Stigma Experienced By Children And Adolescents With Obesity
POLICY STATEMENTOrganizational Principles to Guide and Define the Child Health Care Systemand/or Improve the Health of all ChildrenStigma Experienced by Childrenand Adolescents With ObesityStephen J. Pont, MD, MPH, FAAP, a, b Rebecca Puhl, PhD, FTOS, c Stephen R. Cook, MD, MPH, FAAP,FTOS, d Wendelin Slusser, MD, MS, FAAP, e SECTION ON OBESITY, THE OBESITY SOCIETYThe stigmatization of people with obesity is widespread and causes harm.Weight stigma is often propagated and tolerated in society becauseof beliefs that stigma and shame will motivate people to lose weight.However, rather than motivating positive change, this stigma contributesto behaviors such as binge eating, social isolation, avoidance of health careservices, decreased physical activity, and increased weight gain, whichworsen obesity and create additional barriers to healthy behavior change.Furthermore, experiences of weight stigma also dramatically impair qualityof life, especially for youth. Health care professionals continue to seekeffective strategies and resources to address the obesity epidemic; however,they also frequently exhibit weight bias and stigmatizing behaviors. Thispolicy statement seeks to raise awareness regarding the prevalence andnegative effects of weight stigma on pediatric patients and their familiesand provides 6 clinical practice and 4 advocacy recommendations regardingthe role of pediatricians in addressing weight stigma. In summary, theserecommendations include improving the clinical setting by modeling bestpractices for nonbiased behaviors and language; using empathetic andempowering counseling techniques, such as motivational interviewing, andaddressing weight stigma and bullying in the clinic visit; advocating forinclusion of training and education about weight stigma in medical schools,residency programs, and continuing medical education programs; andempowering families to be advocates to address weight stigma in the homeenvironment and school setting.abstractaTexasCenter for the Prevention and Treatment of Childhood Obesity,Dell Children’s Medical Center of Central Texas, Ascension, Austin,Texas; bDepartment of Pediatrics, Dell Medical School; Center forHealth Communication, Moody College of Communication; Departmentof Nutritional Sciences; University of Texas at Austin, Austin Texas;cRudd Center for Food Policy and Obesity and Department of HumanDevelopment and Family Studies, University of Connecticut, Storrs,Connecticut; dDepartment of Pediatrics, Golisano Children's Hospital,University of Rochester Medical Center, Rochester, New York; andeJane and Terry Semel Healthy Campus Initiative, David Geffen Schoolof Medicine and Jonathan and Karin Fielding School of Public Health,University of Los Angeles, Los Angeles, CaliforniaDr Pont conceptualized the report; Drs Pont and Puhl led the writing ofthe manuscript; Drs Cook and Slusser served as contributing authors;and all authors contributed to drafts and revisions and approved thefinal manuscript.This document is copyrighted and is property of the AmericanAcademy of Pediatrics and its Board of Directors. All authors havefiled conflict of interest statements with the American Academyof Pediatrics. Any conflicts have been resolved through a processapproved by the Board of Directors. The American Academy ofPediatrics has neither solicited nor accepted any commercialinvolvement in the development of the content of this publication.Policy statements from the American Academy of Pediatrics benefitfrom expertise and resources of liaisons and internal (AAP) andexternal reviewers. However, policy statements from the AmericanAcademy of Pediatrics may not reflect the views of the liaisons or theorganizations or government agencies that they represent.The guidance in this statement does not indicate an exclusive courseof treatment or serve as a standard of medical care. Variations, takinginto account individual circumstances, may be appropriate.More children in the United States suffer from obesity than from anyother chronic condition, with one-third of US children and youth havingoverweight or obesity and 17% of children 2 to 19 years of age havingobesity. 1 In some pediatric populations, such as children living ineconomically challenged communities, as many as two-thirds of childrenhave overweight or obesity. 2 Although some promising signs suggest theprevalence of obesity may be stabilizing, rates remain unacceptably high,All policy statements from the American Academy of Pediatricsautomatically expire 5 years after publication unless reaffirmed,revised, or retired at or before that time.To cite: Pont SJ, Puhl R, Cook SR, et al, AAP SECTION ONOBESITY, THE OBESITY SOCIETY. Stigma Experienced by Chil dren and Adolescents With Obesity. Pediatrics. 2017;140(6):e20173034from http://pediatrics.aappublications.org/ by guest onNovember2017Fromthe 20,AmericanPEDIATRICS Volume 140, numberDownloaded6, December 2017:e20173034Academy of Pediatrics
