Abstract
No research has compared expressions of weight bias across different subgroups of obese individuals. This study compared attitudes toward and beliefs about obesity in women with and without binge eating disorder (BED) and examined whether these attitudes are related to psychological factors. Fifty obese women with BED were compared with an age- and body mass index (BMI)-matched group of 50 obese women without BED on a battery of established measures of anti-fat attitudes and beliefs about weight controllability and psychological factors (self-esteem, depression, and eating disorder features). The ageand BMI-matched groups did not differ with respect to beliefs about obesity or attitudes toward obese persons, or in self-esteem or depression. Correlational analyses conducted separately within each group revealed that women with BED who reported more favorable attitudes towards obese persons had higher self-esteem and lower levels of depression, whereas there were no significant associations between these variables among women without BED. In addition, weight controllability beliefs and eating disorder features were unrelated to self-esteem and depression in both groups. These findings suggest that stigmatizing attitudes endorsed by obese persons are neither tempered nor worsened by psychological distress or eating pathology. Given that stigmatizing attitudes did not differ between obese women with and without BED, it may be that obesity itself, rather than psychological features or disordered eating, increases vulnerability to negative weight-based attitudes. Potential implications for stigma reduction efforts and clinical practice are discussed.
References
Puhl RM, Brownell KD. Bias, discrimination, and obesity. Obes Res 2001; 9: 788–905.
Puhl RM, Heuer CA. The stigma of obesity: a review and update. Obesity 2009; 17: 941–64.
Himes SM, Thompson JK. Fat stigmatization in television shows and movies: a content analysis. Obesity 2007; 15: 712–8.
Brownell KD, Puhl RM, Schwartz MB, et al. (Eds) Weight bias: nature, consequences, and remedies. New York, The Guilford Press, 2005.
Wang SS, Brownell KD, Wadden TA. The influence of the stigma of obesity on overweight individuals. Int J Obes 2004; 28: 1333–7.
Schwartz MB, Vartanian LR, Nosek BA, et al. The influence of one’s own body weight on implicit and explicit anti-fat bias. Obesity 2006; 14: 440–8.
Crocker J, Luhtanen R. Collective self-esteem and ingroup bias. J Pers Soc Pscyhol 1990; 58: 60–7.
Crocker J, Luhtanen R, Baline B, et al. Collective selfesteem and psychological well-being among White, Black, and Asian college students. Pers Soc Psychol Bull 1994; 20: 502–13.
Tajfel H, Turner JC. Social identity theory of intergroup behavior. In: Worchel S, Austin WG (Eds) Psychology of intergroup relations. Chicago, Newlson-Hall, 1986, pp 7–24.
Rudman LA, Feinberg J, Fairchild K. Minority members’ implicit attitudes: automatic ingroup bias as a function of group status. Soc Cogn 2002; 20: 294–320.
Puhl RM, Moss-Racusin CA, Schwartz MB. Internalization of weight bias: implications for binge eating and emotional well-being. Obesity 2007; 15: 19–23.
Allison KC, Grilo CM, Masheb RM, et al. Binge eating disorder and night eating syndrome: a comparative study of disordered eating. J Consult Clin Psychol 2005; 73: 1107–15.
Friedman MA, Brownell KD. Psychological correlates of obesity: moving to the next generation of research. Psychol Bull 1995; 117: 3–20.
Davis CA, Levitan RD, Reid C, et al. Dopamine for “wanting” and opioids for “liking”: a comparison of obese adults with and without binge eating. Obesity 2009; 17: 1220–5. Advance online publication, March 12, 2009; doi:10.1038/oby.2009.52.
Grilo CM, Pogue-Geile MF. The nature of environmental influences on weight and obesity: a behavior genetic analysis. Psychol Bull 1991; 110: 520–37.
Grucza RA, Przybeck TR, Cloninger CR. Prevalence and correlates of binge eating disorder in a community sample. Compr Psychiatry 2007; 48: 124–31.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC, American Psychiatric Association, 1994.
Bannon KL, Hunter-Reel D, Wilson GT, et al. The effects of causal beliefs and binge eating on the stigmatization of obesity. Int J Eat Disord 2009; 42: 118–24.
Annis NM, Cash TF, Hrabosky JI. Body image and psychosocial differences among stable average weight, currently overweight, and formerly overweight women: the role of stigmatizing experiences. Body Image 2004; 1: 155–67.
Ashmore JA, Friedman KE, Reichmann SK, et al. Weight-based stigmatization, psychological distress, and binge eating behavior among obese treatmentseeking adults. Eat Behav 2008; 9: 203–9.
Womble LG, Williamson DA, Martin CK, et al. Psychosocial variables associated with binge eating in obese males and females. Int J Eat Disord 2001; 30: 217–21.
Friedman KE, Ashmore JA, Applegate KL. Recent experiences of weight-based stigmatization in a weight loss surgery population: psychological and behavioral correlates. Obesity 2008; 16: S69–74.
Benas JS, Gibb BE. Weight-related teasing, dysfunctional cognitions, and symptoms of depression and eating disturbances. Cogn Ther Res 2008; 32: 143–60.
Grilo CM, Wilfley DE, Brownell KD, et al. Teasing, body image, and self-esteem in a clinical sample of obese women. Addict Behav 1994; 19: 443–50.
