![[PDF]](/pb-assets/Icons/adobe-pdf-icon-1498649896243.png){kind=icon}
Abstract
Anti-fat bias by professors in physical education departments may interfere with the training provided to pre-service teachers. The purpose of this study was to evaluate the attitudes of professors in physical education departments toward obese individuals. Professors from randomly selected institutions across all four US regions participated in the study (N = 94). Participants took the Implicit Association Test and answered the Anti-Fat Attitude Scale and two questions specifically designed to measure their attitudes toward physical education teachers and majors who are obese. The participants exhibited implicit good–bad (p < .001) and lazy–motivated (p < .001) anti-fat biases. Professors favored accepting majors who are obese (p < .001), but they strongly disapproved of obese physical education teachers as role models to their students (p < .001). Explicit anti-fat bias was associated with a stronger disapproval of physical education teachers who are obese as role models to students (p < .001) and accepting majors who are obese (p < .001). Implicit good–bad anti-fat bias was associated with a stronger disapproval of obese physical education teachers as role models to students (p = .047). The anti-fat bias demonstrated by the professors may negatively affect the training of pre-service physical education teachers to work with students of all body sizes. Awareness programs may be necessary to diminish anti-fat bias among professors in physical education teacher education programs.
Introduction
While a large proportion of the population in the USA is currently obese (Ogden et al., 2014), anti-fat attitudes are commonly expressed in this society. In fact, individuals who are obese are overlooked during hiring decisions (Pingitore et al., 1994), make lower wages than their normal weight peers (DeBeaumont, 2009; Han et al., 2009; Wada and Tekin, 2010), and are portrayed less often and more negatively in the media (Greenberg et al., 2003; Lin, 1998). In addition, health professionals such as physicians (Adams et al., 1993; Foster et al., 2003; Hebl and Xu, 2001; Sabin et al., 2012), nurses (Poon and Tarrant, 2009; Waller et al., 2012), and dietitians (Puhl et al., 2009; Swift et al., 2013a) have expressed anti-fat bias. Health care professionals have characterized obese individuals as lazy and weak-willed (Foster et al., 2003; Mulherin et al., 2013). Weight status also compromises the quality of health care provided to obese individuals. For example, physicians are reluctant to perform necessary diagnostic procedures and spend less time consulting patients who are obese (Adams et al., 1993; Hebl and Xu, 2001). Furthermore, physicians provide fewer preventive services, such as mammography and Pap smear exams, to obese individuals (Fontaine and Faith, 1998; Østbye et al., 2005).
Exercise-related professionals have also expressed explicit and implicit anti-fat biases. While both types of bias refer to negative attitudes toward individuals who are obese, explicit attitudes are conscious and controlled, while implicit attitudes are unconscious and automatic (Dimmock et al., 2009; O’Brien et al., 2007; Robertson and Vohora, 2008; Rukavina et al., 2010). For example, undergraduate majors in exercise science (Chambliss et al., 2004) and physical education (Fontana et al., 2013) have demonstrated implicit anti-fat bias. Fitness instructors and physical education teachers have expressed explicit (Greenleaf et al., 2008; Peterson et al., 2012a) and implicit anti-fat biases (Dimmock et al., 2009; Fontana et al., 2013; Robertson and Vohora, 2008). In addition, physical education teachers have indicated that overweight female students are less cooperative and have inferior social skills than their normal weight counterparts (Peterson et al., 2012a).
Demonstrations of anti-fat bias by physical education teachers are especially troubling. Firstly, many physical education teachers believe that physical education plays an essential role in the prevention of obesity (Greenleaf and Weiller, 2005; Greenleaf et al., 2008; Price et al., 1990). Secondly, obesity affects a large proportion of the youth population in the USA (Ogden et al., 2014), and childhood obesity is associated with a higher prevalence of cardiovascular syndrome (Weiss et al., 2004) and adult obesity (Singh et al., 2008). Finally, anti-fat bias by physical education teachers may diminish the effectiveness of physical education teachers in including children who are obese in physical activity classes. Negative experiences, such as being weighed in front of others (Sykes and McPhail, 2008) or being the subject of weight teasing (Faith et al., 2002; Jensen and Steele, 2009; Losekam et al., 2010; Storch et al., 2007), can be traumatic and reduce the engagement of children who are obese in physical activity. Although pre-service physical educators should be adequately trained to effectively work with children of all body sizes, anti-fat bias intensifies as physical education teacher education (PETE) majors progress through their academic studies (Fontana et al., 2013; O’Brien et al., 2007). Thus, the purpose of this study was to examine the explicit and implicit attitudes of professors teaching pre-service physical education teachers toward individuals who are obese.
