Weight Stigma and Physical Activity Behaviors Among Adults: Context Matters

Abstract

Physical activity is an important health behavior for adults of all weight statuses to engage in. Many factors have been explored as they relate to adult physical activity behavior, including weight stigma. Weight stigma can take different forms - experienced weight stigma (EWS), internalized weight stigma (IWS), and fitness center stigma – and can result in negative psychosocial and physical health outcomes. However, much of the current literature around the association between weight stigma and physical activity remains mixed, potentially due to the different forms that in can take. Additionally, literature around fitness center stigma and physical activity is sparce, but important to explore given that they are common spaces for engaging in physical activity among adults. Thus, the purpose of this dissertation study was to use a mixed methods approach to explore the associations between all weight stigma types (EWS, IWS, and fitness center stigma) and physical activity behaviors among a weight diverse sample of adults. Participants (n=214) completed self-report survey measures of weight stigma, physical activity, psychosocial factors (self-efficacy for exercise, exercise avoidance motivation, and self-esteem), and sociodemographic information. A subsample of participants (n=8) who reported high levels of EWS and at least some level of fitness center stigma were contacted based on survey responses and completed individual semi-structured virtual interviews to provide more detailed context to their experiences with EWS and fitness center stigma, and how these incidents have had a perceived impact on their physical activity behaviors and feelings toward physical activity and fitness spaces. Regression analyses indicated that EWS was positively associated with physical activity behavior, but neither IWS or fitness center stigma had significant associations. Parallel multiple v mediation analyses indicated that self-efficacy for exercise significantly mediated the relationships between IWS and lower levels of physical activity, and fitness center stigma and lower levels of physical activity. No significant relationships were found between exercise avoidance motivation or self-esteem and any weight stigma variables. Qualitative data analysis revealed that context matters when it comes to specific weight stigma experiences. When participants experienced weight stigma in their lifetime, and from whom, played differential roles in how participants responded to it in relation to physical activity behavior. When participants were younger, they noted they would engage in more extreme behaviors and levels of activity as a result of the stigmatizing experiences. Although fitness center stigma was not perceived to play a major role in participants current engagement in physical activity, it may still have created an additional barrier which drove some participants to choose different fitness settings for physical activity, certain clothing, and reduced their motivation to engage altogether. In sum, the psychological impact or internalization of weight stigma may contribute to negative physical activity behaviors more so than actual experiences themselves. Further, the context in which these experiences occur may be an important consideration for understanding their potential impact on physical activity. Exercise professionals and clinicians of weight management programs should take time to understand and address weight stigma experiences of their patients to better address physical activity. Additionally, fitness centers and spaces should take steps to reduce weight stigma in their spaces in order to reduce the barriers that people may face when looking to engage in physical activity.