ABOUT FAT SHAMING, WEIGHT STIGMA AND HEALTH A.E.M. HENDRIKS & R.C. HAVERMANS

The worldwide prevalence of obesity and overweight has risen over the last decades. The growing group of people with overweight and obesity is facing weight stigma and discrimination in almost all areas of life. Weight stigma and discrimination lead to negative physical and mental health consequences. The ‘health at every size®’ approach promotes fat acceptance and tries to eliminate stig- ma. Interventions based on this approach target healthy behavior instead of weight loss and have shown some beneficial physical and psychological outcomes. However, the evidence is still mixed and critics argue that the health at every size® approach might not be very appropriate to tackle the obesity problem. Nevertheless, the obesity epidemic certainly will not be tackled by stigmatizing obese individuals. Shifting the focus of interventions from weight-loss to physical fitness may not be such a bad idea.


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Terwijl een steeds groter deel van de bevolking overgewicht of zelfs obesitas heeft, lijkt deze groep niet minder te worden gestigmatiseerd. Maar uitgemaakt worden voor varken (of erger) motiveert geenszins om af te vallen. Een tegenbeweging, ‘health at every size®’ genaamd, probeert de acceptatie van zwaarlijvigheid te bewerkstelligen en de focus te verleggen van lichaamsgewicht naar gezond gedrag. Is dat beter, vragen Anouk Hendriks en Remco Havermans zich af.

Steeds meer mensen in Nederland hebben obesitas. Vergeleken met de jaren tachtig hebben ruim 2,5 keer zo veel mensen van 20 jaar of ouder deze vorm van ernstig overgewicht’, zo schreef de Nederlandse Omroepstichting (NOS) vorig jaar op basis van nieuwe cijfers van het Centraal Bureau voor de Statistiek (CBS) en het Rijksinstituut voor Veiligheid en Milieu (RIVM; ANP, 2018). In april 2019 was overgewicht bij jongeren in het nieuws (‘Steeds meer jongeren met overgewicht’; ANP, 2019) en in november 2019 kopte de NOS: ‘Nederlanders groeien vooral nog in de breedte’ (NOS & van Eijndhoven, 2019). De laatste cijfers over volwassenen van de Wereldgezondheidsorganisatie (WHO) laten zien dat er in 2016 wereldwijd 39% van de mannen en 39% van de vrouwen overgewicht had (WHO, 2017). Overgewicht is wereldwijd een belangrijk en groeiend probleem.

De wereldwijde toename van het aantal mensen met overgewicht gaat gepaard met stigmatisering en discriminatie van mensen met overgewicht en obesitas. Uit een onderzoek in de Verenigde Staten waarin de prevalentie van gewichtsdiscriminatie werd vergeleken

Titel is geïnspireerd op het krantenartikel ‘Gatverdamme, je zou er maar zo uitzien’ https://www.parool.nl/nieuws/mayra-louise-de-wilde-over-fat- shaming-de-maat-is-vol~b92f031a/

