OpenLB
Open Library of Bioscience
Advanced Search
Journal of minimal access surgery
Mar 24, 2025;

From flab to fab: A cross-sectional study for cultural adaptation and validation of the Fat Phobia Scale-Short Form in India.

Kumari Rina, Rosali Bhoi, Anubhav Vindal, Pawanindra Lal
Author Information
  1. Kumari Rina: Department of Psychiatry, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, Maulana Azad Medical College (University of Delhi) and Associated Lok Nayak Hospital, New Delhi, India.
  2. Rosali Bhoi: Department of Psychiatry, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, Maulana Azad Medical College (University of Delhi) and Associated Lok Nayak Hospital, New Delhi, India.
  3. Anubhav Vindal: Department of Surgery, Maulana Azad Medical College (University of Delhi) and Associated Lok Nayak Hospital, New Delhi, India.
  4. Pawanindra Lal: Department of Surgery, Maulana Azad Medical College (University of Delhi) and Associated Lok Nayak Hospital, New Delhi, India.
PMID: 40126402 DOI: 10.4103/jmas.jmas_271_24

Abstract

BACKGROUND: Due to the lack of a validated instrument to measure fatphobia, its epidemiology in India remains unknown. This study aimed to culturally adapt and validate the Fat Phobia Scale-Short Form (FPS-SF) in Hindi.
PATIENTS AND METHODS: A cross-sectional study using a purposive sampling technique was conducted in the metabolic surgery clinic of a tertiary care teaching institution. We followed the World Health Organization's procedure for cultural adaptation and validation of an instrument. The study was biphasic. The phase-1 entailed forward translation, formation of an expert panel, backward translation and cognitive interviewing with the two groups of seven individuals, each with severe obesity. During phase-2, 175 participants (students [n = 120], patients [n = 55]) were recruited after written informed consent. Hindi-FPS-SF was administered to students twice, 1 week apart. All participants completed Hindi-FPS-SF, Modified Weight Bias Internalization Scale (Hindi-WBIS-M), Patient Health Questionnaire (Hindi-PHQ-9) and Generalised Anxiety Disorder Questionnaire (Hindi-GAD-7). Statistical analysis was done.
RESULTS: Several items of forward-translated Hindi-FPS-SF underwent culture-specific modifications in Phase-1. Content or curricular validity and face validity were assessed. In Phase-2, the reliability and validity of Hindi-FPS-SF were evaluated. The internal consistency (Cronbach's alpha), intra-class correlation type-A coefficient (ICC) and cross-cultural reliability were �� =0.902 (P < 0.001), 0.799 (95% CI = 0.753-0.840) (P < 0.001) and (ICC: 0.865-0.992) (P < 0.001), respectively. The convergent-construct validity assessed by correlations between total scores of Hindi-WBIS-M and Hindi-FPS-SF was significant. Criterion validity measured through correlations with original FPS-SF, Hindi-WBIS-M, PHQ-9 and GAD-7 was significant.
CONCLUSIONS: The Hindi-FPS-SF demonstrated good psychometric properties and may be used to measure fat phobia and its correlates in India for epidemiological purposes.

