Living while fat: Development and validation of the Fat Microaggressions Scale.

Fat microaggressions are microlevel social practices in the form of commonplace everyday indignities that insult fat people and have been documented anecdotally and qualitatively. However, no psychometrically validated scale exists for measuring fat microaggressions, despite decades of microaggression research demonstrating their negative health associations. This research describes the development and construct validation of the Fat Microaggressions Scale across four studies. Study 1 focused on item development through a systematic review, qualitative analysis of Tweets using #fatmicroaggressions, and a Delphi review. Study 2 (N = 343) determined that a four-factor structure was appropriate in an online community sample of fat adults. Study 3 (N = 410) confirmed the factor structure in a new online sample of fat adults and provided initial evidence of construct validity. Study 4 (N = 197) found evidence of test-retest reliability and demonstrated additional construct validity. Our findings offer a newly validated quantitative measure of fat microaggressions and an initial framework for naming and categorizing these experiences, which may be used to advance the study of fat microaggressions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Effects of online self-compassionate writing on stigmatizing and affirming self-perceptions: Potential boundary conditions in undergraduate women.

This study investigated the effects of an online self-compassionate writing intervention on stigmatizing and affirming self-views toward the body in a sample of college women (N = 254). Participants were randomly assigned to a self-compassionate writing, attentional-control writing, or wait-list control condition for one week, and completed measures of self-compassion, affirming self-perceptions, and stigmatizing self-perceptions at baseline, one-week post intervention, and one-month post intervention. A series of mixed AN(C)OVAs revealed no significant effects by condition or time on stigmatizing or affirming self-views toward the body when controlling for self-esteem, internalized weight stigma, and eating disorder symptomatology. Follow-up exploratory analyses demonstrated no significant effects by condition on the six facets of self-compassion. Notably, participants were significantly more likely to drop out from the study over time if they were lower in self-compassion and self-esteem, and higher in internalized weight stigma at baseline. These results suggest that online self-compassion writing interventions may need to be longer and more potent, especially for women with more entrenched and stigmatized views about their bodies, as well as potential boundary conditions of cultivating self-compassion in a short-term online intervention.

Mediating effects of a weight-inclusive health promotion program on maladaptive eating in women with high body mass index.

Research shows that individuals with a body mass index (BMI) over 30 have experienced an 11-fold increase in restrictive eating and a 7-fold increase in binge eating since the 1990s. Most health promotion programs for higher-weight individuals have not been developed with the high eating disorder risk for this population in mind. The purpose of current study was to test two hypothesized mechanisms underlying improvement in maladaptive eating patterns shown in a weight-inclusive health promotion program designed for women with BMIs at or above 30. Participants (N = 40) were primarily White (93 %), 30-45 years old (M = 39.83, SD = 4.34) with BMIs ranging from 30 to 45 kg/m2 (M = 37.42, SD = 3.58). Using the MEMORE macro, we tested a parallel mediation model hypothesizing that internalized weight stigma and intuitive eating would explain improvements on two subscales from the Three-Factor Eating Questionnaire-R18 after a 6-month program. Total effects of the program on uncontrolled (b = -3.76, SE = 0.64, p < .0001) and emotional eating (b = -1.79, SE = 0.34, p < .0001) were significant. The indirect effects (IE) of internalized weight stigma on uncontrolled eating (IE = 1.59, SE = 0.79, 95 % CI = 0.46, 3.49) and emotional eating (IE = 0.67, SE = 0.40, 95 % CI = 0.11, 1.68) were also significant. Likewise, the IEs of intuitive eating on uncontrolled eating (IE = 2.09, SE = 0.70, 95 % CI = 0.60, 3.38) and emotional eating (IE = 1.03, SE = 0.43, 95 % CI = 0.08, 1.82) were significant. These findings indicate that weight-inclusive health promotion programs that directly address weight bias and eating according to cues from the body may help higher-weight individuals improve maladaptive eating patterns via reductions in internalized weight stigma and increases in intuitive eating.

Medical and physiological complications of exercise for individuals with an eating disorder: A narrative review.

