Weight bias and support of public health policies

Abstract

Objectives

Public health policies have been proposed to help address prevalent Canadian obesity rates. Along with the increase in obesity prevalence, explicit weight bias is also rampant in Western society. This paper aimed to assess the association between explicit weight bias attitudes and Canadian public support of these policy recommendations.

Methods

Canadian adults (N = 903; 51% female; BMI = 27.3 ± 7.0 kg/m2) completed an online survey measuring explicit weight bias, using the three subscales of the Anti-Fat Attitudes Questionnaire: Willpower (belief in weight controllability), Fear of fat (fear of gaining weight), and Dislike (antipathy towards people with obesity). Whether these subscales were associated with policy support was assessed with logistic regression. Analyses were adjusted for age, race, gender, and income.

Results

Public support of policy recommendations ranged from 53% to 90%. Explicit weight bias was primarily expressed through a fear of weight gain and the belief that weight gain was within the individual’s control based on willpower. Although the Dislike subscale was associated with lower support for several policies that enable or guide individual choice in behaviour change, the Willpower and Fear of fat subscales were associated with greater support for similar policies.

Conclusion

This study contributes to evidence-informed public health action by describing public support of public health policies and demonstrating an association between explicit weight bias and public support. A higher total explicit weight bias score increased the odds of supporting primarily less intrusive policies. However, dislike of individuals with obesity was associated with decreased odds of supporting many policies.

Résumé

Objectifs

Il a été proposé que les politiques de santé publique soient adoptées pour contribuer à réduire la prévalence de l’obésité au Canada. Le biais et les préjugés liés au poids ont augmenté considérablement avec l’accroissement de la prévalence de l’obésité dans notre société occidentale. L’objectif de notre étude était d’examiner si le biais explicite lié au poids était associé au soutien des politiques et des stratégies canadiennes de prévention de l’obésité.

Méthode

Des adultes canadiens (N = 903; 51 % femmes; IMC = 27,3 ± 7,0 kg/m2) ont répondu à un questionnaire en ligne qui examinait le biais explicite lié au poids (en utilisant les trois composantes du questionnaire Anti-Fat Attitudes Questionnaires: la volonté, la peur du gain de l’excès de poids, et l’aversion). Une regression logistique a été employée pour examiner si les trois composantes du biais lié au poids étaient associées au soutien des politiques canadiennes. L’âge, la race, le sexe et le revenu ont été pris en compte dans les analyses.

Résultats

Le soutien du public aux recommandations des politiques variait de 53 % à 90 %. Le biais explicite relié au poids s’exprimait principalement par une peur du gain de poids, et la croyance que c’est à l’individu qu’il revient de maîtriser le gain de poids par sa volonté. La composante de l’aversion était associée à un soutien plus faible des politiques qui guident l’individu à faire ses propres choix pour changer ses comportements, mais les composantes de la volonté et la peur du gain de poids étaient associés avec un plus grand soutient de ces politiques.

Conclusion

Cette étude basée sur des données scientifiques contribue à l’action de santé publique en décrivant le soutien accordé par le public aux politiques canadiennes de prévention de l’obésité et démontrant une association entre le biais explicite relié au poids et le soutien du public. Le biais explicite relié au poids plus élevé augmentait la chance du soutien des politiques moins intrusives. L’aversion pour les personnes qui présentent de l’obésité était associé à un faible soutien de plusieurs politiques.

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Funding

The first author was supported by the France and André Desmarais and the William R. Sellers graduate student fellowships at Concordia University, Montréal. The second and third authors both hold Junior 1 salary awards from les Fonds de Recherche du Québec – Santé.

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Authors

Contributions

All authors were involved in the conception and design of this study. Since the results reported in this manuscript were also presented in partial fulfillment of the first author’s M.Sc. degree, similar results are published in a research repository. The first author was responsible for the acquisition of data, conducting the data analysis and interpreting the results with guidance from the second and third authors. The first author drafted the manuscript which was revised and edited by the second and third authors. All authors approved the final version of this manuscript.

Corresponding author

Correspondence to Angela S. Alberga.

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Conflict of interest

The first author received funding for a Mitacs Accelerate Fellowship for another research project, unrelated to the submitted work, under the supervision of the third author. The second author has no conflicts of interest to disclose.

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Edache, I.Y., Kakinami, L. & Alberga, A.S. Weight bias and support of public health policies. Can J Public Health 112, 758–765 (2021). https://doi.org/10.17269/s41997-020-00471-7

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Keywords

  • Canada
  • Obesity
  • Policy
  • Public health
  • Bias
  • Weight stigma

Mots-clés

  • Canada
  • obésité
  • politique (principe)
  • santé publique
  • biais
  • préjugés liés au poids