The Relationship between Weight Stigma, Physical Appearance Concerns, and Enjoyment and Tendency to Avoid Physical Activity and Sport
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Weight Stigma
2.3. Weight Bias Internalisation
2.4. Appearance Evaluation
2.5. Fear of Negative Appearance Evaluation
2.6. Enjoyment of Physical Activity and Sport
2.7. Tendency to Avoid Physical Activity and Sport
2.8. Analysis
3. Results
3.1. Bivariate Analyses
3.2. Regression Models
3.3. Mediation Analysis
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Warburton, D.E.; Nicol, C.W.; Bredin, S.S. Health benefits of physical activity: The evidence. Cmaj 2006, 174, 801–809. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Haskell, W.L.; Lee, I.M.; Pate, R.R.; Powell, K.E.; Blair, S.N.; Franklin, B.A.; Macera, C.A.; Heath, G.W.; Thompson, P.D.; Bauman, A. Physical activity and public health: Updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation 2007, 116, 1081. [Google Scholar] [CrossRef] [Green Version]
- Durstine, J.L.; Gordon, B.; Wang, Z.; Luo, X. Chronic disease and the link to physical activity. J. Sport Health Sci. 2013, 2, 3–11. [Google Scholar] [CrossRef] [Green Version]
- Guthold, R.; Stevens, G.A.; Riley, L.M.; Bull, F.C. Worldwide trends in insufficient physical activity from 2001 to 2016: A pooled analysis of 358 population-based surveys with 19 million participants. Lancet Glob. Health 2018, 6, e1077–e1086. [Google Scholar] [CrossRef] [Green Version]
- Guthold, R.; Stevens, G.A.; Riley, L.M.; Bull, F.C. Global trends in insufficient physical activity among adolescents: A pooled analysis of 298 population-based surveys with 16 million participants. Lancet Child Adolesc. Health 2020, 4, 23–35. [Google Scholar] [CrossRef]
- Hallal, P.C.; Andersen, L.B.; Bull, F.C.; Guthold, R.; Haskell, W.; Ekelund, U. Lancet Physical Activity Series Working Group. Global physical activity levels: Surveillance progress, pitfalls, and prospects. Lancet 2012, 380, 247–257. [Google Scholar] [CrossRef]
- Weed, M. Should we privilege sport for health? The comparative effectiveness of UK government investment in sport as a public health intervention. Int. J. Sport Policy Politics 2016, 8, 559–576. [Google Scholar] [CrossRef] [Green Version]
- Somerset, S.; Hoare, D.J. Barriers to voluntary participation in sport for children: A systematic review. BMC Pediatrics 2018, 18, 47. [Google Scholar] [CrossRef]
- Humpel, N.; Owen, N.; Leslie, E. Environmental factors associated with adults’ participation in physical activity: A review. Am. J. Prev. Med. 2002, 22, 188–199. [Google Scholar] [CrossRef]
- Vartanian, L.R.; Pinkus, R.T.; Smyth, J.M. Experiences of weight stigma in everyday life: Implications for health motivation. Stigma Health 2018, 3, 85. [Google Scholar] [CrossRef]
