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Piran N, Teall TL, Counsell A. Expanding the social lens: A quantitative study of the developmental theory of embodiment. Body Image 2023; 44:246-261. [PMID: 36566166 DOI: 10.1016/j.bodyim.2022.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 11/07/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022]
Abstract
The developmental theory of embodiment (DTE) is a research-based theory of social factors that shape the experience of embodiment, a construct that is strongly correlated with body esteem and body appreciation. The DTE is anchored in prospective and retrospective qualitative research studies with cisgender girls and women of diverse backgrounds. This paper describes the first comprehensive quantitative study of factors in the social environment the DTE delineates as shaping the experience of embodiment involving a cross-sectional design, among 412 cisgender women. The 13 quantitative social factors correlated positively with the Experience of Embodiment Scale and accounted together for over 60% of its score variance. The findings of significant positive correlations between all social factors and of a large shared variance amongst these factors in a simultaneous multiple regression predicting the experience of embodiment are in line with the DTE and with a multi-level model of causality central to public health perspectives, whereby social structures and positions, such as those related to gender, shape multiple lower-level protective and risk factors. Future studies of the theory should include prospective designs with samples of varied backgrounds along different dimensions of social location.
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Affiliation(s)
- Niva Piran
- Department of Applied Psychology and Human Development, OISE/University of Toronto, 252 Bloor St. West, Toronto, ON M5S 1V6, Canada.
| | - Tanya Luanne Teall
- Clinical Psychologist, Department of Applied Psychology and Human Development, OISE/University of Toronto, 252 Bloor St. West, Toronto, ON M5S 1V6, Canada.
| | - Alyssa Counsell
- Department of Psychology (JOR 926), Toronto Metropolitan University, 350 Victoria St., Toronto, ON M5B 2K3, Canada.
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Herbozo S, Brown KL, Burke NL, LaRose JG. A Call to Reconceptualize Obesity Treatment in Service of Health Equity: Review of Evidence and Future Directions. Curr Obes Rep 2023; 12:24-35. [PMID: 36729299 PMCID: PMC9894524 DOI: 10.1007/s13679-023-00493-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/10/2022] [Indexed: 02/03/2023]
Abstract
PURPOSE OF REVIEW Rates of obesity and associated comorbidities are higher among Black and Latino adults compared to white adults. We sought to provide an overview of both structural and individual factors contributing to obesity inequities and synthesize available evidence regarding treatment outcomes in Black and Latino adults, with an eye towards informing future directions. RECENT FINDINGS Obesity disparities are influenced by myriad systemic issues, yet the vast majority of interventions target individual-level factors only, and most behavioral treatments fail to target drivers beyond eating and physical activity. Extant treatments are not equally accessible, affordable, or effective among Black and Latino adults compared with white counterparts. Asset-based, culturally relevant interventions that target the root causes of obesity and address intersectional stress-designed in partnership with intended beneficiaries-are urgently needed. Treatment trials must improve enrollment of Black and Latino adults and report treatment outcomes by race and ethnicity.
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Affiliation(s)
- Sylvia Herbozo
- Department of Surgery, Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Illinois at Chicago, Chicago, USA.
- Department of Psychiatry and Behavioral Sciences and Department of Surgery, Rush University Medical Center, 1725 West Harrison Street, Chicago, IL, 60612, USA.
| | - Kristal Lyn Brown
- Division of General Internal Medicine, School of Medicine, The Johns Hopkins University, Baltimore, USA
| | - Natasha L Burke
- Department of Psychology, Fordham University, The Bronx, USA
| | - Jessica Gokee LaRose
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, USA
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53
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The effects of an acute weight stigma exposure on cardiovascular reactivity among women with obesity and hypertension: A randomized trial. J Psychosom Res 2023; 165:111124. [PMID: 36571973 DOI: 10.1016/j.jpsychores.2022.111124] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 12/16/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Weight stigma induces cardiovascular health consequences for people with obesity. How stigma affects cardiovascular reactivity in individuals with both obesity and hypertension is not known. METHODS In a randomized experiment, we assessed the influence of two video exposures, depicting either weight stigmatizing (STIGMA) or non-stigmatizing (NEUTRAL) scenes, on cardiovascular reactivity [resting blood pressure (BP), heart rate (HR), ambulatory BP (ABP), and ambulatory HR (AHR)], among women with obesity and high BP (HBP; n=24) or normal BP (NBP; n=25). Systolic ABP reactivity was the primary outcome. Laboratory BP and HR were measured before/during/following the videos, and ABP and AHR were measured over 19 hours (10 awake hours, 9 sleep hours) upon leaving the laboratory. A repeated measures ANCOVA tested differences in BP and HR changes from baseline in the laboratory and over ambulatory conditions between the two groups after each video, controlling for body mass index, baseline BP and HR. RESULTS Laboratory SBP/DBP increased 5.5+7.3/2.4+8.8mmHg more in women with HBP than NBP following the STIGMA versus NEUTRAL video (Ps<0.05). For the primary outcome, ABP increased more in HBP than NBP over sleep (SBP/DBP=4.2+20.6/4.7+14.2mmHg; Ps<0.05) following the STIGMA versus NEUTRAL video, as did HR during sleep (7.5+15.7bpm more in HBP than NBP; P<0.05). CONCLUSIONS Weight stigma increases cardiovascular reactivity among women with obesity and HBP in the laboratory and under ambulatory conditions. CLINICAL TRIAL REGISTRATION Registered at ClinicalTrials.gov (Identifier: NCT04161638).
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O'Neill EA, Trout K, Ramseyer Winter V. Relationships between experiencing anti-fat microaggressions, body appreciation, and perceived physical and mental health. J Health Psychol 2023; 28:107-118. [PMID: 35699369 DOI: 10.1177/13591053221103421] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study examined whether body appreciation mediates the relationships between anti-fat microaggression experiences and perceived physical and mental health. Using a cross-sectional survey design, our study included 384 adult cisgender women in the United States. We found that anti-fat microaggression experiences had a negative association with body appreciation, and perceived physical and mental health. Body appreciation had a positive relationship to perceived physical and mental health. Our study further suggests that body appreciation is an important modifiable factor that mediates the relationships between anti-fat microaggression experiences and perceived mental and physical health. Implications for practice and research are discussed.
