J. M., & Tomiyama, A. J. (2014). Weight labeling and obesity: A longitudinal study of girls aged 10 to 19years. JAMA Pediatrics, 168, 579-580. doi: 10.1001/jamapediatrics.2014.122
39. Inzlicht, M., & Kang, S. K. (2010). Stereotype threat spillover: How coping with threats to social identity affects aggression, eating, decision making, and attention. Journal of Personality and Social Psychology, 99, 467-481. doi: 10.1037/a0018951
40. Inzlicht, M., McKay, L., & Aronson, J. (2006). Stigma as ego depletion how being the target of prejudice affects self-control. Psychological Science, 17, 262-269. doi: 10.1111/j.1467-9280.2006.01695.x
41. Inzlicht, M., & Schmeichel, B. J.(2012). What is ego depletion? Toward a mechanistic revision of the resource model of self-control. Perspectives on Psychological Science, 7, 450-463.
42. Jackson, S. E., Beeken, R. J., & Wardle, J. (2014). Perceived discrimination and changes in weight, waist circumference, and weight status. Obesity. Advanced online publication. doi: 10.1002/oby.20891
43. Johns, M., Inzlicht, M., & Schmader, T. (2008). Stereotype threat and executive resource depletion: Examining the influence of emotion regulation. Journal of Experimental Psychology: General, 137, 691-705. doi: 10.1037/a0013834
44. King, E. B., Shapiro, J. R., Hebl, M. R., Singletary, S. L., & Turner, S. (2006). The stigma of obesity in customer service: A mechanism for remediation and bottom-line consequences of interpersonal discrimination. Journal of Applied Psychology, 91, 579-593. doi: 10.1037/0021-9010.91.3.579
45. Latner, J. D., Wilson, T., Jackson, M. L., & Stunkard, A. J. (2009). Greater history of weight-related stigmatizing experience is associated with greater weight loss in obesity treatment. Journal of Health Psychology, 14, 190-199. doi: 10.1177/1359105308100203
46. Lick, D. J., Durso, L. E. & Johnson, K. L. (2013). Minority stress and physical health among sexual minorities. Perspectives on Psychological Science, 8, 521-548.
47. Lovallo, W. R., & Gerin, W. (2003). Psychophysiological reactivity: Mechanisms and pathways to cardiovascular disease. Psychosomatic Medicine, 65, 36-45. doi: 10.1097/01.PSY.0000033128.44101.C1
48. Major, B., & O'Brien, L. T. (2005). The social psychology of stigma. Annual Review of Psychology, 56, 393-421. doi: 10.1146/annurev.psych.56.091103.070137
49. Major, B., Eliezer, D., & Rieck, H. (2012). The psychological weight of weight stigma. Social Psychological and Personality Science, 3, 651-658. doi: 10.1177/1948550611434400
50. Major, B., Hunger, J. M., Bunyan, D., & Miller, C. T. (2014). The ironic effects of weight stigma. Journal of Experimental Social Psychology, 51, 74-80. doi: 10.1016/j.jesp.2013.11.009
51. Major, B., Mendes, W. B. & Dovidio, J. F. (2013). Intergroup relations and health disparities: a social psychological perspective. Health Psychology, 32, 514-524.