- More, K.R.; Phillips, L.A.; Colman, M.H. Evaluating the potential roles of body dissatisfaction in exercise avoidance. Body Image 2019, 28, 110–114. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Pearl, R.L.; Puhl, R.M.; Dovidio, J.F. Differential effects of weight bias experiences and internalization on exercise among women with overweight and obesity. J. Health Psychol. 2015, 20, 1626–1632. [Google Scholar] [CrossRef]
- Schvey, N.A.; Sbrocco, T.; Bakalar, J.L.; Ress, R.; Barmine, M.; Gorlick, J.; Pine, A.; Stephens, M.; Tanofsky-Kraff, M. The experience of weight stigma among gym members with overweight and obesity. Stigma Health 2017, 2, 292. [Google Scholar] [CrossRef]
- Rodgers, R.; Chabrol, H.; Paxton, S.J. An exploration of the tripartite influence model of body dissatisfaction and disordered eating among Australian and French college women. Body Image 2011, 8, 208–215. [Google Scholar] [CrossRef]
- Cheng, O.Y.; Yam, C.L.; Cheung, N.S.; Lee, P.L.; Ngai, M.C.; Lin, C.Y. Extended theory of planned behavior on eating and physical activity. Am. J. Health Behav. 2019, 43, 569–581. [Google Scholar] [CrossRef] [PubMed]
- Vartanian, L.R.; Shaprow, J.G. Effects of weight stigma on exercise motivation and behavior: A preliminary investigation among college-aged females. J. Health Psychol. 2008, 13, 131–138. [Google Scholar] [CrossRef] [PubMed]
- Fung, X.C.; Pakpour, A.H.; Wu, Y.K.; Fan, C.W.; Lin, C.Y.; Tsang, H.W. Psychosocial variables related to weight-related self-stigma in physical activity among young adults across weight status. Int. J. Environ. Res. Public Health 2020, 17, 64. [Google Scholar] [CrossRef] [Green Version]
- Jackson, S.E.; Steptoe, A. Association between perceived weight discrimination and physical activity: A population-based study among English middle-aged and older adults. BMJ Open 2017, 7, e014592. [Google Scholar] [CrossRef] [PubMed]
- Phibbs, S.; Thorburn, S.; Branscum, A.J. Is weight discrimination associated with physical activity among middle aged and older adults? J. Prim. Prev. 2019, 40, 279–295. [Google Scholar] [CrossRef] [PubMed]
- Alimoradi, Z.; Golboni, F.; Griffiths, M.D.; Broström, A.; Lin, C.Y.; Pakpour, A.H. Weight-related stigma and psychological distress: A systematic review and meta-analysis. Clin. Nutr. 2020, 39, 2001–2013. [Google Scholar] [CrossRef]
- O’Brien, K.S.; Daníelsdóttir, S.; Ólafsson, R.P.; Hansdóttir, I.; Fridjónsdóttir, T.G.; Jónsdóttir, H. The relationship between physical appearance concerns, disgust, and anti-fat prejudice. Body Image 2013, 10, 619–623. [Google Scholar] [CrossRef]
- O’Brien, K.S.; Latner, J.D.; Puhl, R.M.; Vartanian, L.R.; Giles, C.; Griva, K.; Carter, A. The relationship between weight stigma and eating behavior is explained by weight bias internalization and psychological distress. Appetite 2016, 102, 70–76. [Google Scholar] [CrossRef]
- Puhl, R.M.; Brownell, K.D. Confronting and coping with weight stigma: An investigation of overweight and obese adults. Obesity 2006, 14, 1802–1815. [Google Scholar] [CrossRef] [PubMed]
- Puhl, R.M.; Heuer, C.A. The stigma of obesity: A review and update. Obesity 2009, 17, 941. [Google Scholar] [CrossRef] [PubMed]