and some studies suggest that therate of children with severe obesity(BMI 120% of the 95th percentile)continues to increase. 1, 2 Although numerous efforts areunderway to help children andadults reach and maintain a healthyweight, many such efforts do notaddress the social consequencesof obesity, specifically weightstigmatization and discrimination. 3Weight stigma refers to the societaldevaluation of a person because heor she has overweight or obesityand often includes stereotypes thatindividuals with obesity are lazy,unmotivated, or lacking in willpowerand discipline. These stereotypesmanifest in different ways, leading toprejudice, social rejection, and overtunfair treatment and discrimination.For children and adolescents withoverweight or obesity, weight stigmais primarily expressed as weightbased victimization, teasing, andbullying.Weight stigmatization is oftenpropagated and tolerated in societybecause of beliefs that stigmaand shame will motivate peopleto lose weight. 4 However, ratherthan motivate positive change, thisstigma contributes to behaviorssuch as binge eating, social isolation,avoidance of health care services,decreased physical activity, andincreased weight gain over time,which worsen obesity and createbarriers to healthy behavior change. 5Experiences of weight stigma alsodramatically impair quality of life,especially for youth. A landmarkstudy by Schwimmer et al 6 revealedthat children and adolescents withsevere obesity had quality-of-lifescores that were worse than agematched children who had cancer.Furthermore, the manifestation ofweight stigma is not isolated to olderadolescents with severe levels ofobesity, because negative weightbased stereotypes toward childrenwith overweight emerge as youngas 3 years old. 7 Importantly, peers2are not the only sources of weightstigma. Research documents weightstigma by parents and other familymembers, teachers, health careprofessionals, and society at large,including the popular media.3, 8, 9 Thus, children are vulnerable tostigma and its negative consequencesin school, at home, and in clinicalsettings.Pediatricians and pediatric healthcare professionals strive to improvethe health of patients through directclinical care and through advocatingfor systemic and environmentalchange to support the health andsuccess of patients in homes, schools,and communities. Weight stigmais prevalent through numeroussettings and negatively affectsthe health and success of patientsacross several domains, includingpersonal and social development,education, and the workplace. Manyexamples throughout the historyof public health demonstrate thatdisease stigma is a legitimate barrierto prevention, intervention, andtreatment. Conditions such as HIV/AIDS, various forms of cancer,alcoholism, and drug use wereinitially stigmatized and requiredconsiderable efforts by the medicalfield to reduce stigma-inducedbarriers that impaired effectivetreatment. 10 Weight stigma is noexception but unfortunately remainsan ongoing omission in approachesto address obesity. To best supportpatients’ healthy changes, it isimportant to recognize, address, andadvocate against weight stigma in allsettings.Extent of Weight Stigma inMultiple SettingsWeight Stigma in YouthWeight stigma among youth is mostoften experienced as victimization,teasing, and bullying. In the schoolsetting, weight-based bullying isamong the most frequent formsof peer harassment reported bystudents. As early as preschool,young children attribute negativecharacteristics and stereotypes topeers with larger body sizes. 11, 12 Byelementary school, negative weightbased stereotypes are common.Students are less likely to offer helpto peers with overweight or obesity,and those with overweight or obesityare more likely to be bullied than arestudents of a healthier weight. 12–14 The likelihood of being targetedby verbal, relational, and physicalvictimization from peers increaseswith a student’s BMI percentile.Longitudinal evidence demonstratesthat weight status significantlypredicts future victimization, withyouth of the highest weight beingthe most vulnerable to bullying. 15Recent evidence demonstrates thatadolescents report the primaryreason their peers are teased orbullied at school is because of theirweight. 