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      Obese Children, Adults and Senior Citizens in the Eyes of the General Public: Results of a Representative Study on Stigma and Causation of Obesity


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          Obese individuals are blamed for their excess weight based on causal attribution to the individual. It is unclear whether obese individuals of different age groups and gender are faced with the same amount of stigmatization. This information is important in order to identify groups of individuals at risk for higher stigmatization and discrimination. A telephone interview was conducted in a representative sample of 3,003 participants. Experimental manipulation was realized by vignettes describing obese and normal-weight children, adults and senior citizens. Stigmatizing attitudes were measured by semantic differential. Causal attribution was assessed. Internal factors were rated with highest agreement rates as a cause for the vignette's obesity. Lack of activity behavior and eating too much are the most supported causes. Importance of causes differed for the different vignettes. For the child, external causes were considered more important. The overweight vignette was rated consistently more negatively. Higher educational attainment and personal obesity were associated with lower stigmatizing attitudes. The vignette of the obese child was rated more negatively compared to that of an adult or senior citizen. Obesity is seen as a controllable condition, but for children external factors are seen as well. Despite this finding, they are faced with higher stigmatizing attitudes in the general public, contradicting attribution theory assumptions. Internal and external attribution were found to be inter-correlated. Obese children are the population most at risk for being confronted with stigmatization, making them a target point in stigma-reduction campaigns.

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          Most cited references29

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          An attributional analysis of reactions to stigmas.

          In two experiments, we examined the perceived controllability and stability of the causes of 10 stigmas. Guided by attribution theory, we also ascertained the affective reactions of pity and anger, helping judgments, and the efficacy of five intervention techniques. In the first study we found that physically based stigmas were perceived as onset-uncontrollable, and elicited pity, no anger, and judgments to help. On the other hand, mental-behavioral stigmas were perceived as onset-controllable, and elicited little pity, much anger, and judgments to neglect. In addition, physically based stigmas were perceived as stable, or irreversible, whereas mental-behavioral stigmas were generally considered unstable, or reversible. The perceived efficacy of disparate interventions was guided in part by beliefs about stigma stability. In the second study we manipulated perceptions of causal controllability. Attributional shifts resulted in changes in affective responses and behavioral judgments. However, attributional alteration was not equally possible for all the stigmas.
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            An attribution model of public discrimination towards persons with mental illness.

            In this study, we build on previous work by developing and estimating a model of the relationships between causal attributions (e.g., controllability, responsibility), familiarity with mental illness, dangerousness, emotional responses (e.g., pity, anger, fear), and helping and rejecting responses. Using survey data containing responses to hypothetical vignettes, we examine these relationships in a sample of 518 community college students. Consistent with attribution theory, causal attributions affect beliefs about persons' responsibility for causing their condition, beliefs which in turn lead to affective reactions, resulting in rejecting responses such as avoidance, coercion, segregation, and withholding help. However, consistent with a danger appraisal hypothesis, the effects of perceptions of dangerousness on helping and rejecting responses are unmediated by responsibility beliefs. Much of the dangerousness effects operate by increasing fear, a particularly strong predictor of support for coercive treatment. The results from this study also suggest that familiarity with mental illness reduces discriminatory responses.
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              Changes in perceived weight discrimination among Americans, 1995-1996 through 2004-2006.

              Little is known about the prevalence and patterns of weight discrimination in the United States. This study examined the trends in perceived weight/height discrimination among a nationally representative sample of adults aged 35-74 years, comparing experiences of discrimination based on race, age, and gender. Data were from the two waves of the National Survey of Midlife Development in the United States (MIDUS), a survey of community-based English-speaking adults initially in 1995-1996 and a follow-up in 2004- 2006. Reported experiences of weight/height discrimination included a variety of settings in major lifetime events and interpersonal relationships. The prevalence of weight/height discrimination increased from 7% in 1995-1996 to 12% in 2004-2006, affecting all population groups but the elderly. This growth is unlikely to be explained by changes in obesity rates. Weight/height discrimination is highly prevalent in American society and increasing at disturbing rates. Its prevalence is relatively close to reported rates of race and age discrimination, but virtually no legal or social sanctions against weight discrimination exist.

                Author and article information

                Role: Editor
                PLoS One
                PLoS ONE
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                12 October 2012
                : 7
                : 10
                [1 ]Integrated Research and Treatment Center (IFB) Adiposity Diseases, University of Leipzig, Leipzig, Germany
                [2 ]Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
                [3 ]Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
                [4 ]Department of Medical Sociology and Health Economics, Hamburg-Eppendorf University Medical Center, Hamburg, Germany
                Chiba University Graduate School of Medicine, Japan
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: CS ML SRH EB HHK. Performed the experiments: CS ML SRH. Analyzed the data: CS EB HHK ML SRH. Contributed reagents/materials/analysis tools: EB ML SRH HHK CS. Wrote the paper: CS. Designed the research questions and outlined the design of the study: CS ML SRH. Advised the study team in regard to the assessment of prevention attitudes: EB HHK. Contributed to the interpretation: EB HHK ML. Read and approved the final version of the manuscript: CS ML EB HHK SRH.


                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                Page count
                Pages: 9
                This work was supported by the Federal Ministry of Education and Research (BMBF), Germany, FKZ: 01EO1001. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Research Article
                Clinical Research Design
                Survey Research
                Mental Health
                Eating Disorders
                Non-Clinical Medicine
                Health Care Policy
                Health Education and Awareness
                Psychological and Psychosocial Issues
                Eating Disorders
                Social and Behavioral Sciences
                Human Relations
                Psychological Stress
                Social Psychology
                Social Discrimination
                Social Prejudice
                Social Research



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