Journal of Behavioral Medicine

, Volume 41, Issue 6, pp 784–791 | Cite as

Parents have both implicit and explicit biases against children with obesity

  • Janet A. LydeckerEmail author
  • Elizabeth O’Brien
  • Carlos M. Grilo


Weight bias (negative attitudes towards individuals with obesity) has been widely observed, but not examined in parents. In this study, we measured parents’ (N = 658; 74.2% female) explicit and implicit weight bias against children with obesity. Many parents (n = 612; 93%) endorsed some moderate explicit weight bias. Fathers had greater explicit bias than mothers and parents with overweight/obesity had less bias than those with healthy-weight. Other parent/child variables (i.e., parent age, child sex, child weight, child age) were not significantly associated with explicit bias. Parents also demonstrated implicit weight bias. No parent or child variables were significantly associated with implicit bias. Parents may contribute, among many others, to the stigmatizing environment experienced by youth with overweight/obesity, which has been associated with negative child psychosocial functioning and health. Clinical research into strategies to reduce parental weight bias against children with obesity or increase children’s resilience to weight discrimination is needed to improve children’s health and well-being.


Implicit bias Weight stigma Body image Parents 



This research was funded, in part, by National Institutes of Health (K24 DK070052). An earlier version of this research was presented at the Society for Adolescent Health and Medicine annual conference in 2017.

Compliance with Ethical Standards

Conflict of interest

Janet A. Lydecker, Elizabeth O’Brien, and Carlos M. Grilo declare that they have no conflict of interest. Dr. Grilo reports no relevant direct or indirect conflicts of interest with respect to this study, but reports the following recent and previous broader interests. For the past 12-months, Dr. Grilo reports receiving honoraria for lectures delivered for CME-related activities and plenaries and lectures at professional academic conferences and reports royalties from academic books published by Guilford Press and Taylor & Francis Publishers. Beyond 12-months, Dr. Grilo reports having received consultant fees from Shire and Sunovion, and honoraria for CME-related lectures and for lectures delivered at grand rounds and professional academic conferences nationally and internationally.

Human and animal rights and Informed consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.


