Responding to weight stigma: Helpful and unhelpful coping strategies
Lead Research Organisation:
University of Exeter
Department Name: Psychology
Abstract
The prevalence of high-weight status is increasing globally, with approximately 60% of people in the UK considered "overweight" or "obese" by BMI standards, and similar rates in many other countries. Despite this, higher-weight individuals experience prejudice and discrimination in practically every domain of daily living, including education, employment, healthcare, and interpersonal relationships. We know from other oppressed groups that stigma is associated with poorer health and life outcomes, and in the last ten years, these effects have been demonstrated also in the case of weight stigma. A better understanding of how these processes occur and identification of potential targets for intervention to reduce resulting harms is of critical importance to public policy.
Little is known about how the impact of weight stigma is transmitted, and even less on how the harms can be minimised. My PhD work focused predominantly on internalised weight stigma (IWS) - the phenomenon where higher-weight people devalue themselves because of their weight. IWS has been linked with a range of physical and psychological health problems, and unhelpful coping strategies such as disordered eating, avoidance of exercise, social isolation, and substance use. IWS is also an intermediary in many of the problems associated with experiencing stigma from others. However, we do not know why some people internalise societal stigma, others are largely unaffected, and some actively resist and challenge the stigma.
During my PhD, I developed the first questionnaire to measure weight stigma resistance and demonstrated that resistance was associated with improved psychological wellbeing. I also drew on research from the mental health stigma literature and identified a number of key characteristics of internalisers and resisters. One important factor was whether the individual had a strong group identity - that is, whether they feel a sense of kinship and belonging with other higher-weight people. People with high group identity were less likely to internalise and more likely to resist. Another important factor was whether or not they felt that body weight was under individual control and simply a matter of willpower. Those who believed they could become slimmer tended not to resist stigma and were more likely to internalise it. But perhaps most interestingly, believing that stigma of higher-weight people was not justified helped to define resisters even if they didn't have high group identity and whether or not they felt their weight status was controllable. This means that it may be possible to develop health promotion interventions that take a social justice-based approach: that stigma is wrong whatever the circumstances and people deserve to be treated equally and with respect whatever their weight. Such an intervention may improve psychological wellbeing in higher-weight individuals regardless of their current beliefs and feelings about their weight.
My goal is to pursue this avenue of research within academia. This fellowship would enhance my future applications for research funding and faculty positions in a number of ways. Two small studies would help me test the statistical properties of my stigma resistance measure, and would increase the likelihood that my resistance research will be published in a top journal where it would have a greater impact. Another study I would like to do would explore the relationship between both being stigmatised and observing other people being stigmatised on health, wellbeing, and use of unhealthy coping strategies in a large sample of medical students over the course of their training. I would also use the opportunity to build professional networks, disseminate my work more widely, enhance subject-specific knowledge, and acquire additional research, teaching, and other acadmic skills that would significantly strengthen my future career prospects and help me take the next steps toward an independent research career.
Little is known about how the impact of weight stigma is transmitted, and even less on how the harms can be minimised. My PhD work focused predominantly on internalised weight stigma (IWS) - the phenomenon where higher-weight people devalue themselves because of their weight. IWS has been linked with a range of physical and psychological health problems, and unhelpful coping strategies such as disordered eating, avoidance of exercise, social isolation, and substance use. IWS is also an intermediary in many of the problems associated with experiencing stigma from others. However, we do not know why some people internalise societal stigma, others are largely unaffected, and some actively resist and challenge the stigma.
During my PhD, I developed the first questionnaire to measure weight stigma resistance and demonstrated that resistance was associated with improved psychological wellbeing. I also drew on research from the mental health stigma literature and identified a number of key characteristics of internalisers and resisters. One important factor was whether the individual had a strong group identity - that is, whether they feel a sense of kinship and belonging with other higher-weight people. People with high group identity were less likely to internalise and more likely to resist. Another important factor was whether or not they felt that body weight was under individual control and simply a matter of willpower. Those who believed they could become slimmer tended not to resist stigma and were more likely to internalise it. But perhaps most interestingly, believing that stigma of higher-weight people was not justified helped to define resisters even if they didn't have high group identity and whether or not they felt their weight status was controllable. This means that it may be possible to develop health promotion interventions that take a social justice-based approach: that stigma is wrong whatever the circumstances and people deserve to be treated equally and with respect whatever their weight. Such an intervention may improve psychological wellbeing in higher-weight individuals regardless of their current beliefs and feelings about their weight.
