Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Legislating for weight-based equality: national trends in public support for laws to prohibit weight discrimination

Abstract

The prevalence of weight discrimination in the United States has led to increasing calls for legal measures to address weight-based inequities on a broader scale. This study examined public support in 2014 and 2015 for three proposed laws prohibiting weight discrimination, and compared findings with public attitudes towards the same laws from 2011 to 2013. An online survey was completed by a diverse national sample of US adults (N=2411) in June–July of 2014 and 2015 to assess their support for anti-discrimination legislation. Public support increased for the anti-discrimination laws from 2014 to 2015, and at least 71% of participants expressed support for each of the laws in both years. Compared with public support documented in 2011–2013, there was a significant increase in support in 2014–2015 for legislation to extend disability protections to individuals with obesity and for laws that would include body weight in existing state civil rights statutes. Consistently, high levels of support (78%) were documented across this 5-year period for laws to address weight-based discrimination in employment. As public approval is a powerful catalyst motivating political will needed to make policy changes, these findings provide important insights and implications for advancing policy-level discourse about remedies for weight discrimination.

Introduction

Weight-based discrimination is a prevalent form of unfair treatment against individuals with overweight and obesity.1, 2 At the root of weight-based inequities are negative stereotypes that individuals with obesity are lazy, lacking in self-discipline, sloppy, non-compliant, unintelligent and personally to blame for their weight.1 Although the validity of such stereotypes has been challenged and refuted,3 these beliefs continue to reinforce societal stigma and perpetuate discriminatory practices in multiple settings, such as the workplace. Considerable evidence has documented weight-based employment discrimination, showing that employees with obesity face inequities in hiring practices, promotions, wages and job termination.4, 5

High obesity rates coupled with an increasing prevalence of weight discrimination in the United States2, 6 have led to calls for legal measures to address weight-based inequities on a broader scale.7 However, legal remedies have thus far been limited. To date, it remains legal to discriminate on the basis of weight under federal law, and US State Civil Rights laws prohibit discrimination only on the basis of race, color, religion, sex and national origin.8 With the exception of Michigan and several cities across the country that have passed legislation to prohibit weight discrimination, there are few outlets for Americans to seek legal recourse if they have experienced weight discrimination. Some people have attempted to seek legal recourse for weight discrimination under the Americans with Disabilities Act (ADA), which has historically had limited success due to the burden placed on plaintiffs to prove that their obesity was a real or perceived disability according to ADA definitions.7, 9

Despite these challenges, recent efforts indicate several small, but important, steps to increase legal protections to individuals with obesity. Congress recently passed the ADA Amendments Act, which expanded definitions of disability to include ‘severe obesity’ and has resulted in several successful case settlements for individuals who experienced weight-based employment discrimination.9 In addition, in 2015, Massachusetts proposed a law to prohibit weight discrimination that received a favorable vote in an initial state hearing.10 If the law is passed, Massachusetts will become the second state in the country to prohibit weight discrimination.

As efforts like these emerge, it is critical to examine trends in public support for anti-discrimination legal measures. Public opinion is a powerful catalyst motivating political will needed to make policy changes.11 Recent public opinion studies suggest that many Americans continue to blame individuals for their obesity12 and attribute causes of obesity to personal factors.13 Nevertheless, evidence simultaneously shows high public support for legislation to address obesity-related risk factors,14 and numerous laws have been enacted across the country to increase access to healthy foods, physical activity and educational programs.15 This complex and somewhat contradictory social climate of personal blame in conjunction with implementation of policies targeting environmental factors contributing to obesity warrants continued examination of trends in policy support that pertain to obesity, such as weight discrimination.

In addition, a previous national study by the authors compared the levels of public support for laws to prohibit weight discrimination from 2011 to 2013, and found substantial and increasing support for laws to (a) prohibit weight discrimination in the workplace, (b) add body weight as a protected class in Civil Rights Laws and (c) extend disability protections for individuals with obesity.16 These shifts in public attitudes have not yet stabilized, further underscoring the need to continue to monitor trends and identify what types of demographic factors may be related to increasing public support. Thus, the present study provides a comparison and update to these findings, assessing changes in the percentage of public support for anti-discrimination measures in 2014 and 2015, and examining determinants of public support for these measures.

Materials and methods

During June–July in 2014 and 2015, online surveys were completed by two independent, national samples of 1207 and 1204 US adults, respectively. These surveys were part of a larger study examining public opinions about various policy strategies to address obesity.17 Participants aged 21–65 years were recruited through Survey Sampling International (SSI; http://www.surveysampling.com), a provider of consumer panels for survey research. To obtain a diverse national sample and offset variations in response rates, quotas were established for gender, income groups and black participants. This SSI sample was also augmented with Hispanic adults recruited from Offerwise (http://www.offerwise.com), one of the largest and most representative online samples of US Hispanics. This sampling methodology reflects identical approaches and participant panels that were used in our previous national study,16 which yielded highly similar sample characteristics, allowing for appropriate comparisons to be made between the previous and current study samples.

