Résumés
Résumé
La stigmatisation basée sur le poids est un enjeu sociétal important, puisqu’elle engendre une exclusion sociale marquée pouvant générer du stress et nuire à la santé physique et mentale des personnes qui en sont la cible, en plus de contribuer à maintenir l’obésité. La présente étude vise à explorer les prédicteurs sociodémographiques et individuels des attitudes négatives face à l’obésité au sein d’un échantillon d’adultes québécois. Un sondage en ligne par questionnaires a été complété par 1615 adultes résidant au Québec. La taille et le poids ont été autorapportés afin de calculer l’indice de masse corporelle (IMC). Des analyses acheminatoires avec estimateurs robustes ont permis d’examiner les prédicteurs de trois attitudes négatives face à l’obésité, soit la dépréciation de l’obésité, la peur de prendre du poids et les croyances quant à la contrôlabilité du poids. Les résultats montrent que les expériences passées de stigmatisation basée sur le poids, l’IMC ainsi que le genre des répondants sont les prédicteurs les plus fortement associés aux attitudes négatives face à l’obésité. La fréquence des expériences passées de stigmatisation est associée à des scores plus élevés d’attitudes négatives face à l’obésité. De plus, il semble que les hommes et les personnes dont le poids est plus bas soient plus critiques envers l’obésité, alors que les femmes craignent davantage de prendre du poids. Ces résultats alimentent les efforts de prévention et d’intervention en matière de stigmatisation à l’égard du poids.
Mots-clés :
- attitudes négatives,
- préjugés,
- obésité,
- adultes québécois,
- caractéristiques sociodémographiques,
- stigmatisation basée sur le poids
Abstract
Weight-based stigmatization is an important societal issue because it may lead to significant social exclusion that can induce stress and contribute to poor physical and mental health in people who are targeted. It may also ironically contribute to the maintenance of obesity. The present study aimed to explore sociodemographic and individual predictors of negative attitudes towards obesity in the general population of the province of Quebec. An online survey was completed by 1615 adults living in Quebec. Height and weight were self-reported to calculate body mass index (BMI). A path analysis was performed with robust estimators in order to examine predictors of three negative attitudes towards obesity, namely dislike of fat people, fear of fat, and willpower (i.e., beliefs about the controllability of weight and fat). The results showed that respondents’ experiences of weight-based stigmatization, BMI, and gender are the most important predictors of negative attitudes towards obesity. The frequency of experiences of weight-based stigmatization was associated with increased negative attitude scores. Furthermore, men and lower weight individuals appeared to be more critical of obesity, whereas women were more afraid to gain weight. These findings inform prevention and intervention efforts regarding weight-based stigma.
Keywords:
- antifat attitudes,
- prejudices,
- obesity,
- sample of Quebecers,
- sociodemographic characteristics,
- weight-based stigmatization
Parties annexes
Bibliographie
- Andreeva, V. A., Salanave, B., Castetbon, K., Deschamps, V., Vernay, M., Kesse-guyot, E. et Hercberg, S. (2015). Comparison of the sociodemographic characteristics of the large NutriNet-Santé e-cohort with French Census data : the issue of volunteer bias revisited. Journal of Epidemiology et Community Health, 69, 893-898. https://doi.org/10.1136/jech-2014-205263
- Bernard, M., Fankhänel, T., Riedel-Heller, S. G. et Luck-Sikorski, C. (2019). Does weight-related stigmatisation and discrimination depend on educational attainment and level of income? A systematic review. BMJ Open, 9(11), 1-16. https://doi.org/10.1136/bmjopen-2018-027673
- Blodorn, A., Major, B., Hunger, J. et Miller, C. (2016). Unpacking the psychological weight of weight stigma: A rejection-expectation pathway. Journal of Experimental Social Psychology, 63, 69-76. https://doi.org/10.1016/j.jesp.2015.12.003
- Corrigan, P. W., Green, A. E., Lundin, R., Kubiak, M. A. et Penn, D. L. (2001). Familiarity with and social distance from people who have serious mental illness. Psychiatric Services, 52(7), 953-958. https://doi.org/10.1176/appi.ps.52.7.953