Jackson TD, Grilo CM, Masheb RM. Teasing history, onset of obesity, current eating disorder psychopathology, body dissatisfaction, and psychological functioning in binge eating disorder. Obes Res 2000; 8: 451–8.
Crow SJ, Agras WS, Halmi K, et al. Full syndromal versus subthreshold anorexia nervosa, bulimia nervosa, and binge eating disorder: a multicenter study. Int J Eat Disord 2002; 32: 309–18.
Striegel-Moore RH, Dohm FA, Solomon EE, et al. Subthreshold binge eating disorder. Int J Eat Disord 2000; 27: 270–8.
First MB, Spitzer RL, Gibbon M, et al. Structured clinical interview for DSM-IV — Patient edition (SCID-I/P), Bimetrics research department. New York, New York State Psychiatric Institute, 1996.
Fairburn CG, Cooper Z. The Eating Disorder Examination (12th Edition). In: Fairburn CG, Wilson GT (Eds) Binge eating: nature, assessment, and treatment. New York, Guilford Press, 1993, pp 317–60.
Puhl RM, Brownell KD. Confronting and coping with weight stigma: an investigation of overweight and obese adults. Obesity 2006; 14: 1802–15.
Yanovski SZ, Nelson JE, Dubbert BK, et al. Association of binge eating disorder and psychiatric comorbidity in obese subjects. Am J Psychiatry 1993; 150: 1472–9.
Allison DB, Basile VC, Yuker HE. The measurement of attitudes toward and beliefs about obese persons. Int J Eat Disord 1991; 10: 599–607.
Harvey EL, Hill AJ. Health professionals’ views of overweight people and smokers. Int J Obes 2001; 25: 1253–61.
Rosenberg M. Society and adolescent self-image. Princeton, NJ, Princeton University Press, 1965.
Beck AT, Steer R. Manual for Revised Beck Depression Inventory. New York, Psychological Corporation, 1987.
Beck AT, Steer R, Garbin MG. Psychometric properties of the Beck Depression Inventory: 25 years of evaluation. Clin Psych Rev 1988; 8: 77–100.
Grilo CM, Masheb RM, Wilson GT. Subtyping binge eating disorder. J Consult Clin Psychol 2001; 69: 1066–72.
Spitzer RL, Yanovski SZ, Marcus MD. The Questionnaire on Eating and Weight Patterns-Revised (QEWP-R), 1993. Available from the New York State Psychiatric Institute, 722 West 168th Street, New York, NY 10032.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders (4th ed., Text Revision). Washington, DC, APA, 2000.
Celio AA, Wilfley DE, Crow SJ, et al. A comparison of the Binge Eating Scale, Questionnaire for Eating and Weight Patterns-Revised, and Eating Disorder Examination Questionnaire with Instructions with the Eating Disorder Examination in the Assessment of Binge Eating Disorder and its symptoms. Int J Eat Disord 2004; 36: 434–44.
de Zwaan M, Mitchell JE, Specker SM, et al. Diagnosing binge eating disorder: level of agreement between self-report and expert-rating. Int J Eat Disord 1993; 14: 289–95.
Grilo CM, Masheb RM, Wilson GT. A comparison of different methods for assessing the features of eating disorders in patients with binge eating disorder. J Consult Clin Psychol 2001; 69: 317–22.
Grilo CM, Masheb RM, Wilson GT. Different methods for assessing the features of eating disorders in patients with binge eating disorder: a replication. Obes Res 2001; 9: 418–22.
Grilo CM, Masheb RM, Lozano-Blanco C, et al. Reliability of the eating disorder examination in patients with binge eating disorder. Int J Eat Disord 2004; 35: 80–5.
Crandall CS, Biernat M. The ideology of anti-fat attitudes. J Appl Soc Psychol 1990; 20: 227–43.
Durso LE, Latner JD. Understanding self-directed stigma: development of the Weight Bias Internalization Scale. Obesity 2008; 16 (Suppl 2): S80–6.
Friedman KE, Reichmann SK, Costanzo PR, et al. Weight stigmatization and ideological beliefs: relation to psychological functioning in obese adults. Obes Res 2005; 13: 907–16.
Gorber SC, Tremblay M, Moher D, et al. A comparison of direct versus self-report measures for assessing height, weight, and body mass index: a systematic review. Obes Rev 2007; 8: 307–26.
Jambekar SA, Masheb RM, Grilo CM. Gender differences in shame in patients with binge eating disorder. Obes Res 2003; 11: 571–7.
Robinson BE, Bacon JG, O’Reilly J. Fat phobia: measuring, understanding, and changing anti-fat attitudes. Int J Eat Disord 1993; 14: 467–80.
Teachman BA, Brownell KD. Implicit anti-fat bias among health professionals: is anyone immune? Int J Obes Relat Metab Disord 2001; 25: 1525–31.
Brown I, Stride C, Psarou A, et al. Management of obesity in primary care: nurses’ practices, beliefs, and attitudes. J Adv Nurs 2007; 59: 329–41.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Puhl, R.M., Masheb, R.M., White, M.A. et al. Attitudes toward obesity in obese persons: A matched comparison of obese women with and without binge eating. Eat Weight Disord 15, e173–e179 (2010). https://doi.org/10.3275/6797
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.3275/6797