Literatuurlijst

  1. Andreyeva, T., Puhl, R.M. & Brownell, K.D. (2008). Changes in per- ceived weight discrimination among Americans, 1995-1996 through 2004-2006. Obesity, 16(5), 1129–1134. https://doi.org/10.1038/oby.2008.35
  2. ANP (2018, 4 juli). Meer mensen met zwaarste vorm van overgewicht. Opgehaald van https://nos.nl/artikel/2239762-meer-mensen-met- zwaarste-vorm-van-overgewicht.html
  3. ANP (2019, 10 april). Steeds meer jongeren met overgewicht. Opgehaald van https://nos.nl/artikel/2279773-steeds-meer-jongeren-met- overgewicht.html
  4. Ashmore, J.A., Friedman, K.E., Reichmann, S.K. & Musante, G.J. (2008). Weight-based stigmatization, psychological distress, & binge eating behavior among obese treatment-seeking adults. Eating Behaviors, 9(2), 203–209. https://doi.org/10.1016/j.eatbeh.2007.09.006
  5. Association for Size Diversity and Health. (z.j.). HAES® principles. Opgehaald van https://www.sizediversityandhealth.org/content.asp?id=76
  6. Ata, R.N. & Thompson, J.K. (2010). Weight bias in the media: A review of recent research. Obesity Facts, 3(1), 41–46. https://doi.org/10.1159/000276547
  7. Bacon, L., Stern, J.S., Van Loan, M.D. & Keim, N. L. (2005). Size Accep- tance and Intuitive Eating Improve Health for Obese, Female Chron- ic Dieters. Journal of the American Dietetic Association, 105(6), 929–936. https://doi.org/10.1016/j.jada.2005.03.011
  8. Banack, H.R. & Stokes, A. (2017). The ‘obesity paradox’ may not be a paradox at all. International Journal of Obesity, 41, 1162–1163. https://doi.org/10.1038/ijo.2017.99
  9. Bombak, A. (2014). Obesity, Health at Every Size, and Public Health Policy. American Journal of Public Health, 104(2), 60–67. https://doi.org/10.2105/AJPH.2013.301486
  10. Boon, M. & Van Rossum, L. (2019). Vet belangrijk. Amsterdam: Ambo|Anthos.
  11. Bruce, L.J. & Ricciardelli, L.A. (2016). A systematic review of the psychosocial correlates of intuitive eating among adult women. Appetite, 96, 454–472. https://doi.org/10.1016/j.appet.2015.10.012
  12. Campos, P., Saguy, A., Ernsberger, P., Oliver, E. & Gaesser, G. (2006). The epidemiology of overweight and obesity: public health crisis or moral panic? International Journal of Epidemiology, 35, 55–60. https://doi.org/10.1093/ije/dyi254
  13. Chou, W.S., Prestin, A. & Kunath, S. (2014). Obesity in social media: a mixed methods analysis. Translational Behavioral Medicine, 4(3), 314–323. https://doi.org/10.1007/s13142-014-0256-1
  14. Giel, K.E., Zipfel, S., Alizadeh, M., Schä eler, N., Zahn, C., Wessel, D., ... Thiel, A. (2012). Stigmatization of obese individuals by human resource professionals: an experimental study. BMC Public Health, 12(525). https://doi.org/10.1186/1471-2458-12-525
  15. Han, S.J. & Boyko, E.J. (2018). The Evidence for an Obesity Paradox in Type 2 Diabetes Mellitus. Diabetes Metabolism Journal, 42(3), 179–187. https://doi.org/10.4093/dmj.2018.0055
  16. Heuer, C.A., McClure, K.J. & Puhl, R.M. (2011). Obesity stigma in on- line news: A visual content analysis. Journal of Health Communication, 16(9), 976–987. https://doi.org/10.1080/10810730.2011.561915
  17. Himmelstein, M.S., Puhl, R.M. & Quinn, D.M. (2017). Intersection- ality: An Understudied Framework for Addressing Weight Stigma. American Journal of Preventive Medicine, 53(4), 421–431. https://doi.org/10.1016/j.amepre.2017.04.003