Individuals with eating disorders (ED) experience prolonged malnutrition, binge episodes, and compensatory behaviours that affect every organ system. Psychological and physiological symptoms are worsened with comorbid dysfunctional exercise, seen in up to 80% of those with an ED. Although return to exercise is an important component of treatment and recovery, little is known about the contraindications and risks of exercise engagement specific to those with an ED. This paper provides a comprehensive narrative review of the medical and physiological complications of engaging in exercise during ED treatment and outlines when exercise may be contraindicated or used in modified or cautionary ways. We conducted a literature search on MEDLINE, PubMed, and PsychArticles to identify relevant articles, which yielded six categories of medical and physiological complications of ED that may be exacerbated by exercise: energy availability, cardiovascular health, electrolyte abnormalities, biomedical function markers, sex hormones, and body composition. We summarize the evidence for these complications for readers and offer an initial set of recommendations for incorporating exercise during ED treatment based on our findings. This review may serve as a resource for members of ED treatment teams to help evaluate more readily and confidently whether exercise is safe for individual patients and when modifications and caution may be warranted.

Dysfunctional exercise (DEX) is a symptom of eating disorders (ED) that precedes, maintains and exacerbates ED pathology. Health professionals struggle to clinically address and manage DEX as little information is available about its assessment and safe management. The current review provides a comprehensive summary of the medical and physiological complications of ED that may be exacerbated by exercise and outlines when exercise may be contraindicated or used in a modified or cautionary way. The literature review yielded six categories of complications: energy availability, cardiovascular health, electrolyte abnormalities, biomedical function markers, sex hormones, and body composition. We summarize the evidence for these complications for readers and offer an initial set of recommendations for incorporating exercise during ED treatment based on our findings. This review may serve as a resource for members of ED treatment teams to help evaluate more readily and confidently whether exercise is safe for individual patients and when modifications and caution may be warranted.

Integrating social media variables as predictors, mediators, and moderators within body image frameworks: Potential mechanisms of action to consider in future research.

In this article, we consider how social media variables may be integrated as predictors, mediators, and moderators within dominant theoretical frameworks of body image in order to identify potential mechanisms of action that can be empirically examined in future research and used to direct prevention and intervention efforts. To achieve this goal, we first articulate social media variables that have been investigated as predictors, mediators, and moderators in body image research. Next, we present the following critical and sociocultural theoretical frameworks: social comparison theory, tripartite influence model, objectification theory, developmental theory of embodiment, acceptance model of intuitive eating, cultivation theory, and uses and gratifications theory. Additionally, we present the theory of development of critical body awareness, a newly developed model that may provide further insight regarding the relationships between social media and body image-related outcomes. For each model, we articulate extant research that has explored social media variables within its context and explicate how social media variables could potentially be studied as predictors, mediators, and moderators within its structure. To conclude, we address pertinent limitations and gaps within this research space that could direct future research across the theoretical frameworks.

Disordered eating symptoms as a function of perceived weight status and race: An intersectional examination.

Disordered eating (DE) exhibited by individuals with intersecting marginalized identities may be less likely to be perceived as pathological compared to DE exhibited by individuals with non-marginalized identities. The present experiment tested the intersectional impact of weight status and race stimuli on responses to DE in a college sample. Undergraduate students (N = 193, Mage = 18.57, SD = 1.88, 71 % female) read a fictional account from a female target with DE who was described as "underweight," "average weight," or "overweight," and "White" or "Black." Participants completed an in-lab survey assessing detection of and responses to DE. Three 2 (race: Black, White) x 3 (weight status: underweight, average weight, overweight) ANCOVAs revealed a main effect of weight status. DE was more likely to be detected in "underweight" than "average" and "overweight" targets (p < .001). Participants encouraged weight loss for "average" and "overweight" targets compared to "underweight" targets (p < .001) and encouraged weight restoration for "underweight" targets compared to "average weight" and "overweight" targets (p < .001). No significant effects for target race or interaction between weight status and race emerged. These findings underscore the salience of weight status in shaping perceptions of DE.

Stigmatizing effects of weight status on lay perceptions of eating disorder-related distress.