Measures

In light of previous research documenting individual differences in attitudes towards weight-related anti-discrimination laws,16, 18, 19 participants were asked demographic questions and political orientation. Participants were then introduced to the topic of weight discrimination and presented with three proposed legislative measures. These included (1) providing individuals who have obesity with the same protections that exist for people with physical disabilities (Law 1); (2) enumerating body weight as a protected characteristic in existing state civil rights laws (Law 2); and (3) prohibiting discrimination based on body weight in employment (Law 3). The development of the introductory statement and proposed policy questions are described previously.16, 18 Participants indicated their level of support for each law on a 10-point Likert scale from 1=‘definitely would oppose’ to 10=‘definitely would support.’

Analysis

All the data were analyzed using Stata (SE 13.1).20 Chi-square analyses were used to test differences in the percentage of participants expressing support for each of the three legal measures to prohibit weight discrimination in 2014 and 2015. The association between demographic variables and support for legal measures was examined with multiple logistic regression models that tested for significant individual-level predictors of support (P0.05).

Results

Sample characteristics are presented in Table 1. The total sample (N=2411) consisted of 1469 women (61%) and 942 men (39%). Fifty-two percent of participants identified as White non-Hispanic, followed by Hispanic (25%) and Black (16.8%). Forty-two percent of participants reported a moderate political affiliation, followed by 34% conservatives and 24% liberal. Sociodemographic characteristics were similar in the samples for 2014 and 2015.

Table 1 Sample characteristics

Table 2 presents the percentage of participants’ support for each of the three legal measures for both the total and independent samples. At least 71% of participants expressed support for each of the three anti-discrimination laws in both 2014 and 2015. Public support also increased for each of the laws from 2014 to 2015, although the only significant increase occurred for Law 2 (including weight as a protected category in Civil Rights Laws). In both years, public support was higher for Laws 2 and 3 (76.9–80.1%) than for Law 1 (71–73.9%).

Table 2 Ratings of support for anti-discrimination laws within total and independent samples

Included in Table 2 are the percentages of public support for these legal measures documented in our initial study from 2011 to 2013.16 Comparing these results with the present findings shows that public support in 2014–2015 significantly increased for Law 1 (from 63.8% in 2011–2013 to 72.2% in 2014–2015) and for Law 2 (from 72.2% in 2011–2013 to 78.9% in 2014–2015), and remained consistently high for Law 3 (78.1% in 2011–2013 and 78.8% 2014–2015).

Results of multiple logistic regressions (Table 3) identified several associations between sociodemographic variables and participants’ likelihood of support for each of the anti-discrimination laws. Overall, the likelihood of support for laws was significantly higher among individuals who were White, Hispanic and those with higher education. Support for laws was variable across participants’ political orientation: liberals were more likely than moderates and conservatives to support Law 1, moderates were more likely to support Law 2 and Law 3 compared with conservatives, and no differences emerged between liberals and conservatives on these two laws. In general, sex, age and household income did not predict likelihood of support for the laws.

Table 3 Multiple logistic regression results for predictors of public support for three laws to prohibit weight discrimination

Conclusion

This study offers insights into the current public mindset towards legal measures to prohibit weight discrimination. The finding that public support remains consistently high for different types of anti-discrimination laws suggests that one of the essential components necessary to motivate political will for policy change is fairly well established. This is especially apparent in light of comparisons between the present findings and our previous research on public attitudes towards the same laws from 2011 to 2013.16

Of particular note is the significant increase in support for Law 1 (disability protections) and Law 2 (civil rights statutes) in 2014–2015 compared with support for these laws in 2011–2013. Although it was beyond the scope of this study to examine potential explanations for policy attitudes, it is possible that these findings coincide with increasing public awareness in the United States of obesity being declared an official disease. In the summer of 2013, the American Medical Association classified obesity as a disease,21 and recent research suggests that public attitudes are somewhat favorable towards this classification.22 Future research should examine whether views about obesity as a disease influence support for weight-related anti-discrimination policies. More broadly, research needs to identify other explanations for changes in public support, such as increased public awareness, advocacy and research on weight bias, as well as the ways that messages are framed about obesity, and other individual-level factors contributing to shifts in public attitudes.

Finally, sociodemographic characteristics associated with support for anti-discrimination laws are noteworthy. Although previous studies suggest that women are more likely than men to support anti-discrimination laws,16, 18 the present findings suggest that men may becoming more supportive of these measures. Similarly, compared with previous research documenting higher support for these laws among liberals,16, 18 we found no significant differences between liberals and conservatives in support for laws addressing weight discrimination in employment and civil rights statutes. Although is not clear why this finding emerged, it could have important implications for advocacy efforts to educate policy makers and potentially motivate bipartisan political will to pursue anti-discrimination legislation.

References

  1. 1

    Puhl RM, Heuer CA . The stigma of obesity: a review and update. Obesity 2009; 17: 941–964.

    Article  Google Scholar 

  2. 2

    Puhl RM, Andreyeva T, Brownell KD . Perceptions of weight discrimination: prevalence and comparison to race and gender discrimination in America. Int J Obes 2008; 32: 992–1000.

