GENERAL INTRODUCTION
1.1 Introduction
Obesity has emerged as a major challenge facing the world today and its prevalence has
increased substantially to epidemic proportions in both the UK and across the globe (James,
2008; Hossain, Kawar, & Nehas, 2007). Obesity has become a putative public health concern
(Zhu, Norman, & While, 2011), acknowledged in 2002 by the World Health Organisation
(WHO), who recently coined the term ‘Globesity’ in reference global epidemic of obesity
(www.who.int) and to represent the rising trends in obesity across the world as opposed to
solely the Western World, where the condition has been most common in the past. There is
however a marked discrepancy in prevalence rates of obesity across regions within different
countries and across countries within continents (James, 2002). For example, Rennie and
Judd (2005) report a higher prevalence of obesity in Wales and Scotland relative to England
in the UK.
With reference to tackling obesity, the former US Surgeon General (Richard Camona) has
warned that “unless we do something about it, the magnitude of the dilemma will dwarf 9/11
or any other terrorist attempts” (Associated Press, 2006). The Surgeon General has also
suggested that as a result of the obesity epidemic, the US nation is now battling on two fronts:
one a ‘war on terror’ and the other a ‘war on obesity’, that he refers to as “the terror within”
(Biltekoff, 2010). This is not an uncommon reference with a cluster of studies that refer to
tackling obesity as a “war” (e.g., Evans, 2009; Friedman, 2003; O’Hara & Gregg, 2006).
Similarly, the Department of Health (2002) reported that the “growth of overweight and
obesity in the population of our country – particularly amongst children – is a major
concern. It is a health time bomb with the potential to explode over the next three decades….
Unless this time bomb is defused the consequences for the population’s health, the costs to
the NHS and losses to the economy will be disastrous” (p. 44). The extent of the obesity
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GENERAL INTRODUCTION
epidemic has been framed alongside climate change concerns, with both purportedly priority
areas that require a rapid response (Foresight, 2007, p. 14). It should be noted here, that
overweight and obesity are often discussed together where obesity represents the enemy and
overweight the associate, reflecting the notion of a ‘war on obesity’ (Evans, 2009). The
metaphor of a war on obesity also highlights the importance of appreciating how the obese
are perceived by others, where the ability to assign fault for a condition is key:
“In an all out war, expenditure is all out, imprudent - war being defined as an emergency in
which no sacrifice is excessive. But the wars against diseases are not just calls for more zeal,
and more money to be spent on research. The metaphor implements the way particularly
dreaded diseases are envisaged as an alien "other," as enemies are in modern wars; and the
move from demonization of the illness to the attribution of fault to the patient is an inevitable
one” (Sontag, 1989, p. 99).
It would also be worth noting here that the terms overweight and obesity have been and are
continued to be used interchangeably. Although they have been defined differently by the
World Health Organisation (1998) where overweight is defined as lower than obesity on the
basis of Body Mass Index (BMI), there appears to be no evidence to suggest these cut off
ranges are beneficial to the understanding of psychological and social consequences of these
conditions (Schwartz & Brownell, 2004). In response to the epidemic and the significance
placed on treating, managing and preventing the condition, scientific investigation has
revealed that obesity represents an array of consequences for individuals and society.
It comes as no surprise that an obsession with body weight has been reported (O’Hara &
Gregg, 2006) given the idealisation of thinness and the stigmatisation of fatness.
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GENERAL INTRODUCTION
Paradoxically, this obsession with body weight is incoherent with the nature of the obesity
problem. Despite a greater likelihood of obesity when body weight increases, this does not
always reflect obesity as it is excess body fatness that should be the focus of attention.
Obesity by definition refers to “an excess accumulation of body fat, is a heterogeneous
disorder with a final common pathway in which energy intake chronically exceeds energy
expenditure” (McArdle, Katch, & Katch, 2001, p. 823). Similarly, Janssen, Katzmarzyk, and
Ross (2004) report waist circumference and not body mass index as an explanation for
obesity related ill health, thus the emphasis placed on body weight is often misplaced on the
basis of scientific evidence.
