Il peso dello stigma: gli effetti di stereotipi e pregiudizio sulla salute delle persone obese

Titolo Rivista PSICOLOGIA DELLA SALUTE
Autori/Curatori Carlo Tomasetto, Vanessa Privato
Anno di pubblicazione 2013 Fascicolo 2013/3
Lingua Italiano Numero pagine 25 P. 75-99 Dimensione file 413 KB
DOI 10.3280/PDS2013-003004
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Le persone obese costituiscono una delle categorie sociali più colpite da stereotipi, pregiudizi e discriminazioni. In questa rassegna gli autori descrivono gli studi che, in particolare negli ultimi dieci anni, hanno documentato l’impatto negativo dello stigma legato al peso sulla salute e sul benessere psico- fisico delle persone obese. Verranno illustrati lavori correlazionali e sperimentali che evidenziano come, a parità di sovrappeso, le esperienze di stigmatizzazione e di discriminazione percepita riducano il benessere psicologico, incrementino il rischio di patologie organiche correlate all’obesità e riducano la probabilità di adottare comportamenti alimentari corretti e un livello di esercizio fisico adeguato. Verranno inoltre discussi i lavori che individuano negli atteggiamenti negativi e nei comportamenti discriminatori (o percepiti come tali) del personale medico un possibile ostacolo alla fruizione dei servizi sanitari da parte delle persone obese. L’insieme dei risultati suggerisce l’importanza di prevedere, nella progettazione di interventi di prevenzione e riduzione del sovrappeso, azioni di contrasto allo stigma e di supporto psico-sociale per le persone che ne sono colpite.;

Keywords:Obesità, Stigma, Stereotipi, Discriminazione, Salute.

  1. Albert M.A. and Williams D.R. (2011). Invited commentary: Discrimination – An emerging target for reducing risk of cardiovascular disease. American Journal of Epidemiology, 17: 1240-1243. DOI: 10.1093/aje/kwq514
  2. Amy N.K., Aalborg A., Lyons P. and Keranen L. (2006). Barriers to routine gynecological cancer screening for White and African-American obese women. International Journal of Obesity, 30: 147-155. DOI: 10.1038/sj.ijo.080310
  3. Annis N.M., Cash T.F. and Hrabosky J.I. (2004). Body image and psychosocial differences among stable average weight, currently overweight, and formerly overweight women: the role of stigmatizing experiences. Body Image, 1: 155-167. DOI: 10.1016/j.bodyim.2003.12.00
  4. Ashmore J.A., Friedman K.E., Reichmann S.K. and Musante G.J. (2008). Weight-based stigmatization, psychological distress, e binge eating behavior among obese treatment-seeking adults. Eating Behaviors, 9: 203-209. DOI: 10.1016/j.eatbeh.2007.09.00
  5. Averett S. and Korenman S. (1999). Black–white differences in social and economic consequences of obesity. International Journal of Obesity, 23: 166-173. DOI: 10.1038/sj.ijo.080080
  6. Avitsur R., Padgett D.A. and Sheridan J.F. (2009). Social interactions, stress, and immunity. Neurologic Clinics, 24: 483-491. DOI: 10.1016/j.iac.2009.02.00
  7. Bertakis K.D. and Azari R. (2005). The impact of obesity on primary care visits. Obesity Research, 13: 1615-1622. DOI: 10.1038/oby.2005.19
  8. Block J.P., DeSalvo K.B. and Fisher W.P. (2003). Are physicians equipped to address the obesity epidemic? Knowledge and attitudes of internal medicine residents. Preventive Medicine, 36: 669-675. DOI: 10.1016/S0091-7435(03)00055-0
  9. Hebl M.R. and Dovidio J.F. (2005). Promoting the “social” in the examination of social stigmas. Personality and Social Review, 9: 156-182. DOI: 10.1207/s15327957pspr0902_4
  10. Bocquier A., Verger P., Basdevant A., Andreotti G., Baretge J., Villani P. and Paraponaris A. (2005). Overweight and obesity: knowledge, attitudes, and practices of general practitioners in France. Obesity Research, 13: 787-795. DOI: 10.1038/oby.2005.8
  11. Brown I. (2006). Nurses’ attitudes towards adult patients who are obese: literature review. Journal of Advanced Nursing, 53: 221-232. DOI: 10.1111/j.1365-2648.2006.03718.