  18. Horwath, C., Hagmann, D. & Hartmann, C. (2019). Intuitive eating and food intake in men and women: Results from the Swiss food panel study. Appetite, 135, 61–71. https://doi.org/10.1016/j.appet.2018.12.036
  19. Keirns, N.G. & Hawkins, M.A.W. (2019). The relationship between intuitive eating and body image is moderated by measured body mass index. Eating Behaviors, 33, 91–96. https://doi.org/10.1016/j.eatbeh.2019.04.004
  20. Kersbergen, I. & Robinson, E. (2019). Blatant Dehumanization of People with Obesity. Obesity, 00(00), 1–8. https://doi.org/10.1002/oby.22460
  21. Kteily, N., Bruneau, E., Waytz, A. & Cotterill, S. (2015). The Ascent of Man: Theoretical and Empirical Evidence for Blatant Dehumaniza- tion. Journal of Personality and Social Psychology, 109(5), 901–931. http://dx.doi.org/10.1037/pspp0000048
  22. Lavie, C. J., De Schutter, A. & Milani, R.V. (2015). Healthy obese versus unhealthy lean: the obesity paradox. Nat. Rev. Endocrinol., 11(1), 55–62. https://doi.org/10.1038/nrendo.2014.165
  23. Lean, M.E.J. & Malkova, D. (2016). Altered gut and adipose tissue hor- mones in overweight and obese individuals: cause or consequence? International Journal of Obesity, 40, 622–632. https://doi.org/10.1038/ijo.2015.220
  24. Lennon, H., Sperrin, M., Badrick, E. & Renehan, A.G. (2016). The Obesi- ty Paradox in Cancer: a Review. Current Oncology Reports, 18(56), 1–8. https://doi.org/10.1007/s11912-016-0539-4
  25. Major, B., Hunger, J.M., Bunyan, D.P. & Miller, C.T. (2014). The ironic effects of weight stigma. Journal of Experimental Social Psychology, 51, 74–80. https://doi.org/10.1016/j.jesp.2013.11.009
  26. Mensinger, J.L., Calogero, R.M., Stranges, S. & Tylka, T.L. (2016). A weight-neutral versus weight-loss approach for health promotion in women with high BMI: A randomized-controlled trial. Appetite, 105, 364–374. https://doi.org/10.1016/j.appet.2016.06.006
  27. NOS, van Eijndhoven, J. (2019, 27 november). Nederlanders groeien vooral nog in de breedte. Opgehaald van https://nos.nl/artikel/2312186- nederlanders-groeien-vooral-nog-in-de-breedte.html
  28. Nowrouzi, B., Mcdougall, A., Gohar, B., Nowrouz-Kia, B., Casole, J. & Ali, F. (2015). Weight Bias in the Workplace: A Literature Review. Occu- pational Medicine & Health Affairs, 3(3). https://doi.org/10.4172/2329-6879.1000206
  29. Ortega, F.B., Ruiz, J.R., Labayen, I., Lavie, C.J. & Blair, S.N. (2018). The Fat but Fit paradox: what we know and don’t know about it. Br J Sports Med, 52(3), 151–153. https://doi.org/doi:10.1136/bjsports-2016-097400
  30. Overbeek, P. (2018). Grote zorgen om ‘fat shaming’ in samenleving. Opge- haald van https://overgewichtnederland.org/grote-zorgen-om-fat- shaming-in-samenleving/
  31. Patterson, C. & Hilton, S. (2013). Normalisation and Stigmatisation of Obesity in UK Newspapers: a Visual Content Analysis. The Open Obesity Journal, 5, 82–91. https://doi.org/10.2174/1876823720131001011
  32. Penney, T.L. & Kirk, S.F.L. (2015). The Health at Every Size Paradigm and Obe sity: Missing Empirical Evidence May Help Push the Reframing Obesity Debate Forward. American Journal of Public Health, 105(5), 38–42. https://doi.org/10.2105/AJPH.2015.302552
  33. Previte, J. & Gurrieri, L. (2015). Who Is the Biggest Loser? Fat News Coverage Is a Barrier to Healthy Lifestyle Promotion. Health Marketing Quarterly, 32(4), 330–349. https://doi.org/10.1080/07359683.2015.1093881
