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A health promotion-based investigation of weight stigma and physical activity
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- Author / Creator
- Myre, Maxine
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The purposes of this dissertation were to examine the relationship between weight stigma and physical activity (PA) from the perspective of women with obesity and investigate strategies that may reduce the impact of PA-related weight stigma. I conducted three studies to address these objectives.
Study 1, entitled Motivated, Fit, and Strong – Using counter-stereotypical images to reduce weight stigma internalization in women with obesity, aimed to reduce weight bias internalization over the course of three weeks by changing automatic associations between weight and PA using evaluative conditioning principles. Participants in the implicit retraining group (n=48) repeatedly viewed counter-stereotypical images of people with obesity paired with positive PA words. Participants in the control group (n=55) read Canada’s PA guidelines and set a weekly PA goal. The results showed that there was no time by group interaction or main effect of group on weight bias internalization, the main outcome of the study. There were no differences between groups or over time for PA attitudes, self-efficacy, or self-reported behaviour. Sixteen women participated in follow-up interviews to provide their perspectives on the images. They believed the images could help challenge widely held stereotypes about weight, fitness, and health in the general population, improve self-perceptions and encourage PA among individuals with obesity, and help identify safe and inclusive spaces for PA. However, they also noted that the images could cause a backlash to maintain or even increase negative weight-related beliefs and that organizations involved in PA may not be willing to use the images.
Study 2, entitled Exploring the impact of physical activity-related weight stigma among women with self-identified obesity, sought to understand how women with obesity experienced, responded to, and were impacted by PA-related weight stigma. In this study, I applied a qualitative interpretive description approach informed by health promotion. Data was generated through semi-structured telephone interviews (n=16) and data analysis occurred through an inductive and iterative coding process. Women’s experiences of PA-related weight stigma included weight stigmatizing comments and treatment, a lack of plus-size exercise clothing, inaccessible exercise equipment, and weight-centric PA messages. These experiences led to a range of emotional responses (e.g., shame, guilt, sadness, and anger) and a heightened anticipation and dread of future weight stigmatizing experiences. As a result, the women used self-protection strategies, attempted to change their body, and sometimes resisted weight-related beliefs and practices. The impacts of weight stigma on PA were to view PA as a ‘lose-lose’ situation, view PA as a means to an end (i.e., for weight loss), and to uncouple PA from body weight.
Study 3, entitled Experiences of size inclusive physical activity settings among women with obesity, investigated experiences of size inclusion within structured PA settings using interpretive description informed by an ecological settings-based approach. Women with obesity (n=9) participated in face-to-face interviews. An inductive approach was used to analyze the data and the findings were organized according to ecological levels of influence. At the individual level, size inclusion was characterized by enhanced well-being, self-worth, and belonging. This was directly connected with women’s experiences at the interpersonal level, which included the use of weight-neutral practices by group and individual fitness instructors and the encouragement and lack of judgment from other exercisers. At the organizational level, an inclusive organizational culture, weight-neutral marketing, specialized programs, and accessible physical environments contributed to size inclusion. However, weight stigmatizing beliefs and practices at the community level were believed to influence PA settings and compromise size inclusion.
Taken together, the findings of this dissertation demonstrate that weight stigma is prevalent in the PA context and this has implications for health and health equity for women with obesity. They also show that weight stigma is a multidimensional process and thus multiple strategies will be needed to reduce it. Some recommendations for PA promotion and practice are to increase the diversity of body sizes portrayed in PA images, change prevalent weight and fitness stereotypes, adopt weight-neutral approaches to PA messaging and instruction, develop a culture of size inclusion, address accessibility barriers in PA settings, and improve the availability and affordability of plus-size exercise clothing. Researchers and practitioners must also be cautious of any unintended consequences in their efforts to reduce weight stigma.
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- Graduation date
- Fall 2020
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- Type of Item
- Thesis
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- Degree
- Doctor of Philosophy
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- License
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