The present study examined how weight status would affect lay perceptions of a White female student presenting signs of eating disorder-related distress. We recruited a mixed-gender, weight-diverse U.S. community sample through Mechanical Turk (N = 130; 49.2% female) to complete an online survey. Participants were randomly assigned to one of two conditions in which they read a personal statement section of a college application revealing eating disorder-related distress from a student who was either 'overweight' or 'underweight.' Participants evaluated the student on need for support, behavioural prescriptions for eating and exercise, and personal qualities. Although participants recognized a serious mental health concern in both conditions, they were more likely to prescribe eating disorder behaviors to the higher weight student. Findings suggest that weight stigma may bias lay perceptions of and even reinforce an eating disorder when exhibited by higher weight individuals.

Psychometric properties and validation of the Phenomenological Body Shame Scale - Revised (PBSS-R).

Body shame is a common experience among women yet a challenging phenomenon to operationalize, and measures of body shame often fail to capture its embodied aspects. In this article, we examined the structural and psychometric properties of an existing measure of body shame that was developed by Fredrickson et al. (1998) to assess the motivational and behavioral components of feeling body shame. Across three studies, women participants completed the Phenomenological Body Shame Scale (PBSS) and measures of theoretically related constructs in counterbalanced order via online survey platforms. The results demonstrate evidence of construct validity for an abbreviated, 8-item measure of phenomenological body shame (PBSS-R). In Study 1 (n = 341 community women), we evaluated and confirmed the scale's structural validity as a unidimensional measure. In Study 2 (n = 204 college women), we demonstrated positive associations between the PBSS-R and negative body image attitudes and behaviors, and negative associations with self-compassion, supporting the scale's external validity. In Study 3 (n = 235 community women), the PBSS-R explained variance in intuitive eating and happiness above theoretically related measures of self-objectification and body shame, supporting the scale's incremental validity. We recommend use of this abbreviated measure to assess the more embodied and less evaluative features of body shame in women.

Smile pretty and watch your back: Personal safety anxiety and vigilance in objectification theory.

[Correction Notice: An Erratum for this article was reported online in Journal of Personality and Social Psychology on Nov 19 2020 (see record 2020-89294-001). In Table 4, the mean, standard deviation, and range for the Personal Safety Anxiety and Vigilance (PSAVS) variable were incorrect.] Objectification Theory posits that everyday encounters with sexual objectification carry a diffuse nonspecific sense of threat that engenders personal safety anxiety in women. In this article, we provide direct evidence for this tenet across 5 studies and 1,665 participants using multiple methods. Study 1 (N = 207) and Study 2 (N = 161) explored and confirmed the factor structure of the Personal Safety Anxiety and Vigilance Scale (PSAVS), a measure of personal safety anxiety, and provided evidence for the reliability and construct validity of its scores. Study 3 (N = 363) showed that personal safety anxiety is a conceptually different construct for women and men, and differentially mediated the relation between sexual objectification and restricted freedom of movement and the relation between self-objectification and restricted freedom of movement for women and men. Study 4 (N = 460) included a comprehensive test of personal safety anxiety within an expanded Objectification Theory model, which supported personal safety anxiety as a mediator of the links from sexual and self-objectification to women's restricted freedom of movement. Study 5 (N = 474) replicated these results while also adjusting for specific fears of crime and rape. Our findings offer a newly validated assessment tool for future research on safety anxiety, illuminate the real and lasting sense of threat engendered by everyday sexual objectification, and broaden understanding of the mental and physical constraints on women's lived experiences posited in Objectification Theory. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Orthorexic eating in women who are physically active in sport: A test of an objectification theory model.

The present study tested an objectification model of orthorexic eating (i.e., pattern of disordered eating characterized by a preoccupation with food quality and purity, ritualistic styles of eating, avoidance of foods considered unhealthy, and compulsive evaluation of the source and nutritional content of foods) in women who are physically active in sport. A community sample of women physically active in sport (N = 228) completed an online survey with measures of orthorexic eating, phenomenological and appearance-based self-objectification, phenomenological body shame, sport-based perfectionism, and athletic identity. Parallel mediation analysis (PROCESS; Model 4) demonstrated a significant indirect effect (ab) of phenomenological self-objectification on orthorexic eating through phenomenological body shame (b = -0.10, 95 % percentile bootstrap confidence interval (PB CI): -0.15, -0.06), adjusting for three covariate measures. The direct effect (c') of phenomenological self-objectification on orthorexic eating was not significant (b = 0.02, 95 % PB CI: -0.07, 0.10). The findings support an objectification theory model of orthorexic eating in community women who participate in sport.

