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Overcoming weight bias: promoting physical activity and psychosocial health

Patti Lou Watkins (Associate Professor and a Clinical Psychologist, based at School of Psychological Science, Oregon State University, Corvallis, Oregon, USA)
Vicki Ebbeck (Associate Professor, based at School of Biological and Population Health Sciences, Oregon State University, Corvallis, Oregon, USA)
Susan S. Levy (Professor, based at School of Exercise and Nutritional Sciences, San Diego State University, San Diego, California, USA)

Ethnicity and Inequalities in Health and Social Care

ISSN: 1757-0980

Article publication date: 9 December 2014




The purpose of this paper is to evaluate Feel WonderFull Fitness (FWF), a program adhering to the Health At Every SizeTM (HAES) paradigm, on larger women's physical activity and psychosocial health. FWF was tailored to overcome barriers based on weight bias.


The study compared “overweight” and “obese” women in FWF to those not currently enrolled in formal exercise programs. Controls were divided into low physical activity (LPA) and moderate physical activity (MPA) conditions based on pretest exercise level. Outcome measures were collected at pretest and three months later at posttest.


FWF participants had the greatest gains in physical activity and demonstrated significantly greater improvements in depression than the LPA group. FWF and the MPA group showed more improved scores on perceived body attractiveness than the LPA group. Scores on an eating disorders measure improved for all groups, but somewhat more so for the FWF group. Improvements occurred in the absence of weight loss or decreases in body mass index and body fat percentage.

Research limitation

The study was based on a small, homogenous sample using a quasi-experimental design.

Practical implications

The study illustrates HAES strategies that practitioners might incorporate into various health and fitness settings.

Social implications

The study highlights weight bias as a social justice issue and as a barrier to physical activity participation for larger women.


The study adds to a growing body of literature evaluating HAES approaches, with HAES representing a novel alternative to weight-loss interventions for improving psychosocial health among larger women. It also contributes to the literature on weight bias that has been understudied relative to bias based on other areas of difference.



The authors thank Catherine Cudo and all the staff and clients at Feel WonderFull Fitness for their assistance in making this investigation possible. The authors also thank the John C. Erkilla, MD Endowment for Health and Human Performance, Good Samaritan Hospital Foundation (Corvallis, OR) for its financial support of this project.


Lou Watkins, P., Ebbeck, V. and S. Levy, S. (2014), "Overcoming weight bias: promoting physical activity and psychosocial health", Ethnicity and Inequalities in Health and Social Care, Vol. 7 No. 4, pp. 187-197.



Emerald Group Publishing Limited

Copyright © 2014, Emerald Group Publishing Limited

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