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Affiliation(s)
- Elizabeth A O'Neill
- Social Work Department, Washburn University, Topeka, KS, USA.,Center for Body Image Research and Policy, University of Missouri, Columbia, MO, USA
| | - Kate Trout
- School of Health Professions, University of Missouri, Columbia, MO, USA
| | - Virginia Ramseyer Winter
- Center for Body Image Research and Policy, University of Missouri, Columbia, MO, USA.,School of Social Work, University of Missouri, Columbia, MO, USA
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Woods SB, Strenth C, Day P, Tsewang T, Aparicio K, Ross K, Ventimiglia J, Jetpuri Z. Relational and individual stress pathways linking discrimination and ageing cardiometabolic health. Stress Health 2023; 39:35-47. [PMID: 35599438 DOI: 10.1002/smi.3166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 04/18/2022] [Accepted: 05/16/2022] [Indexed: 02/05/2023]
Abstract
Perceived discrimination is a significant risk factor for worse ageing health outcomes. Yet, the specific individual and relational stress pathways linking discrimination to disease are less understood, especially in the context of cardiometabolic health. We tested family stress and psychophysiological distress (negative affect and high-risk lipid/fat metabolism) as mediators linking perceived discrimination to cardiometabolic morbidity and health appraisal over 20 years for midlife adults. Using data from participants who completed the Biomarker Project (2004-2009) of the Midlife in the U.S. project, and examining data over the study's three waves (1995-1996, 2004-2006, and 2013-2014), we used structural equation modelling to test pathways for participants who reported zero cardiometabolic conditions at baseline (n = 799). Greater Time 1 discrimination was associated with greater Time 2 family strain, which was in turn associated with worse negative affect; worse Time 2 negative affect was associated with worse Time 3 health appraisal; metabolic lipids risk did not serve as an indirect pathway to Time 3 cardiometabolic morbidity (χ2 = 147.74, p < 0.001; RMSEA = 0.056; CFI = 0.902; SRMR = 0.047). The inclusion of family in interventions to mitigate the impact of discrimination may be indicated for promoting cardiometabolic wellness.
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Affiliation(s)
- Sarah B Woods
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Chance Strenth
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Philip Day
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Tenzin Tsewang
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Kimberly Aparicio
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Kristin Ross
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Joseph Ventimiglia
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Zaiba Jetpuri
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Mavragani A, Pash E, Zhou MS, Broffman L, Bialonczyk D, Doron T, Chiquette E. Characteristics and Weight Loss Practices From a Cohort of 20,000 Patients Using Direct-to-Consumer Telehealth: Observational Cross-sectional Study. JMIR Form Res 2023; 7:e40062. [PMID: 36602855 PMCID: PMC9893727 DOI: 10.2196/40062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 10/18/2022] [Accepted: 11/04/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Despite the increasing prevalence of obesity, the use of pharmacotherapy treatment remains low. Telehealth platforms have the potential to facilitate access to pharmacotherapy interventions, but little is known about telehealth patients. OBJECTIVE This study describes a large patient population taking Plenity, an oral superabsorbent hydrogel (OSH) used in the treatment of excess weight or obesity (BMI 25-40 kg/m2). The analysis compared differences in weight loss practices and in-person access to obesity care among telehealth patients with preobesity and obesity. METHODS This was a cross-sectional assessment of a random sample of 20,000 telehealth patients who completed a structured, web-based visit and received at least one prescription of OSH. Patients were eligible to receive care via telehealth if they were adults, were not pregnant, and had a BMI ≥25 kg/m2. During the visit, patients provided baseline health information including comorbidities, diet, and exercise habits. Their zip code of residence was used to determine their proximity to an obesity medicine provider. Descriptive statistical analysis and tests of differences (chi-square and 2-tailed t tests) were used to compare patients with preobesity (BMI 25-29.9 kg/m2) and obesity (BMI 30-40 kg/m2). RESULTS Most (15,576/20,000, 77.88%) of the cohort were female, with a mean age of 44 (SD 11) years and a mean BMI of 32.4 (SD 4.1) kg/m2. Among the cohort, 32.13% (6426/20,000) had preobesity, and 40.18% (8036/20,000) of all patients had ≥1 weight-related comorbidity. Almost all (19,732/20,000, 98.66%) patients attempted 1 weight loss method before OSH and half (10,067/20,000, 50.34%) tried ≥4 different methods. Exercise and low-calorie diets were the most attempted weight loss methods, and 28.76% (5752/20,000) of patients reported a prior prescription of weight loss medication. Patients with obesity were more likely than patients with preobesity to have previously tried commercial weight loss plans (7294/13,574, 53.74% vs 2791/6426, 43.43%; P<.001), specialized diets (8493/13,574, 62.57% vs 3799/6426, 59.12%; P<.001), over-the-counter supplements (6807/13,574, 50.15% vs 2876/6426, 44.76%; P<.001), and prescription weight loss medications (4407/13,574, 32.47% vs 1345/6426, 20.93%; P<.001). Females were more likely to seek treatment for preobesity (5332/15,576, 34.23% vs 1094/4424, 24.73% male; P<.001) and reported fewer comorbidities (5992/15,576, 38.47% vs 2044/4424, 46.2% male; P<.001), despite >90% of both sexes reporting the belief that excess weight negatively affected their health (14,247/15,576, 91.47% female participants, 4116/4424, 93.04% male participants). Moreover, 29.25% (5850/20,000) of patients lived in the same zip code and 85.15% (17,030/20,000) lived in the same county as an obesity medicine provider. CONCLUSIONS Data from this large patient cohort supports the potential for telehealth to provide prescriptive weight management treatment to a population seeking care. Patients with preobesity are an undertreated population who actively seek new weight management options. Female participants sought weight management treatment earlier in the disease continuum than males, despite reporting fewer comorbidities.
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Associations among enacted weight stigma, weight self-stigma, and multiple physical health outcomes, healthcare utilization, and selected health behaviors. Int J Obes (Lond) 2023; 47:33-38. [PMID: 36333585 DOI: 10.1038/s41366-022-01233-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 10/19/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND This study examined the relationship among enacted weight stigma, weight self-stigma, and multiple health outcomes. Weight stigma, a stressor experienced across all body sizes, may contribute to poorer physical health outcomes by activating the nervous and endocrine system or by triggering counterproductive health behaviors like lower physical activity, maladaptive eating patterns, and delayed health care, as well as provider bias that may cause a medical concern to be discounted. While associations of weight stigma with mental health issues are well documented, less is known about its association with physical health. METHODS We enrolled 3821 adults who completed an online survey assessing enacted weight stigma, weight self-stigma, multiple self-reported physical health outcomes, healthcare utilization, and selected health behaviors. RESULTS After controlling for BMI, health care delay or avoidance, sedentary behavior, and selected demographic characteristics, enacted weight stigma, significantly increased the odds of six physical health problems including hypertension (OR 1.36; CI 1.08, 1.72), hyperglycemia (OR 1.73; CI 1.29, 2.31), thyroid disorder, (OR 1.65; CI 1.27, 2.13), any arthritis (OR 1.70; CI 1.27, 2.26), non-arthritic chronic pain (OR 1.76; CI 1.4, 2.29), and infertility (OR 1.53; CI 1.14, 2.05). Weight self-stigma significantly increased the odds for three physical health problems including hypertension (OR 1.43; CI 1.16, 1.76), hyperglycemia (OR 1.37; CI 1.03, 1.81), and non-arthritic chronic pain (OR 1.5; CI 1.2,1.87). Enacted stigma was associated with more than a four-fold increase in odds of believing that a medical concern was disregarded by a health care provider. CONCLUSIONS In this study, enacted stigma and weight self-stigma were independently associated with heightened risk for multiple physical health problems, as well as, believing health concerns were discounted by providers. Reducing weight stigma may be an important component of managing multiple physical health conditions.
