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Although the stigma of obesity in our society is well documented, the measurement of antifat attitudes has been a difficult undertaking. Two studies were conducted to construct and validate the Antifat Attitudes Test (AFAT). In study 1, college students (110 men and 175 women) completed the preliminary 54-item AFAT and specific indices of body image and weight-related concerns. Psychometric and factor analysis revealed a 47-item composite scale and three internally consistent factors that were uncorrelated with social desirability: Social/Character Disparagement, Physical/Romantic Unattractiveness, and Weight Control/Blame. Several body images correlates of antifat prejudice were identified, and men expressed more negative attitudes than women. Study 2 experimentally examined the effects of information about the controllability of weight on the antifat attitudes of 120 participants. Exposure to information on behavioral vs. biogenetic control led to greater blame of persons who are fat for their body size. The implications of the findings and the potential utility of the AFAT are discussed.
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PMID:Prejudice toward fat people: the development and validation of the antifat attitudes test. 928 35

Despite increasing trends in the prevalence of overweight and obesity, fatness phobia is common during female adolescence. This study has demonstrated a high level of dissatisfaction with body weight in a sample of Dublin schoolgirls aged 15 y. Of 420 subjects, 59% reported that they wanted to be slimmer and 68% had previously tried to lose weight. Contrary to expectations, overweight girls were not found to hold the monopoly on such dissatisfactions. Normal weight and even underweight girls also expressed a desire to be thinner and reported using unhealthy weight control practices including random avoidance of staple foods, fasting, smoking and purging, in their pursuit of the 'perfect' female figure. Obesity prevention programmes which target adolescent girls 'at risk' of overweight and obesity, must take cognizance of their profound fear of fatness, otherwise the use of harmful slimming strategies may be further increased as teenage girls frantically try to lose weight and to avoid the stigma associated with female fatness.
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PMID:The pursuit of thinness: a study of Dublin schoolgirls aged 15 y. 962 47

The economic costs of obesity can be broken down into three levels: 1. DIRECT COSTS: Costs to the community, related to the diversion of resources to the diagnosis and treatment of diseases directly related to obesity, as well as the treatment of obesity itself. These costs have been estimated to vary between 1-5% of total healthcare costs for various countries. Usually, the cost of obesity alone has been calculated, although it is known that the costs associated with being overweight [body mass index (BMI) 25-30 kg/m2] are also substantial because of the large proportion of individuals involved. These constitute costs to the health service (visits to general practitioners, consultations with medical specialists, hospital admissions and medication). 2. SOCIETAL OR INDIRECT COSTS: These costs are related to the loss of productivity caused by absenteeism, disability pensions and premature death. There is a lack of good economic analysis on this subject, although research from Sweden, Finland and the Netherlands has clearly shown that obesity is associated with increased sick leave and disability pensions. 3. PERSONAL COSTS: Obese subjects may earn less than their lean counterparts because of job discrimination (related to the stigma associated with obesity, or due to diseases and disabilities caused by obesity). Many insurance companies (particularly life insurance) charge higher premiums with increasing degrees of overweight. Obesity is further related to poor physical functioning and limitations in daily life. Some of these require assistance or adaptations which may be costly for an individual. In conclusion, there is much indirect information that obesity and overweight contribute substantially to healthcare-related costs. Data on aspects such as societal costs and personal costs are too fragmentary to allow calculation of the expenses involved. An appropriate analysis of all costs associated with obesity is important in order to persuade responsible bodies to develop strategies towards the prevention and long-term management of obesity.
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PMID:Societal and personal costs of obesity. 979 74

The worldwide epidemic of obesity has made the development of effective treatment ever more urgent. Appropriate use of medication for the treatment of obesity may benefit patients at risk for developing diabetes, hypertension, coronary artery disease, osteoarthritis or gall bladder disease. In addition, with the appearance of very safe medications, short-term treatment for the relief of the stigma associated with obesity may also be valuable. The currently available medications for obesity work either by reducing fat digestion or by acting on receptor systems in the brain. Both have potential side-effects, but may be useful alone or in combination. The expansion of knowledge about the control of obesity offers the hope that many new agents will become available over the next decade.
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PMID:Uses and misuses of the new pharmacotherapy of obesity. 1021 9

Many of the behavioral interventions designed to promote dietary change in individuals include medical assessment, initial assessment of diet history, assessing readiness, establishing dietary goals, self-monitoring, stimulus control training, training in problem solving, relapse prevention training, enlisting social support, nutrition education, dietary therapy, and ongoing contact to maintain progress. The comprehensive nature of a cognitive-behavioral weight management program is of value in modifying behaviors that are linked to adverse health effects and psychological distresses, without necessarily causing a drastic weight loss in obese individuals. The behavioral treatments for overweight and obesity directly modify behaviors that bear on health and illness, such as improving dietary choices, decreasing sedentary behaviors, and increasing habitual physical activity and exercises. Cognitive-behavioral treatment can be used to help overweight adolescents become more assertive in coping with the adverse social stigma of being overweight, enhance their self-esteem, and reduce their dissatisfaction with body image regardless of their weight loss. Cognitive-behavioral treatments seem to be more effective in children when delivered before puberty than they are for adults.
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PMID:Cognitive-behavioral approaches in the management of obesity. 1252 89