16 Self-reported experiencesof bullying, even among raciallydiverse samples of adolescents,indicate weight-based harassmentis the most prevalent form ofharassment reported by girls andthe second-most common form ofharassment among boys. 17 A studyof adolescents seeking weight losstreatment found that 71% reportedbeing bullied about their weight inthe past year, and more than onethird indicated that the bullying hadpersisted for 5 years. 9Weight Stigma and Parents andEducatorsPerspectives of parents andeducators have similarly identifiedweight-based bullying as a prevalentand problematic issue. A 2011national study by the NationalEducation Association examinedperspectives of bullying among 5000 educators and found thatweight-based bullying was viewedby teachers as the most problematicform of bullying in the classroom,more so than bullying because ofa student’s sex, sexual orientation,or disability. 18 In a national studyDownloaded from http://pediatrics.aappublications.org/ by guest on NovemberFROM20, 2017THE AMERICAN ACADEMY OF PEDIATRICS
of parents, having overweight wasperceived by parents to be themost common reason youth arebullied, and these perspectivesremained consistent regardless oftheir children’s weight status. 19Furthermore, a recent multinationalstudy (including the United States,Canada, Australia, and Iceland)showed that adults across thesecountries consistently viewed havingoverweight as the most commonreason youth are bullied. 20 Thus,reports by students, educators, andparents all point to weight-basedbullying as a significant problem inthe school setting.Unfortunately, weight-basedvictimization of youth extendsbeyond peer relationships. Increasingevidence indicates educatorscan be sources of weight stigma.Experimental research shows thatteachers have lower expectations ofstudents with obesity than they haveof students without obesity, includingexpectations of inferior physical,social, and academic abilities. 21 Datafrom 5 waves of the Early ChildhoodLongitudinal Study, Kindergartenfound that weight status in studentswas more negatively related toteachers’ assessments of theiracademic performance than to theirtest scores, indicating that teachersrate academic performance ofstudents with obesity as worse thantheir test performance suggests. 22Self-report studies have additionallydemonstrated negative weightrelated stereotypes and beliefsamong educators in the schoolsetting. 23– 26 Of concern, parents have also beenidentified as a source of weightbased victimization toward youthwith obesity. In a survey study ofadolescents attending weight-losscamps, 37% reported they had beenteased or bullied about their weightby a parent. 9 Survey researchersassessing experiences of weightstigma among women with obesityfound that family members werereported to be the most prevalentinterpersonal source of weightstigma incidents, with 53% reportingweight stigma from their mothersand 44% reporting it from theirfathers. 27 Weight stigma expressedby parents can have a lasting effecton children, who continue to reportemotional consequences from theseexperiences through adulthood. 28Weight Stigma and the MediaBeyond the school and home settings,youth are additionally vulnerableto weight stigma through themedia. Content analyses of popularchildren’s television shows andmovies reinforce weight stigmathrough stereotypical portrayalsof characters who appear to havelarger body sizes. Characters whoare visually slim in children’smedia are often portrayed as beingkind, popular, and attractive, butcharacters with larger body sizes aredepicted as aggressive, unpopular,evil, unhealthy, and the target ofhumor or ridicule. 29– 31 A contentanalysis of recent children’s moviesfound 70% included weight-relatedstigmatizing content, of which 90%targeted characters with obesity. 32Similarly, research examiningpopular adolescent television showsidentified a significantly higherproportion of weight-stigmatizingcontent in youth-targeted shows(50%) compared with showstargeting a general audience(38.3%).33 Given that youth spendmultiple hours per day watchingtelevision and other media, thereis a considerable likelihood theyare exposed to negative weightbased stereotypes and stigma. 34Furthermore, research hasdocumented associations betweengreater media exposure among youthand increased expressions by thoseyouth of weight stigma toward peerswith overweight and obesity. 35 Takentogether, this evidence highlightsyouth-targeted media as sources ofweight-based stereotypes that mayreinforce and add to stigmatizingmessages communicated to childrenat school and home.Weight Stigma in Health CareResearch shows that health careprofessionals express weight stigmatoward patients with obesity, andpatients with obesity frequentlyfeel stigmatized in health caresettings. 