My goal is to pursue this avenue of research within academia. This fellowship would enhance my future applications for research funding and faculty positions in a number of ways. Two small studies would help me test the statistical properties of my stigma resistance measure, and would increase the likelihood that my resistance research will be published in a top journal where it would have a greater impact. Another study I would like to do would explore the relationship between both being stigmatised and observing other people being stigmatised on health, wellbeing, and use of unhealthy coping strategies in a large sample of medical students over the course of their training. I would also use the opportunity to build professional networks, disseminate my work more widely, enhance subject-specific knowledge, and acquire additional research, teaching, and other acadmic skills that would significantly strengthen my future career prospects and help me take the next steps toward an independent research career.
People |
ORCID iD |
Angela Meadows (Principal Investigator / Fellow) |
Publications
Bombak A
(2019)
Fat acceptance 101: Midwestern American women's perspective on cultural body acceptance
in Health Sociology Review
Calogero R
(2018)
Recognizing the Fundamental Right to be Fat: A Weight-Inclusive Approach to Size Acceptance and Healing From Sizeism
in Women & Therapy
Meadows A
(2019)
Internalised Weight Stigma Moderates the Impact of a Stigmatising Prime on Eating in the Absence of Hunger in Higher- but Not Lower-Weight Individuals.
in Frontiers in psychology
Meadows A
(2020)
Internalized weight stigma and the progression of food addiction over time.
in Body image
Meadows A
(2019)
The Multifaceted Nature of Weight-Related Self-Stigma: Validation of the Two-Factor Weight Bias Internalization Scale (WBIS-2F).
in Frontiers in psychology
Meadows A
(2018)
Yes, We Can (No, You Can't): Weight Stigma, Exercise Self-Efficacy, and Active Fat Identity Development
in Fat Studies
Meadows A
(2019)
Weight stigma and physical health: an unconsidered 'obesity' cost : Letter to the Editor: Response to Singh et al. (2018). Is there more to the equation? Weight bias and the costs of obesity. Canadian Journal of Public Health. https://doi.org/10.17269/s41997-018-0146-2. Online first: 26 October 2018.
in Canadian journal of public health = Revue canadienne de sante publique
Meadows A
(2021)
Signaling hostility: The relationship between witnessing weight-based discrimination in medical school and medical student well-being
in Journal of Applied Social Psychology
Meadows A
(2020)
A bifactor analysis of the Weight Bias Internalization Scale: What are we really measuring?
in Body image
Potter L
(2021)
Experiences of weight stigma in everyday life: An ecological momentary assessment study.
in Journal of health psychology
Description | This ESRC fellowship was a little unusual as its purpose was to help with career development, rather than research per se. In fact, the amount of time that could be spent conducting new research was capped at 25%. My goals for this fellowship were: (1) to transition more fully into the field of social psychology; (2) to firmly establish the novel field of weight stigma resistance; and (3) to strengthen my position as a future independent researcher. All of these were successful. (1) I was able to take advantage of the excellent educational programme at the University of Exeter, becoming more familiar with the fields of social and personality psychology, sociology, anthropology, and philosophy as they relate to my interest in the positioning of higher-weight bodies in modern society. I also took part in departmental seminars for the Social, Environmental and Organisational Psychology Research Group, broadening my knowledge in the field. Several members of the group discussed research ideas with me, informally, and helped to develop my ongoing research programme. I have directly collaborated with three members of the research group on four separate studies. I presented my work at the annual conference of the Society for the Psychological Study of Social Issues (SPSSI) in San Diego in June 2019 and was able to network extensively with established and upcoming researchers in the field of social psychology. SPSSI also has a strong focus on application of research to real-world problems and the conference was extremely inspiring - I left with an even stronger desire to deliver research with the potential to impact policy. (2) In terms of research, I was able to conduct the additional planned studies to show that my new Weight Stigma Resistance Scale performed well in research studies. Combined with one study from my PhD, this three-study paper is currently under review with a top social psychology journal. Although my interests have shifted from primarily health focused to a more socially oriented approach to studying stigma and resistance, my publications to date have tended to be in generalist or health-related journals. As I hope to work in academia in the field of social psychology, one of the goals of this fellowship was to provide me with the opportunity to publish in social psychology journals to increase my employability in this field. As well as this paper currently under review, I have another that is currently in preparation and is also targeted at a social psychology journal. (3) The award has allowed me to strengthen my publication record by taking my PhD work to the publication stage. So far, this has resulted in three publications from my PhD. I have published an additional three paper, not directly related to my PhD, two with international