The first hypothesis stated that PETE professors would demonstrate implicit but not explicit anti-fat bias. Professors teaching PETE majors are expected to have a large knowledge base about obesity and may decide to consciously suppress explicit anti-fat bias. Professors’ knowledge base about obesity is not expected to affect automatic bias measured by the Implicit Association Test – IAT (Greenwald et al., 1998). The second hypothesis stated that professors would oppose accepting majors who are obese and disapprove of physical education teachers who are obese as role models to students. Physical education teachers have expressed the belief that maintaining a normal body weight is necessary to set a good example to students (Greenleaf and Weiller, 2005; Greenleaf et al., 2008). The third and last hypothesis stated that higher levels of disapproval of majors and teachers who are obese would be associated with stronger anti-fat bias attitudes. Past evidence suggests a link between discriminatory behaviors and implicit and explicit anti-fat biases (Bessenoff and Sherman, 2000; Puhl et al., 2009).
Methods
Participants
One-hundred and twelve professors participated in the study, but 18 professors reported not teaching a minimum of one course in their PETE program and were eliminated from data analyses. Demographic characteristics for the final sample of 94 participants are available in Table 1. Participant selection occurred across two academic semesters. The following cross-sectional stratified random sampling procedures were used to select participants in the fall of 2012: (a) institutions were clustered based on region in the USA (Northeast, Midwest, South, and West); (b) four states were randomly drawn from each region; (c) using the College Navigator Tool (National Center for Educational Statistics, 2012), a list of all institutions with PETE programs was created per selected state; (d) five universities were randomly selected from each state; each institution’s website was searched and a list of emails for PETE was created; (f) potential participants were contacted via email. Three invitations were sent approximately 10 days apart from each other. The emails contained a link to the study procedures. In the spring of 2013, a second round of data collection was performed by randomly selecting two more states from each region and creating email lists of professors from three randomly selected institutions from each state. The response rate of 8.46% was similar to past investigations on the topic using online surveys (Peterson et al., 2012a, 2012b). Institutional review board approval and informed consent from participants were attained prior to data collection.
|
Table 1. Demographic characteristics of participants.
Measures
Anti-Fat Attitude Scale
The Anti-Fat Attitude Scale (AFAS) measures explicit negative attitudes toward individuals who are obese. The AFAS consists of five items (“Fat people are less sexually attractive than thin people”; “I would never date a fat person”; “On average, fat people are lazier than thin people”; “Fat people only have themselves to blame for their weight”; “It is disgusting when a fat person wears a bathing suit at the beach”). Items were rated on a five-point Likert-type scale ranging from 1 (strongly disagree) to 5 (strongly agree). Higher scores indicate stronger explicit anti-fat bias. Adequate internal consistency and construct validity evidence support the use of the AFAS among adults (Morrison and O’Connor, 1999). The internal consistency of the AFAS for this study was Cronbach’s α = .81.
Implicit Association Test
The IAT (Greenwald et al., 1998) is a timed assessment of implicit cognition widely used to assess anti-fat bias (Brochu and Morrison, 2007; Chambliss et al., 2004; Dimmock et al., 2009; Fontana et al., 2013; O’Brien et al., 2007; Robertson and Vohora, 2008; Sabin et al., 2012). In the current study, the computerized version of the IAT “weight attitude” task was used (Nosek et al., 2007). In the test, two pairs of superordinate words were located on the top right- and left-hand corners of the computer screen. Each pair consisted of a concept and an attribute. “Thin people” and “fat people” were used as concept words across conditions, “good” and “bad” were used as attributes in one experimental condition, and “motivated” and “lazy” were used as attributes in the second experimental condition. Subordinate images and words randomly appeared in the center of the screen. Images consisted of pictures of obese and thin people, and subordinate words were alternative ways to express the attributes (e.g. energetic and sluggish were used in the lazy/motivated IAT).
Participants classified subordinate images and words twice with reverse superordinate pairing order by pressing the keyboard keys “E” and “I”. The length of time it took participants to categorize subordinate images and words was measured. Differences in the average response latency between the two reverse superordinate IAT pairings indicated the strength of implicit preference of one group over another (Greenwald et al., 2003). For example, participants who on average classified subordinate images and words more quickly when fat people/lazy and thin people/motivated were paired together than when fat people/motivated and thin people/lazy were paired together implicitly perceived thin people to be more motivated. Before taking the experimental trials, participants were given four practice trials using flowers and insects as the concept superordinate words. Differently from explicit measures, the IAT measures unconscious or automatic implicit attitudes toward one group over another group regardless of social desirability (Greenwald et al., 1998; Schwartz et al., 2003). Extensive validity evidence supports the use of the IAT to assess social prejudice among adults (Cunningham, 2001; Egloff et al., 2010; Gawronski, 2002; Greenwald et al., 1998, 2009).