36 Some research hasfound that more than two-thirds ofwomen with overweight or obesityreport being stigmatized about theirweight by doctors. 27 Health careprofessionals, including physicians,nurses, dietitians, psychologists,and medical trainees, self-reportbias and prejudice toward patientswith obesity. 8, 37 Research showsthat physicians associate obesitywith noncompliance and decreasedmedication adherence, hostility,dishonesty, and poor hygiene. Theyoften view patients with obesityas being lazy, lacking self-control,and being less intelligent.8, 38 Furthermore, this prejudicenegatively affects quality of care andcan result in patients with obesitybeing less likely to seek preventivecare and delaying or cancelingappointments. 39– 41 Physiciansspend less time and engage in lessdiscussion in office visits withpatients with obesity than theydo with patients with a lower BMIand are more reluctant to performpreventive health screenings, suchas pelvic examinations, cancerscreenings, and mammograms, forpatients with obesity. Psychologistshave been shown to ascribe morepathology, more negative and severesymptoms, and worse prognosisto patients with obesity than tothose at a healthier weight but withotherwise similar behavioral healthhistories.8, 36, 41 Anecdotal reportsin the news suggest that patientshave been denied care becausethey have obesity, which suggestsa need for future studies exploringthis discriminatory practice. 42from http://pediatrics.aappublications.org/ by guest on November 20, 2017PEDIATRICS Volume 140, number 6, DownloadedDecember 20173
Additionally, patients with obesityhave reported not being providedwith appropriate-sized medicalequipment, such as blood pressurecuffs and patient gowns, whichresults in a less welcoming clinicalenvironment and affects thequality of the health care that isprovided. 8, 38, 43 When it comes to youth, evennuances in the language doctors useto discuss body weight with patientscan lead to stigma and health careavoidance. Parental perceptions ofwords commonly used to describeexcess body weight were examinedin a national study of parents ofchildren 2 to 18 years of age. 44Parents were asked to evaluate 10common words regarding the extentto which each word was desirable,stigmatizing, blaming, or motivatingfor weight loss. The terms “fat, ”“obese, ” and “extremely obese”were rated as the most undesirable,stigmatizing, blaming, and leastmotivating. In contrast, more neutralwords like “weight” or “unhealthyweight” were rated as the mostdesirable and motivating for weightloss. 44– 46 When parents were askedhow they would react if a doctorreferred to their children’s weight ina stigmatizing way, 34% respondedthat they would switch doctors, and24% stated that they would avoidfuture medical appointments fortheir children.44 Limited literaturehas evaluated how health careprofessionals might most effectivelyand sensitively discuss weight withtheir patients and families and alsowith whom pediatric patients preferto talk with about their weight. 47, 48 These findings merit further studyand underscore the importanceof how health care professionalscommunicate with patients aboutobesity and weight-related health.Traditionally, medical school andresidency education have providedlimited training regarding successfulapproaches to encouraging healthbehavior change (eg, motivational4interviewing) and addressing obesityin patients and their families, leadinghealth care professionals to reportthat they do not feel competentor comfortable discussing weightwith their patients. 49– 51 Moretraining is needed for trainees andpracticing health care professionalsregarding effective approaches toempowering children and familiesto make healthy changes. There aredifferent approaches to educatingmedical students and health careprofessionals about weight stigma,such as educational strategies thatemphasize the complex causes ofobesity (eg, biological, genetic, andenvironmental contributors beyondpersonal control), communicationskills training, interacting withvirtual standardized patients, andusing brief educational films, roleplay, and dramatic readings inaddition to traditional lecture-stylelearning. 3, 52–57 These approacheshave been tested in different formatsand can be incorporated into healthcare professional training programs.Psychological, Social, andPhysical Health Consequences ofWeight StigmaEmotional and Psychological EffectsWeight stigma poses numerousconsequences for the psychologicaland physical health of childrenand adolescents, including adverseoutcomes that may reinforceunhealthy behaviors that promoteobesity and weight gain. Experiencesof weight-based teasing and bullyingincrease the risk for a range ofemotional and psychologicalconsequences for youth. Evidence hasdocumented increased vulnerabilityto depression, anxiety, substance use,low self-esteem, and poor body imageamong youth who are teased orbullied about their weight. 