In the United States, which currently has the highest rates of obesity across the world, poor
diet and physical inactivity is the second most common cause of death and with healthcare
costs soaring it has been proposed to overtake tobacco as the leading cause of death (Mokdad,
Marks, Stroup, & Gerberding, 2004). In the UK, obesity has trebled over the last twenty years
(Royal College of Paediatrics & Child Health, Faculty of Public Health, 2004), with costs for
overweight and obesity estimated at approximately £3.2billion (Allender & Rayner, 2007). In
2006, approximately 24% of adults in the UK aged over 16 years were classified as obese,
which is an overall increase of 15% since 1993. A similar pattern has also been observed for
children aged 2-15 years with 16% classified as obese, an 11% increase since 1995 (Health
Survey for England, 2006). Thus, there is an increased concern for the rapid rate at which
children and adolescents are becoming obese (British Medical Report, 2003; Seidell, 2000;
World Health Organization, 2000). It was proposed that by 2010, 38% of children in the
European Union will become overweight (Wang & Lobstein, 2006), although statistics on the
prevalence in 2010 are yet to be released, thus this prediction cannot be verified. Obesity is a
chronic disorder that is particularly prevalent among poor and minority children (Troiano &
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GENERAL INTRODUCTION
Flegal, 1998). For example, a higher prevalence of obese boys and girls in the UK live in the
lowest household income group (Health Survey for England, 2006). Despite this finding,
obesity appears to affect individuals of all backgrounds; however, the answer to why
prevalence is higher in certain sections of the population may lie in the environment.
Environmental Factors
There has been much interest in genetic influences on obesity and while this is of high
importance, the role of environmental factors and others within a given environment can not
be underestimated with regards to not only the development but also the management of the
condition (Brownell, 2002). Barnett and Casper (2001) refer to the social environment as
encompassing the “immediate physical surroundings, social relationships and cultural
milieus within which defined groups of people function and interact” (p. 465). In a foresight
review of obesity in 2007, MPs heard that the UK population is becoming a victim of its own
economic success. Human life has become more comfortable as a result of the modern
transport systems, sedentary employment and the convenience of food, which appear to be
major contributors to the predicament. Humans evolved in a world where food was scarce
and physical work was tough, however, in the current world food and labour saving devices
are in abundance (Johnson, 2007).
It is purported that the current environment is ‘obesogenic’ resulting from the generation of
an elevated equilibrium level of ‘fatness’ across the entire population comparative to average
amounts of activity and therefore to combat the ‘obesity crisis’, one must intervene with the
environment as opposed to directly with the individual (Marks, Murray, Evans, Willig,
Woodall, & Sykes, 2006). Hill and Peters (1998) support this view proposing that to protect
against obesity it is essential for the individual to control the size of food portions, consume a
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GENERAL INTRODUCTION
low fat diet and to be physically active; however, performing these behaviours has become
increasingly difficult due to advancements that make human life easier. Similarly, Wadden,
Brownell, and Foster (2002) refer to the current world as a “toxic environment” which
encourages the consumption of super-sized food portions high in fat and sugar, whilst
actively discouraging physical activity. One factor that has played a role in the consumption
of super-sized food portions is the fast food restaurant. For example, Macdonald, Cummins
and Macintyre (2007) reported a greater density of fast food restaurants in more deprived
areas of Scotland and England (where levels of obesity are elevated) whilst Davis and
Carpenter (2009) purported that poor quality eating environments increase adolescents’
likelihood to become overweight. It is also reported that in the United States, almost 5,000
schools have fast food outlets in their cafeterias (Brownell, 2002). Furthermore, Jamie Oliver
(celebrity chef) examined the content of school dinners reporting that only 37 pence is spent
on ingredients that lack nutritional goodness (Marks et al., 2006). Thus, UK school dinners
are viewed as ‘toxic’ and as a potential contributor to the increasing levels of fatness in UK
children.