PETE professors’ perceptions of obese physical education teachers and majors
The following two items assessed the perceptions of PETE professors toward obese physical education teachers and majors: (a) physical education teachers should not be obese, since they are role models to their students; (b) PETE programs should not accept students who are obese. Items were rated on a five-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Items were based on previous research in which physical education teachers indicated that as role models to students they should maintain a normal body weight (Greenleaf and Weiller, 2005; Greenleaf et al., 2008).
Procedures
The Inquisit 3 Web (Inquisit 3 Web Edition, 2012) was used to administer the IAT and the explicit tests (web-based surveys). Despite its name, the test was not taken on the web per se. Upon clicking “Start”, the engine was downloaded and ran locally on the participant’s machine. This ensured participants had access to all of the high-performance native Windows components necessary to achieve millisecond precision timing. Once participants completed the test, the data were sent securely to an online database. The Inquisit 3 Web form used in this study was sent as a link to potential participants as part of the email invitations. Upon agreeing to participate in the study, participants read instructions and consecutively answered the demographic, perceptions of obese physical education teachers and majors, AFAS, and IAT questionnaires.
Statistical analysis
One-sample t-tests were conducted to assess implicit (IAT referenced to 0) and explicit (AFAS referenced to 3) fat biases. Separate one-sample sign tests were utilized to analyze the two items measuring the perceptions of professors toward physical education teachers and majors who are obese (referenced to 3). Cohen’s d was used for parametric effect sizes and r for nonparametric effect sizes. Spearman correlations were used to measure the association between anti-fat bias and acceptance of physical education majors and teachers who are obese. Statistical analyses were performed using IBM SPSS statistics software 22 (IBM Corp., Armonk, NY).
Results
Anti-fat bias
The participants disagreed with the explicit negative portrayal of obese individuals on the AFAS instrument (t93= 5.74, p < .001, d’ = .59; M = 2.54, SD = .78), but they expressed implicit good–bad (t93= 8.56, p < .001, d’ = .88; M = .37, SD = .41) and lazy–motivated (t93= 9.99, p < .001, d’ = 1.03; M = .44, SD = .42) anti-fat biases on the IAT test. Professors favored accepting majors who are obese into PETE programs (Z = –4.95, p < .001, r = .51; Md = 2), but they disapproved of obese physical education teachers as role models to students (Z = 6.53, p < .001, r = .67; Md = 4). Table 2 shows the proportion of PETE professors disapproving of obese physical education teachers and majors.
|
Table 2. Proportion of disapproval of obese physical education teachers and majors.
Associations between anti-fat bias and professor perceptions of obese teachers and majors
Explicit anti-fat bias was moderately associated with a stronger disapproval of both physical education teachers who are obese as role models to students (rho = .45, p < .001) and accepting majors who are obese (rho = .39, p < .001). In addition, a weak positive relationship was found between implicit anti-fat bias in the good–bad IAT and the levels of disapproval of obese physical education teachers as role models to students (r = .21, p = .047).
Discussion
Physical education teachers perceive physical education classes as a fundamental component of obesity prevention efforts (Greenleaf and Weiller, 2005; Greenleaf et al., 2008; Price et al., 1990), but their ability to encourage students who are obese to become more physically active may be undermined by their anti-fat bias attitudes (Fontana et al., 2013; Greenleaf et al., 2008; Peterson et al., 2012a). Unfortunately, anti-fat bias intensifies during academic training (Fontana et al., 2013; O’Brien et al., 2007), and it is stronger among majors in physical education than in other non-exercise-related disciplines (O’Brien et al., 2007). Thus, the purpose of this study was to determine the attitudes of PETE professors toward individuals who are obese.
PETE professors expressed implicit anti-fat bias, but they disagreed with the negative descriptions of obese individuals in the explicit questionnaire. The contradiction in implicit and explicit attitudes was consistent with the first hypothesis, and it may be due to difficulties assessing explicit social bias. Questionnaires assessing explicit social bias measure attitudes that are consciously controlled and vulnerable to social desirability (Schwartz et al., 2003). In fact, explicit attitudes toward obese individuals have been mixed in previous studies (Chambliss et al., 2004; Dimmock et al., 2009; Fontana et al., 2013; Robertson and Vohora, 2008). On the other hand, exercise-related professionals have consistently demonstrated implicit anti-fat attitudes (Chambliss et al., 2004; Dimmock et al., 2009; Fontana et al., 2013; Robertson and Vohora, 2008). PETE professors’ implicit anti-fat bias may undermine the training of physical educators to teach physically diverse students.