58–62 Thesefindings persist after accounting forfactors such as age, sex, BMI, andage of obesity onset, which suggestsstigmatizing experiences rather thanjust body weight are contributingto these negative outcomes. Ofconcern, self-harm behaviors andsuicidality are also higher amongyouth who have been teased orbullied about their weight comparedwith same-weight peers who havenot been teased. In addition to highersuicidal attempts reported amongadolescents with obesity, researchhas found that the odds of thinkingabout and attempting suicide areapproximately 2 times higher amonggirls and boys who are teased abouttheir weight compared with thosewho are not teased about theirweight. 63, 64 Social Isolation and AcademicOutcomesWeight-based teasing and bullyingalso contribute to social isolationand adverse academic outcomes foryouth. Evidence from the NationalLongitudinal Study of AdolescentHealth demonstrated that comparedwith students without overweight,adolescents with overweight orobesity are significantly more likelyto experience social isolation andare less likely to be nominated asfriends by peers. 65, 66 Youth arekeenly aware at an early age thattheir weight status may affect theirsocial relationships; 1 study foundthat more than two-thirds of 9- to11-year-old children who perceivedthemselves as having excess weightbelieved they would have morefriends if they could lose weight. 37Teasing that impairs social bondsmay have an additional negativeeffect on academic performance.Weight-based teasing has beenfound to mediate the relationshipbetween students’ higher BMI andpoorer school performance 67 andmay lead students to disengagefrom their school environment. Ina recent study, adolescents whoreported experiencing weight-basedbullying during the previous yearindicated that their grades wereharmed by these experiences, andthey avoided going to school toDownloaded from http://pediatrics.aappublications.org/ by guest on NovemberFROM20, 2017THE AMERICAN ACADEMY OF PEDIATRICS
escape weight-based teasing andbullying.68 The likelihood of studentsreporting these reactions increasedby 5% per teasing incident even afteraccounting for sex, race, age, grades,and weight status.Unhealthy Eating BehaviorsWeight-based victimization mayreinforce unhealthy eating behaviorsthat contribute to increased bodyweight. Among boys and girlsenrolled in weight-loss camps,those who reported weight-basedteasing were more likely to engagein unhealthy eating behaviors andbinge eating than were peers whowere not teased. 69, 70 Prospectiveresearch has demonstratedlongitudinal associations betweenearly experiences of weight-basedteasing and later disordered eatingbehaviors. 71 Other work has foundlinks between weight-based teasingand disordered eating for bothadolescent boys and girls acrossweight strata. 65 Among Hispanicand African American girls, weightbased teasing from peers andparents was associated with moreemotional eating and binge eating.72Retrospective research with youngadult women has additionallydemonstrated that those whoexperienced weight-based teasing inchildhood are more likely to engagein unhealthy eating behaviors thanpeers who were not teased, and asthe variety of weight-based teasinginsults increased in childhood, sodid the disordered eating patternsand current body weight status inadulthood. 67Decreased Exercise and PhysicalActivityExperiences of weight-basedteasing and bullying have negativeimplications for exercise motivationand physical activity. Youth whoexperience more frequent weightbased teasing have decreased levelsof physical activity. 73, 74 Middleschool students who report beingteased about their weight have lessself-confidence in being physicallyactive and lower levels of physicalfitness compared with peers who arenot teased even after controlling forsociodemographic characteristics. 75Furthermore, adolescents who reportmore emotional distress in responseto experiences of weight-basedteasing are more likely to cope withteasing by avoiding school activities,including physical activities andgoing to physical education class. 