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McEntee ML, Philip SR, Phelan SM. Dismantling weight stigma in eating disorder treatment: Next steps for the field. Front Psychiatry 2023; 14:1157594. [PMID: 37113547 PMCID: PMC10126256 DOI: 10.3389/fpsyt.2023.1157594] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 03/20/2023] [Indexed: 04/29/2023] Open
Abstract
The authors posit current guidelines and treatment for eating disorders (EDs) fail to adequately address, and often perpetuate, weight stigma. The social devaluation and denigration of higher-weight individuals cuts across nearly every life domain and is associated with negative physiological and psychosocial outcomes, mirroring the harms attributed to weight itself. Maintaining focus on weight in ED treatment can intensify weight stigma among patients and providers, leading to increased internalization, shame, and poorer health outcomes. Stigma has been recognized as a fundamental cause of health inequities. With no clear evidence that the proposed mechanisms of ED treatment effectively address internalized weight bias and its association with disordered eating behavior, it is not hard to imagine that providers' perpetuation of weight bias, however unintentional, may be a key contributor to the suboptimal response to ED treatment. Several reported examples of weight stigma in ED treatment are discussed to illustrate the pervasiveness and insidiousness of this problem. The authors contend weight management inherently perpetuates weight stigma and outline steps for researchers and providers to promote weight-inclusive care (targeting health behavior change rather than weight itself) as an alternative approach capable of addressing some of the many social injustices in the history of this field.
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Affiliation(s)
- Mindy L. McEntee
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
- *Correspondence: Mindy L. McEntee,
| | - Samantha R. Philip
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
| | - Sean M. Phelan
- Division of Health Care Delivery Research, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, United States
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Martingano AJ, Telaak SH, Schopp EM, Fortney C, Dolwick AP, Carnell S, Batheja S, Persky S. Using Educational Videos and Perspective-Taking to Communicate Gene-By-Environment Interaction Concepts about Eating Behavior: Effects on Empathy and Weight Stigma. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:55-67. [PMID: 36621267 PMCID: PMC9833839 DOI: 10.1016/j.jneb.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 09/13/2022] [Accepted: 09/15/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE This study investigated whether education about gene-by-environment interaction (G × E) concepts could improve G × E knowledge and positively affect empathy and weight stigma. DESIGN We conducted a randomized trial using a 2 × 2 between-subjects design. SETTING Online. PARTICIPANTS Five hundred eighty-two American participants from the Prolific platform. INTERVENTION Participants were randomly assigned to watch an educational or a control video. Participants then watched a set of vignette scenarios that depicted what it is like to have a predisposition toward obesogenic eating behaviors from either a first-person or third-person perspective. MAIN OUTCOME MEASURE(S) Participants completed questionnaires measuring G × E knowledge, causal attributions, weight stigma, and empathy postintervention. ANALYSIS Two-by-two between-subjects ANOVAs and exploratory mediation analyses were conducted. RESULTS Participants who watched the educational video demonstrated greater G × E knowledge, reported higher empathy toward the characters in the vignette scenarios and held fewer stigmatizing attitudes (notably blame) toward individuals with higher weight. Exploratory mediation analyses indicated that the educational video led to these positive downstream effects by increasing the extent to which participants attributed genetic causes to eating behaviors. CONCLUSIONS AND IMPLICATIONS Education about G × E causes of eating behaviors can have beneficial downstream effects on attitudes toward people with higher weight.
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Affiliation(s)
- Alison Jane Martingano
- Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD
| | - Sydney H Telaak
- Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD
| | - Emma M Schopp
- Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD
| | - Christopher Fortney
- Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD
| | - Alexander P Dolwick
- Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD
| | - Susan Carnell
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD
| | - Sapna Batheja
- Department of Food and Nutrition Studies, College of Health and Human Services, George Mason University, Fairfax, VA
| | - Susan Persky
- Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD.
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Maxwell CV, Shirley R, O'Higgins AC, Rosser ML, O'Brien P, Hod M, O'Reilly SL, Medina VP, Smith GN, Hanson MA, Adam S, Ma RC, Kapur A, McIntyre HD, Jacobsson B, Poon LC, Bergman L, Regan L, Algurjia E, McAuliffe FM. Management of obesity across women's life course: FIGO Best Practice Advice. Int J Gynaecol Obstet 2023; 160 Suppl 1:35-49. [PMID: 36635081 PMCID: PMC10107516 DOI: 10.1002/ijgo.14549] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Obesity is a chronic, progressive, relapsing, and treatable multifactorial, neurobehavioral disease. According to the World Health Organization, obesity affects 15% of women and has long-term effects on women's health. The focus of care in patients with obesity should be on optimizing health outcomes rather than on weight loss. Appropriate and common language, considering cultural sensitivity and trauma-informed care, is needed to discuss obesity. Pregnancy is a time of significant physiological change. Pre-, ante-, and postpartum clinical encounters provide opportunities for health optimization for parents with obesity in terms of, but not limited to, fertility and breastfeeding. Pre-existing conditions may also be identified and managed. Beyond pregnancy, women with obesity are at an increased risk for gastrointestinal and liver diseases, impaired kidney function, obstructive sleep apnea, and venous thromboembolism. Gynecological and reproductive health of women living with obesity cannot be dismissed, with accommodations needed for preventive health screenings and consideration of increased risk for gynecologic malignancies. Mental wellness, specifically depression, should be screened and managed appropriately. Obesity is a complex condition and is increasing in prevalence with failure of public health interventions to achieve significant decrease. Future research efforts should focus on interprofessional care and discovering effective interventions for health optimization.