PETE professors expressed contradictory opinions about physical education majors and teachers who are obese. They agreed to accept obese PETE majors, but they disapproved of obese physical education teachers. Considering that PETE programs do not offer weight control strategies nor have graduation requirements based on body composition, expecting majors who are obese to become normal-weight physical education teachers is unwise. After all, obesity rates are higher during mid-adulthood than early adulthood (Ogden et al., 2014). It is possible that PETE professors based their opinions on prevailing social norms (Zitek and Hebl, 2007). In a society where anti-fat bias is robust (Foster et al., 2003; Lin, 1998; Wada and Tekin, 2010), disapproval of obese physical education teachers as role models to students may be an acceptable social view. However, deciding on the admission of students to a major based on their physical characteristics is unlikely to have much social support. Further research is necessary to clarify the conflicting opinions of PETE professors toward physical education teachers and majors who are obese.
PETE professors believed that physical education teachers should not be obese in order to be good role models to their students. Physical education teachers have shared the same opinion (Greenleaf and Weiller, 2005; Greenleaf et al., 2008). After comprehensively searching the literature, we found two studies supporting this belief. These studies concluded that students learn theoretical fitness information more effectively when taught by a normal weight physical educator than a “mock obese” instructor (Dean et al., 1998; Melville and Maddalozzo, 1988). The same instructor played both roles, but the mock instructor was fitted with a fat suit around the trunk and thigh areas to give the appearance of obesity. However, these two studies had several methodological limitations. They lacked random assignment of participants, incorrectly used statistical procedures, and failed to perform a manipulation check for the trustworthiness of the “mock obese” instructor. They also contradicted other findings in the literature indicating that the physical appearance of classroom teachers does not influence academic performance (Bischoff et al., 1988; Chaikin et al., 1978). The notion that physical education teachers are less effective educators when they appear obese lacks strong scientific support.
Despite the strong interest in physical activity, physical education teachers are predisposed to some of the same obesity risk factors affecting other members of society. For example, genetic predisposition to obesity (Ang et al., 2012), depression (Markowitz et al., 2008), pregnancy (Gunderson, 2009), or living in a neighborhood with deficient community design (Frank et al., 2005; Saelens et al., 2003) are some of the factors contributing to obesity that may also affect physical education teachers. Disapproval of obese physical education teachers neglects the complex combination of risk factors contributing to obesity.
The obesity of some physical education teachers may not adequately portray their health habits. In fact, a considerable number of overweight or obese adults in the USA are highly fit (Duncan, 2010). A substantial proportion of obese individuals do not display metabolic risk factors, such as low insulin sensitivity and hypertension, while a substantial proportion of normal weight individuals have metabolic abnormalities (Karelis et al., 2004; Wildman et al., 2008). All-cause (Crespo et al., 2002; Fogelholm, 2010) and cardiovascular mortality (Fogelholm, 2010) rates are lower in obese aerobically fit individuals than normal-weight aerobic unfit individuals. Placing excessive value on physical appearance may undermine efforts to offer academically rigorous knowledge and experiences to physical education majors.
This study indicated that PETE professors with higher levels of anti-fat bias more strongly opposed accepting majors who are obese and disapproved of teachers who are obese as role models to students. Similarly, Greenleaf et al. (2008) concluded that physical education majors with higher levels of anti-fat bias more strongly agreed that physical education teachers should maintain a normal body weight to set a good example to students. These findings are insufficient evidence for a link between anti-fat bias and direct (i.e. differential treatment of an obese student) or indirect (i.e. academic courses should stress the improvement of overall health rather than focusing on the prevention of obesity) discriminatory behaviors in physical education, but they complement previous evidence. For example, dietetic students endorsing explicit anti-fat bias rated the diet quality of patients who were obese more poorly, even though obese and normal-weight patients had the same mock dietary profiles (Puhl et al., 2009), and college students exhibiting stronger implicit anti-fat bias placed a chair to sit further away from an obese woman during a mock interview (Bessenoff and Sherman, 2000).