- Hunger, J.M.; Tomiyama, A.J. Weight labeling and obesity: A longitudinal study of girls aged 10 to 19 years. JAMA Pediatrics 2014, 168, 579–580. [Google Scholar] [CrossRef] [Green Version]
- Pearl, R.L.; Puhl, R.M.; Himmelstein, M.S.; Pinto, A.M.; Foster, G.D. Weight stigma and weight-related health: Associations of self-report measures among adults in weight management. Ann. Behav. Med. 2020, 54, 904–914. [Google Scholar] [CrossRef]
- Pila, E.; Barlow, M.A.; Wrosch, C.; Sabiston, C.M. Comparing the body to superior others: Associations with daily exercise and body evaluation in men and women. Psychol. Sport Exerc. 2016, 27, 120–127. [Google Scholar] [CrossRef]
- Vartanian, L.R.; Pinkus, R.T.; Smyth, J.M. The phenomenology of weight stigma in everyday life. J. Contextual Behav. Sci. 2014, 3, 196–202. [Google Scholar] [CrossRef]
- Scanlan, T.K.; Carpenter, P.J.; Simons, J.P.; Schmidt, G.W.; Keeler, B. An introduction to the sport commitment model. J. Sport Exerc. Psychol. 1993, 15, 1–5. [Google Scholar] [CrossRef]
- World Health Organization. Obesity: Preventing and Managing the Global Epidemic; (WHO Technical Report Series 894); World Health Organization: Geneva, Switzerland, 2000. [Google Scholar]
- Simone, M.; Hooper, L.; Eisenberg, M.E.; Neumark-Sztainer, D. Unhealthy weight control behaviors and substance use among adolescent girls: The harms of weight stigma. Soc. Sci. Med. 2019, 233, 64–70. [Google Scholar] [CrossRef]
- Thompson, J.K.; Cattarin, J.; Fowler, B.; Fisher, E. The perception of teasing scale (POTS): A revision and extension of the physical appearance related teasing scale (PARTS). J. Personal. Assess. 1995, 65, 146–157. [Google Scholar] [CrossRef]
- Durso, L.E.; Latner, J.D. Understanding self-directed stigma: Development of the weight bias internalization scale. Obesity 2008, 16, S80–S86. [Google Scholar] [CrossRef]
- Pearl, R.L.; Puhl, R.M. Measuring internalized weight attitudes across body weight categories: Validation of the modified weight bias internalization scale. Body Image 2014, 11, 89–92. [Google Scholar] [CrossRef]
- Cash, T.F. The multidimensional body-self relations questionnaire. Old Dominion University: Norfolk, VA, USA, 1990; Unpublished test manual. [Google Scholar]
- Lundgren, J.D.; Anderson, D.A.; Thompson, J.K. Fear of negative appearance evaluation: Development and evaluation of a new construct for risk factor work in the field of eating disorders. Eating Behav. 2004, 5, 75–84. [Google Scholar] [CrossRef]
- Kendzierski, D.; DeCarlo, K.J. Physical activity enjoyment scale: Two validation studies. J. Sport Exerc. Psychol. 1991, 13, 50–64. [Google Scholar] [CrossRef]
- Motl, R.W.; Dishman, R.K.; Saunders, R.; Dowda, M.; Felton, G.; Pate, R.R. Measuring enjoyment of physical activity in adolescent girls. Am. J. Prev. Med. 2001, 21, 110–117. [Google Scholar] [CrossRef]
- Bevan, N.; O’Brien, K.S. Tendency to avoid physical activity and sport scale: Development of a scale to measure weight stigma and appearance-related concerns. Under Review.