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Affiliation(s)
- Cynthia V Maxwell
- Maternal Fetal Medicine; Sinai Health and Women's College Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Rachelle Shirley
- Maternal Fetal Medicine, Sinai Health, University of Toronto, Toronto, Ontario, Canada
| | - Amy C O'Higgins
- Maternal Fetal Medicine, Sinai Health, University of Toronto, Toronto, Ontario, Canada
| | - Mary L Rosser
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York-Presbyterian, New York, New York, USA
| | - Patrick O'Brien
- Institute for Women's Health, University College London, London, UK
| | - Moshe Hod
- Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sharleen L O'Reilly
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland.,School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
| | - Virna P Medina
- Department of Obstetrics and Gynecology, Faculty of HealthUniversidad del Valle, Clínica Imbanaco Quirón Salud, Universidad Libre, Cali, Colombia
| | - Graeme N Smith
- Department of Obstetrics and Gynecology, Kingston Health Sciences Centre, Queen's University, Kingston, Ontario, Canada
| | - Mark A Hanson
- Institute of Developmental Sciences, University Hospital Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Sumaiya Adam
- Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.,Diabetes Research Centre, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Ronald C Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, SAR, China.,Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Anil Kapur
- World Diabetes Foundation, Bagsvaerd, Denmark
| | - Harold David McIntyre
- Mater Health, University of Queensland, Mater Health Campus, South Brisbane, Queensland, Australia
| | - Bo Jacobsson
- Department of Obstetrics and Gynecology, Sahlgrenska University Hospital/Ostra, Gothenburg, Sweden.,Department of Genetics and Bioinformatics, Domain of Health Data and Digitalisation, Institute of Public Health, Oslo, Norway
| | - Liona C Poon
- Department of Obstetrics and Gynecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, SAR, China
| | - Lina Bergman
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Obstetrics and Gynecology, Stellenbosch University, Cape Town, South Africa.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | - Esraa Algurjia
- The World Association of Trainees in Obstetrics & Gynecology, Paris, France.,Elwya Maternity Hospital, Baghdad, Iraq
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
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Graham Y, Hayes C, Mahawar K, Tahrani A, López Landiribar JM, Martinez P. Social Aspects of Bariatric Surgery. OBESITY, BARIATRIC AND METABOLIC SURGERY 2023:1299-1310. [DOI: 10.1007/978-3-030-60596-4_116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Conradson HE, Hayden KA, Russell‐Mayhew S, Raffin Bouchal S, King‐Shier K. Positive psychological well-being in women with obesity: A scoping review of qualitative and quantitative primary research. Obes Sci Pract 2022; 8:691-714. [PMID: 36483121 PMCID: PMC9722462 DOI: 10.1002/osp4.605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 03/30/2022] [Accepted: 04/06/2022] [Indexed: 11/12/2022] Open
Abstract
Background Positive psychological well-being (PPWB) is generally associated with improved physical health, mental well-being, and healthy behaviors. However, it is not clear how PPWB differs in women with obesity or if improving PPWB will improve their health. The objective of this study was to summarize the evidence on PPWB in women with obesity. Method A scoping review was conducted in APA PsycINFO, EMBASE, MEDLINE, Cochrane Central Register of Controlled Trials, CINAHL, SocINDEX, Family & Society Studies Worldwide, ProQuest Dissertations and Theses Global databases. Primary research studies, with an analysis of adult women with a BMI ≥30 kg/m2 with measures of PPWB are included. Results Thirty-two studies encompassing >57,000 women with obesity, measured constructs of PPWB included: self-esteem, life satisfaction, positive affect, social support, vitality, happiness, self-acceptance, and optimism. Most studies showed that PPWB was lower in women with obesity although this association dissipated in studies when health and negative social factors were considered. Improvements in PPWB were associated with weight loss and with successful lifestyle changes with and without weight loss. Positive psychological interventions (PPIs) were used to bolster psychological well-being. PPIs were associated with improved measures of self-esteem and well-being. Conclusions Prospective longitudinal and intervention studies are required to understand how evaluating and fostering PPWB might support gender-informed obesity care.
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Affiliation(s)
| | - K. Alix Hayden
- Libraries & Cultural ResourcesUniversity of CalgaryCalgaryAlbertaCanada
| | - Shelly Russell‐Mayhew
- Counselling PsychologyWerklund School of EducationUniversity of CalgaryCalgaryAlbertaCanada
| | | | - Kathryn King‐Shier
- Faculty of NursingDepartment of Community Health SciencesUniversity of CalgaryCalgaryAlbertaCanada
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Macho S, Andrés A, Saldaña C. Anti-fat attitudes among Spanish general population: Psychometric properties of the anti-fat attitudes scale. Clin Obes 2022; 12:e12543. [PMID: 35848847 PMCID: PMC9786687 DOI: 10.1111/cob.12543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/26/2022] [Accepted: 06/22/2022] [Indexed: 12/30/2022]
Abstract
Weight discrimination is one of the worst forms of prejudice and is deeply rooted in society. The aim of this study was to adapt the anti-fat attitudes scale (AFA) to the Spanish general population. The sample consisted of 1248 participants from the Spanish community population. They were recruited through the internet and participated voluntarily. Women (77.8%) were more predominant than men. Regarding body weight categories, 5.3% were underweight, 43.5% were normal-weight, 24.9% were overweight and 26.3% had obesity. A cross-validation method with an exploratory and confirmatory factor analysis confirmed the three-factor structure of the AFA. The Spanish version of the AFA showed a satisfactory internal consistency for all three factors, as well as adequate test-retest reliability after a 1-month interval. Finally, the Spanish version of the AFA seems to be an adequate tool to assess negative attitudes towards obesity in both clinical and research settings. Men presented more negative attitudes towards obesity and were convinced that obesity is under someone's control. Women presented more fear of gaining weight. Normal-weight people were those who discriminated more. Participants with overweight or obesity suffered more fear of gaining weight. There was no intra-group discrimination between individuals with overweight and obesity.
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Affiliation(s)
- Sergio Macho
- Departament de Psicologia Clínica i PsicobiologiaUniversitat de Barcelona (UB), Passeig Vall d'Hebron171, 08035BarcelonaSpain
| | - Ana Andrés
- Faculty of Psychology, Education and Sport SciencesRamon Llull UniversityBarcelonaSpain
| | - Carmina Saldaña
- Departament de Psicologia Clínica i PsicobiologiaUniversitat de Barcelona (UB), Passeig Vall d'Hebron171, 08035BarcelonaSpain
- Institut de NeurociènciesUniversitat de Barcelona (UB)BarcelonaSpain
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Borgatti AC, Crockett KB, Jacob AE, Davis AL, Dutton GR. Correlates of psychological distress among adults with obesity during the COVID-19 pandemic. Psychol Health 2022; 37:1547-1564. [PMID: 35156476 PMCID: PMC9946156 DOI: 10.1080/08870446.2022.2038790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 11/03/2021] [Accepted: 01/04/2022] [Indexed: 02/01/2023]
Abstract
OBJECTIVE The present study evaluated changes in stress and loneliness among participants with obesity engaged in weight loss self-management in the United States (US) during COVID-19, and identified factors that may increase risk or protect against psychosocial distress during this time. DESIGN Participants who were enrolled in a weight self-management program prior to the COVID-19 pandemic (N = 55, 91% female, 36% Caucasian, mean age = 49.8 years) completed an online survey about social, economic and health behaviour changes during COVID-19 and their relationship to changes in perceived stress and loneliness. MAIN OUTCOME MEASURES Perceived Stress (PSS-4), Loneliness (PROMIS loneliness and social isolation questionnaire). RESULTS Compared to pre-COVID assessments, stress and loneliness increased 40% two months into the COVID-19 pandemic-related shutdown. Higher body mass index (BMI) and social distancing were associated with increases in both loneliness and stress. Alcohol intake was associated with increased stress, and working from home was associated with increased loneliness. CONCLUSION Individuals with obesity endorsed increased stress and loneliness during COVID-19, which may be exacerbated among those with a higher BMI and greater adherence to social distancing guidelines. Ongoing attention to psychosocial well-being among individuals with obesity will remain imperative both during the ongoing pandemic and beyond.