  12. Brown I., Stride C., Psarou A., Brewins L. and Thompson J. (2007). Management of obesity in primary care: nurses’ practices, beliefs, and attitudes. Journal of Advanced Nursing, 59: 329-341. DOI: 10.1111/j.1365-2648.2007.04297.
  13. Brownell K.D., Schwartz M.B., Puhl R.M., Henderson K.E. and Harris J.L. (2009). The need for bold action to prevent adolescent obesity. Journal of Adolescent Health, 45: 8-17. DOI: 10.1016/j.jadohealth.2009.03.00
  14. Budd G., Mariotti M., Graff D. and Falkestein K. (2009). Health care professionals’ attitudes about obesity: an integrative review. Applied Nursing Research, 24: 127-137. DOI: 10.1016/j.apnr.2009.05.00
  15. Byrne S., Barry D. and Petry N.M. (2012). Predictors of weight loss success. Exercise vs. dietary selfefficacy and treatment attendance. Appetite, 58: 695-698. DOI: 10.1016/j.appet.2012.01.00
  16. Campbell K. and Crawford D. (2000). Management of obesity: attitudes and practices of Australian dietitians. International Journal of Obesity, 24: 701-710. DOI: 10.1038/sj.ijo.080122
  17. Campbell K., Engel H., Timperio A., Cooper C. and Crawford D. (2000). Obesity management: Australian general practitioners’ attitudes and practices. Obesity Research, 8: 459-466. DOI: 10.1038/oby.2000.5
  18. Carpenter K.M., Hasin D.S., Allison D.B. and Faith M.S. (2000). Relationships between obesity and DSM-IV major depressive disorder, suicide ideation, and suicide attempts: results from a general population study. American Journal of Public Health, 90: 251-257. DOI: 10.1016/j.iac.2009.02.00
  19. Carr D. and Friedman M.A. (2005). Is obesity stigmatizing? Body weight, perceived discrimination, and psychological well being in the United States. Journal of Health and Social Behavior, 46: 244-259. DOI: 10.1177/00221465050460030
  20. Chambliss H.O., Finley C.E. and Blair S.N. (2004). Attitudes toward obese individuals among exercise science students. Medicine and Science in Sports and Exercise, 36: 468-474. DOI: 10.1249/01.MSS.0000117115.94062.E4
  21. Chang V.W., Asch D.A. and Werner R.M. (2010). Quality of care among obese patients. The Journal of the American Medical Association, 303: 1274-1281. DOI: 10.1001/jama.2010.339
  22. Chen E.Y., Bocchieri-Ricciardi L.E., Munoz D., Fischer S., Katterman S., Roehrig M., Dymek-Valentine M., Alverdy J.C. and Le Grange D. (2007). Depressed mood in class III obesity predicted by weight-related stigma. Obesity surgery, 17: 669-671. DOI: 10.1007/s11695-007-9112-4
  23. Crandall C.S. (1994). Prejudice against fat people: ideology and self-interest. Journal of Personality and Social Psychology, 66: 882-894. DOI: 10.1037/0022-3514.66.5.882
  24. Cuddy A.J.C., Fiske S.T. and Glick P. (2008). Warmth and competence as universal dimensions of social perception: The stereotype content model and the bias map. Advances in Experimental Social Psychology, 40: 61-149. DOI: 10.1016/S0065-2601(07)00002-0
  25. De Jong W. (1980). The stigma of obesity: the consequences of naive assumptions concerning the causes of physical deviance. Journal of Health and Social Behavior, 21: 75-87.
  26. Dickerson S.S., Gable S.L., Irwin M.R., Aziz N. and Kemeny M.E. (2009). Social-evaluative threat and Proinflammatory cytokine regulation. An experimental laboratory investigation. Psychological Science, 20: 1237-1244. DOI: 10.1111/j.1467-9280.2009.02437.