- Hayes, A.F.; Preacher, K.J. Statistical mediation analysis with a multicategorical independent variable. Br. J. Math. Stat. Psychol. 2014, 67, 451–470. [Google Scholar] [CrossRef]
- Vartanian, L.R.; Novak, S.A. Internalized societal attitudes moderate the impact of weight stigma on avoidance of exercise. Obesity 2011, 19, 757–762. [Google Scholar] [CrossRef]
- Pearl, R.L.; Puhl, R.M. The distinct effects of internalizing weight bias: An experimental study. Body Image 2016, 17, 38–42. [Google Scholar] [CrossRef]
- Griffiths, C.; Williamson, H.; Zucchelli, F.; Paraskeva, N.; Moss, T. A systematic review of the effectiveness of Acceptance and Commitment Therapy (ACT) for body image dissatisfaction and weight self-stigma in adults. J. Contemp. Psychother. 2018, 48, 189–204. [Google Scholar] [CrossRef] [Green Version]
- Pearl, R.L. Weight bias and stigma: Public health implications and structural solutions. Soc. Issues Policy Rev. 2018, 12, 146–182. [Google Scholar] [CrossRef]
- Puhl, R.M.; Latner, J.D.; O’Brien, K.; Luedicke, J.; Daníelsdóttir, S.; Forhan, M. A multinational examination of weight bias: Predictors of anti-fat attitudes across four countries. Int. J. Obes. 2015, 39, 1166–1173. [Google Scholar] [CrossRef] [PubMed]
- Puhl, R.M.; Brownell, K.D. Psychosocial origins of obesity stigma: Toward changing a powerful and pervasive bias. Obes. Rev. 2003, 4, 213–227. [Google Scholar] [CrossRef]
- O’Brien, K.S.; Puhl, R.M.; Latner, J.D.; Lynott, D.; Reid, J.D.; Vakhitova, Z.; Hunter, J.A.; Scarf, D.; Jeanes, R.; Bouguettaya, A.; et al. The effect of a food addiction explanation model for weight control and obesity on weight stigma. Nutrients 2020, 12, 294. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Ruffman, T.; O’Brien, K.S.; Taumoepeau, M.; Latner, J.D.; Hunter, J.A. Toddlers’ bias to look at average versus obese figures relates to maternal anti-fat prejudice. J. Exp. Child Psychol. 2016, 142, 195–202. [Google Scholar] [CrossRef]
- Neumark-Sztainer, D.; Paxton, S.J.; Hannan, P.J.; Haines, J.; Story, M. Does body satisfaction matter? Five-year longitudinal associations between body satisfaction and health behaviors in adolescent females and males. J. Adolesc. Health 2006, 39, 244–251. [Google Scholar] [CrossRef]
- Neumark-Sztainer, D.; Wall, M.; Eisenberg, M.E.; Story, M.; Hannan, P.J. Overweight status and weight control behaviors in adolescents: Longitudinal and secular trends from 1999 to 2004. Prev. Med. 2006, 43, 52–59. [Google Scholar] [CrossRef]
- Knight, T.; Illingworth, K.; Ricciardelli, L. Health implications of body size perception and weight tolerance in older adults. J. Health Psychol. 2009, 14, 425–434. [Google Scholar] [CrossRef] [PubMed]
- Tiggemann, M. Body image across the adult life span: Stability and change. Body Image 2004, 1, 29–41. [Google Scholar] [CrossRef] [Green Version]
Variables | Men (N = 151) | Women (N = 427) | Total | Minimum–Maximum | t Value | p Value | Effect SIZE † d’ |
---|---|---|---|---|---|---|---|