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Affiliation(s)
- Alena C Borgatti
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham (UAB), Birmingham, AL, USA
- Department of Psychology, UAB, Birmingham, AL, USA
| | - Kaylee B Crockett
- Department of Health Care Organization and Policy, School of Public Health, UAB, Birmingham, AL, USA
| | | | - Andrea L Davis
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham (UAB), Birmingham, AL, USA
- Department of Psychology, UAB, Birmingham, AL, USA
| | - Gareth R Dutton
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham (UAB), Birmingham, AL, USA
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Andrés A, Fornieles-Deu A, Sepúlveda AR, Beltrán-Garrayo L, Montcada-Ribera A, Bach-Faig A, Sánchez-Carracedo D. Spanish validation of the Modified Weight Bias Internalization Scale (WBIS-M) for adolescents. Eat Weight Disord 2022; 27:3245-3256. [PMID: 35902481 PMCID: PMC9333680 DOI: 10.1007/s40519-022-01453-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 07/14/2022] [Indexed: 01/04/2023] Open
Abstract
PURPOSE Weight Bias Internalization (WBI) is pervasive and potentially damaging for health. Little is known about WBI in youth. As negative effects of WBI have been observed when controlling for BMI, measures that allow WBI to be assessed across different weight categories are needed. The Modified Weight Bias Internalization Scale (WBIS-M) is one of the most frequently used scales in this field. Our purpose was to obtain a Spanish validated version of the WBIS-M for adolescents across different weight statuses. METHODS The data were collected from 298 secondary students (mean age 14.31; 48.32% girls; 18.8% were overweight and 6.4% had obesity). Internal structure was examined by a cross-validation analysis, using both exploratory and confirmatory factor analyses in different subsamples. RESULTS Item 1 showed a psychometric anomalous functioning and was deleted. The one-factor structure of the 10-item version was confirmed with adequate fit ([EFA (KMO = 0.915, χ2(55) = 1075.633, p < 0.0001)]; [CFA (χ2(35) = 200.515; GFI = 0.995; PGFI = 0.992; NFI = 0.991; SRMR = 0.060)]). Internal consistency was high [Formula: see text] ω = 0.93). Significant correlations with the same set of external variables assessed in the original version (anti-fat bias, self-esteem, mood, body dissatisfaction, drive for thinness, binge eating), all of them correlates of WBI in adolescents, were found. Girls and participants with obesity obtained higher scores. CONCLUSION The results provide support for the validity and reliability of our WBIS-M version for use with adolescents across weight categories in Spain. LEVEL OF EVIDENCE Level III, evidence obtained from well-designed cohort studies.
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Affiliation(s)
- Ana Andrés
- Faculty of Psychology, Education and Sport Sciences, Blanquerna, Ramon Llull University, Barcelona, Spain
| | - Albert Fornieles-Deu
- Eating and Weight-Related Problems Unit, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
- Department of Psychobiology and Methodology of Health Sciences, Serra Hunter Fellow, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - Ana Rosa Sepúlveda
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, 28049 Madrid, Spain
| | - Lucía Beltrán-Garrayo
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, 28049 Madrid, Spain
| | - Albert Montcada-Ribera
- Head of Community and Health Service, City Council of Terrassa, Social Rights Section, Barcelona, Spain
| | - Anna Bach-Faig
- FoodLab Research Group (2017SGR 83, Faculty of Health Sciences, Universitat Oberta de Catalunya (Open University of Catalonia, UOC), 08018 Barcelona, Spain
- Food and Nutrition Area, Barcelona Official College of Pharmacists, 08009 Barcelona, Spain
| | - David Sánchez-Carracedo
- Eating and Weight-Related Problems Unit, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
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66
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Heslehurst N, Evans EH, Incollingo Rodriguez AC, Nagpal TS, Visram S. Newspaper media framing of obesity during pregnancy in the UK: A review and framework synthesis. Obes Rev 2022; 23:e13511. [PMID: 36268693 PMCID: PMC9788256 DOI: 10.1111/obr.13511] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 09/29/2022] [Accepted: 10/05/2022] [Indexed: 12/30/2022]
Abstract
Two thirds of women report experiencing weight stigma during pregnancy. Newspaper media is powerful in framing health issues. This review synthesized UK newspaper media portrayal of maternal obesity. NexisUni was searched to identify newspaper articles, published January 2010 to May 2021, reporting content on obesity during pregnancy. Framework synthesis integrated quantitative and qualitative analysis of the content of articles. There were 442 articles included (59% tabloids and 41% broadsheets). Three overarching themes with interacting sub-themes were as follows: (1) Women were blamed for their weight, risks, and NHS impact. (2) Women were solely responsible for solving obesity, gendered from school age. (3) Women with obesity were a burden on individuals (e.g., themselves, their children, and health professionals), to society, and the NHS. Catastrophizing language framed the "problem," "scale," and "public health concern" of maternal obesity, emphasizing risk, and danger and was alarmist, aggressive, and violent as to elicit fear or devalue women. Articles platformed 'expert' voices rather than women's lived experiences. This review identified that UK newspaper media negatively frames and oversimplifies the topic of maternal obesity. Exposure to blaming and alarmist messaging could increase women's guilt, stigma, and internalized weight bias. The newspaper media should be harnessed to de-stigmatize maternal obesity and promote maternal well-being.
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Affiliation(s)
- Nicola Heslehurst
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | | | | | - Taniya S Nagpal
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, Canada
| | - Shelina Visram
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Gueltzow M, Bijlsma MJ, van Lenthe FJ, Myrskylä M. The Contribution of Health Behaviors to Depression Risk Across Birth Cohorts. Epidemiology 2022; 33:880-889. [PMID: 35944161 PMCID: PMC9531992 DOI: 10.1097/ede.0000000000001524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 07/11/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND More recent birth cohorts are at a higher depression risk than cohorts born in the early 20th century. We aimed to investigate to what extent changes in alcohol consumption, smoking, physical activity, and obesity contribute to these birth cohort variations. METHODS We analyzed panel data from US adults born 1916-1966 enrolled in the Health and Retirement Study (N = 163,760 person-years). We performed a counterfactual decomposition analysis by combining age-period-cohort models with g-computation. We thereby compared the predicted probability of elevated depressive symptoms (CES-D 8 score ≥3) in the natural course to a counterfactual scenario where all birth cohorts had the health behaviors of the 1945 birth cohort. We stratified analyses by sex and race-ethnicity. RESULTS We estimated that depression risk of the 1916-1949 and 1950-1966 birth cohort would be on average 2.0% (-2.3 to -1.7) and 0.5% (-0.9 to -0.1) higher with the alcohol consumption levels of the 1945 cohort. In the counterfactual with the 1945 BMI distribution, depression risk is on average 2.1% (1.8 to 2.4) higher for the 1916-1940 cohorts and 1.8% (-2.2 to -1.5) lower for the 1950-1966 cohorts. We find no cohort variations in depression risk for smoking and physical activity. The contribution of alcohol is more pronounced for Whites than for other race-ethnicity groups, and the contribution of BMI more pronounced for women than for men. CONCLUSION Increased obesity levels were associated with exacerbated depression risk in recent birth cohorts in the United States, while drinking patterns only played a minor role.