52. Mann, T., Tomiyama, A. J., Westling, E., Lew, A., Samuels, B., & Chatman, J. (2007). Medicare's search for effective obesity treatments: Diets are not the answer. American Psychologist, 62, 220-233. doi: 10.1037/0003-066X.62.3.220
53. Matthews, K. A., Salomon, K., Kenyon, K., & Zhou, F. (2005). Unfair treatment, discrimination, and ambulatory blood pressure in black and white adolescents. Health Psychology, 24, 258-265. doi: 10.1037/0278-6133.24.3.258
54. McEwen, B. S. (1998). Protective and damaging effects of stress mediators. New England Journal of Medicine, 338, 171-179. doi: 10.1056/NEJM199801153380307
55. Miller, C. T., Rothblum, E. D., Felicio, D., & Brand, P. (1995). Compensating for stigma: Obese and nonobese women's reactions to being visible. Personality and Social Psychology Bulletin, 21, 1093-1106. doi: 10.1177/01461672952110010
56. Muennig, P. (2008). The body politic: The relationship between stigma and obesity-associated disease. BMC Public Health, 8, 128. doi: 10.1186/1471-2458-8-128
57. Myers, A., & Rosen, J. C. (1999). Obesity stigmatization and coping: Relation to mental health symptoms, body image, and self-esteem. International Journal of Obesity, 23, 221-230. doi: 10.1038/sj.ijo.0800765
58. Neumark-Sztainer, D., Falkner, N., Story, M., Perry, C., Hannan, P. J., & Mulert, S. (2002). Weight-teasing among adolescents: Correlations with weight status and disordered eating behaviors. International Journal of Obesity, 26, 123-131. doi: 10.1038/sj.ijo.0801853
59. Neumark-Sztainer, D., Wall, M., Story, M., & Standish, A. R. (2012). Dieting and unhealthy weight control behaviors during adolescence: Associations with 10-year changes in body mass index. Journal of Adolescent Health, 50, 80-86. doi: 10.1016/j.jadohealth.2011.05.010
60. Newman, E., O'Connor, D. B., & Conner, M. (2007). Daily hassles and eating behavior: The role of cortisol reactivity status. Psychoneuroendocrinology, 32, 125-132. doi: 10.1016/j.psyneuen.2006.11.006
61. Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2014). Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA, 311, 806-814. doi: 10.1001/jama.2014.732
62. Pascoe, E. A. & Smart Richman, L. (2009) Perceived discrimination and health: A meta-analytic review. Psychological Bulletin, 135, 531-554.
63. Pearl, R. L., Puhl, R. M., & Dovidio, J. F. (2014). Differential effects of weight bias experiences and internalization on exercise among women with overweight and obesity. Journal of Health Psychology. doi: 10.1177/1359105313520338
64. Phelan, S. M., Dovidio, J. F., Puhl, R. M., Burgess, D. J., Nelson, D. B., Yeazel, M. W., ... & Ryn, M. (2014). Implicit and explicit weight bias in a national sample of 4, 732 medical students: The medical student CHANGES study. Obesity, 22, 1201-1208. doi: 10.1002/oby.20687
65. Puhl, R. M., Andreyeva, T., & Brownell, K. D. (2008). Perceptions of weight discrimination: Prevalence and comparison to race and gender discrimination in America. International Journal of Obesity, 32, 992-1000. doi: 10.1038/ijo.2008.22
66. Puhl, R. M., & Brownell, K. D. (2006). Confronting and coping with weight stigma: An investigation of overweight and obese adults. Obesity, 14, 1802-1815. doi: 10.1038/oby.2006.208
67. Puhl, R. M., & Heuer, C. A. (2009). The stigma of obesity: A review and update. Obesity, 17, 941-964. doi: 10.1038/oby.2008.636
68. Puhl, R. M., & Heuer, C. A. (2010). Obesity stigma: Important considerations for public health. American Journal of Public Health, 100, 1019-1028. doi: 10.2105/AJPH.2009.159491
69. Puhl, R. M., Moss-Racusin, C. A., Schwartz, M. B., & Brownell, K. D. (2008). Weight stigmatization and bias reduction: Perspectives of overweight and obese adults. Health Education Research, 23, 347-358. doi: 10.1093/her/cym052
70. Roehling, M. V., Roehling, P. V., & Pichler, S. (2007). The relationship between body weight and perceived weight-related employment discrimination: The role of sex and race. Journal of Vocational Behavior, 71, 300-318. doi: 10.1016/j.jvb.2007.04.008
71. Sabin, J. A., Marini, M., & Nosek, B. A. (2012). Implicit and explicit anti-fat bias among a large sample of medical doctors by BMI, race/ethnicity and gender. PloS One, 7, e48448. doi: 10.1371/journal.pone.0048448
72. Saguy, A. C., Frederick, D., & Gruys, K. (2014). Reporting risk, producing prejudice: How news reporting on obesity shapes attitudes about health risk, policy, and prejudice. Social Science & Medicine, 111, 125-133. doi: 10.1016/j.socscimed.2014.03.026
73. Schmader, T., Johns, M., & Forbes, C. (2008). An integrated process model of stereotype threat effects on performance. Psychological Review, 115, 336-356. doi: 10.1037/0033-295X.115.2.336
74. Seacat, J. D., Dougal, S. C., & Roy, D. (2014). A daily diary assessment of female weight stigmatization. Journal of Health Hsychology, doi: 10.1177/1359105314525067
75. Seacat, J. D. & Mickelson, K. D. (2009). Stereotype threat and the exercise/dietary health intentions of overweight women. Journal of Health Psychology, 14, 556-567.
