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

IntroductionWeight 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.MethodsA 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.ResultsSupport 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.ConclusionsSupport 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

Positioning of Weight Bias: Moving towards Social Justice

Weight bias is a form of stigma with detrimental effects on the health and wellness of individuals with large bodies. Researchers from various disciplines have recognized weight bias as an important topic for public health and for professional practice. To date, researchers from various areas have approached weight bias from independent perspectives and from differing theoretical orientations. In this paper, we examined the similarities and differences between three perspectives (i.e., weight-centric, nonweight-centric (health-centric), and health at every size) used to understand weight bias and approach weight bias research with regard to (a) language about people with large bodies, (b) theoretical position, (c) identified consequences of weight bias, and (d) identified influences on weight-based social inequity. We suggest that, despite differences, each perspective acknowledges the negative influences that position weight as being within individual control and the negative consequences of weight bias. We call for recognition and discussion of weight bias as a social justice issue in order to change the discourse and professional practices extended towards individuals with large bodies. We advocate for an emphasis on social justice as a uniting framework for interdisciplinary research on weight bias

Canadian Health Care Providers’ Attitudes and Practices Towards Pharmacotherapy and Bariatric Surgery in Youth

Background. Behavioural therapy and lifestyle modifications are pillars of obesity management treatment. However, other treatment options like bariatric surgery (BarSx) and pharmacotherapy (Pharm) are gaining more and more interest. Little is known about healthcare providers’(HCPs) attitudes towards pediatric obesity treatments in Canada. The purpose of this study was to explore the prior knowledge, attitudes and practices (i.e., frequency of treatment recommendations, referrals to specialists) of Canadian HCPs towards pharmacotherapy (Pharm) and bariatric surgery (BarSx) in children and adolescents. We also examined familiarity with pediatric obesity guidelines, differences in attitudes with regards to the type of HCP, prior obesity training and levels of confidence treating obesity and definitions of pediatric obesity management success. Methods. Canadian physicians, nurse practitioners and medical residents completed 39 multiple choice and open-ended questions on LimeSurvey from October 2021 until September 2022. Participants were recruited through convenience and snowball sampling across Canada. Chi-square and Fisher’s exact tests compared attitudes between respondents who were familiar versus unfamiliar with pediatric obesity guidelines. Kruskal-Wallis tests and independent sample t-tests were used to analyze our exploratory objectives. Results. A total of 130 HCPs responded to the survey. Of the respondents, 78% identified as women, 49% were physicians, 39% resided in Ontario, 54% had received pediatric obesity training before working in the field, 48% were most familiar with the 2015 Canadian Task Force Guidelines whereas only 12% were familiar with the 2018 American Society for Metabolic BarSx guidelines. HCPs did not respond favorably towards Pharm and BarSx. Responses varied regarding agreement about the effectiveness, safety, usefulness and willingness to refer adolescents and children. For Pharm, 48% of respondents agreed that it is an effective intervention in adolescents compared to 23% that agreed in children. As for BarSx, only 16% of respondents agreed that it’s a useful treatment for obesity-related co-morbidities in children compared to 47% who agreed that it was useful in adolescents. In general, there was more disagreement in regard to responses for children compared to adolescents. Reasons chosen for HCPs’ reluctance to refer were lack of long-term data (Pharm: 58%, BarSx: 41%) and patients’ unrealistic outcome expectations (Pharm: 45%, BarSx: 49%). Referrals to medical specialists (74%), like dietitians (85%), and multidisciplinary programs (61%) were the most common referrals for patients. Conclusion. Pharmacotherapy and bariatric surgery are not highly endorsed by Canadian HCPs. Future studies should investigate other barriers to treatment recommendations, such as HCPs’ knowledge on obesity and potential bias towards the causes of obesity and severe obesity in youth

Fitspiration and thinspiration: a comparison across three social networking sites

Abstract Background Fitspiration, or images and text promoting health and fitness, and thinspiration, or images and text promoting thinness, have both received criticism for their negative effects on body image and dieting behaviors. In this study, we critically examined and compared the content of fitspiration and thinspiration on three social networking sites (SNS). Methods Fitspiration and thinspiration posts (N = 360) from three photo-sharing SNS (Instagram, Tumblr, and Twitter) were collected quasi-randomly on four days over two weeks. Image and associated text content were coded for variables related to weight and shape, muscularity, thin ideal, and eating. Chi-square and Fisher’s exact tests compared content of fitspiration and thinspiration posts overall and among the three SNS. Results Thinspiration images portrayed body parts more frequently than fitspiration (69.8% vs. 30.2%). Similarly, posts highlighting bony body features and references to mental illness appeared only in thinspiration. No differences were found between fitspiration and thinspiration posts with regard to sexual suggestiveness, appearance comparison, and messages encouraging restrictive eating. Fitspiration and thinspiration posts included similar images across the three SNS—focusing on appearance, sexually suggestive images, and restrictive eating—with three exceptions. Fitspiration posts exhibiting body positivity were found only on Tumblr. In thinspiration posts, references to mental illness were more frequent on Tumblr and Instagram than on Twitter, and bone emphasis was coded more frequently on Twitter than on Instagram. Conclusions Although fitspiration posts were less extreme than thinspiration posts on the whole, notable similarities in their content support that fitspiration endorses problematic attitudes towards fitness, body image, and restrictive eating in pursuit of a fit-and-thin body ideal

Canadian Senate Report on Obesity: Focusing on Individual Behaviours versus Social Determinants of Health May Promote Weight Stigma

Very little attention has been given to unintended consequences of government reporting on obesity. This paper argues that the 2016 Senate report, “Obesity in Canada: A Whole-Of-Society Approach,” exemplifies the systemic public health issue of weight stigma. The purpose of this viewpoint is to critique the approach taken in the Report, by illustrating that it (1) takes a weight-centric approach to health, (2) does not acknowledge important limitations of the definition and measurement of obesity, (3) reifies obesity as a categorical phenomenon that must be prevented, and (4) uses aggressive framing and disrespectful terminology. The Report perpetuates a focus on the individual, thereby failing to recognize the role that governments can play in reducing weight stigma and addressing social determinants of health. If steps are taken to avoid propagating weight stigma, future reports could more constructively address health promotion, equity, and social determinants of health in their policies.Peer Reviewe

Table_1_Predictors of support for anti-weight discrimination policies among Canadian adults.docx

IntroductionWeight 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.MethodsA 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.ResultsSupport 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.ConclusionsSupport 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.</p