- Crandall, C S. (1994). Prejudice against fat people: ideology and self-interest. Journal of Personality and Social Psychology, 66(5), 882-894. https://doi.org/10.1037/0022-3514.66.5.882
- Crandall, Christian S., D’Anello, S., Sakalli, N., Lazarus, E., Wieczorkowska, G. et Feather, N. T. (2001). An attribution-value model of prejudice: Anti-fat attitudes in six nations. Personality and Social Psychology Bulletin, 27(1), 30-37. https://doi.org/10.1177/0146167201271003
- Durso, L. E. et Latner, J. D. (2008). Understanding self-directed stigma: Development of the weight bias internalization scale. Obesity, 16(2), 80-86. https://doi.org/10.1038/oby.2008.448
- Elran-Barak, R. et Bar-Anan, Y. (2018). Implicit and explicit anti-fat bias: The role of weight-related attitudes and beliefs. Social Science and Medicine, 204(June 2017), 117-124. https://doi.org/10.1016/j.socscimed.2018.03.018
- Grabe, S., Ward, L. M. et Hyde, J. S. (2008). The role of the media in body image concerns among women: a meta-analysis of experimental and correlational studies. Psychological Bulletin, 134(3), 460-476.
- Hansson, L. M. et Rasmussen, F. (2014). Attitudes towards obesity in the Swedish general population: The role of one’s own body size, weight satisfaction, and controllability beliefs about obesity. Body Image, 11(1), 43-50. https://doi.org/10.1016/j.bodyim.2013.10.004
- Hilbert, A., Rief, W. et Braehler, E. (2008). Stigmatizing attitudes toward obesity in a representative population-based sample. Obesity, 16(7), 1529-1534. https://doi.org/10.1038/oby.2008.263
- Hu, L. et Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1-55. https://doi.org/10.1080/10705519909540118
- Hunger, J. M., Major, B., Blodorn, A. et Miller, C. T. (2015). Weighed down by stigma: How weight-based social identity threat contributes to weight gain and poor health. Social and Personality Psychology Compass, 9(6), 255-268. https://doi.org/10.1111/spc3.12172
- Institut de la statistique du Québec. (2022a). Distribution selon la tranche de revenu, revenu total, particuliers de 16 ans et plus, Québec, 2019. https://statistique.quebec.ca/fr/produit/tableau/distribution-selon-la-tranche-de-revenu-revenu-total-particuliers-16-ans-et-plus-quebec-2017
- Institut de la statistique du Québec. (2022b). Répartition de la population de 25 à 64 ans selon le plus haut niveau de scolarité atteint, la région administrative, l’âge et le sexe, Québec. https://statistique.quebec.ca/fr/document/repartition-de-la-population-de-25-a-64-ans-selon-le-plus-haut-niveau-de-scolarite-atteint-la-region-administrative-lage-et-le-sexe-quebec/tableau/repartition-de-la-population-de-25-a-64-ans-selon-le-plus-haut-niveau-de-scolarite-atteint-la-region-administrative-lage-et-le-sexe-quebec#tri_tertr=50040000000000000&tri_sexe=1&tri_age=365&tri_stat=8404
- Institut national de santé publique du Québec. (2020). Obésité. https://www.inspq.qc.ca/santescope/syntheses/obesite
- Jackson, S. E., Kirschbaum, C. et Steptoe, A. (2016). Perceived weight discrimination and chronic biochemical stress: A population-based study using cortisol in scalp hair. Obesity, 24(12), 2515-2521. https://doi.org/10.1002/oby.21657
- Kim, T. J., Makowski, A. C. et von dem Knesebeck, O. (2019). Obesity stigma in Germany and the United States - Results of population surveys. PLoS ONE, 14(8), 1-12. https://doi.org/10.1371/journal.pone.0221214
- Knerr, S., Bowen, D. J., Beresford, S. A. A. et Wang, C. (2016). Genetic causal beliefs about obesity , self-efficacy for weight control, and obesity-related behaviours in a middle-aged female cohort. Psychology et Health, 31(4), 420-435. https://doi.org/10.1080/08870446.2015.1115503
- LaCroix, E., Alberga, A., Russell-Mathew, S., McLaren, L. et Von Ranson, K. (2017). Weight bias: A systematic review of characteristics and psychometric properties of self-report questionnaires. Obesity Facts, 10(3), 223-237. https://doi.org/10.1159/000475716
- Little, R. J. (1988). A test of missing completely at random for multivariate data with missing values. Journal of the American Statistical Association, 83(404), 1198-1202.