76. Shapiro, J. R., & Neuberg, S. L. (2007). From stereotype threat to stereotype threats: Implications of a multi-threat framework for causes, moderators, mediators, consequences, and interventions. Personality and Social Psychology Review, 11, 107-130. doi: 10.1177/1088868306294790
77. Shelton, J. N., Richeson, J. A., & Salvatore, J. (2005). Expecting to be the target of prejudice: Implications for interethnic interactions. Personality and Social Psychology Bulletin, 31, 1189-1202. doi: 10.1177/0146167205274894
78. Schvey, N. A., Puhl, R. M., & Brownell, K. D. (2011). The impact of weight stigma on caloric consumption. Obesity, 19, 1957-1962. doi: 10.1038/oby.2011.204
79. Schvey, N. A., Puhl, R. M., & Brownell, K. D. (2014). The stress of stigma: Exploring the effect of weight stigma on cortisol reactivity. Psychosomatic Medicine, 76, 156-162. doi: 10.1097/PSY.0000000000000031
80. Schwartz, M. B., Chambliss, H. O. N., Brownell, K. D., Blair, S. N., & Billington, C. (2003). Weight bias among health professionals specializing in obesity. Obesity Research, 11, 1033-1039. doi: 10.1038/oby.2003.142
81. Steele, C. M., Spencer, S. J., & Aronson, J. (2002). Contending with group image: The psychology of stereotype and social identity threat. Advances in Experimental Social Psychology, 34, 379-439. doi: 10.1016/S0065-2601(02)80009-0
82. Stuber, J., Galea, S., & Link, B. G. (2008). Smoking and the emergence of a stigmatized social status. Social Science & Medicine, 67, 420-430. doi: 10.1016/j.socscimed.2008.03.010
83. Sutin, A. R., Stephan, Y., Suchetti, M., & Terreciano, A. (2014). Perceived weight discrimination and C-reactive protein. Obesity. Advanced online publication. doi: 10.1002/oby.20789
84. Sutin, A. R., & Terracciano, A. (2013). Perceived weight discrimination and obesity. PLoS One, 8, e70048. doi: 10.1371/journal.pone.0070048
85. Szanton, S. L., Rifkind, J. M., Mohanty, J. G., Mille III, E. R., Thorpe, R. J., Nagababu, E. & Evans, M. K. (2012). Racial discrimination is associated with a measure of red blood cell oxidative stress: A potential pathway for racial health disparities. International Journal of Behavioral Medicine, 19, 489-495.
86. Tomiyama, A. J. (2014). Weight stigma is stressful: A review of evidence for the Cyclic Obesity/Weight-Based Stigma model. Appetite, 82, 8-15. doi: 10.1016/j.appet.2014.06.108
87. Tomiyama, A. J., Ahlstrom, B., & Mann, T. (2013). Long-term effects of dieting: Is weight loss related to health? Social and Personality Psychology Compass, 7, 861-877.
88. Tomiyama, A. J., Epel, E. S., McClatchey, T. M., Poelke, G., Kemeny, M. E., McCoy, S. K., & Daubenmier, J. (2014). Associations of weight stigma with cortisol and oxidative stress independent of adiposity. Health Psychology, 33, 862-867. doi: 10.1037/hea0000107
89. Vartanian, L. R., & Novak, S. A. (2011). Internalized societal attitudes moderate the impact of weight stigma on avoidance of exercise. Obesity, 19, 757-762. doi: 10.1038/oby.2010.234
90. Vartanian, L. R., Pinkus, R., & Smyth, J. M. (2014). The phenomenology of weight stigma in everyday life. Journal of Contextual Behavioral Science, 3, 196-202. doi: 10.1016/j.jcbs.2014.01.003
91. Vartanian, L. R., & Shaprow, J. G. (2008). Effects of weight stigma on exercise motivation and behavior: A preliminary investigation among college-aged females. Journal of Health Psychology, 13, 131-138. doi: 10.1177/1359105307084318
92. Vartanian, L. R., & Smyth, J. M. (2013). Primum non nocere: Obesity stigma and public health. Journal of Bioethical Inquiry, 10, 49-57. doi: 10.1007/s11673-012-9412-9
93. Williams, D. R., & Mohammed, S. A. (2009). Discrimination and racial disparities in health: evidence and needed research. Journal of Behavioral Medicine, 32, 20-47.
94. Wott, C. B., & Carels, R. A. (2010). Overt weight stigma, psychological distress and weight loss treatment outcomes. Journal of Health Psychology, 15, 608-614.