Background
Weight stigma as a barrier to exercise and physical activity
Coping with weight stigma and physical activity
Methods
Approach
Recruitment of participants and sample
Gender, n | |
Male | 14 |
Female | 16 |
Age (span), n | |
25–29 | 4 |
30–39 | 16 |
40–49 | 5 |
50–59 | 4 |
Age (mean), years | 37.66 |
BMI, kg/m2 | |
Range | 33–58 |
Mean | 40.64 |
Occupation, n | |
Fulltime student | 6 |
Student with job | 4 |
Academic | 4 |
Printing job | 1 |
Police officer | 1 |
Sales person | 2 |
Driving instructor | 1 |
Sound engineer | 1 |
Nurse | 1 |
Industrial mechanic | 1 |
Office assistant | 2 |
Bus driver | 1 |
Administration secretary | 1 |
Unemployed | 4 |
Partner status, n | |
Single / or no current relationship | 15 |
Married / or in a relationship | 13 |
Divorced | 2 |
Children, n | |
Children | 9 |
No children | 21 |
Execution of the interviews
Topic: Exercise history, experiences of and coping with weight stigma in sport and exercise settings | Central question(s) |
---|---|
Attitude towards sport and exercise | What is your attitude towards sports and exercise? Are you interested in sport or exercise? Why, why not? |
Sport and exercise history | How would you describe your sport and exercise activities across your life span? Were there any times when you were doing a lot of/or almost no exercise or sports? |
(Coping) | What were the reasons you stopped? |
Are you currently doing any sports or exercise? Why, why not? | |
Stigma experiences in sport and exercise settings | What positive and negative experiences have you had in sport/when exercising? Did you ever feel disadvantaged or discriminated against or confronted with prejudices? Can you recall any specific experiences? What experiences did you have during PE classes at school/ or sports clubs? |
Coping | How did that make you feel? How did you respond? |
Data interpretation
Statement on positionality of research team
Results
Reasons for self-exclusion
Global theme one: ‘traumatic’ or ‘memorable’ weight stigma experiences
“Sometimes I just felt like crying. Because sometimes, well, absolutely … not good … When you always have this constant frustration during PE class, you eventually end up not doing it at all. Eventually you’ll sit down on the bench and say ‘guys, just leave me alone.”
“P: She approached me and told an eleven-year-old child ‘you are the best dancer here but it simply doesn’t look nice with your weight’.I: Ok, how did you react at the time, how did you cope with that at the time?P: I was completely dumbfounded … um … I asked her whether she was serious and she said yes, and then I said that I’m not coming anymore, and then she followed me and said that I had misunderstood her, and then I told her I didn’t want to hear anything anymore, and still in front of her … I burst into tears in front of her.”
“Every time I went to the gym, there was discussion with him [the gym trainer], and he pretty openly commented that he did not believe I had the discipline to last there in the long run. [ …] he only did that to me. And I was the only person in that place who was overweight and went there on a regular basis” (P. 2 male, 28 y/o).
Global theme 2: self-stigma
“So all these ball and group games and so on, I really didn’t like them. Simply because of the weight, I was for a long … extremely slow.” (P. 11, female, 30 y/o)
“Yes, I think at least a few years ago I would have liked to play basketball because that always interested me but ( … ) I would have to lose some serious weight to be able to play one of the faster positions.“ (P16, male, 30 y/o)
“It really feels like you’re someone from the outside here, a foreigner or, yes, some person from Mars.” (P. 24, female, 43 y/o)
“I think, um, in gyms it’s like that the lean and the athletic people are among themselves. If someone like me turned up, yes, well I mean most people don’t look like me. I would be someone who would stand out initially.” (P. 6, male, 33 y/o)
Global theme 3: fear of weight stigma
“Then you’ll get laughed at again ( … ) such a monster on such small skis, and I feel, although I would like to go skiing, with my colleagues and all, but I don’t want to. I don’t want to expose myself to that. Maybe it’ll be all right but I can’t, I can’t risk it.”