Professors teaching PETE majors should benefit from awareness programs aimed at diminishing anti-fat bias. Reduction of explicit anti-fat bias is difficult, and interventions have produced mixed results (Daníelsdóttir et al., 2010). Rukavina et al. (2007) attempted to increase the empathy of kinesiology majors toward individuals who are obese during a service learning experience. The intervention reduced perceptions of personal controllability of obesity, but it failed to change other measures of explicit anti-fat bias. More successful interventions have utilized social consensus approaches where the attitudes of participants toward obese people became more positive after being informed that peers had more favorable views of obese people (Daníelsdóttir et al., 2010; Puhl et al., 2009) or combined strategies such as education about the controllability of obesity and empathy-evoking stories describing individuals who experienced weight stigmatization (Daníelsdóttir et al., 2010; Swift et al., 2013b). Evidence supporting prevention programs addressing implicit anti-fat bias is more scarce (Daníelsdóttir et al., 2010). O’Brien et al. (2010) indicated that a 12-week highly engaging intervention about the controllability of obesity was effective at reducing implicit anti-fat bias. Engagement of students in the intervention was accomplished by asking them to complete readings, discussions, presentations, and examinations. Until more evidence is available, we encourage prevention programs aimed at reducing anti-fat bias to combine multiple strategies in engaging sessions.
Strengths and limitations
This study is not without limitations. The response rate was similar to previous studies but small. It is possible that non-respondents have attitudes toward obese individuals different from our findings. In addition, the sample of participants consisted largely of Caucasian professors teaching in public institutions. The homogeneity of the sample of participants limited comparisons among different demographic groups. On the other hand, this is the first study to investigate anti-fat attitudes in PETE professors. PETE professors lead the preparation of physical education teachers and should help eliminate anti-fat prejudice in the profession. In addition, we selected participants from a national pool of PETE professors using stratified random sampling procedures. The implementation of carefully designed sampling procedures increased the likelihood that the sample of participants closely matched the population of professors teaching in physical education departments in the USA.
Conclusion
Professors teaching pre-service physical education teachers expressed implicit good–bad and lazy–motivated anti-fat biases, favored accepting majors who are obese, and disapproved of physical education teachers who are obese as role models to students. In addition, anti-fat bias was associated with the disapproval of both physical education teachers who are obese as role models to students and accepting majors who are obese. PETE professors’ anti-fat bias may compromise the training of pre-service physical education teachers to work with students of all body sizes. Future studies should focus on interventions targeting anti-fat bias prevention. Studies investigating the association between anti-fat bias and discriminatory behaviors among exercise-related professionals are also recommended.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
References
|
Adams, CH, Smith, NJ, Wilbur, DC. (1993) The relationship of obesity to the frequency of pelvic examinations: do physician and patient attitudes make a difference? Women & Health 20(2): 45–57. Google Scholar | Crossref | Medline | |
|
Ang, YN, Wee, BS, Poh, BK. (2012) Multifactorial influences of childhood obesity. Current Obesity Reports 2(1): 10–22. Google Scholar | Crossref | |
|
Bessenoff, G, Sherman, J (2000) Automatic and controlled components of prejudice toward fat people: evaluation versus stereotype activation. Social Cognition 18(4): 329–353. Google Scholar | Crossref | |
|
Bischoff, J, Plowman, S, Lindenman, L (1988) The relationship of teacher fitness to teacher student interaction. Journal of Teaching in Physical Education 7: 142–151. Google Scholar | Crossref | |
|
Brochu, PM, Morrison, MA (2007) Implicit and explicit prejudice toward overweight and average-weight men and women: testing their correspondence and relation to behavioral intentions. The Journal of Social Psychology 147(6): 681–706. Google Scholar | Crossref | Medline | |
|
