“Treated as second class citizens” - the lived experience of obesity-related stigma: an IMI2 SOPHIA study

Figures & data

Table I. Participants’ pseudonyms, subgroups and characteristics.

Pseudonyms	Subgroup	Gender	Age
Angela	Bariatric Surgery (BS) (a week before the conversational interview)	Female	Chose not to disclose
Áine	Pharmacotherapy (PT)	Female	69
April	Type 1 Diabetes (T1D)	Female	Chose not to disclose
Ada	Pharmacotherapy (PT)	Female	47
Cora	Lifestyletherapy (LT)	Female	60
Catherine	Lifestyletherapy (LT)	Female	56
Daniel	Bariatric Surgery (BS) (close to surgery)	Male	Chose not to disclose
Freida	Bariatric Surgery (BS) (several years ago)	Female	55
Kenny	Pharmacotherapy (PT)	Male	69
Keith	Type 2 Diabetes (T2D)	Male	55
Liam	Bariatric Surgery (BS) (four months prior to the conversational interview)	Male	Chose not to disclose
Miriam	Type 2 Diabetes (T2D)	Female	50
Peadar	Type 2 Diabetes (T2D)	Male	56
Rory	Type 1 Diabetes (T1D)	Male	Chose not to disclose
Steve	Lifestyletherapy (LT)	Male	52

Table II. Themes.

Theme Subthemes	1. Exposure to external judgement 1.1 Judgemental comments 1.2 Hypervigilance to societal judgement
Theme Subthemes	2. Societal exclusion 2.1 Feeling overlooked and ignored 2.2 Effects of societal exclusion
Themes Subthemes	3. Felt environmental stigmatization 3.1 Felt environmental stigmatization when engaging in hobbies 3.2 Felt environmental stigmatization in everyday life

Photograph 1: Designer outfits (Áine, PT).

Photograph 2: The ice cream (Freida, BS).

Photograph 3: Public swimming pool (Catherine, LT).

Photograph 4: The garden door (Miriam, T2D).

Photograph 5: Going to the spa (Catherine, LT).

Table III. Vocabulary used in relation to exposure to external judgement.

Exposure to external judgement
fat,^6 ugly, stupid (Ada, PT)
lazy, slob (April, T1D)
“do you have a baby in there” (comment received from a child) (Cora, LT)
’oh, you put on so much weight’ or “I don’t recognize you” (Miriam, T2D)
[your] bum wiggles (Catherine, LT)
“The last thing I need now is for some fat^7 woman to win this outfit” […] “Because it’s just not going to look good” (comment made by a designer) (Áine, PT)
was way too overweight and she’d never look well no matter how good her voice was, she wouldn’t look well’ (comment made by a designer) (Áine, PT)
just looked at [her], and [she] know[s] by him I disgusted him (stare received by a doctor) (Freida, BS)
you have to lose weight before I touch you (comments made by a doctor) (Freida, BS)
well you know you’re just too fat^8 (comments made by doctor’s colleague) (Freida, BS)
what you need to do is pushbacks’, and I said, ‘What are pushbacks? “Push back from the table” (comment received from doctor) (Freida, BS)
all I can do is for you to lose your weight is to wire your mouth together (comment received from doctor) (Angela, BS)
she’d have to move in with me to check what I was doing, I thought, she doesn’t believe it (comments received form dietician) (Áine, PT)
I’m surprised at you and you’re so careful about your appearance to let yourself become like that (comment received from a doctor) (Peadar, T2D)
“Oh fattie,^9 don’t come near me because you’re high risk” (joke made in the media during Covid) (Ada, PT)
what happened, [you] used to be so pretty (comment received from friends) (Ada, PT)
“Look, if you lose weight I will pay for your ticket” (comment received from a family member) (Ada, PT)
you’re a bit big for that (comment received from a family member) (April, T1D)
you’re putting on too much weight (comment received from family member) (Keith, T2D)
“We’re going home to my house for dinner”, I always remember he said, “But don’t worry I told mum you were on a diet” (received comment from partner) (Áine, PT)
“[Other person is] just looking at me now and she’s totally disgusted with what she sees” (Freida, BS)
“Oh, [Ada] is a really nice girl, but her body just doesn’t fit onto my motorbike” (someone she was romantically interested in) (Ada, PT)
saying look what’s in her trolley. You know, look what’s in her trolley, she’s got crips no wonder, she is the size she is (Freida, BS)
she tackled us both for eating ice cream and the size of us and do we realize the damage we’re doing and I just said […] “We’re just having a hard day”, or something like that and she just kept coming at us and we got up and we walked away and she came after us and she was shouting after us and the size of you and you’ll get cancer and you’ll get heart disease and do you realize the cost on the State (Freida, BS)

Photograph 6: Empty chairs (Miriam, T2D).

Table IV. Vocabulary used in relation to societal exclusion.

Societal exclusion
invisible (Miriam, T2D)
because you’re just part of the blobby people (Áine, PT)
Covid um the vaccine is a societal and policies at the moment are segregating it’s not your choice of isolation, it’s just the systematic isolation (Angela, BS)
not seen as the same value, treated as second class citizens (Miriam, T2D)
excluded from what other people would just take as the norm (Catherine, LT)
overlooked and lost (Miriam, T2D)
gyms are opening up everywhere, do you know […] and for males particularly and females, it can be, do you know, if you don’t fit into that category, then, where do you fit in (Angela, BS)
you’re not the type of people that they want in society (Miriam, T2D)

Photograph 7: Horseback riding (April, T1D).

Photograph 8: Sense of adventure (Catherine, LT).

Photograph 9: Parking concerns (Catherine, LT).

Table V. Vocabulary used in relation to felt environmental stigmatization.

Felt environmental stigmatization
calls over to one of the other girls in the stable, “Actually will you get [name of the horse] out for me, this lad’s too small”, mortifying because they had to like get a particularly big horse for me (April, T1D)
no, actually we don’t have your size (Catherine, LT)
let’s be honest. You don’t see very large women or man in wetsuits going diving. Again, not the normal image. (Catherine. LT)
push their chair in to allow you pass, that sort of, that you’re inconveniencing somebody (Catherine, LT)
taking up maybe two or three spaces where there’s one person in another space (Miriam, T2D)
conspicuous, stand out (Miriam, T2D)
they’re not made for guys my size (Peadar, T2D)
thinking “Yeah, I can’t fit in that” (Catherine, LT)