  27. Diedrichs P.C. and Barlow F.K. (2011). How to lose weight bias fast! Evaluating a brief anti-weight bias intervention. British Journal of Health Psychology, 16: 846-861. DOI: 10.1111/j.2044-8287.2011.02022.
  28. Drury C.A.A. and Louis M. (2002). Exploring the association between body weight, stigma of obesity, and health care avoidance. Practitioners, 14: 554-560. DOI: 10.1111/j.1745-7599.2002.tb00089.
  29. Ferrante J.M., Ohman-Strickland P., Hudson S.V., Hahn K.A., Scott J.G. and Crabtree B.F. (2006). Colorectal cancer screening among obese versus non-obese patients in primary care practices. Cancer Detection and Prevention, 30: 459-465. DOI: 10.1016/j.cdp.-2006.09.003
  30. Fikkan J.L. and Rothblum E.D. (2011). Is fat a feminist issue? Exploring the gendered nature of weight bias. Sex Roles, 66: 593-599. DOI: 10.1007/s11199-011-0022-5
  31. Fong R.L., Bertakis K.D. and Franks P. (2006). Association between obesity and patient satisfaction. Obesity, 14: 1402-1411. DOI: 10.1038/oby.2006.15
  32. Foster G.D., Wadden T.A., Makris A.P., Davidson D., Swain Sanderson R., Allison D.B. and Kessler A. (2003). Primary care physicians’ attitudes about obesity and its treatment. Obesity Research, 11: 1168-1177.
  33. Friedman M.A. and Brownell K.D. (1995). Psychological correlates of obesity: Moving to the next research generation. Psychological Bulletin, 117: 3-20. DOI: 10.1037/0033-2909.117.1.
  34. Friedman K.E., Ashmore J.A. and Applegate K.L. (2008). Recent experiences of weight based stigmatization in a weight loss surgery population: psychological and behavioral correlates. Obesity, 16: S69-74. DOI: 10.1038/oby.2008.45
  35. Greenberg B.S., Eastin M., Hofshire L., Lachlan K. and Brownell K.D. (2003). The portrayal of overweight and obese persons in commercial television. American Journal of Public Health, 93: 1342-1348. DOI: 10.2105/AJPH.93.8.134
  36. Greenwald A.G., McGHee D.E. and Schwartz J.L.K. (1998). Measuring individual differences in implicit cognition: The Implicit Association Test. Journal of Personality and Social Psychology, 74: 1464-1480. DOI: 10.1037/0022-3514.74.6.146
  37. Grossi E., Dalle Grave R., Mannucci E., Molinari E., Compare A., Cuzzolaro M. and Marchesini G. (2006). Complexity of attrition in the treatment of obesity: clues from a structured telephone interview. International Journal of Obesity, 30: 1132-1137. DOI: 10.1038/sj.ijo.080324
  38. Gudzune K.A., Huizinga M.M. and Cooper L.A. (2011). Impact of patient obesity on the patient–provider relationship. Patient Education and Counseling, 85: 322-325. DOI: 10.1016/j.pec.2011.01.00
  39. Haines J., Neumark-Sztainer D., Eisenberg M.E. and Hannan P.J. (2006). Weight teasing and disordered eating behaviors in adolescents: longitudinal findings from Project EAT (Eating Among Teens). Pediatrics, 117: 209-215. DOI: 10.1542/peds.2005-124
  40. Harvey E.L., Summerbell C.D., Kirk S.F.L. and Hill A.J. (2002). Dietitians’ views of overweight and obese people and reported management practices. Journal of Human Nutrition and Dietetics, 15: 331-347. DOI: 10.1046/j.1365-277X.2002.00385.
