The Penalization of Obesity: Investigating the Relationship Between Patients’ Sizes and Clinical Weight Discrimination Among College Students. Público

Abstract

The onset of the obesity epidemic in the past couple decades has sparked national

interest in the overweight and obese population, particularly how and why more individuals

have been increasing in body size. Contemporary literature on those who are living in larger

physiques have primarily concentrated on the impact of excess fat on people’s physiological

and psychological wellbeing because of the adverse health conditions that can be induced

from obesity. However, there is a gap in research examining another negative outcome of

those who are overweight or obese: weight discrimination from others. An introductory

assessment of the current studies investigating the phenomenon revealed that people in

bigger bodies face weight-related prejudices in a myriad of settings, such as in healthcare.

The present study aims to explore the association between patients’ sizes and degrees of

weight discrimination executed by medical providers with the hypothesis that overweight and

obese individuals will experience more weight discrimination compared to their average or

underweight counterparts. An online survey capturing the responses of 105 Emory University

students was administered and subsequently used to perform bivariate analyses of the

dependent variables including general weight discrimination, clinical weight discrimination,

fear of medical providers, and penalization of obesity. The study employed a different

approach to classifying weight categories by asking participants to self-report their perceived

size (self-weight) and the size that they believe their medical providers would sort them into

(medical weight). Two-way cross tabulations of the results portrayed that obese participants

were consistently the most likely to encounter weight-stigmatizing occurrences followed by

the overweight participants for all the dependent variables. Additionally, gender-stratified

analyses were performed on the aforementioned measures to find that there was a statistically

significant relationship between clinical weight discrimination and the body weights of

women, especially obese women. Findings from the survey suggest that overweight and

obese patients disproportionately face weight discrimination from medical providers, and that

weight discrimination may be more prevalent in the presence of sexism.

Table of Contents

1. Introduction ................................................................................................................. 1

2. Literature Review ......................................................................................................... 4

2.1 Weight Discrimination in the Public Sphere ......................................................................5

2.2 Weight Discrimination in Healthcare ................................................................................7

2.3 Issues with Measuring BMI ............................................................................................. 11

2.4 Sociological Theories for Understanding Weight Discrimination .................................... 14

2.4.1 Social Stigma Theory ....................................................................................................................... 14

2.4.2 Attribution Theory ........................................................................................................................... 15

2.5 Fatphobia Among college students .................................................................................. 18

2.6 Hypothesis and Research Aims ....................................................................................... 20

3. Data and Methods ...................................................................................................... 21

3.1 Survey Data ..................................................................................................................... 21

3.1.1 Setting ................................................................................................................................................ 21

3.1.2 Sample ............................................................................................................................................... 22

3.1.3 Data collection................................................................................................................................... 23

3.1.4 Recruitment ...................................................................................................................................... 25

3.2 Measures ......................................................................................................................... 26

3.2.1 Independent Variables ..................................................................................................................... 26

3.2.2 Sociodemographic Variables ........................................................................................................... 27

3.2.3 Dependent Variables ........................................................................................................................ 28

3.2.4. Data Analysis ................................................................................................................................... 30

4. Results ....................................................................................................................... 30

4.1 Univariate Statistics ........................................................................................................ 30

4.2 Bivariate Analyses Results .............................................................................................. 32

4.2.1 General Weight Discrimination ...................................................................................................... 32

4.2.2 Clinical Weight Discrimination ....................................................................................................... 33

4.2.3 Fear of Medical Providers ............................................................................................................... 34

4.2.4 Penalization of Obesity .................................................................................................................... 36

4.3 Gender-Stratified Analyses ............................................................................................. 37

4.3.1 Clinical Weight Discrimination ....................................................................................................... 37

4.3.2 Fear of Medical Providers ............................................................................................................... 39

4.3.3 Penalization of Obesity .................................................................................................................... 41

4.4 Qualitative Entries .......................................................................................................... 43

5. Discussion.................................................................................................................. 44

5.1 Review of the Gender-Stratified Analyses ....................................................................... 49

5.2 Limitations ...................................................................................................................... 50

5.3 Conclusion....................................................................................................................... 51

6. Tables ........................................................................................................................ 52

7. Appendices................................................................................................................. 65

Appendix #1 .......................................................................................................................... 65

Appendix #2 .......................................................................................................................... 78

Appendix #3 .......................................................................................................................... 79

Appendix #4 .......................................................................................................................... 81

8. References ................................................................................................................. 84

About this Honors Thesis

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School	Emory College
Department	Sociology
Degree	B.A.
Submission	Honors Thesis
Language	English
Research Field	Sociology, General Health Sciences, Public Health Health Sciences, Health Care Management
Palavra-chave	Weight Discrimination Obesity Sociology Public Health Stigmatization
Committee Chair / Thesis Advisor	Ju Hyun Park, Emory University
Committee Members	Irene Brown, Emory University Andrea Fitzroy, Emory University

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