collaborators. The papers have been published in psychology, public health, and sociology journals. I have another four papers currently under review by journals, and several more in preparation. I undertook the Teaching and Learning in Higher Education certificate and was awarded Associate Fellowship of the Higher Education Academy. I supervised the research projects of a Masters' student and two final-year undergraduate project students. Both of these led to the development of new areas of inquiry, both of which are currently ongoing. One relates to the exploration of how fat bodies are represented (or not) in terms of physical activity, and how this can influence uptake, enjoyment, and continued exercise behaviour. Following an initial study, future studies are now planned in collaboration with researchers at two universities in Canada. The other combined students' interest in organisational psychology with my interest in weight stigma resistance and we tested whether people high in resistance perceived companies who offered weight management programmes more negatively than those who offered other types of programmes (stress management). Unfortunately, as all of this work is ongoing, I can't report the findings at this stage. I really enjoyed supervising students and it is something I look forward to doing a lot more of in future. I also received training in a technique for capturing people's experiences in real time, rather than asking them questions about it afterwards. I visited a US lab specialising in using this technique, called ecological momentary assessment, to study stress in everyday life. This has led to a new collaboration (one paper currently under review, one in preparation) and hopefully I will be able to apply this technique to my own research in future. In terms of public engagement, I gave several talks to a variety of audiences (including exercise science students in Philadelphia, researchers at the European Centre for Environment & Human Health at the University of Exeter Medical School in Truro, and members of the public at a Science in the City event organised by the Centre for Appearance Research, University of the West of England, in Bristol. I was a guest on two international podcasts (based in USA and New Zealand), and was a discussant on the panel at the UK première of the movie Fattitude. I applied for and was successful in receiving a Canadian government Banting Postdoctoral Fellowship to pursue my research further at Western University in Canada. While the overarching objectives of the fellowship were met, some of the individual projects were not achieved. Most of these are ongoing and will hopefully be completed in the next year. |
Exploitation Route | The findings from the Weight Stigma Resistance Scale research will have implications for education, healthcare, counselling, and organisations. Other researchers are already incorporating the scale into their studies, including those exploring the development of interventions designed to reduce weight stigma. The findings from the representation in physical activity study will have implications in the field of exercise education, the fitness industry, and the media. This is a new line of research and it is still in its early stages, however, I have been approached by an established researcher in the field of active identities who is interested in collaborating with me. |
Sectors | Education,Healthcare,Leisure Activities, including Sports, Recreation and Tourism,Other |
Description | Banting Postdoctoral Fellowship Program (Canada) |
Amount | $140,000 (CAD) |
Funding ID | 201809BPF-411947-64696 |
Organisation | Canadian Institutes of Health Research |
Sector | Public |
Country | Canada |
Start | 10/2019 |
End | 09/2021 |
Title | Weight Stigma Resistance Scale - Reliability and validity |
Description | These data were collected for a short validation study of the WSRS. At Time 1, 123 high-weight, UK-based participants completed the WSRS, the Ten-Item Personality Inventory (TIPI), and the Brief Social Dominance Orientation, Short-Form (SDO7s). At Time 2, two weeks later, a subset of 62 of the original participants completed the WSRS a second time. The WSRS demonstrated good convergent and divergent validity and good test-retest reliability. |
Type Of Material | Database/Collection of data |
Year Produced | 2019 |
Provided To Others? | No |
Impact | Deposited with UK Data Service ReShare. Currently awaiting final publication and DOI. Data included in a conference presentation: Meadows A, Barreto M, Doyle D, Higgs S. Resisting weight stigma: Development and validation of a novel measure, Annual Conference of the Society for the Psychological Study of Social Issues, San Diego, USA, 2019 Data included in one multi-study manuscript, currently under review. |
Title | Workplace wellbeing study |
Description | This was an experimental study utilising a workplace wellness paradigm to explore the influence of high-weight individuals' scores on the WSRS as a predictor of response to a potentially stigmatising cue - introduction of a workplace-sponsored weight-management programme, compared with a control cue - introduction of a workplace-sponsored stress-management programme. Dependent variables were attitudes toward the programme, the workplace, affect (PANAS-X subscales guilt, hostility, self-assurance), and self-rated health. Baseline data, including the WSRS, were collected at Time 1. Three filler measures were used to disguise the true nature of the study. These included the Modern Sexism scale, and two measures created for the study relating to (i) environmental/food/social justice concerns and intentions and (ii) to charitable giving and attitudes toward charitable institutions. The experimental manipulation and subsequent measures were collected at Time 2, two weeks later. Data for 197 high-weight UK-based adults were collected for the two time points. |
