“It is over there, next to that fat lady”: a qualitative study of fat women’s own body perceptions and weight-related discriminations

Ulian, Mariana Dimitrov; Sato, Priscila de Morais; Pinto, Ana Jéssica; Benatti, Fabiana B.; Campos-Ferraz, Patricia Lopes de; Coelho, Desire; Roble, Odilon J.; Sabatini, Fernanda; Perez, Isabel; Aburad, Luiz; Vessoni, André; Unsain, Ramiro Fernandez; Gualano, Bruno; Scagliusi, Fernanda B.

doi:10.1590/S0104-12902020180313

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Original articles • Saude soc. 29 (4) • 2020 • https://doi.org/10.1590/S0104-12902020180313 copy

“It is over there, next to that fat lady”: a qualitative study of fat women’s own body perceptions and weight-related discriminations¹ 1 We acknowledge the support by the Fundação de Amparo à Pesquisa do Estado de São Paulo (Fapesp), grant number 2015/03878-2. Finally, each author received a fellowship grant. Scagliusi was supported by the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) (grant numbers 311357/2015-6 and 309514/2018-5); Pinto, Sato, and Unsain by Fapesp (grant numbers 2015/26937-4, 2017/05651-0, and 2015/12235-8, respectively), Gualano has a productivity grant by CNPq and is also supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Capes) and Fapesp, and Ulian by Capes. The funding sources had no involvement in study design and in the collection, analysis and interpretation of data, writing of the article, and in the decision to submit it for publication.

“É lá, perto da moça gorda”: estudo qualitativo sobre as percepções de mulheres gordas acerca de seus corpos e discriminações relacionadas ao peso corporal

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

We investigated fat women’s perceptions of their own bodies and their experiences with weight-related discriminations, and how these situations affected their well-being. Thirty-nine obese women were interviewed, and three axes of analysis were identified: (1) repercussions of being fat, (2) living with a fat body, and (3) am I a person or just a fat body? These axes were composed of eight themes which had similar meaning or complemented each other. The results showed our participants had mechanisms to diminish the magnitude of their stigmatized bodies (e.g., attempting to lose weight and changing their current food choices). Participants also reported being fat had physical and psychological consequences for them. Most notably, their larger bodies influenced their self-evaluation, making them feel devalued, unlovable, incapable, and incomplete. They reported stigmatizing experiences in familiar situations, at the workplace and in public spaces, and reported being stigmatized by both close and unknown individuals, including healthcare professionals. These professionals were reported to treat patients disrespectfully, which urges attention to health care inequalities for obese people. Our results stress stigmatizing attitudes towards fat people and their own considerations about themselves have negative consequences in their physical and mental well-being.

Keywords:
Obesity; Stigmatization; Weight-Related Discrimination; Self-Esteem; Physical Education

Theme	Kappa
Influences of a fat body	0.675
Attitudes about the participants’ own body	0.675
Prejudice against the participants’ fat body	0.836
Prejudice against someone else’s fat body	0.837
Discriminators of the participants’ fat body	0.836
Supportive attitudes	1.000
Fat as a curse	0.847
Indirect discriminatory comments	0.658

Theme	Theme description
Influences of a fat body	The theme described obesity influences on participants’ actions. It included influences on how they dressed their bodies, on their physical disposal, on uncomfortable experiences in public spaces, and on their personality. This quote exemplifies one of these influences: Dress, skirt, it’s been a while since I don’t wear them because I can’t find a size that fits me, I don’t feel good wearing them, so it bothers me a lot… Tight-fitting clothes I haven’t worn in a while too (P10).
Attitudes about the participants’ own body	The theme described excerpts in which participants expressed attitudes towards their own bodies. It included when they expressed how they felt about their bodies and how they related to their bodies. Also, it included how they reacted and dealt with discriminatory situations, as observed in this quote: I guess there are some looks, but then you realize the person is so stupid, so you feel pity and say “That is fine…”. Or when you meet that aunt you have not seen for a while and she says, “How fat you are!,” but then I can’t react (P16).
Prejudice against the participants’ fat body	The theme described discriminatory attitudes of other people towards participants’ fat body. It included when participants mentioned external expectations about how to attain a certain body and interferences with their lifestyles, such as recommending eating changes or physical exercises. Finally, it included examples of discriminatory experiences, as observed in the following quote: A friend of mine said, “Don’t hug me too tightly, you’re so big that you can break my back!” (P26).
Prejudice against someone else’s fat body	The theme described discriminatory attitudes towards other people’s fat body than the participants. It included someone else’s experiences regarding external expectations about how to attain a certain body, such as recommending changes in their eating habits or physical exercises. Finally, it included examples of other peoples’ discriminatory experiences, as observed in the following quote: In social media, I constantly see this kind of comment, and even if it was not directed to me I feel offended. For example, a friend of mine posted a photo of herself wearing a bikini, without any concern. And, in the comments, people told her she should not wear a bikini and if she was not ashamed of her body marks. I was offended because if they think this about her, they’ll definitely think the same about me (P27).
Discriminators of the participants’ fat body	The theme described speeches where participants clearly define who were the people to make a discriminatory comment about the fat body. It included relatives, friends, unknown people, and healthcare professionals. It also included when social media was used to mediate discriminatory comments. An example can be observed in this excerpt: My dad told me, “Wow, you’re really fat!” (P35).
Supportive attitudes	The theme described speeches in which participants mentioned positive and supportive attitudes of people about their bodies. It included experiences in which participants were encouraged to engage in activities or felt welcomed in a certain situation. This is exemplified in the following quote: I never faced prejudice or realized it. On the contrary, the other day in my work we had an event and my colleagues said, “Let us all use the same t-shirt”; and I said, “I’m not wearing a t-shirt at all, I’ll need a large one”; and they said, “That’s nonsense, don’t mind about it!” So I’m always motivated by people around me (P28).
Fat as a curse	The theme described discriminatory attitudes that expressly involved cursing words about her body condition, as exemplified in this quote: At school, my nickname was the killer whale, whale, and sandbag (P37).
Indirect discriminatory comments	The theme described discriminatory experiences that involved indirect comments about their fat body. It included experiences in which participants mentioned comments that did not have “the intention to be discriminatory,” but they understood as if they were. The following excerpt exemplifies it: Sometimes people don’t realize that I’m paying attention and they end up making some nasty comments (P27).

Faculdade de Saúde Pública, Universidade de São Paulo. Associação Paulista de Saúde Pública. Av. dr. Arnaldo, 715, Prédio da Biblioteca, 2º andar sala 2, 01246-904 São Paulo - SP - Brasil, Tel./Fax: +55 11 3061-7880 - São Paulo - SP - Brazil
E-mail: saudesoc@usp.br

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[1] Correspondence Mariana Dimitrov Ulian Universidade de São Paulo, Faculdade de Saúde Pública, Departamento de Nutrição. Av. Dr. Arnaldo, 715. São Paulo, SP, Brasil. CEP 01246-904.