- Mogre, V., Aleyira, S. et Nyaba, R. (2015). Misperception of weight status and associated factors among undergraduate students. Obesity Research et Clinical Practice, 9(5), 466-474. https://doi.org/10.1016/j.orcp.2015.03.002
- Muthén, L. K. et Muthén, B. O. (2017). Mplus user’s Guide (8e éd.). Muthén et Muthén.
- Myers, A. et Rosen, J. C. (1999). Obesity stigmatization and coping: Relation to mental health symptoms, body image, and self-esteem. International Journal of Obesity, 23(3), 221-230. http://www.ncbi.nlm.nih.gov/pubmed/10193866
- Neter, J., Wasserman, W. et Kutner, M. H. (1985). Applied linear regression models. In Applied Linear Regression Models. Richard D. Irwin.
- O’Brien, K. S., Daníelsdóttir, S., Ólafsson, R. P., Hansdóttir, I., Fridjónsdóttire, T. G. et Jónsdóttir, H. (2020). The relationship between physical appearance concerns, disgust, and anti-fat prejudice. Body Image, 10, 619-623. https://doi.org/10.1016/j.bodyim.2013.07.012
- O’Keeffe, M., Flint, S. W., Watts, K. et Rubino, F. (2020). Knowledge gaps and weight stigma shape attitudes toward obesity. The Lancet Diabetes and Endocrinology, 8(5), 363-365. https://doi.org/10.1016/S2213-8587(20)30073-5
- Organisation mondiale de la Santé (OMS). (2018). Obésité et surpoids. https://www.who.int/fr/news-room/fact-sheets/detail/obesity-and-overweight
- Prunty, A., Clark, M. K., Hahn, A., Edmonds, S. et O’Shea, A. (2020). Enacted weight stigma and weight self stigma prevalence among 3821 adults. Obesity Research and Clinical Practice, 14(5), 421-427. https://doi.org/10.1016/j.orcp.2020.09.003
- Puhl, R. M., Himmelstein, M. S. et Quinn, D. M. (2018). Internalizing weight stigma: Prevalence and sociodemographic considerations in US adults. Obesity, 26(1), 167-175. https://doi.org/10.1002/oby.22029
- Puhl, R. M., Latner, J. D., O’Brien, K., Luedicke, J., Danielsdottir, S. et Forhan, M. (2015). A multinational examination of weight bias: Predictors of anti-fat attitudes across four countries. International Journal of Obesity, 39(7), 1166-1173. https://doi.org/10.1038/ijo.2015.32
- Puhl, R. M., Lessard, L. M., Pearl, R. L., Himmelstein, M. S. et Foster, G. D. (2021). International comparisons of weight stigma: addressing a void in the field. International Journal of Obesity, 1-10. https://doi.org/10.1038/s41366-021-00860-z
- Puhl, R. M., Moss-Racusin, C. A., Schwartz, M. B. et Brownell, K. D. (2008). Weight stigmatization and bias reduction: Perspectives of overweight and obese adults. Health Education Research, 23(2), 347-358. https://doi.org/10.1093/her/cym052
- Puhl, R et Brownell, K. D. (2001). Bias, discrimination, and obesity. Obesity Research, 9(12), 788-805. https://doi.org/10.1038/oby.2001.108
- Puhl, R et Heuer, C. (2009). The stigma of obesity: A review and update. Journal of Obesity, 17(5), 941-964. https://doi.org/10.1038/oby.2008.636
- Puhl, Rebecca et Suh, Y. (2015). Health consequences of weight stigma: Implications for obesity prevention and treatment. Current Obesity Reports, 4(2), 182-190. https://doi.org/10.1007/s13679-015-0153-z