References

  1. Bacon JG, Scheltema KE, Robinson BE. Fat phobia scale revisited: The short form. Int J Obes Relat Metab Disord 2001;25:252���7.
  2. Lewinsohn PM, Graf M. Pleasant activities and depression. J Consult Clin Psychol 1973;41:261���8.
  3. Phelan SM, Burgess DJ, Yeazel MW, Hellerstedt WL, Griffin JM, van Ryn M. Impact of weight bias and stigma on quality of care and outcomes for patients with obesity. Obes Rev 2015;16:319���26.
  4. Garcia FK, Verkooijen KT, Veen EJ, Mulder BC, Koelen MA, Hazebroek EJ. Stigma toward bariatric surgery in the Netherlands, France, and the United Kingdom: Protocol for a cross-cultural mixed methods study. JMIR Res Protoc 2022;11:e36753.
  5. Luhar S, Tim��us IM, Jones R, Cunningham S, Patel SA, Kinra S, et al. Forecasting the prevalence of overweight and obesity in India to 2040. PLoS One 2020;15:e0229438.
  6. Garg A. India Ranks 3rd in Global Obesity Index. HealthSoul, Newswires; 2019. Available from: https://www.einnews.com/pr_news/486386188/india-ranks-3rd-in-global-obesity-index. [Last accessed on 2024 Sep 03].
  7. Prejudice Against Fat People: Ideology and Self-interest. Available from: https://scholar.google.co.in/scholar?hl=en&as_sdt=0%2C5&q=Prejudice+against+fat+people%3A+Ideology+and+selfinterest.&btnG=. [Last accessed on 2024 Sep 03].
  8. The Measurement of Attitudes Toward and Beliefs About Obese Persons. Available from: https://scholar.google.co.in/scholar?hl=en& as_sdt=0%2C5&q=The+measurement+of+attitudes+toward+and+beliefs+about+obese+persons&btnG=. [Last accessed on 2024 Sep 03].
  9. Prejudice Toward Fat People: The Development and Validation of the Antifat Attitudes Test. Available from: https://scholar.google.co.in/scholar?hl=en&as_sdt=0%2C5&q=Prejudice+toward+fat+people%3A+the+development+and+validation+of+the+antifat+attitudes+test&btnG=. [Last accessed on 2024 Sep 03].
  10. Psychometric Properties of a Scale Measuring Negative Attitudes Toward Overweight Individuals. Available from: https://scholar.google.co.in/scholar?hl=en&as_sdt=0%2C5&q=Psychometric+properties+of+a+scale+measuring+negative+attitudes+toward+overweightindividuals&btnG=. [Last accessed on 2024 Sep 03].
  11. Fat Phobia Scale Revisited: The Short Form. Available from: https://scholar.google.co.in/scholar?hl=en&as_sdt=0%2C5&q=Fat+phobia+scale+revisited%3A+the+short+form&btnG=. [Last accessed on 2024 Sep 03].
  12. Crandall CS. Prejudice against fat people: Ideology and self-interest. J Pers Soc Psychol 1994;66:882���94.
  13. Allison DB, Basile VC, Yuker HE. The measurement of attitudes toward and beliefs about obese persons. Int J Eat Disord 1991;10:599���607.
  14. Lewis RJ, Cash TF, Jacobi L, Bubb-Lewis C. Prejudice toward fat people: The development and validation of the antifat attitudes test. Obes Res 1997;5:297���307.
  15. Yuker HE, Allison DB, Faith MS. Methods for measuring attitudes and beliefs about obese people Allison DB. Handbook of Assessment Methods for Eating Behaviors and Weight-Related Problems: Measures, Theory, and Research. Thousand Oaks, CA: Sage Publications, Inc.;1995.81���118. Available from: https://psycnet.apa.org/record/1995-97460-003. [Last accessed on 2022 Jan 11].
  16. Cattell RB. Fixing the number of factors: The most practicable psychometric procedures. In: The Scientific Use of Factor Analysis in Behavior and Life Sciences. New York: Plenum; 1978.72���91.
  17. World Health Organization. Process of Translation and Adaptation of Instruments. WHO; 2010. Available from: https://www.who.int/substance_abuse/research_tools/translation/en/. s[Last accessed on 2020 Oct 11].
  18. Pearl RL, Puhl RM. Measuring internalized weight attitudes across body weight categories: Validation of the modified weight bias internalization scale. Body Image 2014;11:89���92.
  19. Rina K, Bhoi R, Vindal A, Lal P. Hindi translation, cultural adaptation, and validation of modified Weight bias internalization scale (WBIS-M): A cross-sectional study from the metabolic surgery clinic in North India. Indian J Psychol Med 2024;02537176241280109.
  20. Kroenke K, Spitzer RL. The PHQ-9: A new depression diagnostic and severity measure. Psychiatr Ann 2002;32:509���15.
  21. Spitzer RL, Kroenke K, Williams JB, L��we B. A brief measure for assessing generalized anxiety disorder: The GAD-7. Arch Intern Med 2006;166:1092���7.
  22. Stein J, Luppa M, Ruzanska U, Sikorski C, K��nig HH, Riedel-Heller SG. Measuring negative attitudes towards overweight and obesity in the German population ��� Psychometric properties and reference values for the German short version of the Fat phobia scale (FPS). PLoS One 2014;9:e114641.
  23. Elboim-Gabyzon M, Attar K, Peleg S. Weight stigmatization among physical therapy students and registered physical therapists. Obes Facts 2020;13:104���16.
  24. Kim EM, Lee K, Hwang KM, Kim JS, Park TJ. Reliability and validity of Korean version of questionnaire for weight bias measurement. Korean J Fam Med 2016;31:461���71.
  25. Ko��ak S, Sara�� L, Hurmeri�� I. Determining the relationships among body mass index, body composition and attitudes toward fat people. In: ICHPER-SD Annivarsary World Congress. ��stanbul, ��stanbul, Turkey: ICHPER-SD; 2005.
  26. de Souza GC, Laus MF, da Silva WR, Japur CC. Fat phobia scale-short form and beliefs about obese persons scale: Cross-cultural adaptation to Brazilian Portuguese. Discov Psychol 2024;4:8.
  27. Puhl RM, Latner JD, O'Brien K, Luedicke J, Danielsdottir S, Forhan M. A multinational examination of weight bias: Predictors of anti-fat attitudes across four countries. Int J Obes (Lond) 2015;39:1166���73.
  28. Langdon J, Rukavina P, Greenleaf C. Predictors of obesity bias among exercise science students. Adv Physiol Educ 2016;40:157���64.
  29. Flint SW, Hudson J, Lavallee D. UK adults' implicit and explicit attitudes towards obesity: A cross-sectional study. BMC Obes 2015;2:31.
  30. Makowski AC, Kim TJ, Luck-Sikorski C, von dem Knesebeck O. Social deprivation, gender and obesity: Multiple stigma? Results of a population survey from Germany. BMJ Open 2019;9:e023389.
Journal Article

