Most images depicting larger bodies or obesity in pregnancy are negative, such as promoting stereotypes of being physically inactive or eating unhealthily. Constantly viewing larger bodies or obesity in a negative light will contribute to advancing weight stigmatizing perspectives. Images are a powerful way to influence public health perceptions, and the aim of this work was to collect and share positive stories and depictions of obesity or larger bodies in pregnancy. Eligible participants were ≥ 18 years of age, had obesity or a larger body in pregnancy and could communicate in English. Participants were prompted to share a positive or meaningful image from their pregnancy and detail the story behind their selection. Textual and visual thematic analyses were completed. Eleven participants shared a photograph and story which were organized into two themes: 1. Proud of their pregnant body; 2. Social connections in pregnancy. Participant stories emphasized wanting to share with others how gratified they felt for having a healthy pregnancy. Photos were taken with or by loved ones, highlighting the importance of social connections throughout their pregnancy. These findings may inspire the development of image banks and the overall visual representation of obesity and larger bodies in pregnancy to better communicate and convey inclusion.

Females who have larger bodies or obesity may be at an increased risk for experiencing infertility. Problematically, both weight or body size and infertility are stigmatized, harming quality of care. We conducted a scoping review to understand the lived experiences of patients who may be subjected to intersecting stigmas of weight and infertility in healthcare. Searches included six databases (Medline, Embase, CINAHL, PsycInfo, Scopus, and Proquest Theses and Dissertations). Data were narratively summarized. With a team of interest holders, including lived experience experts, we identified future directions for research, clinical practice, and policy. Searches yielded 2724 articles, and 13 were included. Four themes were derived: 1. Lack of education/information on the link between infertility and obesity provided to the patient and focusing on weight alone; 2. Restricted access to fertility care; 3. Lack of weight management support; and 4. Self-blame. Directions forward for research include ensuring missing perspectives are studied (i.e., partners, gender diverse individuals, and healthcare professionals), examining the impact of stigma on behavioral responses (e.g., weight loss attempts), and comparing the use of body mass index versus other comprehensive measures of excess adiposity on fertility outcomes. Shared decision-making tools to guide patient-centered discussions about fertility and body weight are needed.

This study sought to explore the role of transformative learning in addressing the problem of internalised weight stigma (IWS), which has negative repercussions for both physical and psychological wellbeing. Transformative learning theory is a useful framework for understanding how someone can challenge and reject learned beliefs and biases. This narrative inquiry study explored the stories shared by six women who identified as practicing self-acceptance after having once worried about weight. Participants were encouraged to recall significant moments and learning experiences from throughout their life to understand their journey and perspective transformations from weight concern to size acceptance. Participants learned to relate to their bodies differently through multiple domains of learning, and expect continual engagement in this counter-cultural work. Their empowering stories speak to the healing impact of transformative learning in adult lives and have implications for those seeking to help others reduce internalised weight stigma and prevent its dissemination to future generations.

Weight bias is a social justice issue that manifests in social and health inequities, affecting the lives of millions of individuals globally. Although weight bias research has increased over the last two decades, it remains pervasive, and more work is needed to establish effective strategies to reduce it. The 2024 International Weight Bias Summit aimed to collaboratively identify future research directions for prioritization as well as perceived barriers in the global field of weight bias and stigma. This paper presents the primary findings from the Summit. Experts in weight bias (N = 33 researchers, clinicians, representatives of professional/national organizations with interests in weight bias and stigma, and individuals with lived experiences) from across North and Latin America, Europe, and Australia attended the two-day Summit. Attendees participated in semi-structured small group discussions using the Nominal Group Technique (NGT). Notes were collected from all discussions and thematically analyzed to identify the most prominent research directions and barriers that emerged from the Summit. Experts identified six key research directions (presented without hierarchical ranking): (1) consequences of weight bias, (2) conceptual and methodological clarity, (3) diversity in sampling, cultures, and settings, (4) interventions, (5) policy, and (6) implementation science. Three key barriers were also identified in weight bias and stigma research: (1) widespread misconceptions and lack of recognition of weight bias as a legitimate issue, (2) funding challenges, and (3) lack of collaborations and working in silos. Experts identified six critical research directions that should be prioritized to advance weight bias and stigma research and drive meaningful progress. Continued international collaboration was recognized as essential to driving this work forward.