- Rubino, F., Puhl, R. M., Cummings, D. E., Eckel, R. H., Ryan, D. H., Mechanick, J. I., Nadglowski, J., Ramos Salas, X., Schauer, P. R., Twenefour, D., Apovian, C. M., Aronne, L. J., Batterham, R. L., Berthoud, H. R., Boza, C., Busetto, L., Dicker, D., De Groot, M., Eisenberg, D., … Dixon, J. B. (2020). Joint international consensus statement for ending stigma of obesity. Nature Medicine, 26(4), 485-497. https://doi.org/10.1038/s41591-020-0803-x
- Ruggs, E. N., King, E. B., Hebl, M. et Fitzsimmons, M. (2010). Assessment of weight stigma. Obesity Facts, 3(1), 60-69. https://doi.org/10.1159/000273208
- Schafer, M. H. et Ferraro, K. F. (2011). The stigma of obesity: Does perceived weight discrimination affect identity and physical health? Social Psychology Quarterly, 74(1), 76-97. https://doi.org/10.1177/0190272511398197
- Schwartz, M. B., Vartanian, L. R., Nosek, B. A. et Brownell, K. D. (2006). The influence of one’s own body weight on implicit and explicit anti-fat bias. Obesity, 14(3), 440-447. https://doi.org/10.1038/oby.2006.58
- Sikorski, C., Luppa, M., Brähler, E., König, H. H. et Riedel-Heller, S. G. (2012). Obese children, adults and senior citizens in the eyes of the general public: Results of a representative study on stigma and causation of obesity. PLoS ONE, 7(10). https://doi.org/10.1371/journal.pone.0046924
- Slof-Op ‘t Landt, M. C. T., van Furth, E. F., van Beijsterveldt, C. E. M., Bartels, M., Willemsen, G., de Geus, E. J., Ligthart, L. et Boomsma, D. I. (2017). Prevalence of dieting and fear of weight gain across ages: a community sample from adolescents to the elderly. International Journal of Public Health, 62(8), 911-919. https://doi.org/10.1007/s00038-017-0948-7
- Statistique Canada. (2021). Indice de masse corporelle, embonpoint ou obèse, autodéclaré corrigé, adulte, selon le groupe d’âge (18 ans et plus). Enquête sur la santé dans les collectivités canadiennes. https://www150.statcan.gc.ca/t1/tbl1/fr/tv.action?pid=1310009620&pickMembers%5B0%5D=1.6&pickMembers%5B1%5D=3.1&cubeTimeFrame.startYear=2018&cubeTimeFrame.endYear=2019&referencePeriods=20180101%2C20190101
- Sutin, A. et Terracciano, A. (2013). Perceived weight discrimination and obesity. Plos ONE, 8(7), 1-4. https://doi.org/10.1371/journal.pone.0070048
- Thornton, L., Batterham, P. J., Fassnacht, D. B., Kay-lambkin, F., Calear, A. L. et Hunt, S. (2016). Recruiting for health , medical or psychosocial research using Facebook : Systematic review. Internet Interventions, 4, 72-81. https://doi.org/10.1016/j.invent.2016.02.001
- Tomiyama, J. A. (2014). Weight stigma is stressful. A review of evidence for the cyclic Obesity/weight-based stigma model. Appetite, 82, 8-15. https://doi.org/10.1016/j.appet.2014.06.108
- Vallis, M. et Macklin, D. (2021). When behaviour meets biology: if obesity is a chronic medical disease what is obesity management? Clinical Obesity, December 2020. https://doi.org/10.1111/cob.12443
- Vartanian, L. R., Peter Herman, C. et Polivy, J. (2005). Implicit and explicit attitudes toward fatness and thinness: The role of the internalization of societal standards. Body Image, 2(4), 373-381. https://doi.org/10.1016/j.bodyim.2005.08.002
- Wellman, J. D., Araiza, A. M., Newell, E. E. et Mccoy, S. K. (2018). Weight stigma facilitates unhealthy eating and weight gain via fear of fat. Stigma and Health, 3(3), 186-194. https://doi.org/http://dx.doi.org/10.1037/sah0000088