Another major component of the purported “toxic environment” is the media and its role in
advertisement of the so-called big four being pre-sugared breakfast cereals, soft drinks,
confectionary and savoury snacks (Marks et al., 2006). The recent ban on advertisement of
junk food around television programmes aimed at children aged 4-9 years is an attempt to
manage the growing prevalence of overweight and obese children, however, individuals are
reportedly unconvinced as to whether a major effect will be observed, with beliefs that this
ban does not extend far enough (Potter, 2007). The ‘toxic environment’ is also characterised
by the discouragement of physical activity, of which there has been a major decline since the
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GENERAL INTRODUCTION
mid-1900s, where sedentary behaviour has become increasingly appealing as a result of
computers, televisions, and video games, especially for children (Brownell, 2002).
Holistic Appreciation
In addition to the potential health consequences of suffering from the condition, the
biological causes and prevalence of obesity are well researched (e.g., Biddle & Mutrie, 2003;
Racette, Deusinger, & Duesinger, 2003); however, less is known about the social and
psychological costs of obesity (Schwartz & Brownell, 2004; Teachman & Brownell, 2001).
The importance of gaining a holistic understanding of obesity cannot be underestimated and
as Farrell (2006) states “all biological crises are also cultural crises” (p. 517), and therefore
the link between biology and culture should not be overlooked in attempts to understand
obesity. Farrell elaborates further suggesting that “biological and medical problems are also
cultural sites, where social power and ideological meanings are played out, contested and
transformed” (p. 517). Thus, a greater appreciation for other aspects common to the condition
alongside biological knowledge is warranted. Specifically, understanding of the role others
play and the experiences the obese population have as a result of the condition is required. It
is anticipated that by gaining a greater insight into psychosocial aspects of the condition, help
to suggest coping mechanisms and inform the development of efficient and effective
interventions, which appear to lacking regardless of the ever rising prevalence of obesity.
Lewis, Cash, Jacobi, and Bubb-Lewis (1997) reported that being perceived as “fat” is the
ultimate failure and this can be perceived as a public demonstration of internal weakness. In
modern society, there are several influential factors that contribute to social awareness of
body appearance and shape, which includes the booming diet industry that has been estimated
to draw $30 billion annually (Gaesser, 2002), the mass media through thin-ideals (Fouts &
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GENERAL INTRODUCTION
Burggraf, 2000), and the social value placed on having a lean physique (Hesse-Biber, 1996;
Wolf, 1991). There is persistent societal pressure to comply with a trim appearance and with
high failure rates, this has created a billion dollar industry that has lowering calorie intake as
the objective (Heil & Henschen, 1996). As a result of the diet industry and the pressures to
comply with idealised physiques, attitudes are likely to be developed about those who do
achieve the desired physique (favourable) and those who deviate from the ideal
(unfavourable).
1.1.1 Attitudes
Attitudes are conceived as evaluative summaries of people, behaviours, or objects (Fazio,
1989) and often reflect a variety of information sources (Betsch, Kaufmann, Lindow,
Plessner, & Hoffmann, 2006). Attitudes and beliefs influence the way individuals behave
towards and think about other people, and as a result refer to “a state of readiness, based on
past experiences, which guides, biases or otherwise influences our behaviour” (Cardwell,
2003, p. 20). It is believed that attitudes consist of three components:
1. Affective component: referring to emotions or feelings towards an object.
2. Behavioural component: referring to actions and behaviour towards an object.
3. Cognitive component: referring to knowledge and perceptions of an object or direct
experiences and information gained from relevant sources.
(Cardwell, 2003)
The formation of attitudes is of great interest given their influence on behaviour (e.g., Gross,
1992). When there is uniformity between the three attitude components, it would be rational
to propose that one would act or behave in a manner consistent with one’s thoughts and
feelings; however, this is not necessarily the case and inconsistencies have been reported. For
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GENERAL INTRODUCTION
example, early research by La Piere (1934) examining ‘anti-Oriental’ attitudes demonstrated
that although 91% of establishments responded that they would not allow members of the
Chinese race to stay in their accommodation, six months earlier only 1 out of 251
establishments had prevented a Chinese couple from staying there when visited previously.
