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.
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Agerstrom, J., & Rooth, D. O. (2011). The role of automatic obesity stereotypes in real hiring discrimination. Journal of Applied Psychology, 96, 790–805. https://doi.org/10.1037/a0021594
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. https://doi.org/10.1111/cob.12147
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.
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. https://doi.org/10.1016/j.eatbeh.2014.04.005
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.
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. https://doi.org/10.1177/1745691610393980
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. https://doi.org/10.1007/s12160-009-9109-4
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. https://doi.org/10.1080/02701367.2009.10599605
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. https://doi.org/10.1037/pspa0000016
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.
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. https://doi.org/10.1037/a0015575
Hahn, A., Judd, C. M., Hirsh, H. K., & Blair, I. V. (2014). Awareness of implicit attitudes. Journal of Experimental Psychology: General, 143, 1369–1392. https://doi.org/10.1037/a0035028
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. https://doi.org/10.1177/0146167205275613
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. https://doi.org/10.1186/1472-6920-14-53
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. https://doi.org/10.1002/eat.22858
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. https://doi.org/10.1111/josh.12287
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.
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. https://doi.org/10.1038/sj.ijo.0803398
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. https://doi.org/10.1111/medu.12770
Pont, S. J., Puhl, R., Cook, S. R., Slusser, W., Section On, O., & Obesity, S. (2017). Stigma experienced by children and adolescents with. Obesity. https://doi.org/10.1542/peds.2017-3034
Puhl, R. M., & Heuer, C. A. (2009). The stigma of obesity: A review and update. Obesity, 17, 941–964. https://doi.org/10.1038/oby.2008.636
Puhl, R. M., & Latner, J. D. (2007). Stigma, obesity, and the health of the nation’s children. Psychological Bulletin, 133, 557–580. https://doi.org/10.1037/0033-2909.133.4.557
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. https://doi.org/10.1001/jama.289.14.1813
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. https://doi.org/10.1542/peds.2016-3936
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. https://doi.org/10.1159/000348714
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. https://doi.org/10.1038/sj.ijo.0801745
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.
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. https://doi.org/10.1002/oby.20910
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. https://doi.org/10.1016/j.jpsychores.2017.07.007
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. https://doi.org/10.1111/ijcp.12902
U.S. Equal Employment Opportunity Commission, (1978). Uniform Guidelines on Employee Selection Procedures § 1607.4.D. Retrieved from: https://www.gpo.gov/fdsys/pkg/CFR-2013-title29-vol4/xml/CFR-2013-title29-vol4-part1607.xml
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. https://doi.org/10.1038/oby.2009.347
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.
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.
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Lydecker, J.A., O’Brien, E. & Grilo, C.M. Parents have both implicit and explicit biases against children with obesity. J Behav Med 41, 784–791 (2018). https://doi.org/10.1007/s10865-018-9929-4
- Implicit bias
- Weight stigma
- Body image