Type Of Material | Database/Collection of data |
Year Produced | 2019 |
Provided To Others? | No |
Impact | Deposited with UK Data Service ReShare. Currently awaiting final publication and DOI. Data included in one conference presentation: Meadows A, Barreto M, Doyle D, Higgs S. Resisting weight stigma: Development and validation of a novel measure, Annual Conference of the Society for the Psychological Study of Social Issues, San Diego, USA, 2019 Data used in one manuscript, currently under review. |
Description | Exeter social identity group |
Organisation | University of Exeter |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Expertise in the field of weight stigma, study conception and design. |
Collaborator Contribution | Expertise in the field of social identity theory, broader prejudice literature, organisational psychology; experimental design and analysis. |
Impact | Several studies underpinning the development of the novel research area of weight stigma resistance. Currently one multi-study manuscript under review. Two further studies awaiting follow-up studies. |
Start Year | 2018 |
Description | Penn State EMA |
Organisation | Penn State University |
Country | United States |
Sector | Academic/University |
PI Contribution | Weight stigma expertise; working with higher-weight participants - improvements in protocols for study intake to reduce stigmatisation |
Collaborator Contribution | Training in EMA techniques; Provision of EMA data set including weight stigma variables. |
Impact | One manuscript under review. One in preparation. |
Start Year | 2019 |
Description | Stigma resistance in the classroom |
Organisation | Nova Southeastern University |
Country | United States |
Sector | Academic/University |
PI Contribution | Expertise in area of weight stigma and weight stigma resistance. Use of Weight Stigma Resistance Scale. Study design and analysis. |
Collaborator Contribution | Study conducted in classes taught by professors at these institutions. Provided data for analysis. |
Impact | Conference presentation: Meadows A, Cooper Stoll S, Brochu P. Developing weight stigma resistance: Fat studies and emerging fat activism identity in a weight-diverse sample, 7th Annual International Weight Stigma Conference, London, Ontario, Canada Manuscript in preparation. |
Start Year | 2019 |
Description | Stigma resistance in the classroom |
Organisation | University of Wisconsin–La Crosse |
Country | United States |
Sector | Academic/University |
PI Contribution | Expertise in area of weight stigma and weight stigma resistance. Use of Weight Stigma Resistance Scale. Study design and analysis. |
Collaborator Contribution | Study conducted in classes taught by professors at these institutions. Provided data for analysis. |
Impact | Conference presentation: Meadows A, Cooper Stoll S, Brochu P. Developing weight stigma resistance: Fat studies and emerging fat activism identity in a weight-diverse sample, 7th Annual International Weight Stigma Conference, London, Ontario, Canada Manuscript in preparation. |
Start Year | 2019 |
Description | Fattitude premiere |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Public/other audiences |
Results and Impact | Invited as one of five expert panelists to discuss issues arising out of UK premiere screening of the documentary "Fattitude". The screening was held in London but many in the audience travelled from further afield. 75 tickets were available and sold out. The panelists responded to questions about the documentary itself and questions from the audience, predominantly around what form future action to reduce weight-related stigma in society and at an indiviudal level should take. This was particularly relevant to my area of research on weight stigma resistance, which I had the opportunity to communicate to the first time to a non-academic audience (i.e. the target population). The panelist discussion was recorded and streamed (not the movie) and had been viewed over 750 times as of the end of May 2019. I received a few emails afterwards from people who had found my work interesting and wanting to know where they could read more or how they could be involved in studies. Several also followed me on social media. |
Year(s) Of Engagement Activity | 2019 |
URL | https://www.pscp.tv/w/1BdxYOMyLBgGX |
Description | Friend of Marilyn podcast |
Form Of Engagement Activity | A broadcast e.g. TV/radio/film/podcast (other than news/press) |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Media (as a channel to the public) |
Results and Impact | Interview on the Friend of Marilyn podcast about my research. Focus on self-stigma, stigma resistance, the findings, and how people can apply this in their own lives, as well as the Weight Stigma Conference and the difficulties of moving from academic research into actually changing policy or society at large. |
Year(s) Of Engagement Activity | 2019 |
URL | https://podcasts.apple.com/us/podcast/friend-of-marilyn-episode-286-05-09-2019/id462034226?i=1000448... |
Description | Guest lecture at College of Nursing & Health Professionals, Drexel University, PA, USA |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Undergraduate students |