“P: I used to be a very enthusiastic swimmer, I really loved it but I haven’t been to the swimming pool in eight years.I: Ok.P: I simply don’t dare to go at all, um … anxious about comments, fear of stares [ …] I simply wouldn’t feel comfortable.[She goes on to talk about stares at the gym:]“It’s rather an atmosphere of feeling uneasy because you have to overcome yourself and go and you think ‘please, please no-one watch me”
Strategies of self-exclusion
Global theme 4: actively avoiding exposure
“I went the gym for two years, it made me feel uncomfortable. I cancelled [the membership] eventually. I went there because of my slipped disc. For two years I went regularly, two or three times per week, but then (-) I simply didn’t feel comfortable. That was, for me that was too, only obligation and no fun. So, I think with that you notice, so I also felt uncomfortable because of stares there” (our insertion).
“NEVER would I have dared to go outside, for God’s sake, to dare to go the swimming pool, pff … that wasn’t even a question.” (P. 17, female, 27 y/o)
“I consciously avoided the whole dumbbells area and everything because that’s where the people, the athletic people, people with a good figure are. Um … there and um - doesn’t look that good when someone like [me] comes and – totally stomping as if he’s like – well like I said”
“P: I never NEVER wanted to go to swimming lessons, I forged … um … letters to excuse myself as if they were from my parents.... that, that.I: And why did you not want to?P: Well … because they looked at me, because they laughed at me, the children. Children can be horrible. They laughed at me, they … um … bullied me [ … ]… Well you got bullied at school, you (.) like I said, I forged letters to be excused from PE, that I’m sick or something, so I didn’t have to go. When I did attend PE class, I often … um … forgot my [sports] shoes (.) on purpose, so I could sit on the bench or something.”
“P: When I go for a run I usually go in the evening [ …] around nine, half past ten. I live in a village near a town [ … ]: After eight there is no one outside who could see you.”I: Would that play a role for you that … um … people could see you?P: Um, if I’m out of shape and starting again, yes!”
Global theme 5: managing social relations
“Nowadays I prefer individual sports. I swim on my own. So what I mean [ …] I mean that I swim my laps - even when I’m with a group - on my own. And I also do winter sports, which for me, so I also regard that as more of an individual sport, too.”
“It used to be a bigger burden. Um … and the negative reactions … yes I believe this, this social pressure that you are simply exposed to as a student. Yes. And then during my time at university, I would have had the energy to participate in some class from university sports class, but for God’s sake – no! [ …] To imagine to [exercising] in a group of thirty people in one room – that’s a total nightmare for me. Instead, prefer the new Metallica album and [run] through the forest.’ (our insertion).
“You can just be by yourself on this ergo-bike; I can close my curtains and shut the door, and then I do it for myself and then it’s ok.”
Discussion
Practical implications for public health (educators) and recommendations for sport and exercise settings
-
Educate Health Professionals (gym trainers, PE teachers, coaches, lecturers in health sciences at universities) about weight stigma and raise awareness for its potentially harmful effects. In this regard, we propose a mandatory training for PE teachers and any staff working in sport and exercise settings.
-
More Inclusive Sport and Exercise Settings: for example through less mirrors in gyms [71], awareness of visibility, the provision of larger and stronger equipment for all body sizes, less posters and images depicting unrealistic body ideals (e.g. sixpacks), and, as also proposed by Picket and Cunningham [71], by making people with obesity feel comfortable and included in sport and exercise spaces, for instance by using respectful language (this could be a specific goal of gym staff training),
-
Anti-Stigma Policies: Implement no tolerance policies for any overt discriminatory behaviour (comments, ridicule, marginalisation) in PE classes, sport and exercise settings [71].
-
Educate People with Obesity about the potentially isolating effects of self-excluding coping strategies.
-
Target Self-Stigma: Our results show that self-stigma and self-discriminatory attitudes can be barriers to physical activity. Therefore, public health strategies must target the societal roots of self-stigma. As proposed by the research team surrounding Puhl and Schwartz [74] and other experts [46], one important strategy in this regard could be to display positive and motivating images of people with obesity exercising in the media and in sport and exercise settings. The UConn Rudd Center for Food Policy and Obesity website provides a freely accessible media gallery [74].