Weight bias internalization and beliefs about the causes of obesity among the Canadian public.

BACKGROUND: Explicit weight bias is known as negative attitudes and beliefs toward individuals due to their weight status and can be perpetuated through misconceptions about the causes of obesity. Individuals may also experience weight bias internalization (WBI) when they internalize negative weight-related attitudes and self-stigmatize. There is a paucity of research on the beliefs about the causes of obesity and the prevalence of WBI among public Canadian samples. The aim of this study was to describe these attitudes and beliefs about obesity among a large Canadian sample across the weight spectrum. METHODS: A Canadian sample of adults (N = 942; 51% Women; mean age group = 45-54 years; mean body mass index [BMI] = 27.3 ± 6.7 kg/m2) completed an online questionnaire. Participants completed the Modified Weight Bias Internalization Scale, the Anti-Fat Attitudes Questionnaire, and the Causes of Obesity Questionnaire. RESULTS: Mean WBI score within the entire sample was 3.38 ​​ ± 1.58, and females had higher mean scores as compared to males (p < 0.001). Mean scores were also higher among individuals with a BMI of > 30 kg/m2 (4.16 ± 1.52), as compared to individuals with a BMI of 25-30 kg/m2 (3.40 ± 1.50), and those with a BMI of 20-25 kg/m2 or below 18.5 kg/m2 (2.81 ± 1.44) (p < 0.001 for all). Forty four percent of Canadians believed behavioural causes are very or extremely important in causing obesity, 38% for environmental causes, 28% for physiological and 27% for psychosocial causes. Stronger beliefs in behavioural causes were associated with higher levels of explicit weight bias. No BMI differences were reported on the four different subscales of the Causes of Obesity Questionnaire. CONCLUSIONS: Weight bias internalization is prevalent among Canadians across all body weight statuses, and the public endorses behavioural causes of obesity, namely physical inactivity and overeating, more than its other causes. Findings warrant the reinforcement of efforts aimed at mitigating weight bias by educating the public about the complexity of obesity and by highlighting weight bias as a systemic issue that affects all Canadians living in diverse body weight statuses.

Predictors of support for anti-weight discrimination policies among Canadian adults.

Introduction: Weight discrimination of individuals with overweight or obesity is associated with adverse mental and physical health. Weight discrimination is prevalent in many sectors such as within workplaces, where individuals with overweight and obesity are denied the same opportunities as individuals with lower weight status, regardless of performance or experience. The purpose of this study was to understand the Canadian public's support or opposition of anti-weight discrimination policies and predictors of support. It was hypothesized that Canadians will show support of anti-weight discrimination policies to some extent. Methods: A secondary analysis was conducted on a previous cross-sectional sample of Canadian adults (N = 923, 50.76% women, 74.4% White) who responded to an online survey assessing weight bias and support of twelve anti-weight discrimination policies related to societal policies (e.g., implementing laws preventing weight discrimination) and employment-related policies (e.g., making it illegal to not hire someone due to their weight). Participants completed the Causes of Obesity Questionnaire (COB), the Anti-Fat Attitudes Questionnaire (AFA) and the Modified Weight Bias Internalization Scale (WBIS-M). Multiple logistic regressions were used to determine predictors of policy support. Results: Support for policies ranged from 31.3% to 76.9%, with employment anti-discrimination policies obtaining greater support than societal policies. Identifying as White and a woman, being over the age of 45 and having a higher BMI were associated with an increased likelihood of supporting anti-weight discrimination policies. There were no differences between the level of support associated with attributing obesity to behavioral or non-behavioral causes. Explicit weight bias was associated with a reduced likelihood of supporting 8/12 policies. Weight Bias Internalization was associated with an increased likelihood of supporting all societal policies but none of the employment policies. Conclusions: Support for anti-weight discrimination policies exists among Canadian adults, and explicit weight bias is associated with a lower likelihood of supporting these policies. These results highlight the need for education on the prevalence and perils of weight discrimination which may urge policy makers to consider weight bias as a form of discrimination that must be addressed. More research on potential implementation of anti-weight discrimination policies in Canada is warranted.

Effects of the HEARTY exercise randomized controlled trial on eating behaviors in adolescents with obesity.

Background: There are well-recognized benefits of behavioral interventions that include exercise for children and adolescents with obesity. However, such behavioral weight management programs may precipitate unintended consequences. It is unclear if different exercise modalities impact eating behaviors differently in youth with obesity. Objectives: The purpose of this study was to examine the effects of aerobic, resistance, and combined aerobic and resistance exercise training on eating attitudes and behaviors (uncontrolled eating, restrained eating, emotional eating, external eating and food craving) among adolescents with overweight and obesity. Methods: N = 304 (70% female) adolescents with overweight and obesity participated in the 6-month Healthy Eating Aerobic and Resistance Training in Youth (HEARTY) randomized controlled trial. All participants were inactive post-pubertal adolescents (15.6 ± 1.4 years) with a mean BMI = 34.6 ± 4.5 kg/m2. The Food Craving Inventory (food cravings), Dutch Eating Behavior Questionnaire (restrained eating, emotional eating, external eating), and the Three-Factor Eating Questionnaire (uncontrolled eating) were used to assess eating attitudes and behaviors. Results: All exercise groups showed within-group decreases in external eating and food cravings. Participants randomized to the Combined training group and were more adherent showed the greatest improvements in eating behaviors and cravings. Conclusions: A 6-month exercise intervention produced improvements in disordered eating behaviors and food cravings, but effects may be gender and modality-specific. Findings highlight the need to tailor exercise intervention to participant characteristics for the promotion of healthier eating and weight management outcomes in youth with obesity.Clinical Trial Registration # and Date: ClinicalTrials.Gov NCT00195858, September 12, 2005.