Age | 20.21 (1.92) | 19.70 (2.20) | 19.83 (2.14) | 17–35 | 2.54 | 0.011 | 0.26 |
BMI | 23.22 (3.20) | 22.22 (3.49) | 22.48 (3.45) | 14.88–38.74 | 3.10 | 0.002 | 0.30 |
Weight stigma | 6.00 (4.29) | 6.49 (4.83) | 6.36 (4.70) | 2.50–23 | −1.09 | 0.276 | 0.11 |
WBIS | 2.60 (1.17) | 3.30 (1.39) | 3.12 (1.37) | 1–7 | −5.39 | 0.000 | 0.52 |
Appearance Evaluation | 3.49 (0.76) | 3.17 (0.76) | 3.25 (0.77) | 1–5 | 4.36 | 0.000 | 0.24 |
FNAE | 16.23 (5.70) | 18.98 (6.37) | 18.26 (6.32) | 6–30 | −4.70 | 0.000 | 0.45 |
Enjoyment | 4.12 (0.66) | 3.72 (0.77) | 3.82 (0.76) | 1.31–5 | 5.34 | 0.000 | 0.55 |
TAPAS | 16.16 (8.66) | 20.86 (10.40) | 19.63 (10.18) | 10–50 | −4.92 | 0.000 | 0.50 |
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | |
---|---|---|---|---|---|---|---|---|
1. Age | - | 0.07 | −0.03 | 0.01 | 0.09 | −0.08 | 0.19 * | −0.14 |
2. BMI | 0.01 | - | 0.17 * | 0.23 ** | −0.21 ** | −0.04 | 0.12 | 0.14 |
3. Weight stigma | 0.03 | 0.24 *** | - | 0.60 *** | −0.45 *** | 0.39 *** | −0.28 ** | 0.46 *** |
4. WBIS | 0.02 | 0.35 *** | 0.51 *** | - | −0.75 *** | 0.54 *** | −0.33 *** | 0.58 *** |
5. Appearance evaluation | 0.07 | −0.32 *** | −0.41 *** | −0.71 *** | - | −0.43 *** | 0.36 *** | −0.51 *** |
6. FNAE | −0.06 | 0.10 * | 0.31 *** | 0.62 *** | −0.55 *** | - | −0.18 * | 0.35 *** |
7. Enjoyment | 0.03 | −0.07 | −0.11 * | −0.27 *** | 0.27 *** | −0.19 *** | - | −0.50 *** |
8. TAPAS | −0.04 | 0.26 *** | 0.50 *** | 0.60 *** | −0.47 *** | 0.50 *** | −0.33 *** | - |
Enjoyment of Physical Activity and Sport | ||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Model 1 | Model 2 | Model 3 | Model 4 | |||||||||||||||||
B | SE | β | CI | B | SE | β | CI | B | SE | β | CI | B | SE | β | CI | |||||
Age | 0.02 | 0.02 | 0.06 | −0.01 | 0.05 | 0.02 | 0.02 | 0.06 | −0.01 | 0.05 | 0.02 | 0.01 | 0.05 | −0.01 | 0.04 | 0.02 | 0.01 | 0.05 | −0.01 | 0.05 |
Sex | −0.37 | 0.07 | −0.22 *** | −0.52 | −0.23 | −0.34 | 0.07 | −0.20 *** | −0.49 | −0.20 | −0.20 | 0.07 | -0.12 * | −0.34 | −0.05 | −0.20 | 0.07 | −0.12 * | −0.34 | −0.05 |
BMI | −0.01 | 0.01 | −0.03 | −0.03 | 0.01 | 0.00 | 0.01 | 0.01 | −0.02 | 0.02 | 0.02 | 0.01 | 0.09 * | 0.00 | 0.04 | 0.02 | 0.01 | 0.09 * | 0.00 | 0.04 |
WS | - | −0.03 | 0.01 | −0.16 *** | −0.04 | −0.01 | 5.13 | 0.01 | 0.00 | −0.02 | 0.02 | −2.58 | 0.01 | 0.00 | −0.02 | 0.02 | ||||
AE | - | - | 0.19 | 0.06 | 0.19 ** | 0.07 | 0.30 | 0.19 | 0.06 | 0.20 ** | 0.08 | 0.31 | ||||||||
WBIS | - | - | −0.10 | 0.04 | −0.19 * | −0.17 | −0.04 | −0.11 | 0.04 | −0.20 * | −0.19 | −0.35 | ||||||||
FNAE | - | - | - | 0.00 | 0.01 | 0.02 | −0.01 | 0.02 | ||||||||||||
R2 | 0.05 *** | 0.08 *** | 0.16 *** | 0.16 *** | ||||||||||||||||
Tendency to Avoid Physical Activity and Sport | ||||||||||||||||||||
Age | −0.35 | 0.19 | −0.07 | −0.73 | 0.03 | −0.39 | 0.17 | −0.08 * | −0.72 | −0.05 | −0.37 | 0.16 | −0.08 * | −0.68 | −0.07 | −0.33 | 0.15 | −0.07 * | −0.63 | −0.03 |
Sex | 5.53 | 0.96 | 0.24 *** | 3.6 | 7.41 | 4.6 | 0.85 | 0.20 *** | 2.98 | 6.31 | 1.98 | 0.80 | 0.09 * | 0.41 | 3.55 | 1.98 | 0.79 | 0.09 * | 0.43 | 3.53 |