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Affiliation(s)
- Maria Gueltzow
- From the Max Planck Institute for Demographic Research, Rostock, Germany
- Public Health Department, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Maarten J. Bijlsma
- From the Max Planck Institute for Demographic Research, Rostock, Germany
- Unit PharmacoTherapy, -Epidemiology, and -Economics (PTEE), Groningen Research Institute of Pharmacy, University of Groningen, the Netherlands
| | - Frank J. van Lenthe
- Public Health Department, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Mikko Myrskylä
- From the Max Planck Institute for Demographic Research, Rostock, Germany
- Center for Social Data Science, University of Helsinki, Helsinki, Finland
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68
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Simone M, Slaughter‐Acey J, Hazzard VM, Eisenberg M, Neumark‐Sztainer D. Exploring the intersection of multiple social determinants of health and disordered eating behaviors in a population-based sample in the United States. Int J Eat Disord 2022; 55:1589-1602. [PMID: 36324296 PMCID: PMC9633979 DOI: 10.1002/eat.23795] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/25/2022] [Accepted: 07/25/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Disordered eating behaviors (DEBs) have long-term, deleterious effects on health and are more prevalent among socially marginalized groups, likely as a result of systemic inequities across social determinants of health (SDoH). This exploratory study aimed to identify subgroups of emerging adults characterized by main and interactive associations between SDoH and two forms of DEB (binge eating, extreme unhealthy weight control behaviors). METHOD Participants (n = 1568; age 22.2 ± 2.1 years) from the United States were drawn from the EAT 2010-2018 longitudinal study. Conditional inference tree (CIT) analyses derived main and intersecting SDoH related to DEB across 33 input variables collected during adolescence and emerging adulthood. RESULTS The binge eating CIT revealed five subgroups (prevalence: 6.3-23.2%) shaped by variables collected during emerging adulthood: appearance-based teasing (p < .001), financial difficulty (p = .003), gender (p < .001), and everyday discrimination (p = .008). The CIT results for extreme unhealthy weight control behaviors derived six subgroups (prevalence: 2.3-45.5%) shaped by weight teasing (p < .001) and gender (p < .001) during emerging adulthood and public assistance (p = .008) and neighborhood safety (p = .007) in adolescence. DISCUSSION This exploratory study revealed distinct subgroups of emerging adults with varying DEB prevalence, suggesting that variability in DEB prevalence may be partially explained by intersecting SDoH during adolescence and emerging adulthood. Hypothesis-driven research and replication studies are needed to further explore the associations between SDoH and DEB during emerging adulthood. PUBLIC SIGNIFICANCE STATEMENT Disordered eating behaviors are common among young people in the United States and have long-term health consequences. This exploratory study identified subgroups of young people, characterized by combinations of social inequities (e.g., financial difficulties, teasing). Results highlight high-risk subgroups of emerging adults that should be examined further in hypothesis-driven research.
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Affiliation(s)
- Melissa Simone
- Division of Epidemiology and Community HealthUniversity of Minnesota School of Public HealthMinneapolisMinnesotaUSA
| | - Jaime Slaughter‐Acey
- Division of Epidemiology and Community HealthUniversity of Minnesota School of Public HealthMinneapolisMinnesotaUSA
| | - Vivienne M. Hazzard
- Division of Epidemiology and Community HealthUniversity of Minnesota School of Public HealthMinneapolisMinnesotaUSA
| | - Marla Eisenberg
- Department of PediatricsUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA
| | - Dianne Neumark‐Sztainer
- Division of Epidemiology and Community HealthUniversity of Minnesota School of Public HealthMinneapolisMinnesotaUSA
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69
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Jaensson M, Josefsson E, Stenberg E, Dahlberg K. Do reasons for undergoing bariatric surgery influence weight loss and health-related quality of life?-A Swedish mixed method study. PLoS One 2022; 17:e0275868. [PMID: 36215261 PMCID: PMC9550063 DOI: 10.1371/journal.pone.0275868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 09/23/2022] [Indexed: 11/06/2022] Open
Abstract
Background A wish for improved health or avoidance of ill health is often given as reason for wanting to undergo bariatric surgery. How such reasons relate to postoperative outcome is unclear. Objective The aim was to explore Swedish patients’ reasons for undergoing bariatric surgery. Also, we wanted to analyze if there were sex and age differences and associations with weight loss and health-related quality of life (HRQoL). Settings This was a single-center study conducted at a university hospital. Method Data on 688 patients (528 women and 160 men) including a free text response was analyzed inductively and deductively using predefined statements and was merged with data from the Scandinavian Obesity Surgery Registry. All data was analyzed using descriptive and analytic statistics. Result The most common reason for undergoing bariatric surgery was pain in different body parts. A wish for an improved medical condition was reported by most patients (59%, n = 408), followed by physical limitations making daily life difficult (42%, n = 288). Men and women reported similar reasons. Younger patients were more distressed about physical appearance (p = 0.001) and older patients wanted to improve their medical condition (p = 0.013). Health-related quality of life improved irrespective of reasons for undergoing surgery. Conclusion The most reported reasons for undergoing bariatric surgery were a wish for improved medical condition and to make daily life easier. Factors associated with the decision for surgery showed that there were few sex differences, but age seemed to be a factor. The HRQoL trajectory showed improvement regardless of reasons for undergoing surgery.
