Weight and discrimination: evidence of intersectional effects from an ethnically diverse, UK general population survey

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BackgroundWeight-related discrimination is widespread in society. Some US studies have suggested weight discrimination may differ between demographic groups, impacting White women more than minority women or men. However, stigma differs substantially between societies, and few studies have explored intersectional effects outside the US.MethodsIn a large (N=7,406) ethnically diverse study of UK adults, we examined associations of body mass index (BMI) with two stigma-related outcomes in the past year: being insulted in an everyday setting and being denied a promotion or training at work. We adjusted for confounders including psychological distress. To explore intersectional effects, we examined whether sex, ethnicity, sex-ethnicity-combinations, or educational qualifications modified associations. ResultsBMI was not associated with either outcome across all participants, or separately for males, females, or any educational group. In ethnicity-stratified models, higher BMI was associated with being insulted only for Black participants (absolute risk difference, ARD, per kg/m2: 0.55%, CI: 0.66, 1.04) and Asian participants (ARD per kg/m2: 0.37, CI: 0.00,0.73), and with being denied a promotion or training only for Black (ARD, per kg/m2: 0.45%, CI: 0.04,1.87) and mixed or other ethnicity participants (ARD per kg/m2: 0.86, CI: 0.49,1.24). Estimates from models stratified by sex-ethnicity combination suggested similar associations by sex within ethnic groups.ConclusionsResults suggest greater impact of weight-related discrimination on ethnic groups which already experience discrimination for other reasons. Longitudinal studies are needed to unravel causal mechanisms linking weight and discrimination in ethnic minority groups in the UK and elsewhere.

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