End of Weight Stigma: A Proposal for a Multilevel Classification of its Components for Intervention Purposes

Author:

de Souza Gabriela Cristina Arces1,Laus Maria Fernanda2,Penaforte Fernanda Rodrigues de Oliveira3,Santos Lucas Brandão dos1,Japur Camila Cremonezi1

Affiliation:

1. Universidade de São Paulo

2. Universidade de Ribeirão Preto

3. Federal University of Triângulo Mineiro

Abstract

Abstract

Background Weight stigma is a complex construct formed by various components. This study aimed to compile these components and classify them into the multilevel intervention levels of stigma (structural, interpersonal, and intrapersonal).Methods A non-systematic literature review was conducted to identify the most commonly used definitions of weight stigma components. Subsequently, a proposal was made to classify these components into different intervention levels as proposed (Structural, Interpersonal, Intrapersonal). The components were categorized based on their definitions and specificities at each level. A panel of experts evaluated the proposal, and the degree of agreement was assessed using Fleiss' Kappa coefficient (₭). Values of ₭ between 0.40 and 0.60 indicated moderate agreement; between 0.61 and 0.75, good agreement; and above 0.75, excellent agreement.Results Ten terms were identified and classified in the different levels of stigma, except “Weight stigma” and “Weight bias”. At the structural level were included "fatphobia" and "weight-based stereotypes"; at the interpersonal level, "weight discrimination" and "explicit weight bias"; and at the intrapersonal level, "implicit weight bias", "lipophobia," "fat stigma", and "internalized weight bias". Agreement among the experts' responses for the structural and interpersonal levels was 100% (₭ = 1.0). For the components allocated at the intrapersonal level, there were some disagreements in the classification of the “Fat stigma” component (₭ = 0.4), and “Lipophobia” and “Implicit weight bias” were considered inappropriate by one specialist (₭ = 0.6).Conclusion The proposed classification of weight stigma components across multi-level interventions is novel and deemed appropriate by the experts. In future studies, this classification can help assess associations between weight stigma components across inter- and intra-levels and guide interventions across different levels for more effective outcomes in combating weight stigma.

Publisher

Springer Science and Business Media LLC

Reference74 articles.

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