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Affiliation(s)
- Maria Jaensson
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
- * E-mail:
| | - Emma Josefsson
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Erik Stenberg
- Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Karuna Dahlberg
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
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70
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Galán CA, Meza JI, Ridenour TA, Shaw DS. Racial Discrimination Experienced by Black Parents: Enduring Mental Health Consequences for Adolescent Youth. J Am Acad Child Adolesc Psychiatry 2022; 61:1251-1261. [PMID: 35513191 DOI: 10.1016/j.jaac.2022.04.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 12/19/2021] [Accepted: 04/25/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Despite evidence linking experiences of racial discrimination by Black parents and problem behaviors in youth, little is known about the mechanisms that explain this link. To elucidate these developmental pathways, a serial mediation model was tested, in which Black parents' experiences of racial discrimination were hypothesized to predict increased parental depression and parent-child conflict in early adolescence, which in turn would be associated with youth depression, anxiety, and conduct problems in early to mid-adolescence. METHOD Participants were 252 Black parent-child dyads. Youth (56% female) were on average 11.98 years old at study entry (wave 1). Parents and youth completed questionnaires during a home-based assessment at wave 1 and were assessed again 1 and 2 years later (waves 2 and 3). RESULTS Black parents' experiences of racial discrimination at wave 1 were linked to higher levels of parent-child conflict at wave 2 (0.20; 95% CI [0.05, 0.33]), which in turn predicted greater youth-reported depression at wave 3 (0.30; 95% CI [0.15, 0.47]). There was a significant indirect effect of racial discrimination on youth-reported depression via parent-child conflict (indirect effect: 0.06, 95% CI [0.02, 0.10]). Findings were replicated across multiple outcomes (ie, depression, anxiety, conduct problems) and multiple informants (ie, youth report, parent report). There was no evidence to support a serial mediation model via parental depression and then parent-child conflict. CONCLUSION This study identified a developmental pathway from Black parents' experiences of racial discrimination to adolescent problem behaviors via parent-child conflict. Findings may inform interventions aimed at promoting resilience in parents and youth faced with pervasive racism. CLINICAL TRIAL REGISTRATION INFORMATION Substance Use Screening and Prevention for Adolescents in Pediatric Primary Care (SKY); https://clinicaltrials.gov/; NCT03074877.
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71
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Harwood A, Carter D, Eliott J. A public health framework for reducing stigma: the example of weight stigma. JOURNAL OF BIOETHICAL INQUIRY 2022; 19:511-520. [PMID: 35857213 PMCID: PMC9463314 DOI: 10.1007/s11673-022-10199-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 04/01/2022] [Indexed: 05/15/2023]
Abstract
We examine stigma and how it operates, then develop a novel framework to classify the range of positions that are conceptually possible regarding how stigma ought to be handled from a public health perspective. In the case of weight stigma, the possible positions range from encouraging the intentional use of weight stigma as an obesity prevention and reduction strategy to arguing not only that this is harmful but that weight stigma, independent of obesity, needs to be actively challenged and reduced. Using weight stigma as an illustrative example, we draw on prior theoretical work on stigma mechanisms and intervention strategies to develop a framework for improving the understanding, evaluation, and planning of anti-stigma interventions. This framework has the potential to help public health actors to map out how protest, contact, education, and regulation strategies can be used to reduce direct discrimination, structural discrimination, and internalized stigma (self-stigma).
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Affiliation(s)
- Alison Harwood
- The Office of Research Ethics, Compliance and Integrity, The University of Adelaide, Adelaide, South Australia 5005 Australia
| | - Drew Carter
- Adelaide Health Technology Assessment, School of Public Health, The University of Adelaide, Adelaide, South Australia 5005 Australia
| | - Jaklin Eliott
- Associate Professor, School of Public Health, The University of Adelaide, Adelaide, South Australia 5005 Australia
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Godbolt D, Opara I, Amutah-Onukagha N. Strong Black Women: Linking Stereotypes, Stress, and Overeating Among a Sample of Black Female College Students. JOURNAL OF BLACK STUDIES 2022; 53:609-634. [PMID: 36710718 PMCID: PMC9881457 DOI: 10.1177/00219347221087453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
This qualitative study examines how the "Strong Black Woman" (SBW) label can have potentially negative health effects for African American/Black women that contribute to eating disorders. This study addresses the gap in literature on racial disparities that are present in understanding eating disorders that contribute to obesity and obesityrelated issues. Through semi-structured individual interviews conducted with (N = 11) Black female higher education students, participants were able to discuss how disorganized overeating patterns were associated with the emotional stress of being labeled a Strong Black Woman. Findings provide implications to clinicians, educators, and researchers by identifying stress inducing factors heightened by racist and sexist microaggressions that contribute to the mental and physical health of Black women. This study also adds to the limited literature on the intersection of racism and sexism that contribute to poor health outcomes in Black women.
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Affiliation(s)
- Dawn Godbolt
- National Partnership for Women & Families, Washington, DC, USA
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73
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Decker KM, Philip SR, Thurston IB. Measuring weight- and shape-based social identity threat vulnerability in young adults. Body Image 2022; 42:136-144. [PMID: 35714420 DOI: 10.1016/j.bodyim.2022.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 06/03/2022] [Accepted: 06/04/2022] [Indexed: 11/26/2022]
Abstract
This study assessed the factor structure of a novel self-report measure of weight- and shape-based social identity threat vulnerability, Social Identities and Attitudes Scale-Weight and Body Shape (SIAS-WBS). Weight and race diverse young adults (N = 542; Mage=21.69 +2.32; 69% ciswomen) were recruited from Amazon Mechanical Turk and a university participant pool. Exploratory and confirmatory factor analyses, measurement invariance, internal consistency, convergent validity, and test-retest reliability were conducted. The SIAS-WBS had acceptable factor structure with 15 subscales that were invariant across race, ethnicity, gender, weight perception, and CDC-defined weight groups. The measure demonstrated high internal consistency, convergent validity, and good test-retest reliability. Subscales were Weight & Shape Identification (Influence and Centrality), Weight & Shape Stigma Consciousness, six identification and six negative affect factors across the domains of: Social, Familial, Romantic, Intellectual, Physical Activity, and Physical Attractiveness. Participants in higher weight groups who perceived themselves as lower weight status, reported lower Weight & Shape Identification-Influence (p = 0.02) and lower Stigma Consciousness (p = 0.01), relative to those perceiving themselves as higher weight status. Participants perceiving themselves as higher weight status endorsed lower Physical Activity Identification (p < 0.001) and more negative affect across all domains (p's < 0.02). This suggests that weight misperceivers may be less susceptible to weight-based identity threat.
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Affiliation(s)
- Kristina M Decker
- Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
| | - Samantha R Philip
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, USA
| | - Idia B Thurston
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, USA; Department of Health Promotion and Community Health Sciences, Texas A&M Health, College Station, TX, USA; Department of Psychology, The University of Memphis, Memphis, TN, USA
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74
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Sarwer DB, Siminoff LA, Gardiner HM, Spitzer JC. The psychosocial burden of visible disfigurement following traumatic injury. Front Psychol 2022; 13:979574. [PMID: 36110275 PMCID: PMC9468754 DOI: 10.3389/fpsyg.2022.979574] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 07/21/2022] [Indexed: 12/15/2022] Open
Abstract
Hundreds of thousands of individuals experience traumatic injuries each year. Some are mild to moderate in nature and patients experience full functional recovery and little change to their physical appearance. Others result in enduring, if not permanent, changes in physical functioning and appearance. Reconstructive plastic surgical procedures are viable treatments options for many patients who have experienced the spectrum of traumatic injuries. The goal of these procedures is to restore physical functioning and reduce the psychosocial burden of living with an appearance that may be viewed negatively by the patient or by others. Even after receipt of reconstructive procedures, many patients are left with residual disfigurement. In some, disability and disfigurement may be so profound that individuals are candidates for vascularized composite allotransplantation (VCA) procedures, i.e., the transplantation of a vascularized human body part containing multiple tissue types (skin, muscle, bone, nerves, and blood vessels) as an anatomical and/or structural unit. This narrative review paper summarizes the literature on the psychosocial burden experienced by those who have visible disfigurement. While many of these individuals experience stigma and discrimination, relatively few studies have employed a stigma framework to understand the psychosocial sequelea. This paper briefly addresses this framework. Last, particular focus is given to the psychosocial issues of individuals with particularly severe injuries who are potential candidates for VCA procedures.