70These findings raise additionalconcerns in light of recent researchshowing that as many as 85% of highschool students report witnessingweight-based teasing toward theirpeers during gym class at school.19Worsening ObesityEmerging research has demonstratedassociations between weight-basedteasing and increased body weightstatus in youth. One study found thatcompared with girls who did notexperience weight stigmatization,girls reporting previous experiencesof weight stigmatization had a 64%to 66% increased risk of developingand/or worsening overweight orobesity. 76, 77 During adolescence,teasing and hurtful weight labelsfrom family members may beespecially harmful; evidence froma diverse sample of girls foundgreater odds of obesity as a result ofstigmatization from family membersthan from friends and teachers. 78Recent longitudinal evidenceadditionally shows that weight-basedteasing experienced by girls and boysin adolescence predicts higher BMIand obesity for both women and men15 years later. 79 In addition, severalrecent longitudinal studies of adultshave found that perceived weightstigma and discrimination increasethe risk of developing and continuingto have obesity over time even aftercontrolling for baseline BMI, sex,race, and socioeconomic factors.80, 81 Furthermore, emerging researchreports that perceived pressure to bethin in adolescence is associated witha greater elevation of fasting insulinand poorer insulin sensitivity. Thenegative effect of emotional pressureon hyperinsulinemia was sustainedeven after controlling for fat massand adiposity. 82 Taken together,these findings raise significantconcerns about the effects of weightstigma on health behaviors andoutcomes of vulnerable youth.RecommendationsImproving Clinical PracticeThe American Academy of Pediatricsrecommends that pediatriciansengage in efforts to mitigate weightstigmatization at the practicelevel and beyond. The followingrecommendations offer practice-levelstrategies for pediatricians.1. Role Modeling. It is important forpediatricians and pediatric healthcare professionals to demonstrateand model professional behaviorwith colleagues, staff, and traineesthat is supportive and nonbiasedtoward children and familieswith obesity. These efforts shouldinclude the recognition andacknowledgment of the complexetiology of obesity, includinggenetic and socioeconomic factors,environmental contributors,community assets, family andcultural traditions, and individualchoices. This recognition can helpdispel common assumptions andstereotypes that place blame andjudgment solely on individualsfor having excess weight ordifficulties achieving weight loss.2. Language and Word Choice. It isimportant for pediatricians andpediatric health care professionalsto use appropriate, sensitive,and nonstigmatizing languagein communication about weightwith youth, families, and othermembers of the pediatrichealth care team. Words canheal or harm, intentionally andunintentionally. Recent evidencefrom http://pediatrics.aappublications.org/ by guest on November 20, 2017PEDIATRICS Volume 140, number 6, DownloadedDecember 20175
shows that neutral words like“weight” and “body mass index”are preferred by adolescentswith overweight and obesity,whereas terms like “obese, ”“extremely obese, ” “fat, ” or“weight problem” induce feelingsof sadness, embarrassment, andshame if parents use these wordsto describe their children’s bodyweight. 83, 84 Furthermore, usingpeople-first language is onestep to help reduce the use ofpotentially stigmatizing language,and it is now emerging as thepreferred standard with obesityas well as other diseases anddisabilities. People-first languageplaces the individual first beforethe medical condition or disabilityand involves using phrases such as“a child with obesity” rather thanan “obese child.”3. Clinical Documentation. Obesityis a medical diagnosis withreal health consequences, so itis important for children andfamilies to understand the currentand future health risks associatedwith the degree to which a patientweighs more than what is healthy.However, this should be addressedwith a balanced and empatheticapproach so that the informationis conveyed and understood in asensitive and supportive manner.Using more neutral terms, suchas “unhealthy weight and “veryunhealthy weight, ” both in clinicalnotes and when speaking topatients and family members canassist in these efforts. Electronichealth records and medical codingnomenclature could considerusing the terms “unhealthyweight” and “very unhealthyweight” instead of “obesity” and“morbid obesity” in problemlists to further support the use ofpatient-sensitive language duringclinical encounters.4. Behavior Change Counseling.Beyond specific word choice,it is recommended that6patient-centered, empatheticbehavior change approaches, suchas motivational interviewing, beused as a framework to supportpatients and families in makinghealthy changes. 