Perception of overweight and obesity from different angles – a qualitative study

Background/Objectives: Prevalence rates of obesity are still rising in most countries. Aside from numerous negative consequences such as co-morbid diseases and a reduction in life expectancy due to excessive body weight and the economic impact of obesity on health care systems, overweight and obese individuals are also affected by perceived stigmatization and discrimination. Knowledge of common views and perceptions of overweight and obesity in the general public as well as in specific populations (e.g. health care professionals) is crucial in order to develop interventions to reduce stigma. This qualitative study reports results from focus groups with normal-weight and overweight individuals as well as with health care professionals. The specific aim of the current study was to develop an appropriate questionnaire to be used in a survey to follow, enhancing existing instruments.

Methods: Focus groups served as a qualitative approach to inform the development of an interview schedule for the project „The stigma of overweight and obesity in the general population and among health care professionals“, conducted at the Leipzig Medical Centre's Integrated Research and Treatment Centre AdiposityDiseases. Three stakeholder groups were identified whose attitudes are crucial in improving the prevention and treatment of obesity: people with obesity, health professionals, and members of the general public with normal body weight. Focus groups followed a semi-structured format based on 7 main questions that were complemented with follow-up questions as needed.

Results: Contents of the discussion of overweight and obesity did not differ substantially between the three groups. Results show that the definition of obesity in our focus groups is a subjective construct influenced mainly by aesthetics, sympathy and activity. Within the groups, obesity was mainly seen as a controllable condition; however, external (societal) factors were named as well. In line with this and as expected from theoretical background, obese individuals are ascribed mainly negative attributions.

Discussion/Conclusions: Qualitative research can enrich quantitative studies on the stigma of obesity. This study enlightens lived realities of different groups of people. The results can be applied to improve existing instruments for the measurement of attitudes towards obesity. Also, as linking obesity and overweight to an individual's failure of a healthy lifestyle is associated with the attribution of stereotypes and weight stigma, public campaigning with elaborated models on obesity etiology may help reduce weight stigma in general.

Funding: Federal Ministry of Education and Research (grant no. 01EO1001).

Keywords: Stigmatization, adiposity, social stigma.