Chaikin, A, Gillen, B, Derlega, V. (1978) Students’ reactions to teachers’ physical attractiveness and nonverbal behavior: Two exploratory studies. Psychology in the Schools 15: 588–595. Google Scholar | ISI | |
|
Chambliss, HO, Finley, CE, Blair, SN (2004) Attitudes toward obese individuals among exercise science students. Medicine & Science in Sports & Exercise 36(3): 468–74. Google Scholar | Crossref | Medline | |
|
Crespo, CJ, Palmieri, MRG, Perdomo, RP. (2002) The relationship of physical activity and body weight with all-cause mortality: results from the Puerto Rico Heart Health Program. Annals of Epidemiology 12(8): 543–552. Google Scholar | Crossref | Medline | |
|
Cunningham, W (2001) Implicit attitude measures: consistency, stability, and convergent validity. Psychological Science 12(2): 163–170. Google Scholar | SAGE Journals | ISI | |
|
Daníelsdóttir, S, O’Brien, KS, Ciao, A (2010) Anti-fat prejudice reduction: A review of published studies. Obesity Facts 3(1): 47–58. Google Scholar | Crossref | Medline | |
|
Dean, MB, Adams, TM, Comeau, MJ (1998) The effect of a female physical educator’s physical appearance on physical fitness knowledge and attitudes of junior high students. The Physical Educator 62(1): 14–25. Google Scholar | |
|
DeBeaumont, R (2009) Occupational differences in the wage penalty for obese women. The Journal of Socio-Economics 38(2): 344–349. Google Scholar | Crossref | |
|
Dimmock, J, Hallett, B, Grove, R (2009) Attitudes toward overweight individuals among fitness center employees: An examination of contextual effects. Research Quarterly for Exercise and Sport 80(3): 641–647. Google Scholar | Medline | |
|
Duncan, GE (2010) The ‘fit but fat’ concept revisited: Population-based estimates using NHANES. The International Journal of Behavioral Nutrition and Physical Activity 7: 47. Google Scholar | Crossref | Medline | |
|
Egloff, B, Schwerdtfeger, A, Schmukle, SC. (2010) Temporal stability of the Implicit Association Test – Anxiety. Journal of Personality Assessment 84(1): 82–88. Google Scholar | Crossref | |
|
Faith, MS, Leone, MA, Ayers, TS. (2002) Weight criticism during physical activity, coping skills, and reported physical activity in children. Pediatrics 110(2): 1–8. Google Scholar | Crossref | Medline | |
|
Fogelholm, M (2010) Physical activity, fitness and fatness: Relations to mortality, morbidity and disease risk factors. A systematic review. Obesity Reviews 11(3): 202–221. Google Scholar | Crossref | Medline | |
|
Fontaine, K, Faith, M (1998) Body weight and health care among women in the general population. Archives of Family Medicine 7: 381–384. Google Scholar | Crossref | Medline | |
|
Fontana, FE, Furtado, O, Marston, R. (2013) Anti-fat bias among physical education teachers and majors. The Physical Educator 70(1): 15–31. Google Scholar | |
|
Foster, GD, Wadden, TA, Makris, AP. (2003) Primary care physicians’ attitudes about obesity and its treatment. Obesity Research 11(10): 1168–1177. Google Scholar | Crossref | Medline | |
|
Frank, LD, Schmid, TL, Sallis, JF. (2005) Linking objectively measured physical activity with objectively measured urban form: findings from SMARTRAQ. American Journal of Preventive Medicine 28(2 Suppl 2): 117–125. Google Scholar | Crossref | Medline | |
|
Gawronski, B (2002) What does the Implicit Association Test measure? A test of the convergent and discriminant validity of prejudice-related IATs. Experimental Psychology 49(3): 171–180. Google Scholar | Crossref | Medline | |
|
Greenberg, BS, Eastin, M, Hofschire, L. (2003) Portrayals of overweight and obese individuals on commercial television. American Journal of Public Health 93(8): 1342–1348. Google Scholar | Crossref | Medline | ISI | |
|
Greenleaf, C, Martin, SB, Rhea, D (2008) Fighting fat: How do fat stereotypes influence beliefs about physical education? Obesity 16(Suppl 2): S53–S59. Google Scholar | Crossref | Medline | |
|
Greenleaf, C, Weiller, K (2005) Perceptions of youth obesity among physical educators. Social Psychology of Education 8(4): 407–423. Google Scholar | Crossref | |
|
Greenwald, AG, McGhee, DE, Schwartz, JL (1998) Measuring individual differences in implicit cognition: The Implicit Association Test. Journal of Personality and Social Psychology 74(6): 1464. Google Scholar | Crossref | Medline | ISI | |
|
Greenwald, AG, Nosek, BA, Banaji, MR (2003) Understanding and using the Implicit Association Test: I. An improved scoring algorithm. Journal of Personality and Social Psychology 85(2): 197–216. Google Scholar | Crossref | Medline | ISI | |
|
Greenwald, AG, Poehlman, TA, Uhlmann, EL. (2009) Understanding and using the Implicit Association Test: III. Meta-analysis of predictive validity. Journal of Personality and Social Psychology 97(1): 17–41. Google Scholar | Crossref | Medline | ISI | |