Results and Impact | During a planned conference and research visit to the US, a colleague arranged for me to present a lecture to upper-level UG students in the College of Nursing and Health Professionals at Drexel University in Philadelphia. The class was an elective module entitled Exercise for Special Populations (HSCI T480). During the two-hour class, I presented an overview on literature relating to weight, health, and physical activity not normally covered in mainstream health professional education; discussed how weight stigma directly and indirectly impacts on the experience and engagement of higher-weight individuals with physical activity, including my own work on weight stigma and exercise and terminology use with higher-weight clients. In addition to my presentation, the session involved several sessions of small group and pair work activities. We finished with a section on how best to provide non-stigmatising effective interactions with higher-weight clients. |
Year(s) Of Engagement Activity | 2019 |
Description | Research presentation at SPSSI conference |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Other audiences |
Results and Impact | xxxx |
Year(s) Of Engagement Activity | 2019 |
Description | Seminar for students, staff, and members of the public |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Professional Practitioners |
Results and Impact | This was a seminar on the subject of weight stigma, weight and health presented under the aegis of the Wellcome Trust Centres for Cultures and Environments of Health at the University of Exeter. The seminar was open to university staff (a range of transdisciplinary departments were targeted), students, and members of the public and efforts were made to promote the event throughout regular and social media channels throughout the university, surrounding healthcare institutions, and local media. I invited a co-presenter with experience working in the NHS and in social enterprises. The free event was attended by around 50 people (selling out the intial ticketing release) and sparked some interesting questions and group discussions. A large number of people spoke to me after the event or contacted me later to tell me how it had influenced their thinking and attitudes. I have also since been contacted by two healthcare professionals who would like me to speak at their institutions, and three upper-level undergraduate or graduate students have requested my assistance in guiding future research in the area. |
Year(s) Of Engagement Activity | 2018 |
URL | http://connect.exeter.ac.uk/py0oatw89ej2/?OWASP_CSRFTOKEN=f9010631397ee9ba5798a76a93dc157a23d832c9a0... |
Description | Seminar, ECEEH |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Other audiences |
Results and Impact | Approximately 15 researchers at the European Centre for Environment and Human Health at University of Exeter Medical School, Truro campus attended a 1-hour seminar entitled 'Just too sensitive? Everyday indignities: Microaggressions in daily life.' I was invited to give this talk by an attendee at a presentation skills training event I also attended, who was so interested in my 5-minute practice talk, that he arranged for me to visit his institution to talk about it. There was some good interaction with the audience, and several people indicated that they would behave differently in situations where minor incidents occurred, speaking up more often. Two people also wrote to me for further information about my research and wanting to keep in touch in the future. One was particularly interested in how these issues could influence her own professional practice. |
Year(s) Of Engagement Activity | 2019 |
Description | Social Science in the City: Body Positivity Café: Through the Lens of Intersectionality |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Public/other audiences |
Results and Impact | Between 60 and 70 people attended this event in Bristol, with some attending from surrounding areas in the South West. I was one of five panelists speaking about the intersectional nature of body image issues. I spoke about weight stigma, and others spoke about LGBTQ+, race, transgender, and disability issues. Interestingly, all five speakers challenged the use of the term "body positive" as situating the problem in our own bodies, rather than in a society that objectifies us and marginalises certain groups of people. This is the second in a series of seminars and the organisers (from the Centre for Appearance Research at UWE) are now planning to change the name of the event in future. A number of audience members and some of the other panelists approached me afterwards to thank me for providing this perspective and/or for giving voice to their own battles. Some asked for further resources or if they could take part in my research (sadly no, as no longer a naive sample!), and several followed me on social media after the event. |
Year(s) Of Engagement Activity | 2019 |
URL | https://info.uwe.ac.uk/events/event.aspx?id=24264 |
Description | WSC 2019 - Classroom studies research |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Presentation of research studies carried out with two international collaborators at institutions in the US. 15' talk titled 'Developing weight stigma resistance: Fat studies and emerging fat activism identity in a weight-diverse sample'. Research looked at how fat studies/weight-neutral curricula influenced development of activism orientation and identity in (1) undergraduate social science students, (2) graduate clinical psychology students. Approximately 60 people attended. Onecontacted me afterwards about potential collaboration on future studies, something that is still under discussion. |
Year(s) Of Engagement Activity | 2019 |
URL | https://stigmaconference.com/london-2019/ |