Obesity related to over-nutrition is investigated in a sample of 219 Mexican children from affluent families, ages 6-12 years. Defined as weight-for-age at or above the 95(th) percentile, obesity rates in middle childhood are very high in this population, being 24.2% of children (29.4% of boys and 19.1% of girls). Binary logistic regression shows that children are more likely to be obese if they are boys, from small households with few or no other children, and have more permissive, less authoritarian parents. Diet at school and activity patterns, including television viewing, are not different for boys and girls and so do not explain this gender variation. The value placed on children, especially sons, in smaller middle-class families, can result in indulgent feeding because food treats are a cultural index of parental caring. Parents also value child fatness as a sign of health. These obese Mexican children have no greater social problems (peer rejection or stigma) or psychological problems (anxiety, depression, or low self esteem) than their non-obese peers. More study specifically focused on feeding practices in the home environment is required to explain very high rates of child obesity. The differences in obesity risk related to specific aspects of children's developmental microniche emphasize the importance of including a focus on gender as a socio-ecological construct in human biological studies of child growth, development, and nutrition.
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PMID:Biocultural aspects of obesity in young Mexican schoolchildren. 1270 21

The purpose of this article is to provide a succinct overview of obesity. It will be useful to highlight some of the epidemiological issues associated with this disease. Obesity is intertwined between public health issues, increased risk of morbidity and mortality, rising health care costs and expensive treatment options, social stigma, and internal psychological challenges--clearly no easy answers as to how to treat this health dilemma. Even with all of the challenges, bariatric surgery certainly offers a viable option for patients to get their health back, and more important, their lives back.
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PMID:Overview of obesity. 1274 88

Erectile dysfunction (ED) is defined as the inability to achieve and maintain a penile erection which is adequate for satisfactory sexual intercourse. It is a significant male health problem affecting approximately 150 million men worldwide. This value is expected to more than double by the year 2025. The incidence of ED increases sharply with age since it is a common cross-cultural denominator, affecting 19 to 64% of men aged 40 to 80 years, both in developing and industrialized countries. Epidemiological studies may underestimate the true dimensions of the problem because of the embarrassment or stigma that is associated with ED. Men with ED may experience diminished self-image and self-esteem, anxiety and fears of rejection, and even depression as psychogenic factors. Pathologic conditions which are commonly encountered in the ageing male (diabetes, hypertension, atherosclerosis, cardiovascular disease, etc) as well as chronic diseases (arthritis, renal and hepatic failure, pulmonary disease) represent a frequent cause of organic ED and are often treated with medications that can interfere with sexual function at central and/or peripheral level. In addition, incorrect lifestyle--i.e. obesity, cigarette smoking, alcohol or drug abuse--may all contribute to the onset of ED. Finally, trauma or surgery affecting either the nervous system or interfering with the blood supply to the penis are associated with increased incidence of ED.
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PMID:Pathology of erection. 1283 29

Obesity is an epidemic disease that threatens to inundate health care resources by increasing the incidence of diabetes, heart disease, hypertension, and cancer. These effects of obesity result from two factors: the increased mass of adipose tissue and the increased secretion of pathogenetic products from enlarged fat cells. This concept of the pathogenesis of obesity as a disease allows an easy division of disadvantages of obesity into those produced by the mass of fat and those produced by the metabolic effects of fat cells. In the former category are the social disabilities resulting from the stigma associated with obesity, sleep apnea that results in part from increased parapharyngeal fat deposits, and osteoarthritis resulting from the wear and tear on joints from carrying an increased mass of fat. The second category includes the metabolic factors associated with distant effects of products released from enlarged fat cells. The insulin-resistant state that is so common in obesity probably reflects the effects of increased release of fatty acids from fat cells that are then stored in the liver or muscle. When the secretory capacity of the pancreas is overwhelmed by battling insulin resistance, diabetes develops. The strong association of increased fat, especially visceral fat, with diabetes makes this consequence particularly ominous for health care costs. The release of cytokines, particularly IL-6, from the fat cell may stimulate the proinflammatory state that characterizes obesity. The increased secretion of prothrombin activator inhibitor-1 from fat cells may play a role in the procoagulant state of obesity and, along with changes in endothelial function, may be responsible for the increased risk of cardiovascular disease and hypertension. For cancer, the production of estrogens by the enlarged stromal mass plays a role in the risk for breast cancer. Increased cytokine release may play a role in other forms of proliferative growth. The combined effect of these pathogenetic consequences of increased fat stores is an increased risk of shortened life expectancy.
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PMID:Medical consequences of obesity. 1518 Oct 27

Previous research demonstrates that we tend to derogate individuals who are perceived to be in a social relationship with stigmatized persons. Two experiments examined whether this phenomenon also occurs for individuals seen in the presence of an obese person and whether a social relationship is necessary for stigmatization to spread. The results from both experiments revealed that a male job applicant was rated more negatively when seen with an overweight compared to a normal weight female and that just being in the mere proximity of an overweight woman was enough to trigger stigmatization toward the male applicant. Experiment 2 examined possible moderating effects of the proximity finding. Applicants seated next to heavy (vs. average weight) individuals were denigrated consistently regardless of the perceived depth of the relationship, the participant's anti-fat attitudes or gender, and whether or not positive information was presented concerning the woman. The profound nature of the obesity stigma and implications for impression formation processes are discussed.
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PMID:The weight of obesity in evaluating others: a mere proximity effect. 1527 57


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