Eating disorders have high relapse and mortality rates, complex treatment needs, and disproportionately affect women. A common characteristic of women with eating disorders is a lack of embodiment and disconnection from the body. Increasing positive embodiment may be a means to help support recovery. This study qualitatively examined the impact of time spent in nature as a potential mechanism for increasing positive embodiment during eating recovery among six women in Canada and the USA using semi-structured interviews and reflexive thematic analysis. Participants shared that spending time in nature helped them appreciate and care for their bodies and slow their eating disorder voice, providing a foundation on which to build and maintain recovery from their eating disorder. Participants also described how being in nature helped them feel connected, leading to feeling a sense of belonging and a part of something bigger than themselves. The findings from this pilot study warrant further investigation, and may have implications for eating disorder treatment for women, as spending time in nature during eating disorder recovery may help counterbalance societal pressures on women and support recovery maintenance.

OBJECTIVE:To examine the case for de-centering weight in the diagnosis of both anorexia nervosa (AN) and atypical anorexia nervosa (AAN). METHOD:We summarized research examining the weight-based similarities and differences between AN and AAN as well as how weight is measured and discussed in research on AAN. RESULTS:We suggest that weight-based differences in the diagnosis of AN and AAN may unintentionally perpetuate weight stigma experienced by individuals with AAN throughout the diagnostic and treatment processes. We extend the work of previous researchers by considering how AAN and AN might be considered as one disorder that occurs across the weight spectrum, with presentation and severity specifiers that remove a focus on BMI and enable more equitable access to care for those with AAN. DISCUSSION:We propose further examination and scholarly discussion for the conceptualization of AN and AAN as one disorder that occurs across the weight spectrum.

Weight stigma negatively impacts people with higher weights across the lifespan as well as social contexts and can lead to weight discrimination. As weight is not a protected identity in Canadian human rights legislation, it is important to better understand how weight discrimination is being argued in Canada’s legal system. The purpose of this environmental scan was to examine and describe Canadian case law and scholarly articles pertaining to the argumentation of weight discrimination in Canada. A three-step search process was taken to identify relevant cases and articles that included; (1) Boolean keyword searches in HeinOnline, WestLaw, and LexisPlus; (2) citation searching within all results that met inclusion criteria; and (3) a keyword search in CanLII. These searches yielded a total of 33 documents that were included for analysis, including 8 scholarly articles and 25 cases. Scholarly articles highlighted consistent criticisms of existing human rights protections for higher-weight people in Canada, mostly pertaining to Limitations of disability protections. Of the 25 cases included, 16 were unsuccessful and 9 were successful, with most cases related to employment (n = 19). Our findings point to significant gaps in Canada’s legal system for identifying and correcting instances of weight discrimination. Current Canadian disability protections are inadequate for those who experience weight discrimination, especially those who do not experience disability due to their weight. Our results highlight that weight ought to be a bona fide human rights issue, independent from disability protections.

Weight stigma affects healthcare providers’ practice and contributes to poor patient outcomes. While it has been well-documented among providers of adult patients, research among providers of pediatric patients is limited and descriptive. The aim of this study was to answer the question: to what extent do pediatric healthcare professionals hold weight stigma towards patients and their parents, and what factors influence these attitudes? An anonymous cross-sectional online survey was distributed from June-August 2023 to all healthcare workers, including providers-in-training, working with pediatric patients at a single centre in a province in central Canada. Participants who did not complete the survey, or who submitted it with excessive missing data, were removed. Primary outcome measures included weight stigma towards pediatric patients and their parents. 113 respondents were included. There was both a significant and positive direct effect of weight controllability beliefs on weight stigma towards parents (b = 0.58, 99

Education-based reality television shows that mix education with entertainment, such as The Biggest Loser (TBL), has been coined '' edutainment.'' The premise that weight-based edutainment offers potentially positive educational or public health benefits has received little attention. The purpose of this systematic review is to examine if, and the extent to which, TBL serves to improve the health-related knowledge, attitudes, and behaviors of viewers as well as whether or not it contributes to harm, contrary to the purported purpose of edutainment. A systematic review of seven databases was conducted on March 30, 2022, to identify original, peer-reviewed research articles examining perceptions of, and responses to, viewing TBL with regard to health-related knowledge, attitudes, and behaviors of viewers. Two hundred thirty-nine abstracts were screened, and 14 articles were included in the final review.Results were synthesized according to study purpose including: (a) general reactions to viewing TBL (TBL as stigmatizing, unrealistic, potentially unhelpful), (b) mixed responses to viewing the show on self-reported physical activity attitudes and behaviors, and (c) the association between TBL and increased weight-stigmatizing beliefs. Although researchers have identified potential benefits of TBL, the potential harms seem to outweigh any benefits. Weight-based edutainment is fraught with assumptions, stereotypes, and inaccuracies about weight that serve to reinforce stigmatizing discourses in society. We call for researchers and policymakers to advocate for strategies to reduce the harmful consequences of weight-based edutainment, including further investigation of the utility of such programming for viewers of the reality television genre.