85– 87 Throughmotivational interviewing, healthcare professionals collaborativelyengage the patient and/or parentsin determining their goals andaddressing barriers to how theywill achieve sustained healthbehavior change.5. Clinical Environment.Pediatricians should create a safe,welcoming, and nonstigmatizingclinic space for youth with obesityand their families. This requirescreating a supportive practicesetting that accommodatespatients of diverse body sizes,from the clinic entrance tothe examination room (seeAppendix 1).6. Behavioral Health Screening.Addressing weight stigma inclinical practice also necessitatesthat pediatricians assess patientsnot only for physical but alsoemotional comorbidities andnegative exposures associatedwith obesity, including bullying,low self-esteem, poor schoolperformance, depression, andanxiety. 88– 90 These are oftenoverlooked but can be signs achild is experiencing weight-basedbullying.Advocating Against Weight StigmaCreating a healthy environmentin which patients live is critical toeffectively address and preventobesity. As part of these efforts,it is important to promote anenvironment that supports andempowers youth and families tobe healthy rather than reinforcingsocietal shame or stigma directedtoward those with obesity. Thus,pediatricians can be importantadvocates to reduce weight stigma inmultiple settings.1. Schools. Pediatricians canwork with schools to ensureantibullying policies includeprotections for students who arebullied about their weight. Giventhat weight-based bullying isoften absent in school policies,advocacy efforts by health careprofessionals could play animportant role in reducing suchbullying.2. Youth-Targeted Media. It isimportant that pediatriciansand pediatric health careprofessionals advocate for aresponsible and respectfulportrayal of individuals withobesity in the media. Byspeaking out (eg, opinions andcommentaries, letters to editors,pr
of obesity, specifically weight stigmatization and discrimination. 3 Weight stigma refers to the societal devaluation of a person because he or she has overweight or obesity and often includes stereotypes that individuals with obesity are lazy, unmotivated, o
addiction-related stigma, this chapter provides a brief overview of addiction-related stigma. This chapter includes a discussion of four broad types of addiction-related stigma, ways to understand stigma, and definitions of stigma. It reviews several ways in which stigma is sustained, the effects of stigma, an exercise to consider whether
the roots of stigma and how it affects PLHAs, families, children and communities and develop strategies and skills to confront stigma and discrimination. How was the Toolkit Developed? The toolkit developed out of a three country research project on HIV stigma.* At the start of the research project, workshops were organized for research .
Edited by Imogen Tyler and Tom Slater Table of Contents Tyler, I. and T. Slater, ZIntroduction: Rethinking the Sociology of Stigma [Living with Stigma Tyler, I. Resituating Erving Goffman: From Stigma Power to lack Power Scambler, G. Heaping
Stigma of Addiction Summit Innovation Abstract Compendium Table of Contents 45. Reducing Opioid Use Disorder-Related Stigma among Pharmacy Students Using Contact-Based Education 87 46. Reducing Stigma of Individuals with Opioid U
In Georgia, LGBT people face a challenging legal landscape and social climate, which contribute to stigma and discrimination against LGBT people in the workplace, at school, in housing, and in public life. Stigma and discrimination have been linked to negative economic impacts on governments, businesses, and the economy.
perceived stigma among family and friends in an individual's help-seeking behavior. Methods: Data were collected using semi-structured interviews with patients with depressive disorders from a tertiary psychiatric hospital in Singapore to capture individuals' self-reported experience with depression and stigma-tization among family and friends.
: The level of stigma towards mental illness is low and . insignificant, and participants generally hold a positive attitude towards seeking mental health services. There is a significant positive correlation between the level of stigma and their attitude towards seeking mental health services. Keywords:
Daniel Gutierrez, Allison Crowe, Patrick R. Mullen, Laura Pignato, Shuhui Fan Stigma, Help Seeking, and Substance Use Researchers used path analysis to examine self-stigma, help seeking, and alcohol and other drug (AOD) use in a community sample of individuals (N 406) recruited through the crowdsourcing platform MTurk. Self-