  41. Hayden-Wade H.A., Stein R.I., Ghaderi A., Saelence B.E., Zabinski M.F. and Wilfley D.E. (2005). Prevalence, characteristics, and correlates of teasing experiences among overweight children vs. non-overweight peers. Obesity Research, 13: 1381-1392. DOI: 10.1038/oby.2005.16
  42. Hebl M.R. and Heatherton T.E. (1998). The stigma of obesity in women: The difference in black and white. Personality and Social Psychology Bulletin, 24: 417-426. DOI: 10.1177/014616729824400
  43. Hebl M.R. and Xu J. (2001). Weighing the care: physicians’ reactions to the size of a patient. International Journal of Obesity, 25: 1246-1252. DOI: 10.1038/sj.ijo.0801681
  44. Himes S.M. and Thompson J.K. (2007). Fat stigmatization in television shows and movies: a content analysis. Obesity, 15: 712-718. DOI: 10.1038/oby.2007.63
  45. Hoad V., Somerford P. and Katzenellenbogen J. (2010). High body mass index overtakes tobacco as the leading independent risk factor contributing to disease burden in Western Australia. Australian and New Zeeland Journal of Public Health, 34: 214-215. DOI: 10.1111/j.1753-6405.2010.00509.
  46. Holub S.C. (2008). Individual differences in the anti-fat attitudes of preschool-children: The importance of perceived body size. Body Image, 5: 317-321. DOI: 10.1016/j.bodyim.2008.03.00
  47. Hunte H.E.R. (2011). Association between perceived interpersonal everyday discrimination and waist circumference over a 9-year period in the midlife development in the United States cohort study. American Journal of Epidemiology, 173: 1232-1239. DOI: 10.1093/aje/kwq46
  48. Jackson T.D., Grillo C.M. and Masheb R.M. (2000). Teasing history, onset of obesity, current eating disorder psychopathology, body dissatisfaction, and psychological functioning in binge eating disorder. Obesity Research, 8: 451-458. DOI: 10.1038/oby.2000.5
  49. Latner J.D., Wilson G.T., Jackson M.L. and Stunkard A.J. (2009). Greater history of weight related stigmatizing experience is associated with greater weight loss in obesity treatment. Journal of Health Psychology, 14: 190-199. DOI: 10.1177/135910530810020
  50. Lewis T.T., Kravitz H.M., Janssen I. and Powell L.H. (2011). Self-reported experiences of discrimination and visceral fat in middle-age African-American and Caucasian women. American Journal of Epidemiology, 173: 1223-1231. DOI: 10.1093/aje/kwq46
  51. Major B. and O’Brien L.T. (2005). The social psychology of stigma. Annual Review of Psychology, 56: 393-421. DOI: 10.1146/annurev.psych.56.091103.07013
  52. Manzoni G.M., Pagnini F., Gorini A., Preziosa A., Castelnuovo G., Molinari E. and Riva G. (2009).
  53. Can relaxation training reduce emotional eating in women with obesity? An exploratory study with 3 months of follow-up. Journal of the American Dietetic Association, 109: 1427-1432. DOI: 10.1016/j.jada.2009.05.00
  54. McClure K.J., Puhl R.M. and Heuer C.A. (2011). Obesity in the news: do photographic images of obese persons influence antifat attitudes? Journal of Health Communication: International Perspectives, 16: 359-371. DOI: 10.1080/10810730.2010.53510
  55. Miller C.T. and Downey K.T. (1999). A meta-analysis of heavyweight and self-esteem. Personality and social psychology review, 3: 68-84. DOI: 10.1207/s15327957pspr0301_4
  56. Mitchell R.S., Padwal R.S., Chuck A.W. and Klarenbach S.W. (2008). Cancer screening among the overweight and obese in Canada. American Journal of Preventive Medicine, 35: 127-132. DOI: 10.1016/j.amepre.2008.03.03
  57. Myers A. and Rosen J.C. (1999). Obesity stigmatization and coping: relation to mental health symptoms, body image, and self-esteem. International Journal of Obesity and Related Metabolic Disorders, 23: 221-30. DOI: 10.1038/sj.ijo.080076
  58. O’Brien K.S., Puhl R.M., Latner J.D., Mir A.S. and Hunter J.A. (2010). Reducing anti-fat prejudice in preservice health students: a randomized trial. Obesity, 18: 2138-2144. DOI: 10.1038/oby.2010.7
  59. OMS (2007). Prevention and control of noncommunicable diseases: implementation of the global strategy. Sixty-first World Health Assembly, Resolution WHA61.14. Ginevra: Oraganizzazione Mondiale della Sanità.