Thus, behaviour observed may be somewhat inconsistent with one’s attitudes.
An explanation offered for attitude formation and change is the Elaboration Likelihood
Model (Petty & Cacioppo, 1986). A key component of the conceptual model is persuasion
that operates via two routes: central and peripheral (Figure 1.1). Attitude formation through
central route processing involves repeated exposure and direct attention to relevant stimuli
resulting in stronger, more robust attitudes, whereas peripheral route processing is less
complex, and attitudes may be shaped by superficial aspects of a given message (e.g., source
credibility) resulting in weaker, more malleable attitudes (O’Brien, Puhl, Latner, Mir, &
Hunter, 2010). Consequently, less cognitive effort is required to change attitudes formed
through the peripheral route (Hague & White, 2005).
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GENERAL INTRODUCTION
Figure 1.1: Elaboration Likelihood Model
Persuasive Communication
Peripheral Attitude Shift
Attitude is relatively
temporary, susceptible, and
unpredictive of behaviour
Motivated to Process?
Personal relevance; need
for cognition; personal
responsibility etc.
Peripheral Cue Present
Positive or negative affect;
attractive expert sources;
number of arguments etc.
Ability to Process?
Distraction; repetition; Prior
knowledge; message
comprehensibility etc.
Nature of Cognitive Processing:
(Initial attitude, argument quality, etc)
Favourable
thoughts
predominate
Unfavourable
thoughts
predominate
Neither or
neutral
predominate
Retain or
Regain Initial
Attitude
Cognitive Structure Change:
Are new cognitions adopted and stored in
memory? Are different responses made
salient than previously?
Central Positive
Attitude Change
Central Negative
Attitude Change
Attitude is relatively enduring, resistant,
and predictive of behaviour
(Petty, Kasmer, Haugtvedt, & Cacioppo, 1987)
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GENERAL INTRODUCTION
The extent to which individuals attend to relevant information is an integral aspect of the
model and dictates through which of the routes information is processed. Elaboration and
diligent consideration of all available information are likely to be high when the individual is
motivated and has the ability to attend to the content of the message, resulting in central route
processing, whereas low elaboration is likely to result in peripheral route processing (Petty et
al., 1987). The complexity of central route processing is evident from Figure 1.1, where an
individual needs to be motivated to process the information as this will determine whether
one attends to a message, have the ability to process the information, for example, by
repeated exposure to the message, have either a favourable or unfavourable preference as
indecisiveness will lead to peripheral processing, and to embed those preferences in memory.
Attitudes also serve a number of motivational functions and therefore the rationale for
forming or changing an attitude may be determined by the desired purpose:
1. Ego-defensive: These attitudes protect individuals from experiencing negative
feelings about themselves whilst projecting negative feelings onto others.
2. Value-expressive functions: Attitudes are the way in which individuals express those
things that are important to them.
3. Instrumental functions: Attitudes may be adopted and expressed because they enable
individuals to gain social acceptance or avoid social disapproval.
4. Knowledge functions: These attitudes help individuals to organise their social worlds
along evaluative dimensions (e.g., ‘things I do like’) and allow them to make
predictions about events.
(Cardwell, 2003)
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GENERAL INTRODUCTION
Whilst attitudes are formed on the basis of evaluative summaries, prejudice has less of an
evaluative dimension, thus in its absence prejudice has no grounding and resultant behaviours
displayed towards an individual or group are unwarranted (Allport, 1966).