Weight bias and support of public health policies.

OBJECTIVES: Public health policies have been proposed to help address prevalent Canadian obesity rates. Along with the increase in obesity prevalence, explicit weight bias is also rampant in Western society. This paper aimed to assess the association between explicit weight bias attitudes and Canadian public support of these policy recommendations. METHODS: Canadian adults (N = 903; 51% female; BMI = 27.3 ± 7.0 kg/m2) completed an online survey measuring explicit weight bias, using the three subscales of the Anti-Fat Attitudes Questionnaire: Willpower (belief in weight controllability), Fear of fat (fear of gaining weight), and Dislike (antipathy towards people with obesity). Whether these subscales were associated with policy support was assessed with logistic regression. Analyses were adjusted for age, race, gender, and income. RESULTS: Public support of policy recommendations ranged from 53% to 90%. Explicit weight bias was primarily expressed through a fear of weight gain and the belief that weight gain was within the individual's control based on willpower. Although the Dislike subscale was associated with lower support for several policies that enable or guide individual choice in behaviour change, the Willpower and Fear of fat subscales were associated with greater support for similar policies. CONCLUSION: This study contributes to evidence-informed public health action by describing public support of public health policies and demonstrating an association between explicit weight bias and public support. A higher total explicit weight bias score increased the odds of supporting primarily less intrusive policies. However, dislike of individuals with obesity was associated with decreased odds of supporting many policies.

RéSUMé: OBJECTIFS: Il a été proposé que les politiques de santé publique soient adoptées pour contribuer à réduire la prévalence de l'obésité au Canada. Le biais et les préjugés liés au poids ont augmenté considérablement avec l'accroissement de la prévalence de l'obésité dans notre société occidentale. L'objectif de notre étude était d'examiner si le biais explicite lié au poids était associé au soutien des politiques et des stratégies canadiennes de prévention de l'obésité. MéTHODE: Des adultes canadiens (N = 903; 51 % femmes; IMC = 27,3 ± 7,0 kg/m2) ont répondu à un questionnaire en ligne qui examinait le biais explicite lié au poids (en utilisant les trois composantes du questionnaire Anti-Fat Attitudes Questionnaires: la volonté, la peur du gain de l'excès de poids, et l'aversion). Une regression logistique a été employée pour examiner si les trois composantes du biais lié au poids étaient associées au soutien des politiques canadiennes. L'âge, la race, le sexe et le revenu ont été pris en compte dans les analyses. RéSULTATS: Le soutien du public aux recommandations des politiques variait de 53 % à 90 %. Le biais explicite relié au poids s'exprimait principalement par une peur du gain de poids, et la croyance que c'est à l'individu qu'il revient de maîtriser le gain de poids par sa volonté. La composante de l'aversion était associée à un soutien plus faible des politiques qui guident l'individu à faire ses propres choix pour changer ses comportements, mais les composantes de la volonté et la peur du gain de poids étaient associés avec un plus grand soutient de ces politiques. CONCLUSION: Cette étude basée sur des données scientifiques contribue à l'action de santé publique en décrivant le soutien accordé par le public aux politiques canadiennes de prévention de l'obésité et démontrant une association entre le biais explicite relié au poids et le soutien du public. Le biais explicite relié au poids plus élevé augmentait la chance du soutien des politiques moins intrusives. L'aversion pour les personnes qui présentent de l'obésité était associé à un faible soutien de plusieurs politiques.

The Impact of Financial and Psychological Wellbeing on Children's Physical Activity and Screen-Based Activities during the COVID-19 Pandemic.

The COVID-19 pandemic, and the public health measures to combat it, have strained the finances of many families. While parents transitioned to working from home, children transitioned to learning virtually, limiting their organized social and physical activities. Families also reduced the frequency and size of gatherings, impacting psychological wellbeing. This study sought to understand the influence of financial wellbeing on children's physical activity and leisure screen-based activities via mothers' and children's psychological wellbeing. In May and June of 2020, 254 Grade 7 Canadian children and their mothers completed separate online surveys assessing family financial wellbeing, mothers' and children's psychological wellbeing, and children's physical activity and leisure screen-based activities. Structural equation modelling was used to examine the indirect effects of mothers' and children's psychological wellbeing on the relationship between financial wellbeing and children's physical activity and leisure screen-based activities. Final models were adjusted for potential confounders. Study results indicate a significant indirect association between financial wellbeing and children's physical activity and leisure screen-based activities via mothers' and children's psychological wellbeing. These findings demonstrate that higher levels of financial wellbeing are associated with better mental and physical health benefits in children during the COVID-19 pandemic.

Weight bias and health care utilization: a scoping review.

AIM: The purpose of this scoping review was to explore the evidence on how perceptions and/or experiences of weight bias in primary health care influence engagement with and utilization of health care services by individuals with obesity. BACKGROUND: Prior studies have found discrepancies in the use of health care services by individuals living with obesity; a greater body mass index has been associated with decreased health care utilization, and weight bias has been identified as a major barrier to engagement with health services. METHODS: PubMed was searched from January 2000 to July 2017. Four reviewers independently selected 21 studies examining perceptions of weight bias and its impact on engagement with primary health care services. FINDINGS: A thematic analysis was conducted on the 21 studies that were included in this scoping review. The following 10 themes were identified: contemptuous, patronizing, and disrespectful treatment, lack of training, ambivalence, attribution of all health issues to excess weight, assumptions about weight gain, barriers to health care utilization, expectation of differential health care treatment, low trust and poor communication, avoidance or delay of health services, and 'doctor shopping'. Overall, our scoping review reveals how perceptions and/or experiences of weight bias from primary care health professionals negatively influence patient engagement with primary health care services.