Weight stigma is a social justice issue that can lead to weight-based discrimination and mistreatment. In pregnancy, emerging evidence has highlighted that weight stigma predominantly affects individuals who have larger bodies and is associated with postpartum depression and avoidance of healthcare. Racial and ethnic background will influence perceptions of, and responses to, weight stigma and therefore it is necessary to ensure diverse voices are represented in our understanding of weight stigma. Semi-structured interviews were conducted with ten women who were within one year postpartum; nine identified as Black or African American and one as Hawaiian. Thematic analysis led to identification of three themes: (1) sources of weight stigma and their response to it, (2) support systems to overcome weight stigma, and (3) intersectional experiences. Women reported that sources of weight stigma included unsolicited comments made about their weight often coming from strangers or healthcare professionals that resulted in emotional distress. Support systems identified were family members and partners who encouraged them to not focus on negative remarks made about weight. Intersectional accounts included comparing their bodies to White women, suggesting that they may carry their weight differently. Women shared that, although they felt immense pressure to lose weight quickly postpartum, motherhood and childcare was their utmost priority. These findings inform further prospective examination of the implications of weight stigma in pregnancy among diverse populations, as well as inform inclusive public health strategies to mitigate weight stigma.

BACKGROUND:The words used to refer to weight and individuals with large bodies can be used to reinforce weight stigma. Given that most previous research has examined preferred terminology within homogenous groups, this research sought to examine terminology preferences across populations. METHODS:This paper reports on data gathered with the general public, family physicians, and obesity researchers/practitioners. Participants were asked about the words they commonly: (1) used to refer to people with large bodies (general public); (2) heard in their professional contexts (physicians and obesity specialists); and (3) perceived to be the most socially or professionally acceptable (all samples). RESULTS:Similarities and differences were evident between samples, especially related to weight-related clinical terms, the word fat, and behavioral stereotypes. CONCLUSION:The results provide some clarity into the differences between populations and highlight the need to incorporate use of strategies that may move beyond person-first language to humanize research and clinical practice with people with large bodies.

BackgroundAs a rare endocrine disorder, Cushing's Syndrome (Cushing's) is characterized by numerous symptoms and a non-specific presentation, leading to a delay to diagnosis for patients with this disease. To date, research examining the lived experiences of patients with Cushing's in healthcare is absent in the literature. This preliminary inquiry into the healthcare experiences of women with Cushing's aimed to examine the utility of this line of inquiry to support the patient centered care of individuals with Cushing's.MethodsSeven women from across Canada with endogenous Cushing's participated in the study. Semi-structured interviews were conducted examining participants' healthcare and body-related experiences with Cushing's. Results pertaining to healthcare experiences were analyzed for the current study using reflexive thematic analysis.ResultsFour themes emerged whereby women with Cushing's experienced (1) a lack of patient centered care, characterized by provider miscommunication and medical gaslighting; (2) a misunderstanding of their symptoms as related to weight gain; (3) weight stigma in healthcare encounters; and (4) a shift in their quality of care following diagnosis.ConclusionsThe results highlight the importance of patient centered care as well as the negative impact of commonly reported barriers to patient centered care. Cushing's specific barriers to patient centered care may include weight stigma as well as the rare incidence of Cushing's. Further research is needed to better understand the healthcare experiences of people with Cushing's in Canada.

Objectification theory has been instrumental in better understanding risk for eating disorders, depression, and sexual dysfunction, with self-objectification and body shame as serial mediators leading to these outcomes. Although originally proposed to explain these mental health outcomes in heterosexual women, researchers have extended objectification theory to individuals of various ages, racial identities, and sexual and gender identities. We conducted a systematic literature review of empirical peer-reviewed published research examining the relationship between the constructs of self-objectification, body dissatisfaction, and body shame in adult, youth, and LGBTQ+ samples. Our search yielded 5200 results, of which 318 met inclusion criteria. Of the papers included in this review, 26 reported correlations with sexual and gender diverse samples, 43 reported correlations with youth samples, and 249 reported correlations with samples of general adults (non-sexual or gender minorities). The meta-analyses yielded significant, moderate, positive correlations between body dissatisfaction and self-objectification, and between body shame and self-objectification, for each of the sub-samples. The majority of samples were predominantly White and cisgender female, suggesting the need for additional research examining these constructs among racial and gender minority populations. Overall, the results of this review highlight the unique contributions of body shame and body dissatisfaction to self-objectifying behaviors, and identify the moderating role of race and gender in these interrelations.