1.1.2 Prejudice
Prejudice means “to ‘prejudge’ somebody on the basis of their membership of a particular
category or group” (Cardwell, 2003, p. 190). However, not all prejudgments are necessarily
prejudice, but only those which when exposed to contradictory knowledge remain constant,
resisting reversal. Prejudice refers to more than simply having preconceived ideas about
another person or group, but includes forming evaluations of them. Although prejudice may
be positive or negative, within the psychological literature prejudice is normally accepted as a
negative (i.e. unflattering) attitude towards certain persons or groups. Through stereotyping a
person or group, one can maintain their prejudice, where stereotyping refers to “the belief that
all members of a particular group share the same characteristics” (Cardwell, 2003, p. 190).
For example, individuals may be prejudiced towards all overweight people, believing that
they are all lazy and consume vast quantities of food.
Socio-cultural theories (e.g., Social Identity Theory: Tajfel & Turner, 1986; Social Role
Theory: Eagly, 1987) offer explanations for the origins of prejudice, perceiving prejudice as
part of a ‘shared wisdom’ of a culture. Prejudice may develop as a consequence of
competition between groups, or as a result of an association with one’s own group as the
‘ingroup’, where others are seen as the ‘outgroup’. Prejudice does not necessarily include
behaviours, and therefore is often confused with discrimination, which is behavioural,
whereas prejudice is an attitude. Thus, individuals may have a prejudice towards obese
individuals, but this does not necessarily mean that this affects their behaviour towards obese
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GENERAL INTRODUCTION
them (Cardwell, 2003). Similar to the suggested origins of prejudice, stereotyping is also
proposed to have a social agreement or consensual aspect, and therefore it is of great
importance to comprehend others’ attitudes and beliefs and how they change given the
significance of others’ influence on the perceptions formed by an individual. According to the
Group Norm Theory (Sherif & Sherif, 1953) prejudice and stereotyping are developed and
maintained through social consensus, where prejudice develops through a group’s formation,
identification and continuous interaction (Brownell Puhl, Schwartz, & Rudd, 2005).
With group formation and identity come pressures to adhere to the norms, attitudes and
beliefs of a group, whilst rejecting those who are not part of the group. Given the adaptable
nature of attitudes, those who wish to remain in a group must also shift their attitudes and
behaviours to remain accepted within the group. Crandall, Eshleman, and O’Brien (2002)
demonstrated the influence groups have on the attitudes and prejudices members form,
reporting that participants used social norms to guide their expressions of prejudice, reactions
to hostile jokes and to evaluate discrimination scenarios. An illuminating example of how
perceptions are influenced by others were the findings of Blanchard, Crandall, Bringham, and
Vaughn (1994) who demonstrated that when a student heard another student from their
college condemn racist comments this increased anti-racist opinion, whereas when the
student condoned the racist comments, anti-racist opinion decreased compared with a control
condition where no comment was provided. These findings provide empirical support for
both the influence others have regarding the formation of attitudes and prejudices and for
their adaptable nature.
There is substantial evidence to suggest that society holds negative perceptions of overweight
and obese individuals (Neumark-Szainer, Story, & Faibisch, 1998; Puhl & Brownell, 2001).
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GENERAL INTRODUCTION
Experiences of body size stigmatisation can have serious consequences for the social
interactions of overweight individuals (Cossrow, Jeffery, & McGuire, 2001), and the negative
attitudes and behaviours displayed towards overweight individuals may impact self
perception (Crandall & Biernat, 1990; Musher-Eizenman, Holub, Miller, Goldstein, &
Edwards-Leeper, 2004). Whilst links between anti-fat attitude and negative affect have been
reported (e.g., Muscher-Eizenman et al., 2004), other research (e.g., Latner and Stunkard,
2003) has highlighted concern for the increase anti-fat attitudes over time, alongside
suggestion that these attitudes are likely to be shaped by parents and significant others
(Davison & Birch, 2004). Worryingly, this may indicate that these societal attitudes may be
more widespread than previously estimated (O’Brian, Hunter, Halberstadt, & Anderson,
2007).
Anti-fat attitudes have been suggested to generate a social environment that can be very
detrimental to obese individuals’ psychological and social functioning (Morrison &
O’Connor, 1999). It is suggested that overweight people have a greater probability of being
victimized whilst at school and a lower likelihood of being accepted by elite colleagues, than
their “average weight counterparts” (Rothblum, Brand, Miller, & Oetjen, 1990).