|
Gunderson, EP (2009) Childbearing and obesity in women: Weight before, during, and after pregnancy. Obstetrics and Gynecology Clinics of North America 36(2): 317–ix. Google Scholar | Crossref | Medline | |
|
Han, E, Norton, EC, Stearns, SC (2009) Weight and wages: Fat versus lean paychecks. Health Economics 18(5): 535–548. Google Scholar | Crossref | Medline | |
|
Hebl, MR, Xu, J (2001) Weighing the care: Physicians’ reactions to the size of a patient. International Journal of Obesity 25(8): 1246–1252. Google Scholar | Crossref | |
|
Inquisit 3.0.6.0 (2012) Seattle, WA: Milliseconds Software LLC. Google Scholar | |
|
Jensen, C, Steele, R (2009) Brief report: Body dissatisfaction, weight criticism, and self-reported physical activity in preadolescent children. Journal of Pediatric Psychology 34(8): 822–826. Google Scholar | Crossref | Medline | |
|
Karelis, AD, St-Pierre, DH, Conus, F. (2004) Metabolic and body composition factors in subgroups of obesity: What do we know? The Journal of Clinical Endocrinology and Metabolism 89(6): 2569–2575. Google Scholar | Crossref | Medline | |
|
Lin, C (1998) Uses of sex appeals in prime-time television commercials. Sex Roles 38(5): 461–475. Google Scholar | Crossref | |
|
Losekam, S, Goetzky, B, Kraeling, S. (2010) Physical activity in normal-weight and overweight youth: Associations with weight teasing and self-efficacy. Obesity Facts 3(4): 239–244. Google Scholar | Crossref | Medline | |
|
Markowitz, S, Friedman, MA, Arent, SM (2008) Understanding the relation between obesity and depression: Causal mechanisms and implications for treatment. Clinical Psychology: Science and Practice 15(1): 1–20. Google Scholar | Crossref | |
|
Melville, D, Maddalozzo, J (1988) The effects a physical educator’s appearance of body fatness has on communicating exercise concepts to high school students. Journal of Teaching in Physical Education 7: 343–352. Google Scholar | Crossref | |
|
Morrison, T, O’Connor, W (1999) Psychometric properties of a scale measuring negative attitudes toward overweight individuals. The Journal of Social Psychology 139(4): 436–445. Google Scholar | Crossref | Medline | |
|
Mulherin, K, Miller, YD, Barlow, FK. (2013) Weight stigma in maternity care: Women’s experiences and care providers’ attitudes. BMC Pregnancy and Childbirth 13: 19. Google Scholar | Crossref | Medline | |
|
National Center for Educational Statistics . (2012) College Navigator. Available at: http://nces.ed.gov/collegenavigator (accessed 2 October 2012). Google Scholar | |
|
Nosek, BA, Greenwald, AG, Banaji, MR (2007) The Implicit Association Test at age 7: A methodological and conceptual review. In: Bargh, JA (ed.) Automatic Processes in Social Thinking and Behavior. Psychology Press, pp. 265–292. Google Scholar | |
|
O’Brien, KS, Hunter, JA, Banks, M (2007) Implicit anti-fat bias in physical educators: Physical attributes, ideology and socialization. International Journal of Obesity (2005) 31(2): 308–314. Google Scholar | Crossref | Medline | |
|
O’Brien, KS, Puhl, RM, Latner, JD. (2010) Reducing anti-fat prejudice in preservice health students: a randomized trial. Obesity 18(11): 2138–2144. Google Scholar | Crossref | Medline | |
|
Ogden, CL, Carroll, MD, Kit, BK. (2014) Prevalence of childhood and adult obesity in the United States, 2011-2012. Journal of the American Medical Association 311(8): 806–814. Google Scholar | Crossref | Medline | ISI | |
|
Østbye, T, Taylor, DH, Yancy, WS. (2005) Associations between obesity and receipt of screening mammography, Papanicolaou tests, and influenza vaccination: Results from the Health and Retirement Study (HRS) and the Asset and Health Dynamics Among the Oldest Old (AHEAD) Study. American Journal of Public Health 95(9): 1623–1630. Google Scholar | Crossref | Medline | |
|
Peterson, JL, Puhl, RM, Luedicke, J (2012a) An experimental assessment of physical educators’ expectations and attitudes: the importance of student weight and gender. The Journal of School Health 82(9): 432–440. Google Scholar | Crossref | Medline | |
|
Peterson, JL, Puhl, RM, Luedicke, J (2012b) An experimental investigation of physical education teachers’ and coaches’ reactions to weight-based victimization in youth. Psychology of Sport and Exercise 13(2): 177–185. Google Scholar | Crossref | |
|
Pingitore, R, Dugoni, BL, Tindale, RS. (1994) Bias against overweight job applicants in a simulated employment interview. The Journal of Applied Psychology 79(6): 909–917. Google Scholar | Crossref | Medline | |
|