Since the first papers focused on internalized weight stigma were published in the mid 2000’s, the literature has grown into a robust field that complements existing knowledge on weight stigma. Recently, researchers have documented the need for increased conceptual and measurement clarity, to distinguish internalized weight stigma from body dissatisfaction. Although several systematic reviews have been conducted on portions of the internalized weight stigma literature, no review to date has been conducted examining the entirety of the literature. The aim of this research was to conduct a systematic scoping review and synthesis of research on internalized weight stigma. Specifically, we sought to examine the broad scope of the literature, terms used to refer to internalized weight stigma, how internalized weight stigma is defined, sample characteristics, and weight-based framings of internalized weight stigma research. We conducted a single-concept search across six databases (EMBASE, Medline, PsychINFO, PubMed, SCOPUS, and Web of Science) of peer-reviewed papers published in English on internalized weight stigma. Data were extracted for article authors, year published, journal name and type, general article topic(s), study design, study location, sample characteristics, variables measured, paper framing, term used to describe internalized weight stigma, and definition of internalized weight stigma. Of the 931 unique records screened, 376 were identified for inclusion in the scoping review. The majority of internalized weight stigma research is characterized by cross-sectional methods, has been conducted in the US, and has utilized samples of higher weight white women. Further, 40 unique terms were used across the literature to refer to internalized weight stigma, and 19 different components of definitions of internalized weight stigma were identified. The literature is also characterized by a focus on understanding the association between internalized weight stigma and health outcomes with an emphasis on obesity. This scoping review confirms a lack of concept clarity of internalized weight stigma, in part influenced by an inconsistency in definitions of internalized weight stigma across the literature. Considerations are provided for steps to enhance conceptual and measurement clarity. Given the obesity focused framing of much of the research on internalized weight stigma, considerations are also provided for reducing weight-centric approaches to research. In the early 2000’s, researchers began to pay more attention to the potential health impacts of believing societal stereotypes, negative attitudes, and beliefs about higher weight people. When these stereotypes, negative attitudes, and beliefs are directed towards the self, it can have significant consequences for an individual’s perceptions of self. This research collected and summarized all existing research published in English on internalized weight stigma. Our results highlighted that researchers do not use consistent terminology to refer to internalized weight stigma and that they do not have a consistent definition of internalized weight stigma. Further, a large proportion of the research is focused on obesity or weight loss, which may unintentionally perpetuate weight stigma in scientific research. We provide several recommendations for researchers to address these challenges in future research on internalized weight stigma as well as recommendations to address other identified gaps in the existing literature.

Though anthropometric measurement (AM) frequently occurs in school settings, it is not without risks to child wellbeing. The aim of this scoping review was to examine how AM in school settings takes place and is reported on to make recommendations on best practices. We identified and extracted data from 440 studies published since 2005 that conducted AM in school (pre-school through secondary/high school) settings. Privacy and sensitivity of AM were unclear in over 90% of studies. Thirty-one studies (7.0%) reported protecting student privacy, while nine (2.0%) reported public measurement. Only five studies reported sensitivity regarding AM (1.1%). Exactly who conducted AM was not specified in 201 studies (45.7%). Sixty-nine studies did not provide a weight status criteria citation (19.2%), and 10 used an incorrect citation (2.7%). In summary, serious shortcomings in the reporting of how AM is conducted and by whom, along with details concerning weight status classification, are evident. There is considerable room for improvement regarding the reporting of key methodological details. We propose best practices for AM in school settings, which also double as conditions that should be met before AM takes place in school settings.

The fear of fat, or fear of gaining weight, is conceptually related to both weight stigma and eating disorders. Since sociocultural pressures related to the thin ideal are important to examine within sociocultural models of body image, the Sociocultural Influences on Fear of Fat (SI-FAT) was created and validated on a sample of predominantly White college women. The purpose of this study was to examine the factor structure of the SI-FAT in a sample of racially and ethnically diverse college women, given potential differences in experiences of fear of fat and the need to measure sociocultural pressures related to fear of fat in multiple groups. A sample of college women (72.8% Hispanic/Latina, 14.85% Black, and 12.35% White) completed the SI-FAT as well as measures of weight stigma and body image. Results suggested that the factor structure of the SI-FAT were consistent across racial and ethnic groups. These findings indicate that the SI-FAT is appropriate for use among racially and ethnically diverse samples of young women. Directions for future research, including examining differences between sociocultural pressures related to weight gain and self-reported fear of fat are discussed.