Consequently, Goldfield and Chrisler (1995) remark that “fat people” have a lower chance of
being selected as friends by their peers, which was later supported by Latner, Stunkard, and
Wilson (2005) who reported that obese adults were perceived as less favourable as friends
than non-obese or disabled adults. A similar result has also been shown with childhood
populations (e.g., Latner & Stunkard, 2003).
Based on the findings of anti-fat attitude enquiry, Crandall, D’Anello, Sakalli, Lazarus,
Wieczorkowska Nejtardt, and Feather (2001) proposed an attribution-value model of
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GENERAL INTRODUCTION
prejudice where it is suggested that “a significant amount of the affective component of
attitudes and prejudice toward groups is based on two interrelated factors: attributions of
controllability and cultural value” (p. 31). According to Lerner (1980) those who operate on
the premise that one gets what they deserve in life or have acted in a way that deserves a
certain response, should be treated or receive an appropriate outcome by others in accordance
with the value of the outcome. On this basis, those who have positive characteristics such as
sports stars should be treated as heroes and those with negative characteristics such as those
who are overweight should be punished, avoided and stigmatised, and would therefore
deserve the prejudice experienced (Feather, 1996). Prejudice towards a certain group
develops as a result of a belief that members of that group share negative characteristics such
as a physical handicap or laziness (Crandall et al., 2001). Previous research (e.g., Harris,
1990) has reported the typical perception of those perceived to be fat is of a lack of control,
laziness and ugliness.
Children and young people are the fastest growing segment of the overweight and obese
population (Troiano & Flegal, 2000), and awareness of the potentially harmful perceptions of
others is of importance and the consequential effects that this may have for that individual.
For example, peer rejection is an important hurdle for overweight children to overcome when
in an educational environment, with research reporting that some obese children experience
rejection by peers at school (e.g., Puhl & Brownell, 2001). It has been reported that anti-fat
prejudice has become so rife within American society, particularly in women, that it is
relatively comparable to racial discrimination (Puhl, Andreyeva, & Brownell, 2008),
demonstrating the importance of anti-fat attitude enquiry, and the need for investigation in the
UK given the prevalence of obesity. Prejudice displayed towards the obese appears to hold a
vastly different meaning to prejudice displayed towards other characteristics such as race or
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GENERAL INTRODUCTION
gender. Anti-fat prejudice appears to be openly accepted as opposed to being frowned on as is
prejudice such as racism, which presents a problematic situation where social desirability of
not expressing anti-fat attitudes or behaviours is rare.
Brown and Rothblum (1989) refer to fat oppression as “hatred and discrimination against fat
people, primarily fat women, solely because of their body size. It is the stigmatization of
being fat, the terror of fat, the rationale for thousands of diets and an equal number of
compulsive exercise programmes” (p. 1). Brown and Rothblum (1989) argue that fat
oppression is common among females evolving from a white North American culture, where
fat oppression is internalised and is a “catalyst for self-hatred” with the radical consequences
including starvation and surgery, and the greater likelihood of suffering from eating disorders
such as anorexia and bulimia. They also suggest that these cultures breed perceptions of the
starved body as equating to value and class, through a message that one can “never be too
thin or too rich” (Brown & Rothblum, 1989). Brown and Rothblum suggest that fat
oppression is “like physical and sexual violence against women, sexism in action” (p. 1).
1.2 Purpose of the Thesis
The primary purpose of this thesis is to examine the social perceptions of obesity, the
portrayal of obesity in the UK media, the effect of interpersonal awareness on self
perceptions and whether anti-fat attitudes can be modified. There is a growing appreciation
for the role others play in the management and treatment of obesity, thus there is a clear need
to examine perceptions of obesity in the UK given (1) its rising prevalence (James, 2008), (2)
that the majority of previous research that has examined anti-fat attitudes has presented data
from non-UK based samples (Costa, Del Pino, & Friedman, 2011; Hill, 2007; Vartanian,
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GENERAL INTRODUCTION
2010) and (3) those which have used UK based samples have been small scale and specific to
certain populations (e.g., Robertson & Vohora, 2008; Tailor & Ogden, 2009).