Poon, M-Y, Tarrant, M (2009) Obesity: Attitudes of undergraduate student nurses and registered nurses. Journal of Clinical Nursing 18(16): 2355–2365. Google Scholar | Crossref | Medline | |
|
Price, JH, Desmond, SM, Ruppert, ES (1990) Elementary physical education teachers’ perceptions of childhood obesity. Health Education 21(6): 26–32. Google Scholar | |
|
Puhl, R, Wharton, C, Heuer, C (2009) Weight bias among dietetics students: implications for treatment practices. Journal of the American Dietetic Association 109(3): 438–444. Google Scholar | Crossref | Medline | |
|
Robertson, N, Vohora, R (2008) Fitness vs. fatness: Implicit bias towards obesity among fitness professionals and regular exercisers. Psychology of Sport and Exercise 9(4): 547–557. Google Scholar | Crossref | |
|
Rukavina, PB, Li, W, Rowell, MB (2007) A service learning based intervention to change attitudes toward obese individuals in kinesiology pre-professionals. Social Psychology of Education 11(1): 95–112. Google Scholar | Crossref | |
|
Rukavina, PB, Li, W, Shen, B. (2010) A service learning based project to change implicit and explicit bias toward obese individuals in kinesiology pre-professionals. Obesity Facts 3(2): 117–126. Google Scholar | Crossref | Medline | |
|
Sabin, JA, Marini, M, Nosek, BA (2012) Implicit and explicit anti-fat bias among a large sample of medical doctors by BMI, race/ethnicity and gender. PloS One 7(11): e48448. Google Scholar | Crossref | Medline | ISI | |
|
Saelens, BE, Sallis, JF, Black, JB. (2003) Neighborhood-based differences in physical activity: An environment scale evaluation. American Journal of Public Health 93(9): 1552–1558. Google Scholar | Crossref | Medline | ISI | |
|
Schwartz, MB, Chambliss, HO, Brownell, KD. (2003) Weight bias among health professionals specializing in obesity. Obesity Research 11(9): 1033–1039. Google Scholar | Crossref | Medline | |
|
Singh, AS, Mulder, C, Twisk, JWR. (2008) Tracking of childhood overweight into adulthood: A systematic review of the literature. Obesity Reviews 9(5): 474–488. Google Scholar | Crossref | Medline | ISI | |
|
Storch, EA, Milsom, VA, Debraganza, N. (2007) Peer victimization, psychosocial adjustment, and physical activity in overweight and at-risk-for-overweight youth. Journal of Pediatric Psychology 32(1): 80–89. Google Scholar | Crossref | Medline | ISI | |
|
Swift, JA, Hanlon, S, El-Redy, L. (2013a) Weight bias among UK trainee dietitians, doctors, nurses and nutritionists. Journal of Human Nutrition and Dietetics 26(4): 395–402. Google Scholar | Crossref | Medline | |
|
Swift, JA, Tischler, V, Markham, S. (2013b) 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(1): 91–102. Google Scholar | Crossref | Medline | |
|
Sykes, H, MacPhail, D (2008) Unbearable lessons: Contesting fat phobia in physical education. Sociology of Sport Journal 25: 66–96. Google Scholar | Crossref | ISI | |
|
Wada, R, Tekin, E (2010) Body composition and wages. Economics and Human Biology 8(2): 242–254. Google Scholar | Crossref | Medline | |
|
Waller, T, Lampman, C, Lupfer-Johnson, G (2012) Assessing bias against overweight individuals among nursing and psychology students: An implicit association test. Journal of Clinical Nursing 21(23-24): 3504–3512. Google Scholar | Crossref | Medline | |
|
Weiss, R, Dziura, J, Burgert, TS. (2004) Obesity and the metabolic syndrome in children and adolescents. The New England Journal of Medicine 350(23): 2362–2374. Google Scholar | Crossref | Medline | ISI | |
|
Wildman, RP, Muntner, P, Reynolds, K. (2008) The obese without cardiometabolic risk factor clustering and the normal weight with cardiometabolic risk factor clustering: prevalence and correlates of 2 phenotypes among the US population (NHANES 1999-2004). Archives of Internal Medicine 168(15): 1617–1624. Google Scholar | Crossref | Medline | |
|
Zitek, EM, Hebl, MR (2007) The role of social norm clarity in the influenced expression of prejudice over time. Journal of Experimental Social Psychology 43(6): 867–876. Google Scholar | Crossref |
Author biographies
Fabio Fontana is an Associate Professor at the School of Health, Physical Education and Leisure Services, University of Northern Iowa, USA.
Ovande Furtado Jr is an Assistant Professor at the Department of Kinesiology, California State University – Northridge, USA.
Oldemar Mazzardo Jr is an Assistant Professor at the Physical Education Department, Western Parana State University – UNIOESTE, Brazil.
Deockki Hong is an Assistant Professor at the School of Health, Physical Education and Leisure Services, University of Northern Iowa, USA.
Wagner de Campos is a full Professor at the Department of Physical Education, Federal University of Parana, Brazil.