Word Cloud

Created with Highcharts 10.0.0Hindi-FPS-SF0validitystudyIndia=Hindi-WBIS-MP<001instrumentmeasureFatPhobiaScale-ShortFormFPS-SFcross-sectionalHealthculturaladaptationvalidationtranslationparticipantsstudents[nQuestionnaireassessedreliabilitycorrelationssignificantBACKGROUND:DuelackvalidatedfatphobiaepidemiologyremainsunknownaimedculturallyadaptvalidateHindiPATIENTSANDMETHODS:usingpurposivesamplingtechniqueconductedmetabolicsurgeryclinictertiarycareteachinginstitutionfollowedWorldOrganization'sprocedurebiphasicphase-1entailedforwardformationexpertpanelbackwardcognitiveinterviewingtwogroupssevenindividualssevereobesityphase-2175120]patients55]recruitedwritteninformedconsentadministeredtwice1weekapartcompletedModifiedWeightBiasInternalizationScalePatientHindi-PHQ-9GeneralisedAnxietyDisorderHindi-GAD-7StatisticalanalysisdoneRESULTS:Severalitemsforward-translatedunderwentculture-specificmodificationsPhase-1ContentcurricularfacePhase-2evaluatedinternalconsistencyCronbach'salphaintra-classcorrelationtype-AcoefficientICCcross-cultural��=090279995%CI753-0840ICC:865-0992respectivelyconvergent-constructtotalscoresCriterionmeasuredoriginalPHQ-9GAD-7CONCLUSIONS:demonstratedgoodpsychometricpropertiesmayusedfatphobiacorrelatesepidemiologicalpurposesflabfab:

Similar Articles

Cited By

No available data.