Dissertation

Comparing the Impact of Exposure to GLP-1 Agonists and Lifestyle Interventions on Weight Stigma Through Social Comparison Among Black and White Women

Post, Stacy M

2025

Overview

Glucagon-like peptide 1 receptor agonists (GLP-1s) have garnered widespread interest from the public, media, and medical community. Despite this attention, weight loss achieved with diet and exercise remains widely regarded as the preferred method to lose weight. Perceptions of socially acceptable weight loss methods may influence both attitudes towards women who lose weight and personal maladaptive weight-related cognitions. Additionally, prejudice towards women with obesity is prevalent, and Black women may face additional stigma stemming from both negative weight-based attitudes and racial bias. Differences in preferred weight loss methods and attitudes towards women from different racial groups may also influence social comparison processes, especially given the tendency for women to compare themselves with similar others on appearance-related dimensions. However, no research has examined how these factors, individually or in combination, affect stigma and weight-related cognitions. Using an intersectional framework, the current study tested how exposure to weight loss achieved with either lifestyle changes or a GLP-1 agonist medication influenced stigmatizing attitudes towards a Black or White target woman, as well as personal maladaptive weight-related cognitions, through social comparison processes. This research also investigated the roles of perceived similarity with the target woman and participants’ racial group on stigma and weight-related cognitions.Black and White women with overweight and obesity (ages 30-49; N = 402) first completed a baseline questionnaire of measures related to past eating and exercise behaviors and other individual differences. Then participants completed an online experiment in which they were randomly assigned to read about and view a photo of a target woman, who was either Black or White, and who lost weight with either diet/exercise or a GLP-1 medication. Participants then completed a post-manipulation questionnaire in which they reported upward and downward social comparison, perceived similarity to the target woman, stigmatizing attitudes, and six personal maladaptive weight-related cognitions.Stigma was higher towards a woman who lost weight with a GLP-1 (vs. diet/exercise). Additionally, a White (vs. Black) woman with obesity who lost weight was viewed more negatively, regardless of her weight loss method. However, the effects of weight loss method (GLP-1 vs. diet/exercise) and target race (Black vs. White) on stigma did not occur through downward social comparison. Perceived similarity with the target woman also did not affect stigmatizing attitudes, and participant race had limited influence.Exposure to a target woman who lost weight with diet and exercise (vs. GLP-1) also led to lower binge eating likelihood and body dissatisfaction, regardless of the target woman’s race. However, such exposure also simultaneously, indirectly, led to higher binge and problematic eating likelihood and body dissatisfaction, as well as lower vigorous and compensatory exercise likelihood, through reduced upward social comparison. Perceived similarity with the target woman did not influence maladaptive weight-related cognitions, except compensatory exercise likelihood. More similarity with a White woman who lost weight with diet/exercise led to higher compensatory exercise likelihood. Finally, exposure to weight loss achieved with diet/exercise led to lower binge eating likelihood and higher vigorous exercise likelihood, but only when participants were exposed to a target woman from the same racial group. Implications, methodological limitations, and directions for future research on these topics are discussed.

• Publisher: ProQuest Dissertations & Theses
• Subject: Personality psychology / Social psychology / Womens studies
• ISBN: 9798315715238