title: The association of BMI and social distance towards obese individuals is mediated by sympathy and understanding.
abstract: The desire for social distance towards individuals with obesity as part of the stigmatization process has not been investigated. The aims of this study include: (a) determining the prevalence of social distance and its domains in a population-based sample; (b) reporting levels of emotional response; and (c) investigating the association of BMI, emotional response and social distance. The data were derived from a large population based telephone survey in Germany (total n = 3,003, this sub-sample n = 1008). Emotional response to individuals with obesity was assessed for the emotions discomfort, pity, insecurity, amusement, sympathy, help and incomprehension (5-point Likert scale). Social distance was measured on a 5-point Likert scale covering different areas of social interaction. This served as the dependent variable for a linear regression model and mediation models that included BMI and emotional response. Social distance was highest for job recommendation, introduction to a friend, someone with obesity marrying into the family and renting out a room. Means of emotional responses were highest for pity (Mean = 2.58), sympathy (Mean = 2.87) and wanting to help (M = 2.76). In regression analyses, incomprehension (b = 1.095, p < 0.001) and sympathy (b = -0.833, p < 0.001) and the respondents' own BMI (b = -0.145, p < 0.001) were significantly associated to the overall amount of social distance. Mediation models revealed a significant mediation effect of BMI through sympathy (b = -0.229, % of total effect through mediation = 10.3%) and through incomprehension (b = -0.057, % of total effect through mediation = 27.5%) on social distance. Social distance towards individuals with obesity is prevalent in the general public in Germany and it is associated with emotional responses. Altering the emotional responses may, therefore, be a starting point in anti-stigma interventions. Evoking sympathy and lowering incomprehension may result in lower overall social distance.
authors.affiliation: Leipzig University Medical Center, IFB AdiposityDiseases, Leipzig, Germany; Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Germany. Electronic address: Claudia.Sikorski@medizin.uni-leipzig.de.
authors.forename: Claudia
authors.initials: C
authors.lastname: Sikorski
authors.affiliation: Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Germany.
authors.forename: Melanie
authors.initials: M
authors.lastname: Luppa
authors.affiliation: Center for Public Mental Health, Gösing am Wagram, Austria; Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Italy.
authors.forename: Matthias C
authors.initials: MC
authors.lastname: Angermeyer
authors.affiliation: Department of Psychiatry, Ernst Moritz Arndt University Greifswald, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Schomerus
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University and New York State Psychiatric Institute, New York City, USA.
authors.forename: Bruce
authors.initials: B
authors.lastname: Link
authors.affiliation: Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Germany.
authors.forename: Steffi G
authors.initials: SG
authors.lastname: Riedel-Heller
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D004644:Emotions; D004645:Empathy; D005260:Female; D005858:Germany; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000523:psychology*; D015995:Prevalence; D012929:Psychological Distance; D011639:Public Opinion; D057545:Social Stigma
keywords: Emotional response; Obesity; Social distance; Stigma