    CAS  Article  Google Scholar 

  3. 3

    Roehling MV, Roehling PV, Odland M . Investigating the validity of stereotypes about overweight employees: The relationship between body weight and normal personality traits. Group Organization Management 2008; 33: 392–424.

    Article  Google Scholar 

  4. 4

    Rudolph CW, Wells CL, Weller MD, Baltes BB . A meta-analysis of empirical studies of weight-based bias in the workplace. J Vocat Behav 2009; 74: 1–10.

    Article  Google Scholar 

  5. 5

    Roehling MV, Pichler S, Bruce TA . Moderators of the effect of weight on job-related outcomes: a meta-analysis of experimental studies. J Appl Soc Psychol 2013; 43: 237–252.

    Article  Google Scholar 

  6. 6

    Andreyeva T, Puhl RM, Brownell KD . Changes in perceived weight discrimination among Americans: 1995-1996 through 2004-2006. Obesity 2008; 16: 1129–1134.

    Article  Google Scholar 

  7. 7

    Pomeranz JL . A historical analysis of public health, the law, and stigmatized social groups: the need for both obesity and weight bias legislation. Obesity 2008; 16: S93–S102.

    Article  Google Scholar 

  8. 8

    Title VII of the Civil Rights Act of 1964. (2015). US Equal Employment Opportunity Commission. Available at http://www.eeoc.gov/laws/statutes/titlevii.cfm. Accessed on 30 October 2015.

  9. 9

    Pomeranz JL, Puhl RM . New developments in the law for obesity discrimination protection. Obesity 2013; 21: 469–471.

    Article  Google Scholar 

  10. 10

    Quinn C . State house news—committee backs bill adding height, weight to antidiscrimination law. October, 2013. Available at http://www.statehousenews.com. Accessed on 3 November 2015.

  11. 11

    Mello MM, Wood J, Burris S, Wagenaar AC, Ibrahim JK, Swanson JW . Critical opportunities for public health law: a call for action. Am J Public Health 2013; 103: 1979–1988.

    Article  Google Scholar 

  12. 12

    Lusk JL, Ellison B . Who is to blame for the rise in obesity? Appetite 2013; 68: 14–20.

    Article  Google Scholar 

  13. 13

    Bleich S, Blendon RJ . Public opinion and obesity. In: Blendon RJ, Brodie M, Benson JM, Altman DE (eds). American Public Opinion and Health Care. CQ Press: Washington, DC, USA, 2011.

    Google Scholar 

  14. 14

    Morain S, Mello MM . Survey finds public support for legal interventions directed at health behavior to fight noncommunicable disease. Health Aff (Millwood) 2013; 32: 486–496.

    Article  Google Scholar 

  15. 15

    Donaldson EA, Cohen JE, Villanti AC, Kanarek NF, Barry CL, Rutkow L . Patterns and predictors of state adult obesity prevention legislation enactment in US states: 2010–2013. Prev Med 2015; 74: 117–122.

    Article  Google Scholar 

  16. 16

    Suh Y, Puhl R, Liu S, Fleming Milici F . Support for laws to prohibit weight discrimination in the united states: Public attitudes from 2011 to 2013. Obesity 2014; 22: 1872–1879.

    Article  Google Scholar 

  17. 17

    Harris J. F-MF, Sarda V, Schwartz M . Food marketing to children and adolescents: What do parents think? Yale Rudd Center for Food Policy & Obesity 2012. Available at http://www.uconnruddcenter.org/files/Pdfs/Rudd_Report_Parents_Survey_Food_Marketing_2012.pdf.

  18. 18

    Puhl RM, Heuer CA . Public opinion about laws to prohibit weight discrimination in the United States. Obesity 2011; 19: 74–82.

    Article  Google Scholar 

  19. 19

    Barry CL, Brescoll VL, Brownell KD, Schlesinger M . Obesity metaphors: how beliefs about the causes of obesity affect support for public policy. Milbank Q 2009; 87: 7–47.

    Article  Google Scholar 

  20. 20

    StataCorp. 2013. Stata Statistical Software: Release 13. StataCorp LP: College Station, TX, USA.

  21. 21

    Pollack A . AMA recognizes obesity as a disease. New York Times. 2013; Sect. Business Day. Available at http://www.nytimes.com/2013/06/19/business/ama-recognizes-obesity-as-a-disease.html?_r=0. Accessed on 5 November 2015.

  22. 22

    Puhl RM, Liu S . A national survey of public views about the classification of obesity as a disease. Obesity 2015; 23: 1288–1295.

    Article  Google Scholar 

Download references

Acknowledgements

This research was funded by a donation from the Rudd Foundation and a grant by the Robert Wood Johnson Foundation.

Author information

Affiliations

Authors

Corresponding author

Correspondence to R M Puhl.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Puhl, R., Suh, Y. & Li, X. Legislating for weight-based equality: national trends in public support for laws to prohibit weight discrimination. Int J Obes 40, 1320–1324 (2016). https://doi.org/10.1038/ijo.2016.49

Download citation

Further reading

Search

Quick links