Intuitive eating is connected to self-reported weight stability in community women and men.

Professionals working in eating disorder prevention, treatment, and public health aim to improve eating behaviors to stabilize weight, which is more adaptive for health and well-being than weight variation. However, it is unknown which eating behaviors are linked to weight stability in non-intervention samples. This study examines how intuitive eating and eating restraint (flexible and rigid control) are linked to retrospective reports of weight stability (i.e., maintained weight) and instability (i.e., lost, gained, or cycled weight) during the past year. Community women (n = 192) and men (n = 190) completed online self-report measures of eating behaviors and weight patterns. Intuitive eating was linked to greater weight stability, whereas rigid and flexible control were linked to greater weight instability. Additional research is required to assess the directionality of these associations. Nevertheless, these findings provide preliminary support and clinical implications for the promotion of intuitive eating in prevention and public health contexts.

Conformity to feminine norms and self-objectification in self-identified feminist and non-feminist women.

This study investigated the association between the endorsement of feminine gender role norms and self-objectifying beliefs and behaviors in self-identified feminist and non-feminist women. One hundred and ninety-seven predominantly White heterosexual cisgender women attending a large university in southwestern Canada completed the study questionnaires for course credit. A one-way ANOVA demonstrated no differences in self-objectification between self-identified feminist and non-feminist women. Compared to non-feminist women, however, feminist women were less likely to endorse feminine norms for sexual fidelity, romantic relationships, and domesticity. Regression analyses indicated more endorsement of thinness, investment in appearance, and romantic relationships and less endorsement of domesticity accounted for unique variance in self-objectification. Overall, this study provides further evidence for the association between endorsement of feminine norms, especially the norms for beauty and romance, and the adoption of an objectified self-view, even among feminist women.

Perceptions of male partner pressure to be thin and pornography use: Associations with eating disorder symptomatology in a community sample of adult women.

OBJECTIVE: Partner-specific factors have been neglected in eating disorder (ED) research. The present study examined two partner-specific variables that were hypothesized to be linked to women's ED symptoms: perceived male partner thinness-related pressures and pornography use. METHOD: Community women (N = 409) in relationships with men completed online anonymous measures of ED symptomatology, perceptions of male partner thinness-related pressure and pornography use, and thin-ideal internalization. RESULTS: Partner thinness-related pressure was related to higher ED symptomatology, adjusting for age and thinness-related pressures from media, friends, and family. Current and previous partner pornography use were related to higher ED symptomatology, adjusting for age and women's reports of being bothered by this use. Partner thinness-related pressure and previous partner pornography use were associated with ED symptomatology both directly and through thin-ideal internalization, whereas current partner pornography use was directly associated with ED symptomatology. DISCUSSION: Perceptions of male partner thinness-related pressure and pornography use constitute unique factors associated with women's ED symptomatology that may operate indirectly by positioning women to endorse thinness as a personal standard and directly (e.g., by trying to accommodate their partner's appearance preferences). This study's findings provide initial support for pursuing subsequent investigations to test these partner variables as ED risk factors.

Flattering to deceive: Why people misunderstand benevolent sexism.

Perceptions of warmth play a central role in social cognition. Seven studies use observational, correlational, and experimental methods to examine its role in concealing the functions of benevolent sexism (BS). Together, Studies 1 (n = 297), 2 (n = 252), and 3 (n = 219) indicated that although women recall experiencing benevolent (vs. hostile) sexism more often, they protest it less often, because they see it as warm. In Studies 4 (n = 296) and 5 (n = 361), describing men as high in BS caused them (via warmth) to be seen as lower in hostile sexism (HS) and more supportive of gender equality. In Study 6 (n = 283) these findings were replicated and extended, revealing misunderstanding of relationships between BS and a wide array of its correlates. In Study 7 (n = 211), men experimentally described as harboring warm (vs. cold) attitudes toward women were perceived as higher in BS but lower in known correlates of BS. These findings demonstrate that the warm affective tone of BS, particularly when displayed by men, masks its ideological functions. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Self-objectification, body shame, and disordered eating: Testing a core mediational model of objectification theory among White, Black, and Hispanic women.