  60. Ostbye T., Taylor D.H., Yancy W.S. and Krause K.M. (2005). Associations between obesity and receipt of screening mammography, Papanicolaou tests, and influenza vaccination: results from the Health and Retirement Study (HRS) and the Asset and Health Dynamics Among the Oldest Old (AHEAD) Study. American Journal of Public Health, 95: 1623-1630. DOI: 10.2105/AJPH.2004.04780
  61. Persky S. and Eccleston C.P. (2010). Medical student bias and care recommendations for an obese versus non-obese virtual patient. International Journal of Obesity, 35: 728-735. DOI: 10.1038/ijo.2010.17
  62. Puhl R.M. and Brownell K.D. (2003). Psychosocial origins of obesity stigma: Toward changing a powerful and pervasive bias. Obesity Reviews, 4: 213-227. DOI: 10.1046/j.1467-789X.2003.00122.
  63. Puhl R.M., Schwartz M.B. and Brownell K.D. (2005). Impact of perceived consensus on stereotypes about obese people: a new approach for reducing bias. Health Psychology, 24: 517-525. DOI: 10.1037/0278-6133.24.5.517
  64. Puhl R.M., Moss Racusin C.A. and Schwartz M.B. (2007). Internalization of weight bias: implications for binge eating and emotional well-being. Obesity, 15: 19-23. DOI: 10.1038/oby.2007.52
  65. Puhl R.M. and Heuer C.A. (2009). The stigma of obesity: a review and update. Obesity, 17: 941-964. DOI: 10.1038/oby.2008.63
  66. Puhl R.M., Wharton C. and Heuer C.A. (2009). Weight bias among dietetics students: implications for treatment practices, Journal of the American Dietetic Association, 109: 438-444. DOI: 10.1016/j.jada.2008.11.03
  67. Puhl R.M. and Luedicke J. (2011). Weight-based victimization among adolescents in the school setting: Emotional reactions and coping behaviors. Journal of Youth and Adolescence, 41: 27-40. DOI: 10.1007/s10964-011-9713-z
  68. Rosenberger P.H., Henderson K.E. and Grilo C.M. (2006). Correlates of body image dissatisfaction in extremely obese female bariatric surgery candidates. Obesity Surgery, 16: 1331-1336. DOI: 10.1381/09608920677866378
  69. Rudman L.A., Feinberg J. and Fairchild K. (2002). Minority members’ implicit attitudes: automatic ingroup bias as a function of group status. Social Cognition, 20: 294-320. DOI: 10.1521/soco.20.4.294.1990
  70. Sarwer D.B., Fabricatore A.N., Eisenberg M.H., Sywulak L.A. and Wadden T.A. (2008). Self-reported stigmatization among candidates for bariatric surgery. Obesity, 16: 75-79. DOI: 10.1038/oby.2008.45
  71. Schmalz D.L. (2010). “I feel fat”: Weight-related stigma, body esteem, and BMI as predictors of perceived competence in physical activity. Obesity Facts, 3: 15-21. DOI: 10.1159/00027321
  72. Schvey N.A., Puhl R.M. and Brownell K.D. (2011). The impact of weight stigma on caloric consumption. Obesity, 19: 1957-1962. DOI: 10.1038/oby.2011.20
  73. Schwartz M.B., Chambliss H.O., Brownell K.D., Blair S.N. and Billington C. (2003). Weight bias among health professionals specializing in obesity. Obesity Research, 11: 1033-1039. DOI: 10.1038/oby.2003.14
  74. Seacat J.D. and Mickelson K.D. (2009). Stereotype threat and the exercise/dietary intentions of overweight women. Journal of Health Psychology, 14: 556-567. DOI: 10.1177/135910530910357
  75. Steele C.M. and Aronson J. (1995). Stereotype threat and the intellectual test performance of African Americans. Journal of Personality and Social Psychology, 69: 797-811. DOI: 10.1037/0022-3514.69.5.79
