Experiences of weight-related stigma among low-income rural women of higher weights from the midwestern United States


Submitted: 17 September 2018
Accepted: 18 February 2019
Published: 18 April 2019
Abstract Views: 1513
PDF: 544
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Weight-related stigma and stereotypes are widespread. Despite established research highlighting the disproportionate disparities rural individuals face, studies focusing on women in rural and low-income environments are underrepresented in the literature. The current study addressed these gaps in the literature using 25 in-depth interviews, which were analyzed using interpretive phenomenological procedures. The research questions were: i) what are low income rural women of higher weights’ understandings and experiences of weight stigma in healthcare? and ii) to what extent do their experiences of stigma affect or do not affect their healthcare-related behaviors? Sixteen women in the study experienced weight-related stigma in healthcare. Many delayed their care while others felt their care was essentially denied. Findings indicate that more can be done to address weight-related stigma.


Puhl R, Heuer C. The stigma of obesity: A review and update. Obesity 2009;17:941-64. DOI: https://doi.org/10.1038/oby.2008.636

Phelan S, Burgess D, Yeazel M, et al. Impact of weight bias and stigma on quality of care and outcomes for patients with obesity. Obes Rev 2015;16:319-26. DOI: https://doi.org/10.1111/obr.12266

Gard M, Wright J. The obesity epidemic: science, morality and ideology. Abingdon, Oxon: Routledge; 2005.

Himmelstein M, Puhl R, Quinn D. Intersectionality: An understudied framework for addressing weight stigma. Am J Prev Med 2017;53:421-31. DOI: https://doi.org/10.1016/j.amepre.2017.04.003

Grollman E. Multiple disadvantaged statuses and health: The role of multiple forms of discrimination. J Health Soc Behav 2014;55:3-19. DOI: https://doi.org/10.1177/0022146514521215

Beagan B, Chapman G, Johnston J, et al. Acquired tastes: Why families eat the way they do. Vancouver: University of British Columbia Press; 2015.

Meit M, Knudson A, Gilbert T, et al. The 2014 update of the rural-urban chartbook. 2014. Available from: https://ruralhealth.und.edu/projects/health-reform-policy-research-center/pdf/2014-rural-urban-chartbook-update.pdf

Bove CF, Olson CM. Obesity in low-income rural women: Qualitative insights about physical activity and eating patterns. Women Health 2006;44:57-78. DOI: https://doi.org/10.1300/J013v44n01_04

Hatzenbuehler M, Phelan J, Link B. Stigma as a fundamental cause of population health inequalities. Am J Public Health 2013;103:813-21. DOI: https://doi.org/10.2105/AJPH.2012.301069

Himmelstein M, Incollingo Belsky A, Tomiyama A. The weight of stigma: Cortisol reactivity to manipulated weight stigma. Obesity 2015;23:368-74. DOI: https://doi.org/10.1002/oby.20959

Flint SW. Obesity stigma: Prevalence and impact in healthcare. Br J Obes 2015;1:14-8.

Mensinger J, Tylka T, Calamari M. Mechanisms underlying weight status and healthcare avoidance in women: A study of weight stigma, body-related shame and guilt, and healthcare stress. Body Image 2018;25:139-47. DOI: https://doi.org/10.1016/j.bodyim.2018.03.001

Smith JA. Beyond the divide between cognition and discourse: Using interpretive phenomenological analysis in health psychology. Psychol Health 1996;11:261-71. DOI: https://doi.org/10.1080/08870449608400256

Smith JA. Evaluation the contribution of interpretive phenomenological analysis. Health Psychol Rev 2011;5:9-27. DOI: https://doi.org/10.1080/17437199.2010.510659

Smith JA, Flowers P, Larkin M. Interpretative phenomenological analysis : theory, method and research. London: SAGE Publications Ltd; 2009.

Smith JA, Osborn M. Interpretative phenomenological analysis. In: Smith JA, ed. Qualitative psychology: A practical guide to research method. London: Sage; 2008. pp 53-80.

Creswell JW. Qualitative inquiry and research design: Choosing among five approaches. 2nd ed. Thousand Oaks, CA: Sage Publications; 2007.

Emerson RM, Fretz RI, Shaw LL. Writing ethnographic fieldnotes. Chicago: University of Chicago Press; 2003.

Wright J. Poststructuralist methodologies - The body, schooling and health. In: Evans J, Davies B, Wright J, eds. Body knowledge and control. Studies in the sociology of physical education and health. London, New York: Routledge; 2003. pp 34-59.

Bombak A, McPhail D, Ward P. Reproducing stigma: Interpreting “overweight” and “obese” women’s experiences of weight-based discrimination in reproductive healthcare. Soc Sci Med 2016;166:94-101. DOI: https://doi.org/10.1016/j.socscimed.2016.08.015

Dutton G, Tan F, Perri M, et al. What words should we use when discussing excess weight? J Am Board Fam Med 2010;23:606-13. DOI: https://doi.org/10.3122/jabfm.2010.05.100024

Brown I, Thompson J, Tod A, Jones G. Primary care support for tackling obesity: A qualitative study of the perceptions of obese patients. Br J Gen Pract 2006;56:666-72.

Zilioli S, Imami L, Ong AD, et al. Discrimination and anger control as pathways linking socioeconomic disadvantage to allostatic load in midlife. J Psychosom Res 2017;103:83-90. DOI: https://doi.org/10.1016/j.jpsychores.2017.10.002

McPhail D, Chapman GE, Beagan BL. The rural and the rotund? A critical interpretation of food deserts and rural adolescent obesity in the Canadian context. Health Place 2013;22:132-9. DOI: https://doi.org/10.1016/j.healthplace.2013.03.009

Farrell LC, Warin MJ, Moore VM, Street JM. Socio-economic divergence in public opinions about preventive obesity regulations: Is the purpose to ‘make some things cheaper, more affordable’ or to ‘help them get over their own ignorance’? Soc Sci Med 2016;154:1-8. DOI: https://doi.org/10.1016/j.socscimed.2016.02.028

Attride-Stirling J. Thematic networks: An analytic tool for qualitative research. Qual Res 2001;1:385-405. DOI: https://doi.org/10.1177/146879410100100307

Creswell JW. Research Design: qualitative, quantitative, and mixed methods approaches. 4th ed. Thousand Oaks, CA: Sage Publications; 2009.

Kaczynski J, Salmona M, Smith T. Qualitative research in finance. Aust J Manag 2013;39:127-35. DOI: https://doi.org/10.1177/0312896212469611

Tylka T, Annunziato R, Burgard D, et al. The weight-inclusive versus weight-normative approach to health: Evaluating the evidence for prioritizing well-being over weight loss. J Obes 2014;2014:1-18. DOI: https://doi.org/10.1155/2014/983495

Puhl R, Peterson J, Luedicke J. Fighting obesity or obese persons? Public perceptions of obesity-related health messages. Int J Obes 2012;37:774-82. DOI: https://doi.org/10.1038/ijo.2012.156

Supporting Agencies

Central Michigan University

Hughes, Katherine, Andrea E. Bombak, and Samuel Ankomah. 2019. “Experiences of Weight-Related Stigma Among Low-Income Rural Women of Higher Weights from the Midwestern United States”. Qualitative Research in Medicine and Healthcare 3 (1). https://doi.org/10.4081/qrmh.2019.7832.

Downloads

Download data is not yet available.

Citations