Objectification theory asserts that self-objectification, which manifests as self-surveillance, leads to increased body shame and subsequent eating pathology. Although evidence supports the core mediational model, the majority of this work utilizes primarily White samples, limiting generalizability to other ethnic groups. The current study examined whether the core tenets of objectification theory generalize to Black and Hispanic women. Participants were 880 college women from the United States (71.7% White, 15.1% Hispanic, 13.2% Black) who completed self-report measures of self-surveillance, body shame, and disordered eating. Multivariate analysis of variance tests indicated lower levels of self-surveillance and disordered eating among Black women. Moreover, body shame mediated the relationship between self-surveillance and disordered eating for White and Hispanic women, but not for Black women. These analyses support growing evidence for the role of body shame as a mediator between body surveillance and eating pathology, but only for women in certain ethnic groups.

Trappings of femininity: A test of the "beauty as currency" hypothesis in shaping college women's gender activism.

This study investigated whether believing beauty is a primary currency for women operates as an antecedent force in the relation between self-objectification and gender activism. Ninety-four ethnically diverse women attending a small liberal arts college in the southeastern United States completed the study questionnaires online for course credit. Preliminary results demonstrated beauty as currency belief, self-objectification, and support for the gender status quo were negatively associated with gender activism. A serial mediation analysis revealed support for the proposed model: Beauty as currency belief was indirectly and inversely linked to gender activism through self-objectification and support for the gender status quo, offering initial evidence for our beauty as currency hypothesis. These findings suggest belief in the notion women will reap more benefits from their bodies than other attributes or pursuits may be an important legitimizing feature of feminine beauty ideology that works through self-objectification against gender social change.

Perpetuation of sexual objectification: The role of resource depletion.

Women are sexually objectified when viewed and treated by others as mere objects. Abundant research has examined the negative consequences of being the target of sexual objectification; however, limited attention has focused on the person doing the objectification. Our focus is on the agent and how self-regulatory resources influence sexual objectification. Consistent with prior evidence, we reasoned that people have a well-learned automatic response to objectify sexualized women, and as such, we expected objectifying a sexualized (vs. personalized) woman would deplete fewer regulatory resources than not objectifying her. Findings across three studies confirmed our expectations, demonstrating the extent to which people objectify a sexualized woman or not is influenced by the availability of regulatory resources, a case that heretofore has been absent from the literature. These patterns are discussed in the context of the sexual objectification and self-regulation literature.

A weight-neutral versus weight-loss approach for health promotion in women with high BMI: A randomized-controlled trial.

Weight loss is the primary recommendation for health improvement in individuals with high body mass index (BMI) despite limited evidence of long-term success. Alternatives to weight-loss approaches (such as Health At Every Size - a weight-neutral approach) have been met with their own concerns and require further empirical testing. This study compared the effectiveness of a weight-neutral versus a weight-loss program for health promotion. Eighty women, aged 30-45 years, with high body mass index (BMI ≥ 30 kg/m(2)) were randomized to 6 months of facilitator-guided weekly group meetings using structured manuals that emphasized either a weight-loss or weight-neutral approach to health. Health measurements occurred at baseline, post-intervention, and 24-months post-randomization. Measurements included blood pressure, lipid panels, blood glucose, BMI, weight, waist circumference, hip circumference, distress, self-esteem, quality of life, dietary risk, fruit and vegetable intake, intuitive eating, and physical activity. Intention-to-treat analyses were performed using linear mixed-effects models to examine group-by-time interaction effects and between and within-group differences. Group-by-time interactions were found for LDL cholesterol, intuitive eating, BMI, weight, and dietary risk. At post-intervention, the weight-neutral program had larger reductions in LDL cholesterol and greater improvements in intuitive eating; the weight-loss program had larger reductions in BMI, weight, and larger (albeit temporary) decreases in dietary risk. Significant positive changes were observed overall between baseline and 24-month follow-up for waist-to-hip ratio, total cholesterol, physical activity, fruit and vegetable intake, self-esteem, and quality of life. These findings highlight that numerous health benefits, even in the absence of weight loss, are achievable and sustainable in the long term using a weight-neutral approach. The trial positions weight-neutral programs as a viable health promotion alternative to weight-loss programs for women of high weight.