Institute of Sport Science, Eberhard Karls University Tübingen, Tübingen, Germany.
Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University Tübingen, Tübingen, Germany.
BMC Public Health. 2021 Mar 22;21(1):565. doi: 10.1186/s12889-021-10565-7.
A central strategy to tackle the health risks of obesity is regular physical activity (PA), exercising and participating in sports. However, people with obesity regularly experience weight-related stigma and discrimination in sport and exercise settings. Research has indicated that they often cope with such experiences by simply excluding themselves from sport and exercise. Meanwhile, self-exclusion as a coping strategy has not been fully understood and it remains unclear to what extent self-exclusion from PA settings is accompanied by general inactivity among people with obesity. The goal of this interview study was to determine to what extent physical inactivity among adults with obesity is the result of weight stigma-induced self-exclusion in and from sport and PA settings.
We conducted semi-structured interviews with thirty adult men and women with obesity (average BMI: 40.64) and asked them about experiences with their body, weight stigma and coping behaviours in sport and exercise settings across their lifespans. Employing constant comparative analysis and a thematic network approach, we analysed the interview data to identify the most common reasons for and different strategies of self-exclusion.
Participants reported that they excluded themselves from sport and exercise settings due to traumatic weight stigma experiences, self-discrimination and fear of stigma, using a variety of strategies. Exposure to discrimination was prevented by selectively avoiding certain settings or strategically frequenting them at certain times only, but also by exercising in 'safe' spaces, e.g. at home. Furthermore, people with obesity reported strategically managing their social relations in order to avoid stigmatising reactions by others in exercise settings, for example by exercising individually and avoiding social PA. Most notably, our results strongly indicate that not all self-excluding coping strategies result in less exercising.
In order to successfully promote physical activity among people with obesity, the various forms of self-exclusion should be taken into account as pathways of stigma regarding physical activity. People with obesity may exclude themselves from certain PA settings, yet could still be exercising on their own or in other ways. One focus of public health strategies should thus be directed at the potentially socially isolating effects.
解决肥胖带来的健康风险的一个核心策略是定期进行身体活动（PA），即运动和参加体育活动。然而，肥胖人群在运动和锻炼环境中经常会经历与体重相关的污名化和歧视。研究表明，他们通常通过将自己排除在运动和锻炼之外来应对这些经历。与此同时，自我排斥作为一种应对策略尚未得到充分理解，目前尚不清楚肥胖人群中自我排斥 PA 环境在多大程度上伴随着普遍的不活跃。本访谈研究的目的是确定肥胖成年人的身体不活动在多大程度上是由于体育和 PA 环境中因体重污名化而导致的自我排斥所致。
我们对 30 名肥胖成年人（平均 BMI：40.64）进行了半结构化访谈，询问了他们一生中在运动和锻炼环境中与身体、体重污名和应对行为相关的经历。我们采用恒定性比较分析和主题网络方法，对访谈数据进行分析，以确定自我排斥的最常见原因和不同策略。
参与者报告称，由于创伤性的体重污名化经历、自我歧视和对污名的恐惧，他们会将自己从体育和锻炼环境中排斥出去，同时使用多种策略。通过有选择地回避某些环境或仅在特定时间策略性地光顾这些环境，人们可以避免歧视的暴露，但也可以在“安全”的空间（例如在家中）进行锻炼。此外，肥胖者还报告称，他们会战略性地管理自己的社会关系，以避免在锻炼环境中受到他人的污名化反应，例如独自锻炼和避免社交 PA。最值得注意的是，我们的研究结果强烈表明，并非所有自我排斥的应对策略都会导致锻炼减少。
为了成功促进肥胖人群的身体活动，应将各种形式的自我排斥作为与身体活动相关的污名化途径纳入考虑。肥胖人群可能会将自己排除在某些 PA 环境之外，但他们仍可能以自己的方式或其他方式进行锻炼。公共卫生策略的一个重点应该是针对可能具有社会隔离效应的策略。
