Advancing Health Equity: Relationships Between Anti-Fat Microaggressions, Body Image, and Health

Overview: Health is a human right, including for people of all body sizes. This presentation discusses research that demonstrates that body appreciation and anti-fat microaggressions are important modifiable factors impacting physical and mental health. Curricular and workforce development efforts are needed, such as cultural competencies around anti-fat biases/stigma and evidence-based practices.Proposal text: Social workers strive to promote health equity and the belief that health is a human right. It is well known that bias and stigma contribute to disparities in health and healthcare; however, the research on the ways anti-fat and weight-based biases and stigma affect a person’s health have received less attention. The purpose of this presentation is to advance understanding of ways that anti-fat biases and stigma affect health, present findings from a study examining relationships between anti-fat microaggression experiences, body appreciation, and perceived physical and mental health, and discuss implications for social work education.

Data for the current study were collected via an online survey from 384 cisgender adult women in the United States. The sample included a diverse range of body sizes, as measured by BMI (range = 15.94 – 62.64), and the mean BMI was 28.36. Anti-fat microaggression experiences, the independent variable, was measured using the 32-item Anti-Fat Microaggression Experiences Questionnaire (AFMEQ). The dependent variables, perceived physical health and perceived mental health, were measured, respectively, with the Physical Component Summary and Mental Component Summary scores of the SF-12. Body appreciation was examined as a mediator, and was measured with the Body Appreciation Scale-2 (BAS-2). A series of multivariate linear regression analyses, controlling for age, race/ethnicity, health insurance, BMI, and socioeconomic status, were completed to examine the direct and indirect relationships, and the indirect effects were computed. Results indicated that body appreciation partially mediated the relationship between anti-fat microaggressions and perceived physical health, and fully mediated the relationship between anti-fat microaggressions and perceived mental health. The complete results will be presented and discussed as part of the presentation.

Social workers are commonly employed in micro, mezzo, and macro-level roles within physical and mental health-care settings, and thus they play a critical role in efforts to improve health equity and individual health. It is the role of social work education to prepare students to be ethical and competent members of the workforce, including promoting the development of cultural competence, awareness, and humility. To this aim, this presentation will discuss implications for social work education based on the current study and relevant prior literature, particularly as it relates to efforts regarding the promotion of social justice and human rights, and anti-racism, diversity, equity, and inclusion. Curricular advances to be discussed include: 1) promoting awareness of anti-fat microaggressions and opportunities for exploration of personal biases regarding body size, 2) inclusion of information on ways that anti-fat microaggressions can affect client health and well-being, and 3) dissemination of information on evidence-based interventions to improve body appreciation to improve health equity and individual health.