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Deborah Carr talks with and answers a few questions about this month's Fast Moving Front in the field of Psychiatry/Psychology. The author has also sent along an image of her work.
Deborah Carr Article: Is obesity stigmatizing? Body weight, perceived discrimination, and psychological well-being in the United States
Authors: Carr, D;Friedman, MA
Journal: J HEALTH SOC BEHAVIOR, 46 (3): 244-259 SEP 2005
Addresses: Rutgers State Univ, Inst Hlth Hlth Care Policy & Aging Res, 30 Coll Ave, New Brunswick, NJ 08901 USA.
Rutgers State Univ, Inst Hlth Hlth Care Policy & Aging Res, New Brunswick, NJ 08901 USA.
Rutgers State Univ, Dept Sociol, New Brunswick, NJ 08901 USA.
Rutgers State Univ, Dept Psychol, New Brunswick, NJ 08901 USA.

 Why do you think your paper is highly cited?

Obesity is a tremendous social and health problem in the United States today. About 60% of Americans are overweight, and one-third are obese. Although the physical health consequences are widely documented, we still know relatively little about the social and psychological consequences of excessive weight.

Although our casual observations of the world may lead us to conclude that overweight people are treated more poorly than thinner people, relatively few studies have examined this issue rigorously.

Moreover, most studies of obesity focus on small, non-representative samples of overweight persons, typically those who signed up for a weight-loss program. Our study is based on a random sample of Americans of all shapes and sizes, thus we can compare overweight and obese people with their thinner counterparts.

 Does it describe a new discovery, methodology, or synthesis of knowledge?

Many studies of weight discrimination ask members of the general population whether they find overweight people to be competent, attractive, and the like. That's how discrimination is often measured.

Click to enlarge graph below

Click to enlarge

Graph of the odds of reporting workplace discrimination, by body mass index and occupational category.

We took a reverse approach—asking individuals whether they had ever experienced both institutional (e.g., employment, medical) and interpersonal (e.g., teasing, rudeness) mistreatment, and to what would they attribute this experience—such as their race, their gender, or body weight. We then evaluated whether these responses varied based on one's body mass index (BMI), a standard measure used to calculate the ratio of one's weight to height.

 Would you summarize the significance of your paper in layman’s terms?

We found that overweight and obese people reported significantly more employment discrimination, healthcare-related discrimination, and multiple forms of interpersonal mistreatment compared to persons of "normal" weight.

Additionally, we found that the social disadvantages that come with a high body weight are even more extreme for upper-middle class persons, such as white collar workers. As Figure 1 shows, white-collar workers who are extremely obese—with a BMI of 35 or higher—are more than twice as likely as their thinner counterparts to report work-related discrimination.

However, among persons in less prestigious jobs, obese and non-obese people don't differ in terms of discrimination experiences. These findings suggest that some cultures disdain obesity more than others.

 How did you become involved in this research and were any particular problems encountered along the way?

I became involved in this because I'm interested in the ways that physical appearances shape one's everyday life experiences. One of the major difficulties is that we don’t have direct measures of discrimination (e.g., formal claims to personnel officers) but rather one's perceptions that they’ve been mistreated, and one's own explanation for why they were discriminated against.

Although some critics may quibble with the use of self-reported discrimination data, I believe that if someone perceives that they are mistreated, then that is an important outcome in and of itself. If an obese person feels mistreated by his or her doctor (regardless of what the doctor is actually doing), then he or she may stop seeking timely health care— which could have dire physical consequences.

 Where do you see your research leading in the future?

I'm very curious to explore whether the stigma of obesity increases or decreases over time. It's possible that as more and more people become obese, the stigma (and accompanying mistreatment) will decline. More people will have an obese friend, sibling, coworkers, and the like, and as such they may be more sympathetic.

On the other hand, if obesity rates remain particularly high among ethnic minorities and the poor, we may see an even greater stigma—where thin middle-class whites discriminate against those who face the multiple disadvantages of minority ethnic status, low socioeconomic resources, and excessive body weight.

 Do you foresee any social or political implications for your research?

Yes. My study finds strong evidence that overweight and obese people are discriminated against, especially in terms of hiring and promotions in the workplace. However, overweight persons are not a protected group, according to the "Americans with Disabilities Act (ADA) of 1990."

Although healthcare policies typically target obese people, with recommendations on how to lose weight, my findings suggest that policies should also target those who do the discriminating. Many of the harmful social and interpersonal consequences of obesity come at the hands of others.

Deborah Carr, Ph.D.
Associate Professor of Sociology
Rutgers University
New Brunswick, NJ, USA


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2009 : September 2009 - Fast Moving Fronts : Deborah Carr's Research on Discrimination Against the Obese
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