  76. Swinburn B.A., Sacks G., Hall K.D., McPherson K., Finegood D.T., Moodie M.L. and Gortmaker S.L. (2011). The global obesity pandemic: shaped by global drivers and local environments, Lancet, 378: 804-814. DOI: 10.1016/S0140-6736(11)60813-1
  77. Teachman B.A. and Brownell K.D. (2001). Implicit anti-fat bias among health professionals: is anyone immune? International Journal of Obesity, 25: 1525-1531. DOI: 10.1038/sj.ijo.080174
  78. Thuan J.F. and Avignon A. (2005). Obesity management: attitudes and practices of French general practitioners in a region of France. International Journal of Obesity, 29: 1100-1106. DOI: 10.1038/sj.ijo.080301
  79. Tsenkova V.K., Carr D., Schoeller D.A. and Ryff C.D. (2011). Perceived weight discrimination amplifies the link between central adiposity and nondiabetic glycemic control. Annals of Behavioral Medicine, 41: 243-251. DOI: 10.10007/s12160-010-9238-9
  80. Vartanian L.R. and Shaprow J.G. (2008). Effects of weight stigma on exercise motivation and behavior: a preliminary investigation among college-aged females. Journal of Health Psychology, 13: 131-138. DOI: 10.1177/135910530708431
  81. Vartanian L.R. and Novak S.A. (2011). Internalized societal attitudes moderate the impact of weight stigma on avoidance of exercise. Obesity, 19: 757-762. DOI: 10.1038/oby.2010.23
  82. Wadden T.A., Anderson D.A., Foster G.D., Bennet A., Steinberg C. and Sarwer D.B. (2000). Obese women’s perceptions of their physician’s weight management attitudes and practices. Archives of Family Medicine, 9: 854-860. DOI: 10.1038/oby.2008.45
  83. Wang S.S., Brownell K.D. and Wadden T.A. (2004). The influence of the stigma of obesity on overweight individuals. International Journal of Obesity, 28: 1333-1337. DOI: 10.1038/sj.ijo.080273
  84. Wee C.C., McCarthy E.P., Davis R.B. and Phillips R.S. (2000). Screening for cervical and breast cancer: is obesity an unrecognized barrier to preventive care? Annals of Internal Medicine, 132: 699-704. DOI: 10.1111/j.1526-0976.2001.51012-8.pp.xWeinerB.(1995).Judgmentsofresponsibility:Afoundationforatheoryofsocialconduct.NewYork:GuilfordPress
  85. Wott C.B. and Carels R.A. (2010). Overt weight stigma, psychological distress and weight loss treatment outcomes. Journal of health psychology, 15: 608-614. DOI: 10.1177/-135910530935533
  86. Zabinski M.F., Saelens B.E., Stein R.I., Hayden-Wade H.A. and Wilfley D.E. (2003). Overweight children’s barriers to and support for physical activity. Obesity Research, 11: 238-246. DOI: 10.1038/oby.2003.3
  87. CrockerJ.,CornwellB.andMajorB.(1993).The stigma of overweight: affective consequences of attributional ambiguity, Journal of personality and social psychology, 64:60-70. DOI: 10.1037//0022-3514.64.1.6
  88. Puhl R.M. and BrownellK.D.(2006). Confronting and coping with weight stigma: aninvestigation of overweight and obese adults. Obesity, 14:1802-1815. DOI: 10.1038/oby.2006.20
  89. Hebl M.R., XuJ. And Mason M.F.(2003). Weighing the care: patients’ perceptions of physician care as a function of gender and weight. International Journal of Obesity ,27:269-275. DOI: 10.1038/sj.ijo.80223
  90. Almeida L., SavoyS. And BoxerP. (2011).The role of weight stigmatization in cumulative risk for binge eating. Journal of Clinical Psychology, 67:278-292. DOI: 10.1002/jclp.2074

Carlo Tomasetto, Vanessa Privato, Il peso dello stigma: gli effetti di stereotipi e pregiudizio sulla salute delle persone obese in "PSICOLOGIA DELLA SALUTE" 3/2013, pp 75-99, DOI: 10.3280/PDS2013-003004