Background

Weight bias is pervasive and harmful, yet few protections exist against weight-based discrimination. Perceptions of obesity bias and anti-discrimination laws are understudied, particularly among racial/ethnic groups historically underserved in obesity advocacy.

Methods

A 26-item online questionnaire was completed by 1888 adults: 328 Asian/Pacific Islander (API), 404 Hispanic/Latinx (H), 395 Non-Hispanic Black (NHB), 761 Non-Hispanic White (NHW). Logistic regressions identified predictors of support for anti-discrimination legislation controlling for age, gender, income, and self-reported weight. Chi-square and Kruskal-Wallis tests compared categorical and ordinal variables.

Results

Acknowledgement of societal weight bias was higher among White (94.1%) than API (89.3%), H (86.4%), or NHB respondents (83.0%)(p<0.05 pairwise). Almost half of respondents personally experienced weight bias (47.0% H, 44.6% NHB, 40.5% API, 42.2% NHW, p=0.27). Higher rates of Hispanic (57.7%) than NHB (47.8%, p=0.005) or NHW respondents (43.9%, p<0.001) reported weight bias impacted ability to control their weight. Obesity as a disease was recognized similarly across groups (62.5% API, 61.1% H, 61.3% NHB, 60.4% NHW, p=0.93). In multivariable regression, black race (OR 1.38, p=0.02), female gender (OR 1.43, p<0.001), belief that obesity is a disease (OR 1.78, p<0.001), and personal experience of weight bias (OR 2.02, p<0.001) had higher odds of support for laws against weight-based discrimination.

Conclusions

Personal weight bias experience and recognizing obesity as a disease are widely shared across racial/ethnic groups. Education on medical models of obesity and building on a base of support from individuals who are black, female, and/or have experienced weight bias may strengthen obesity anti-discrimination legislative efforts.