Assessment of obesity stigmatization in children and adolescents: modernizing a standard measure

Stigmatization of overweight children is highly prevalent. However, the measurement of stigma has varied widely across studies. An up-to-date version of a commonly used measure of weight-related stigma is needed.

Poser 5 (DAZ software) was used to develop 12 modernized figures, using three-dimensional models rendered as high-resolution images. They depicted one overweight, one non-overweight, and four disabled children of each sex. Children recruited from public and private schools (N = 261; mean age, 11.3 years; median BMI z-score = 0.33; 77.0% white, 11.5% Asian, and 7.7% Maori) ranked these figures in order of liking. Participants also ranked traditionally used line drawings depicting comparable images. Participants rated each new figure on measures of liking and stereotypical attributes on 100-mm visual analog scales (VASs).

Rankings of liking of the new figures were highly correlated with rankings of corresponding old figures, especially for overweight figures [boys: rho (77) = 0.72, p < 0.001; girls: rho (153) = 0.68, p < 0.001]. Rankings of overweight and other figures were also highly correlated with VAS assessment of liking and with a composite, internally consistent VAS measure of liking and stereotypical attributes. Only negative stereotypes about the intelligence of overweight boys and girls contributed significantly to the variance in liking.

An updated and modernized tool for assessing children's weight stigma was developed and its construct validity supported. The present findings suggest that stereotypes about low intelligence may contribute to weight stigma among children. More research is needed on the causes and components of weight stigma so that it can be effectively reduced.