BMI | 0.71 | 0.13 | 0.23 *** | 0.47 | 0.96 | 0.36 | 0.12 | 0.12 * | 0.13 | 0.58 | 0.05 | 0.12 | 0.02 | −0.17 | 0.26 | 0.13 | 0.12 | 0.04 | −0.08 | 0.34 |
WS | - | 1.0 | 0.80 | 0.46 *** | 0.84 | 1.15 | 0.53 | 0.08 | 0.25** | 0.37 | 0.70 | 0.53 | 0.08 | 0.25 ** | 0.37 | 0.69 | ||||
AE | - | - | −0.71 | 0.64 | −0.05 | −1.96 | 0.54 | −0.33 | 0.64 | −0.03 | −1.58 | 0.92 | ||||||||
WBIS | - | - | 3.16 | 0.38 | 0.42 ** | 2.41 | 3.91 | 2.52 | 0.41 | 0.34 ** | 1.71 | 3.33 | ||||||||
FNAE | - | - | - | 0.26 | 0.07 | 0.16 ** | 0.13 | 0.40 | ||||||||||||
R2 | 0.10 *** | 0.30 *** | 0.44 *** | 0.45 *** |
Consequent | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Appearance Evaluation | WBIS | Enjoyment | ||||||||||
Antecedent | Coeff. | SE | p | Coeff. | SE | p | Coeff. | SE | p | |||
Weight stigma | a1 | −0.06 | 0.01 | <0.000 | a2 | 0.07 | 0.01 | <0.000 | c’ | 0.00 | 0.01 | 0.99 |
Appearance evaluation | - | - | - | d12 | −1.03 | 0.06 | <0.000 | b1 | 0.19 | 0.06 | 0.00 | |
WBIS | - | - | - | - | - | - | b2 | −0.10 | 0.04 | 0.00 | ||
WBIS | FNAE | TAPAS | ||||||||||
Antecedent | Coeff. | SE | p | Coeff. | SE | p | Coeff. | SE | p | |||
Weight stigma | a1 | 0.13 | 0.01 | <0.000 | a2 | 0.03 | 0.05 | 0.52 | c’ | 0.54 | 0.08 | <0.000 |
WBIS | - | - | - | d12 | 2.99 | 0.19 | <0.000 | b1 | 2.58 | 0.36 | <0.000 | |
FNAE | - | - | - | - | - | - | b2 | 0.27 | 0.07 | <0.000 |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Bevan, N.; O’Brien, K.S.; Lin, C.-Y.; Latner, J.D.; Vandenberg, B.; Jeanes, R.; Puhl, R.M.; Chen, I.-H.; Moss, S.; Rush, G. The Relationship between Weight Stigma, Physical Appearance Concerns, and Enjoyment and Tendency to Avoid Physical Activity and Sport. Int. J. Environ. Res. Public Health 2021, 18, 9957. https://doi.org/10.3390/ijerph18199957
Bevan N, O’Brien KS, Lin C-Y, Latner JD, Vandenberg B, Jeanes R, Puhl RM, Chen I-H, Moss S, Rush G. The Relationship between Weight Stigma, Physical Appearance Concerns, and Enjoyment and Tendency to Avoid Physical Activity and Sport. International Journal of Environmental Research and Public Health. 2021; 18(19):9957. https://doi.org/10.3390/ijerph18199957
Chicago/Turabian StyleBevan, Nadia, Kerry S. O’Brien, Chung-Ying Lin, Janet D. Latner, Brian Vandenberg, Ruth Jeanes, Rebecca M. Puhl, I-Hua Chen, Simon Moss, and Georgia Rush. 2021. "The Relationship between Weight Stigma, Physical Appearance Concerns, and Enjoyment and Tendency to Avoid Physical Activity and Sport" International Journal of Environmental Research and Public Health 18, no. 19: 9957. https://doi.org/10.3390/ijerph18199957
APA StyleBevan, N., O’Brien, K. S., Lin, C. -Y., Latner, J. D., Vandenberg, B., Jeanes, R., Puhl, R. M., Chen, I. -H., Moss, S., & Rush, G. (2021). The Relationship between Weight Stigma, Physical Appearance Concerns, and Enjoyment and Tendency to Avoid Physical Activity and Sport. International Journal of Environmental Research and Public Health, 18(19), 9957. https://doi.org/10.3390/ijerph18199957