Table 1.

Studies of weight prejudice reduction

Author	Number	Setting	Population	Design	Strategy	Intervention	Outcome measures	Findings
Children
Anesbury and Tiggemann, 2000 [35]	74	AUS	4th-6th grade; 9–11 years	Quasi-experiment pre-test / post-test	Controllability of obesity	10 min verbal presentation on the un-controllability of weight. Control group received no intervention.	1) Silhouette drawings of an obese and average weight child side-by-side. Participants indicated which child was friendlier, happier, lazier, more attractive, more confident, etc.	Negative: Despite reduction of controllability beliefs, no differences in negative stereotyping between groups were found.
Bell and Morgan, 2000 [36]	184	USA	3rd–6th grade; urban public school; black and white	Experiment post-test only	Controllability of obesity	100 s video of a boy or a girl who was either average weight, obese, or obese with a medical explanation.	1) Adjective Checklist (positive and negative adjectives), 2) modified version of the Shared Activities Questionnaire (SAQ) (assessing willingness to engage in certain activities with a target child).	Mixed: Younger children rated the target in the medical information condition more positively. However, negative effects were found in the same condition among older children.
Haines et al.,	151;	USA	4th-6th grade;	Quasi-experiment pre-test / post-test	Evoking	Multi-component intervention to reduce	A single question assessing the frequency	Negative: Although overall teasing
2006 [40]	120 in post-test		mean 10 years; mixed race		empathy	teasing and unhealthy weight-control behaviors. Compared to control school (no intervention).	of weight-related teasing in the past month.	decreased in the intervention school, the difference for weight-related teasing was not significant.
Irving, 2000 [43]	45	USA	5th grade girls; pre-dominantly white	Cohort study pre-test only / post-test only	Evoking empathy, size acceptance	15–20 min puppet show with a no-teasing/size-acceptance/anti-diet theme.	Modified version of the Figure Rating Scale (child figure drawings from thin to large) with each figure evaluated on six bipolar adjective pairs (e.g. cute/ugly, lazy/works hard).	Positive: Compared to girls who completed pretest only, girls who completed post-test only rated the large body more favorably on three adjective pairs.
Adolescents DeJong, 1980 [37]
Exp 1	64	USA	High-school girls; 14–18 years	Experiment post-test only	Controllability of obesity	Reading a personal statement with a photo of an obese or average weight peer. Half of the participants were told that the peer had a thyroid condition.	1) Continuous-line rating scales to rate targets on seven traits (self-indulgence, self-discipline, laziness, warmth, friendliness, happiness and self-confidence,) 2) questions to assess participants’ liking of the targets and perceived similarity to participants.	Positive: The obese target with a thyroid condition was better liked and rated as more self-disciplined, more attractive and more similar to participants than the obese target without thyroid condition.
Exp 2	162	USA	High-school girls; 14–18 years	Experiment post-test only	Controllability of obesity	Replication of study 1. A condition was added where a subset of participants was told that the obese target had recently lost weight.	Same as in exp 1. Another question to assess liking of the target and nine semantic differential scales were added (e.g. clean/dirty, good/bad, strong/weak).	Positive: Targets who reported a thyroid problem or recent weight loss were rated as less self-indulgent, more self-disciplined, and evaluated more favorably on a ‘goodness index’, but were not liked more than obese targets with no explanation or weight loss.
Hennings et al., 2008 [42]	602	GER	High-school students; mean 16 years	Cohort study pretest / post-test	Evoking empathy	20 min video interview where adolescents discuss their reasons for being overweight and experience of weight discrimination.	13 researcher constructed anti-fat prejudice items (e.g. ‘I don’t like fat people’).	Negative: Although there was increased understanding of the difficulties faced by obese people, there was stronger anti-fat prejudice at post-test.
Adults
Crandall, 1994 [8]	42	USA	University students	Experiment post-test only	Controllability of obesity	Listening to a message about genetic influences on weight or a message about the effects of psychological stress on illness.	Anti-Fat Attitudes (AFA) questionnaire.	Positive: Participants who received the genetic message scored lower on the Willpower and Dislike subscales of the AFA questionnaire.
Gapinski et al., 2006 [38]	108	USA	Female university students; 18–22 years; mixed race	Quasi-experiment post-test only	Evoking empathy, counter-conditioning	10 min empathy or control video, counter-conditioning (obese women featured in positive ways) or negative stereotypes (obese women portrayed negatively) videos.	1) Implicit Association Test (IAT), 2) semantic differential scales to indicate feelings about fat and thin people (e.g. lazy/motivated, blame worthy/blameless), 3) a feeling thermometer assessing feelings toward obese, thin and average weight people, 4) a questionnaire assessing preference for fat relative to thin people, and 5) résumé ratings.	Negative: No difference emerged between groups on implicit or explicit anti-fat bias. Negative video was associated with less prejudice toward an obese job applicant.
Hague and White, 2005 [39]	258	USA	Education students and certified teachers; mean 27 years; mixed ethnicity	Experiment pre-test / post-test w. follow-up	Controllability of obesity, size-acceptance, counter-conditioning	Non-diet, health-centered module via Internet: 1) no image or credentials), 2) presenter credentials (no image), 3) non-obese presenter with credentials, 4) obese presenter with credentials, and 5) control.	1) Anti-Fat Attitudes Test (AFAT), 2) Counselor Rating Form (CRF) (assessing presenter’s expertness, trustworthiness and attractiveness).	Positive: Anti-fat attitudes reduced at post-test and 6-weeks. Perceptions of the credible obese presenter influenced anti-fat attitudes more favorably than perceptions of the credible non-obese presenter.
