Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Integrated Research and Treatment Center (IFB) Adiposity Diseases, University of Leipzig, Leipzig, Germany.
BMJ Open. 2019 Apr 3;9(4):e023389. doi: 10.1136/bmjopen-2018-023389.
Individuals with obesity are subject to stigmatisation, resulting in discrimination. Studies focusing on obesity stigma often do not account for social conditions that also may be associated with stigmatisation. Following an intersectional approach, social categories such as gender and socioeconomic status (SES) can interact and form a basis for multiple stigma. The present study analyses differences in public obesity stigma depending on gender and SES, as well as possible interdependencies between these social categories.
Representative cross-sectional telephone survey.
692 randomly selected adults (≥ 18 years) in Germany.
Different vignettes were presented, depicting a lawyer (male/female) or a janitor/cleaner (male/female) with obesity. Following the vignette, different components of stigma were assessed: (1) fat phobia, (2) emotional reactions to a person with obesity and (3) desire for social distance. Associations between gender, SES and stigma components were tested in multiple linear regression analyses.
A low SES in the obesity vignette (janitor/cleaner) was significantly associated with higher fat phobia scores as well as desire for social distance, compared with the vignette with a person with obesity and a high SES (lawyer). Being a male with obesity was significantly associated with more pronounced negative emotional reactions and greater desire for social distance. There were no significant interaction effects between gender and SES.
Results support the hypothesis of multiple stigma. Being male or of low SES was significantly associated with more pronounced negative attitudes in the German public. Following the concept of intersectionality, our findings indicate that obesity stigma can exacerbate pre-existing inequalities. This needs to be considered in development and implementation of prevention and anti-stigma measures.
肥胖个体容易受到歧视和污名化。关注肥胖污名化的研究往往没有考虑到可能与之相关的社会条件。采用交叉视角，性别和社会经济地位（SES）等社会类别可以相互作用，形成多重污名的基础。本研究分析了公共肥胖污名化因性别和 SES 而异的情况，以及这些社会类别之间可能存在的相互依存关系。
具有代表性的横断面电话调查。
德国 692 名随机选择的成年人（≥18 岁）。
呈现不同的情景描述，描绘一个肥胖的律师（男性/女性）或看门人/清洁工（男性/女性）。在情景描述之后，评估了不同的污名化成分：（1）肥胖恐惧症，（2）对肥胖者的情绪反应，（3）对社会距离的渴望。在多元线性回归分析中测试了性别、SES 和污名化成分之间的关联。
肥胖情景中的低 SES（看门人/清洁工）与更高的肥胖恐惧症得分以及对社会距离的渴望显著相关，而与 SES 较高（律师）的肥胖情景相比。肥胖男性与更明显的负面情绪反应和更大的社会距离渴望显著相关。性别和 SES 之间没有显著的交互作用。
结果支持多重污名假说。男性或 SES 较低与德国公众中更明显的负面态度显著相关。根据交叉性的概念，我们的研究结果表明，肥胖污名化可能会加剧现有的不平等现象。在制定和实施预防和反污名措施时，需要考虑到这一点。
