demonstrates that influence of weight bias on health consequences related to, Psychological Social Economic and educational Physical health These adverse outcomes can reduce the quality of life and impact both short- and long-term well-being. Did you know… Individuals with obesity experience different types of weight stigma in their daily lives.20 o Direct stigma - Being laughed at when exercising or eating in public - Stigmatizing comments at school and in the workplace o Environmental Stigma - Inappropriately-sized equipment and facilities at gyms and medical offices - Unsuitable seating in modes of public transportation and other public venues o Indirect stigma - Being avoided or excluded in social situations - Being ignored by customer service staff 6 Part 2: Psychological Consequences of Weight Bias Research has consistently documented an association between weight bias and adverse psychological consequences. Specifically, individuals who are stigmatized because of their weight are at risk for, 21-30 Research Highlight In a 2009 nationally representative study of more than 22,000 adults, perceived weight bias was associated with,33 o Mood disorders such as, - Major depressive episode - Manic or hypomanic episodes o Anxiety disorders such as, - Social phobia - Panic disorder - Generalized anxiety disorder o Substance dependence for, - Nicotine - Alcohol Findings were significant regardless of perceived stress, social support, and BMI. These findings have been demonstrated in both clinical and non-clinical samples of individuals with overweight and obesity, and persist even after controlling for variables such as BMI, obesity onset, gender, and age.24,31,32 Thus, psychological outcomes are not associated with body weight per se, but rather are linked directly to experiences of weight stigma. · Depression · Anxiety · Poor body image · Substance abuse · Low self-esteem · Suicidal thoughts and behaviors 7 Part 2: Psychological Consequences of Weight Bias Internalization Internalization of weight bias is the extent to which a person engages in self-stigma, attributing negative weight-based stereotypes toward oneself and blaming oneself for being stigmatized. Greater weight bias internalization Increases risk for · Psychological consequences such as lower self-esteem and higher depression and anxiety · Binge eating · Avoidance of exercise such as lower willingness and motivation to exercise, and lower perceived competence in physical activity Research34-42 indicates that, Research Highlight In a 2012 study36 of 100 treatment-seeking participants with obesity and binge eating disorder, findings found that, - Individuals seeking weight-loss treatment endorsed higher levels of self-stigma, compared to those not seeking treatment - Regardless of other risk factors such as depression, self-esteem, and personal anti-fat attitudes, internalization of weight bias uniquely influenced eating disorder pathology 8 Educational and economic disparities exist between individuals with and without obesity. In education, studies have documented that compared to students of lower body weight, students with obesity face,43-49 · Lower expectations from teachers · Lower likelihood of being admitted and completing college, despite equivalent application rates and academic credentials · Lower grades in middle school, community college, and university, despite similar standardized test scores, personalities, and well-being In the workplace, compared to normal weight employees, adults with obesity, 50-57 · Are rated more negatively and less likely to be hired, despite identical qualifications · Face inequalities in wages, promotion potential and benefits eligibility In one nationally representative study of 2,838 adults,51 those with overweight were 12 times more likely to report experiencing discrimination based on their weight, compared to those with normal weight. Furthermore, the likelihood of discrimination increased at higher weights, ranging from 37 to 100 times more likely. Did you know… Weight discrimination extends …even into higher education Despite recommendation letters of comparable quality, female applicants with a higher BMI received fewer post-interview offers of admission into graduate school.49 …even into hiring practices Human resource staff in charge of hiring underestimate the occupational prestige of individuals with obesity and are more likely to disqualify them from being hired.55 Part 2: Educational and Economic Impact of Weight Bias 9 Research28,58-65 shows that individuals with overweight and obesity experience, · Impaired social relationships such as few friends, lacking intimacy and romantic relationships · Feelings of rejection and withdrawal due to body weight · Loneliness The harmful social consequences of weight stigma endure across time. In 2014, nearly 6,500 adults over the age of 50 years were surveyed about their experiences of discrimination. Findings indicate that even in later adulthood, experiences of weight discrimination is related to feelings of loneliness. Studies have documented multiple perpetrators of weight bias: · Adults with overweight and obesity report that perpetrators of weight bias commonly include family members (72%), friends (60%), and spouses (47%).66 · Youth with overweight and obesity report that perpetrators of weight-based teasing and bullying most commonly include