A study published in l’American Journal of Preventive Medicine shows that weight-related prejudices are widespread among French adults, in particular the reductive idea that obesity is due to a lack of willpower.
This work was carried out by a consortium of researchers from the Nutritional Epidemiology Research Team (EREN) of the Sorbonne Paris Nord University and Paris Cité University, Inserm, INRAE, CNAM, Center for Research in Epidemiology and Statistics (CRESS) and nutrition services at the Pitié-Salpêtrière Hospital and the European Georges Pompidou Hospital (AP-HP).
Study context
A significant proportion of people with obesity say they have already been the victim of stigmatization because of their weight, mainly from family, classmates, a doctor, or work colleagues. The consequences of this stigmatization are numerous and include a lower academic success, an alteration of social relations, an increase in eating disorders and anxiety and depressive symptoms, an avoidance of physical activities, an accentuated weight gain or even a lesser recourse to taking care.
Weight-related prejudices, and in particular the acceptance of the idea that people with obesity “lack willpower”, are among the main causes of the stigmatization of people with obesity. Studies carried out abroad have shown that weight prejudice is widespread in the population, particularly among men. To date, however, no study has assessed weight prejudice in a large population of French adults.
Objective of the study and main results
The objective of this study was to assess the negative prejudices related to weight among the participants of the NutriNet-Santé study (see box).
Explicit weight-related biases (defined as conscious and intentional biases) were assessed in 2019 among 33,948 French adults participating in the NutriNet-Santé study. Of these, 24% were overweight and 11% obese, for a total of 35% overweight or obese. The data was adjusted for gender, age, socio-professional category, level of education and residential area to optimize the representativeness of the sample in relation to the French population.
Prejudices related to weight were assessed using the “Anti-Fat Attitude Questionnaire” (Crandall, 1994) assessing three dimensions: 1) antipathy towards people with obesity (example of question: “If I were an employer, I might avoid hiring an overweight person”), 2) excessive preoccupation with weight (sample question: “One of the worst things that might happen to me would be gaining 10 kg”, and 3) agreement with the idea that obesity is linked to a lack of willpower (example of question: “Some people are overweight because they have no will).
Several results emerge from the analyzes carried out by the scientists:
1) Antipathy scores towards obese people were low, with 9% of participants (12% of men and 6% of women) presenting negative prejudices on this point. However, it cannot be ruled out that real prejudices are more widespread and that a potential social desirability bias might have led to under-reporting.
2) Excessive preoccupation with weight was the most common bias, with 55% of participants (62% of women and 47% of men) showing high scores. Scores were higher in people with obesity and in students, in both women and men. The questionnaire used did not make it possible to know whether it was a preoccupation with regard to one’s weight to preserve one’s health or an excessive preoccupation with satisfying the criteria of beauty and thinness as conveyed through the media and social networks. Further studies will be needed to better understand the origin of this concern.
3) With regard to the prejudice relating to the “lack of willpower”, 45% of the people questioned (38% of women, 54% of men) presented high scores indicating support for the idea that obesity is due to a lack of will. People with obesity had lower but not zero scores, which suggests an internalization of these prejudices by people who suffer from obesity. Lower educational attainment was also associated with higher scores, suggesting a role of education in limiting weight bias.
Interpretation of results and perspectives
The results of this study show that the negative prejudices linked to obesity are very widespread among adults in France, and correspond more to an excessive preoccupation with gaining weight and the belief that obesity is linked to a lack of willpower. than an antipathy towards people with obesity. They emphasize the need to implement measures likely to change society’s view of obesity and the people who suffer from it. Obesity is a so-called multifactorial pathology involving behavioral factors (primarily our eating habits and physical activity), environmental and societal, and biological factors. It is therefore simplistic to believe that the way we eat and move is simply a matter of personal choice.
If the daily choices must be oriented in a direction favorable to health and weight maintenance, “it is by acting upstream on the determinants of these choices, in particular by modifying our living environment to make it more favorable to health, that we can hope to prevent the continuous increase in obesity in France and in the world. At the same time, it is fundamental to fight once morest the prejudices according to which people in a situation of obesity are so only because of a lack of personal motivation. »
L’étude NutriNet-Santé est une étude de santé publique coordonnée par l’Équipe de recherche en épidémiologie nutritionnelle du Centre de recherche en épidémiologie et statistiques (Université Sorbonne Paris Nord/Inserm/INRAE/Cnam/Université Paris Cité), qui, grâce à l’engagement et à la fidélité de plus de 170 000 Nutrinautes, fait avancer la recherche sur les liens entre la nutrition (alimentation, activité physique, état nutritionnel) et la santé. Lancée en 2009, l’étude a déjà donné lieu à plus de 250 publications scientifiques internationales. Un appel au recrutement de nouveaux Nutrinautes est toujours lancé afin de continuer à faire avancer la recherche sur les relations entre la nutrition et la santé. En consacrant quelques minutes par mois à répondre, via Internet, sur la plateforme sécurisée etude-nutrinet-sante.fr aux différents questionnaires relatifs à l’alimentation, à l’activité physique et à la santé, les participants contribuent à faire progresser les connaissances sur les relations entre l’alimentation et la santé.
Inserm, press release, March 30, 2023
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