There is also a need to examine the portrayal of obesity in the media. To date, research
examining obesity portrayal is relatively scarce, with the majority focussing on the under
representation of overweight and obese characters on television and their negative portrayal,
with relatively few examining newspaper portrayal. There is a high readership of national
newspapers in the UK, and therefore examining their portrayal of the condition appears
warranted given that it is suggested newspaper portrayal may shape readers attitudes
(Dietrich, Heider, Matschinger, & Anger Meyer, 2006). Furthermore, those which have
examined obesity portrayals have used quantitative analysis; however, given the lack of
newspaper portrayal investigations, qualitative analysis would appear more appropriate when
exploring this relatively un-researched phenomena as well as the nature and tone of the
article. Additionally, with the increasing attention paid to body shape and appearance
research is required that examines the effect of media portrayal of obesity on self perception
and body image given the previously identified deleterious effects of exposure to idealized
bodies (e.g., Tiggemann, 2003).
Finally, with a growing appreciation for the pervasive nature of anti-fat attitudes (e.g., Puhl &
Heuer, 2009) and that they predict anti-fat behaviours (O’Brien, Latner, Halberstadt, Hunter,
Andersen, & Caputi, 2008), there is a clear need to explore potential interventions to change
anti-fat attitudes. Research examining anti-fat attitude interventions is still in its infancy and
therefore with the adverse effects these attitudes present, this highlights the need for further
attempts to reduce anti-fat attitudes.
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GENERAL INTRODUCTION
1.3 Overview of Thesis
The structure of this programme of research consists of seven chapters with two experimental
studies, one descriptive and one observationally qualitative concentrating on the social
perceptions of obesity; Chapter 2 provides a review of the literature examining perceptions of
obesity and their associated negative effects, influential sources within society that play a role
in attitude formation and a consideration of the theoretical underpinnings of the research.
Chapter 3 introduces the first study of this research programme which examined the implicit
and explicit perceptions of obesity in UK adults aged 18-65 years. Chapter 4 presents the
second study which examined the portrayal of obesity in six UK national newspapers over the
period of a year, comparing broadsheet and tabloid portrayals. Chapter 5 presents study three
that examined the effects of media portrayal of obesity on self perception and body image,
using four different sources in an attempt to increase interpersonal awareness through
exposure to others’ physical appearance and behaviour. Chapter 6 then presents study four
which examined the effects of exposure to images of overweight and obese populations as a
counter-conditioning intervention to reduce anti-fat attitudes and finally Chapter 7 provides a
discussion of the overall research programme, including practical implications as a result of
the findings, strengths and limitations, and future research suggestions. As part of chapter 7, a
conclusion is then offered that addresses the overall contributions made by this research
programme.
1.4 Social Psychological Perspective
The basic underlying assumption of the social psychological perspective is that the person
and the environment interact to influence behaviour (Maio, Verplanken, Manstead et al.,
2007). The person and the environment are proposed to be essential factors in the
understanding of “upstream” and “downstream” approaches to lifestyle change (McKinlay,
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GENERAL INTRODUCTION
1993; Verplanken & Wood, 2006). “Upstream” approaches concentrate on altering the
environment where the problematic behaviour occurs as well as endorsing more desirable
alternatives. Conversely, “downstream” approaches concentrate on altering or preventing the
problematic behaviour occurring in individuals considered at risk (Verplanken & Wood,
2006). The research undertaken as part of this thesis has both “upstream” and “downstream”
applications, where altering media content and therefore the environment with which the
individual interacts to form, maintain and intensify anti-fat attitudes is proposed (Chapter 4),
in addition to altering the anti-fat attitudes in individuals observed in Chapter 6.
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