  34. Provencher, V., Bégin, C., Tremblay, A., Mongeau, L., Corneau, L., Dodin, S., ... Lemieux, S. (2009). Health-At-Every-Size and Eating Behaviors: 1-Year Follow-Up Results of a Size Acceptance Intervention. Journal of the American Dietetic Association, 109(11), 1854–1861. https://doi.org/10.1016/j.jada.2009.08.017
  35. Puhl, R.M. & Heuer, C.A. (2009). The stigma of obesity: A review and update. Obesity, 17(5), 941–964. https://doi.org/10.1038/oby.2008.636
  36. Puhl, R.M. & King, K.M. (2013). Weight discrimination and bullying. Best Practice & Research Clinical Endocrinology & Metabolism, 27(2), 117–127. https://doi.org/10.1016/j.beem.2012.12.002
  37. Puhl, R., Wharton, C. & Heuer, C. (2009). Weight Bias among Dietetics Students: Implications for Treatment Practices. Journal of the American Dietetic Association, 109(3), 438–444. https://doi.org/10.1016/j.jada.2008.11.034
  38. Reel, J.J. & Stuart, A.R. (2012). Is The “Health at Every Size” Approach Useful for Addressing Obesity? J Community Med Health Educ, 2(4). https://doi.org/10.4172/2161-0711.1000e105
  39. Robinson, E., Sutin, A. & Daly, M. (2017). Perceived Weight Discrim- ination Mediates the Prospective Relation Between Obesity and Depressive Symptoms in U. S. and U. K. Adults. Health Psychology, 36(2), 112–121. http://dx.doi.org/10.1037/hea0000426
  40. Schaefer, J.T. & Magnuson, A.B. (2014). A Review of Interventions that Promote Eating by Internal Cues. Journal of the Academy of Nutrition and Dietetics, 114(5), 734–760. https://doi.org/10.1016/j.jand.2013.12.024
  41. Sikorski, C., Spahlholz, J., Hartlev, M. & Riedel-Heller, S.G. (2016). Weight-based discrimination: an ubiquitary phenomenon? International Journal of Obesity, 40(2), 333–337. https://doi.org/10.1038/ijo.2015.165
  42. Tobias, D.K. (2017). Addressing Reverse Causation Bias in the Obesity Paradox Is Not “One Size Fits All.” Diabetes Care, 40(8), 1000–1001. https://doi.org/10.2337/dci17-001
  43. Tobias, D.K. & Manson, J.E. (2018). The Obesity Paradox in Type 2 Diabetes and Mortality. American Journal of Lifestyle Medicine, 12(3), 244–251. https://doi.org/10.1177/1559827616650415
  44. Tomiyama, A.J., Ahlstrom, B. & Mann, T. (2013). Long-term Effects of Dieting: Is Weight Loss Related to Health? Social and Personality Psy- chology Compass, 7(12), 861–877. https://doi.org/10.1111/spc3.12076
  45. Ulian, M.D., Aburad, L., Da Silva Oliveira, M.S., Poppe, A.C.M., Sabatini, F., Perez, I., ... Baeza Scagliusi, F. (2018). Effects of health at every size® interventions on health-related outcomes of people with overweight and obesity: a systematic review. Obesity Reviews, 19(12), 1659–1666. https://doi.org/10.1111/obr.12749
  46. Van Dyke, N. & Drinkwater, E.J. (2013). Relationships between intuitive eating and health indicators: literature review. Public Health Nutrition, 17(8), 1757–1766. https://doi.org/10.1017/S1368980013002139
  47. Webb, J.B., Vinoski, E.R., Bonar, A.S., Davies, A.E. & Etzel, L. (2017). Fat is fashionable and fit: A comparative content analysis of Fatspiration and Health at Every Size® Instagram images. Body Image, 22, 53–64. https://doi.org/10.1016/j.bodyim.2017.05.003
  48. WHO. (2017). Global Health Observatory (GHO) data. Overweight and obesity. Opgehaald van https://www.who.int/gho/ncd/risk_factors/overweight/en/
  49. Wu, Y. & Berry, D.C. (2018). Impact of weight stigma on physiological and psychological health outcomes for overweight and obese adults: A systematic review. Journal of Advanced Nursing, 74(5), 1030–1042. https://doi.org/10.1111/jan.13511