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Open Access Highly Accessed Research article

The stigma of obesity in the general public and its implications for public health - a systematic review

Claudia Sikorski12*, Melanie Luppa2, Marie Kaiser3, Heide Glaesmer3, Georg Schomerus4, Hans-Helmut König5 and Steffi G Riedel-Heller2

Author Affiliations

1 Leipzig University Medical Center, IFB AdiposityDiseases, Leipzig, Stephanstraße 9c, 04103 Leipzig, Germany

2 Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany

3 Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany

4 Department of Psychiatry and Psychotherapy, University of Greifswald, Rostocker Chaussee 70, 18437 Stralsund, Germany

5 Department of Medical Sociology, Social Medicine and Health Economics, Hamburg-Eppendorf University Medical Center, Martinistr. 52, 20246 Hamburg, Germany

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BMC Public Health 2011, 11:661  doi:10.1186/1471-2458-11-661

Published: 23 August 2011

Abstract

Background

Up to this date, prevalence rates of obesity are still rising. Aside from co-morbid diseases, perceived discrimination and stigmatization leads to worsen outcomes in obese individuals. Higher stigmatizing attitudes towards obese individuals may also result in less support of preventive and interventive measures. In light of the immense burden of obesity on health care systems and also on the individuals' quality of life, accepted and subsidized preventive measures are needed. Policy support might be determined by views of the lay public on causes of obesity and resulting weight stigma. This study seeks to answer how representative samples of the lay public perceive people with obesity or overweight status (stigmatizing attitudes); what these samples attribute obesity to (causal attribution) and what types of interventions are supported by the lay public and which factors determine that support (prevention support).

Methods

A systematic literature search was conducted. All studies of representative samples reporting results on (a) stigmatizing attitudes towards overweight and obese individuals, (b) causal beliefs and (c) prevention support were included.

Results

Only 7 articles were found. One study reported prevalence rates of stigmatizing attitudes. About a quarter of the population in Germany displayed definite stigmatizing attitudes. Other studies reported causal attributions. While external influences on weight are considered as well, it seems that internal factors are rated to be of higher importance. Across the studies found, regulative prevention is supported by about half of the population, while childhood prevention has highest approval rates. Results on sociodemographic determinants differ substantially.

Conclusions

Further research on public attitudes toward and perception of overweight and obesity is urgently needed to depict the prevailing degree of stigmatization. Introducing a multidimensional concept of the etiology of obesity to the lay public might be a starting point in stigma reduction.