Harris et al., 1991 [41]	244	USA	University students; mean 19 years; predominantly white	Experiment post-test only	Controllability of obesity, counter-conditioning, evoking empathy	1) Reading an expert interview about obesity or 2) no prime, and 1) no models, 2) high status obese models, or 3) obese models similar to participants.	Questionnaire rating overweight people on 18 characteristics (lazy, sexless, ugly, admirable, weak, happy, powerful, pathetic, sexy, sad, sloppy, energetic, self-indulgent, neat, self-denying, selfish, attractive, and generous).	Negative: No reduction of anti-fat bias in any of the conditions.
Puhl et al., 2005 [44]
Exp 1	60	USA	University students; mean 19 years; mostly white	Experiment pre-test / post-test	Social norm	Favorable versus unfavorable social consensus feedback about views toward obese people.	Obese Persons Trait Survey (OPTS).	Positive: Negative trait ratings decreased and positive trait ratings increased in the favorable consensus condition.
Exp 2	55	USA	University students; mean 21 years; mixed race	Experiment pre-test / post-test	Social norm	In-group vs. out-group favorable social consensus feedback.	1) Obese Persons Trait Survey (OPTS), 2) survey assessing feelings toward five social groups, including obese people.	Positive: More positive feelings toward obese people were expressed when social consensus came from an in-group source.
Exp 3	200	USA	University students; mean 20 years; mixed race	Experiment pre-test / post-test	Social norm, controllability of obesity	1) In-group favorable feedback, 2) feedback reflecting bogus ‘true prevalence’ of traits, 3) uncontrollable causes of obesity, 4) controllable causes of obesity, and 5) control group (no information).	Obese Persons Trait Survey (OPTS).	Positive: Ratings of positive traits increased and negative trait ratings decreased in the consensus, in-group, and bogus ‘true’ prevalence conditions. Negative trait ratings decreased in uncontrollable causes condition and increased in controllable causes condition.
Robinson et at., 1993 [45]	40	USA	Women in a self-esteem / body image program; mean 40 years; white	Cohort study pretest/post-test	Controllability of obesity, size acceptance, counter-conditioning	10–17 treatment sessions aimed at increasing size acceptance and enhancing self-esteem.	Fat Phobia Scale.	Positive: Reductions on the Fat Phobia Scale at post-test.
Rukavina et at., 2008 [46]	95; 69 in post-test	USA	Kinesiology students; black and white	Cohort study pre-test/post-test	Evoking empathy	6-week program consisting of a practicum, reflective writing and lectures/discussions on weight bias and switching from a weight-centered to health-centered approach to fitness.	1) AFAT and 2) two semantic differential scales (stupid/smart and lazy/motivated).	Negative: Statistically significant change occurred on the weight control/blame subscale of the AFAT, but not on other subscales. No change on semantic differential scales.
Teachman et at., 2003 [47]  Exp 1	144	USA	Pedestrians at a beach; mean 35 years; mostly white	Quasi-experiment post-test only	Controllability of obesity	1) No prime, 2) reading an article on the genetic causes of obesity, and 3) reading an article on the behavioral causes of obesity.	1) Implicit Association Test (IAT), 2) Fat Phobia Scale.	Negative: Reading about the genetic causes of obesity did not result in reduced anti-fat bias for either implicit or explicit measures.
Exp 2A	90	USA	Women recruited at a university; mean 21 years; mixed race	Quasi-experiment post-test only	Evoking empathy	Reading empathy evoking stories about 1) an obese person, 2) a person in a wheelchair, or 3) a neutral story not meant to evoke empathy. Also, participants completed short reflective writing tasks.	1) Implicit Association Test (IAT), 2) semantic differential scales assessing views about obese, thin and average weight people (e.g. valuable/worthless).	Mixed: Evoking empathy did not reduce implicit or explicit bias except among participants with BMI over 25 (implicit bias only).
Exp 2B	63	USA	Pedestrians at a beach; mean 42 years; mostly white	Quasi-experiment post-test only	Evoking empathy	1) Reading a story about severe weight discrimination, 2) no prime.	Implicit Association Test (IAT).	Mixed: Evoking empathy resulted in less implicit bias only among participants with BMI over 25.
Wiese et al., 1992 [48]	75	USA	First-year medical students; mean 24 years	Experiment pretest/post-test	Controllability of obesity, evoking empathy, counter-conditioning	Intervention: 1) Empathy evoking video, 2) written message about uncontrollable causes of obesity, and 3) role-playing exercises. Control group received similar tasks about a non-obesity related issue.	Semantic differential scales assessing obese stereotypes (e.g. lazy/energetic, sloppy/neat, self-controlled/lacking self-control).	Positive: The intervention group was less likely than control group to endorse anti-fat stereotypes. At one-year follow-up, no significant differences were found in anti-fat stereotyping.
Zitek and Hebl, 2007 [49]	270; 206 in follow-up	USA	Women recruited at a university; 18–59 years	Experiment post-test only	Social norm	Listening to statements about prejudice toward five social groups, including obese people. Confederate participants either, 1) condoned discrimination, 2) condemned discrimination, or 3) responded in a covert manner.	Questions assessing agreement or disagreement with statements about prejudice against the five groups (e.g. ‘People should be able to tell jokes that make fun of [obese people]’).	Positive: Participants displayed the least anti-fat prejudice in the condemn condition, followed by the control condition, but most in the condone condition. One month later less prejudice was still displayed in the condemn than the condone condition.