Discrimination and Stigma Associated with Obesity

This study explores the under-investigated area of obesity-related discrimination and stigmatization across different countries, specifically comparing Spain (Europe) and Egypt (Middle East). We conducted a cross-sectional observational study involving 2,090 participants from both countries. Partici...

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Bibliographic Details
Authors: Sánchez, Enric|||0000-0001-7345-1601, Elghazally, Noha M., El-Sallamy, Rania M., Ciudin, Andreea|||0000-0001-5622-0203, Sánchez-Bao, Ana, Hashish, Mohamed S., Barakat-Barakat, Hosam, Gutiérrez-Medina, Sonsoles, Valdés, Nuria, Flores, Lilliam|||0000-0001-5765-8813, Marí-Sanchis, Amelia, Goñi, Fernando, Sánchez, Marta, Nicolau, Joana|||0000-0001-7819-0471, Muñoz, Concepción, Díaz-Trastoy, Olaia, Cuatrecasas, Guillem, Cañizares, Silvia|||0000-0003-3730-8327, Lecube, Albert|||0000-0001-9684-0183
Format: article
Publication Date:2024
Country:España
Institution:Universitat Autònoma de Barcelona
Repository:Dipòsit Digital de Documents de la UAB
Language:English
OAI Identifier:oai:ddd.uab.cat:306715
Online Access:https://ddd.uab.cat/record/306715
https://dx.doi.org/urn:doi:10.1159/000540635
Access Level:Open access
Keyword:Bariatric surgery
Discrimination
Obesity
Stigma
Weight
Description
Summary:This study explores the under-investigated area of obesity-related discrimination and stigmatization across different countries, specifically comparing Spain (Europe) and Egypt (Middle East). We conducted a cross-sectional observational study involving 2,090 participants from both countries. Participants completed three well-validated questionnaires to assess their attitudes toward obesity, experiences of weight-related stigma, and internalization of weight bias: Antifat Attitudes Scale (AFA), Stigmatizing Situations Inventory (SSI), and Weight Bias Internalization Scale (WBIS). Participants were categorized into four groups based on body mass index (BMI) and history bariatric surgery. Egyptian participants (BMI = 30.2 ± 6.7 kg/m 2 [range: 18.5-69.0 kg/m 2 ]) showed significantly higher aversion toward obesity, as indicated by higher AFA score, compared to their Spanish counterparts (BMI = 35.4 ± 10.1 kg/m 2 [18.5-71.9 kg/m 2 ]). In contrast, Spanish participants reported higher levels of weight bias internalization with increasing BMI, while in Egypt, this association was negative. The association of bariatric surgery on stigma reduction also differed between the countries. Multivariate analysis revealed that residing in Egypt was an independent risk factor for higher scores in AFA and WBIS (odds ratio 8.20 [95% confidence interval: 6.78-9.62], p < 0.001 and odds ratio (OR) 6.28 [95% CI: 4.78-7.78], p < 0.001, respectively). In contrast, Spaniards experienced more stigmatizing situations than Egyptians (OR -2.54 [95% CI: 6.78-9.62], p < 0.001). Our study underscores the complex and diverse nature of obesity-related attitudes across cultures. Understanding these cultural differences is crucial for developing effective, culturally sensitive strategies to tackle weight stigma. This research opens avenues for further studies and interventions tailored to cultural contexts.

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