  1. Agerstrom, J., & Rooth, D. O. (2011). The role of automatic obesity stereotypes in real hiring discrimination. Journal of Applied Psychology, 96, 790–805. CrossRefPubMedGoogle Scholar
  2. Alberga, A. S., Pickering, B. J., Alix Hayden, K., Ball, G. D., Edwards, A., Jelinski, S., et al. (2016). Weight bias reduction in health professionals: A systematic review. Clinical Obesity, 6, 175–188. CrossRefPubMedGoogle Scholar
  3. Allison, D. B., Basile, V. C., & Yuker, H. E. (1991). The measurement of attitudes toward and beliefs about obese persons. International Journal of Eating Disorders, 10, 599–607.Google Scholar
  4. Ambwani, S., Thomas, K. M., Hopwood, C. J., Moss, S. A., & Grilo, C. M. (2014). Obesity stigmatization as the status quo: Structural considerations and prevalence among young adults in the U.S. Eating Behaviors, 15, 366–370. CrossRefPubMedGoogle Scholar
  5. Birch, L. L., Fisher, J. O., Grimm-Thomas, K., Markey, C. N., Sawyer, R., & Johnson, S. L. (2001). Confirmatory factor analysis of the Child Feeding Questionnaire: A measure of parental attitudes, beliefs and practices about child feeding and obesity proneness. Appetite, 36, 201–210.CrossRefGoogle Scholar
  6. Buhrmester, M., Kwang, T., & Gosling, S. D. (2011). Amazon’s Mechanical Turk: A new source of inexpensive, yet high-quality, data? Perspectives on Psychological Science, 6, 3–5. CrossRefPubMedGoogle Scholar
  7. Carels, R. A., Young, K. M., Wott, C. B., Harper, J., Gumble, A., Oehlof, M. W., et al. (2009). Weight bias and weight loss treatment outcomes in treatment-seeking adults. Annals of Behavioral Medicine, 37, 350–355. CrossRefPubMedPubMedCentralGoogle Scholar
  8. Gay, J., Monsma, E. V., & Torres-McGehee, T. (2009). Give or take a few? Comparing measured and self-reported height and weight as correlates of social physique anxiety. Research Quarterly for Exercise and Sport, 80, 656–662. CrossRefPubMedGoogle Scholar
  9. Greenwald, A. G., Banaji, M. R., & Nosek, B. A. (2015). Statistically small effects of the Implicit Association Test can have societally large effects. Journal of Personality and Social Psychology, 108, 553–561. CrossRefPubMedGoogle Scholar
  10. Greenwald, A. G., McGhee, D. E., & Schwartz, J. L. (1998). Measuring individual differences in implicit cognition: the implicit association test. Journal of Personality and Social Psychology, 74, 1464–1480.CrossRefGoogle Scholar
  11. Greenwald, A. G., Poehlman, T. A., Uhlmann, E. L., & Banaji, M. R. (2009). Understanding and using the Implicit Association Test: III. Meta-analysis of predictive validity. Journal of Personality and Social Psychology, 97, 17–41. CrossRefPubMedGoogle Scholar
  12. Hahn, A., Judd, C. M., Hirsh, H. K., & Blair, I. V. (2014). Awareness of implicit attitudes. Journal of Experimental Psychology: General, 143, 1369–1392. CrossRefGoogle Scholar
  13. Hofmann, W., Gawronski, B., Gschwendner, T., Le, H., & Schmitt, M. (2005). A meta-analysis on the correlation between the implicit association test and explicit self-report measures. Personality and Social Psychology Bulletin, 31, 1369–1385. CrossRefPubMedPubMedCentralGoogle Scholar
  14. Kushner, R. F., Zeiss, D. M., Feinglass, J. M., & Yelen, M. (2014). An obesity educational intervention for medical students addressing weight bias and communication skills using standardized patients. BMC Medical Education, 14, 53. CrossRefPubMedPubMedCentralGoogle Scholar
  15. Lydecker, J. A., Riley, K. E., & Grilo, C. M. (2018). Associations of parents’ self, child, and other “fat talk” with child eating behaviors and weight. International Journal of Eating Disorders. CrossRefPubMedGoogle Scholar
  16. Lynagh, M., Cliff, K., & Morgan, P. J. (2015). Attitudes and beliefs of nonspecialist and specialist trainee health and physical education teachers toward obese children: Evidence for “anti-fat” bias. Journal of School Health, 85, 595–603. CrossRefPubMedGoogle Scholar
  17. Nosek, B. A., Greenwald, A. G., & Banaji, M. R. (2005). Understanding and using the Implicit Association Test: II. Method Variables and Construct Validity, 31, 166–180.Google Scholar
  18. O’Brien, K. S., Hunter, J. A., & Banks, M. (2007). Implicit anti-fat bias in physical educators: Physical attributes, ideology and socialization. International Journal of Obesity, 31, 308–314. CrossRefPubMedGoogle Scholar
  19. Phelan, S. M., Puhl, R. M., Burke, S. E., Hardeman, R., Dovidio, J. F., Nelson, D. B., et al. (2015). The mixed impact of medical school on medical students’ implicit and explicit weight bias. Medical Education, 49, 983–992. CrossRefPubMedPubMedCentralGoogle Scholar
  20. Pont, S. J., Puhl, R., Cook, S. R., Slusser, W., Section On, O., & Obesity, S. (2017). Stigma experienced by children and adolescents with. Obesity. CrossRefPubMedGoogle Scholar
  21. Puhl, R. M., & Heuer, C. A. (2009). The stigma of obesity: A review and update. Obesity, 17, 941–964. CrossRefPubMedGoogle Scholar
  22. Puhl, R. M., & Latner, J. D. (2007). Stigma, obesity, and the health of the nation’s children. Psychological Bulletin, 133, 557–580. CrossRefPubMedGoogle Scholar
  23. Schwimmer, J. B., Burwinkle, T. M., & Varni, J. W. (2003). Health-related quality of life of severely obese children and adolescents. Jama, 289, 1813–1819. CrossRefPubMedGoogle Scholar
  24. Skinner, A. C., Payne, K., Perrin, A. J., Panter, A. T., Howard, J. B., Bardone-Cone, A., et al. (2017). Implicit weight bias in children age 9 to 11 years. Pediatrics, 140, e20163936. CrossRefPubMedPubMedCentralGoogle Scholar
  25. Swift, J. A., Tischler, V., Markham, S., Gunning, I., Glazebrook, C., Beer, C., et al. (2013). Are anti-stigma films a useful strategy for reducing weight bias among trainee healthcare professionals? Results of a pilot randomized control trial. Obesity Facts, 6, 91–102. CrossRefPubMedPubMedCentralGoogle Scholar
  26. Teachman, B. A., & Brownell, K. D. (2001). Implicit anti-fat bias among health professionals: is anyone immune? International Journal of Obesity and Related Metabolic Disorders, 25, 1525–1531. CrossRefPubMedGoogle Scholar
  27. Teachman, B. A., Gapinski, K. D., Brownell, K. D., Rawlins, M., & Jeyaram, S. (2003). Demonstrations of implicit anti-fat bias: The impact of providing causal information and evoking empathy. Health Psychology, 22, 68–78.CrossRefGoogle Scholar
  28. Tomiyama, A. J., Finch, L. E., Belsky, A. C., Buss, J., Finley, C., Schwartz, M. B., et al. (2015). Weight bias in 2001 versus 2013: Contradictory attitudes among obesity researchers and health professionals. Obesity, 23, 46–53. CrossRefPubMedGoogle Scholar
  29. Udo, T., & Grilo, C. M. (2017). Cardiovascular disease and perceived weight, racial, and gender discrimination in U.S. adults. Journal of Psychosomatic Research, 100, 83–88. CrossRefPubMedPubMedCentralGoogle Scholar
  30. Udo, T., Purcell, K., & Grilo, C. M. (2016). Perceived weight discrimination and chronic medical conditions in adults with overweight and obesity. International Journal of Clinical Practice, 70, 1003–1011. CrossRefPubMedPubMedCentralGoogle Scholar
  31. U.S. Equal Employment Opportunity Commission, (1978). Uniform Guidelines on Employee Selection Procedures § 1607.4.D. Retrieved from:
  32. White, M. A., Masheb, R. M., & Grilo, C. M. (2010). Accuracy of self-reported weight and height in binge eating disorder: Misreport is not related to psychological factors. Obesity, 18, 1266–1269. CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Janet A. Lydecker
    • 1
    Email author
  • Elizabeth O’Brien
    • 1
    • 2
  • Carlos M. Grilo
    • 1
    • 3
  1. 1.Department of PsychiatryYale School of MedicineNew HavenUSA
  2. 2.Department of PsychologyQuinnipiac UniversityHamdenUSA
  3. 3.Department of PsychologyYale UniversityNew HavenUSA

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