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Affiliation(s)
- David B. Sarwer
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, United States
- *Correspondence: David B. Sarwer,
| | - Laura A. Siminoff
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, United States
| | - Heather M. Gardiner
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, United States
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Mishali M, Kisner M. Psycho-behavioral Factors Related to Weight Regain After Bariatric Surgery. Obes Surg 2022; 32:3041-3046. [PMID: 35819696 DOI: 10.1007/s11695-022-06195-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 06/28/2022] [Accepted: 06/28/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the connection between weight regain 2 to 5 years after bariatric surgery and three psycho-behavioral factors: mental health, general health efficacy, and emotional regulation. METHOD A convenience sample of 120 participants was recruited, 80 of whom had already had bariatric surgery 2 to 5 years earlier, whereas 40 were candidates for such procedure but did not undergo it yet. Each participant filled a consent form, a socio-demographic one, and extra three questionnaires related to socio-behavioral characteristics: Mental Health Inventory (MHI), General Self-efficacy (GSE), and Difficulty in Emotional Regulation Scale (DERS). SPSS version 25 was used to analyze the data, and a one-sample Kolmogorov-Smirnov test was conducted to examine the distribution of the continuous variables. RESULTS Those in the non-reducers group experienced (2.19 ± 0.63) greater difficulties than the reducers group (1.82 ± 0.39) when it came to their emotional regulation, whereas the candidate group (1.96 ± 0.47) were situated in-between the groups already operated in terms of their DERS scores (p = 0.008). The reducers group had higher GSE scores (2.75 ± 0.35) than the non-reducers group (2.59 ± 0.39) (p = 0.03). CONCLUSIONS Effective emotional regulation is linked to weight loss maintenance after bariatric surgery. Difficulties in emotional regulation are negatively correlated with maintaining weight loss among bariatric patients who undergo surgery. General self-efficacy is positively correlated with weight loss maintenance after bariatric surgery.
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Affiliation(s)
- Moshe Mishali
- School of Public Health, University of Haifa, 199 Aba Khoushy Ave., Mount Carmel, ZIP Code 3498838, Haifa, Israel
| | - Mirit Kisner
- A. Mishali Counselling Services, Remez St. 47, ZIP Code 3604447, Kiryat Tivon, Israel.
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Hoffmann K, Paczkowska A, Bryl W, Marzec K, Raakow J, Pross M, Berghaus R, Nowakowska E, Kus K, Michalak M. Comparison of Perceived Weight Discrimination between Polish and German Patients Underwent Bariatric Surgery or Endoscopic Method versus Conservative Treatment for Morbid Obesity: An International Multicenter Study. Nutrients 2022; 14:2775. [PMID: 35807955 PMCID: PMC9268827 DOI: 10.3390/nu14132775] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/29/2022] [Accepted: 07/02/2022] [Indexed: 02/04/2023] Open
Abstract
Objectives: The aim of this study was to compare the level of discrimination among patients with obesity living in Poland and Germany. Methods: This was a retrospective cross-sectional international multicenter survey study including 564 adult participants treated for morbid obesity at selected healthcare facilities in Germany (210 patients) and in Poland (354 patients). Discrimination was evaluated using a custom-made questionnaire based on the related literature. Results: The level of obesity discrimination did not differ between German and Polish patients (p = 0.4282). The presence of obesity was reported to be associated to a large or a very large extent with the feeling of social exclusion and discrimination by 46.63% of German participants and 42.09% of Polish ones (p = 0.2934). The mean level of discrimination related to the lack of employment was higher in patients who underwent bariatric surgery or endoscopic method than in those who underwent conservative treatment (for Germany: 2.85 ± 1.31 (median, 3) vs. 2.08 ± 1.31 (median, 1), p = 0.002; for Poland: 2.43 ± 1.15 (median, 2) vs. 1.93 ± 1.15 (median, 1), p = 0.005). The level of discrimination was associated with sex, age, the degree of obesity, and treatment-related weight loss (p < 0.05). Conclusions: Our findings confirm that obesity significantly affects the social and economic well-being of patients. There is a great need to reduce weight stigma and to take measures to alleviate the socioeconomic and psychological burden of obesity.
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Affiliation(s)
- Karolina Hoffmann
- Department of Internal Diseases, Metabolic Disorders and Arterial Hypertension, Poznan University of Medical Sciences, 60-806 Poznań, Poland;
| | - Anna Paczkowska
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, 60-806 Poznań, Poland; (A.P.); (K.M.); (K.K.)
| | - Wiesław Bryl
- Department of Internal Diseases, Metabolic Disorders and Arterial Hypertension, Poznan University of Medical Sciences, 60-806 Poznań, Poland;
| | - Kinga Marzec
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, 60-806 Poznań, Poland; (A.P.); (K.M.); (K.K.)
| | - Jonas Raakow
- Department of Surgery, Campus Charité Mitte, Campus Virchow Klinikum, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany;
| | - Matthias Pross
- Department of Surgery, DRK Kliniken Berlin, Köpenick, 12559 Berlin, Germany; (M.P.); (R.B.)
| | - Rafael Berghaus
- Department of Surgery, DRK Kliniken Berlin, Köpenick, 12559 Berlin, Germany; (M.P.); (R.B.)
| | - Elżbieta Nowakowska
- Department of Pharmacology and Toxicology, Institute of Health Sciences, Collegium Medicum, University of Zielona Góra, 65-516 Zielona Góra, Poland;
| | - Krzysztof Kus
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, 60-806 Poznań, Poland; (A.P.); (K.M.); (K.K.)
| | - Michał Michalak
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, 60-806 Poznań, Poland;
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77
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Lee KM, Arriola-Sanchez L, Lumeng JC, Gearhardt A, Tomiyama AJ. Weight Stigma by Association Among Parents of Children With Obesity: A Randomized Trial. Acad Pediatr 2022; 22:754-760. [PMID: 34610460 DOI: 10.1016/j.acap.2021.09.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 09/22/2021] [Accepted: 09/25/2021] [Indexed: 11/01/2022]
Abstract
OBJECTIVE To experimentally test weight stigma and weight stigma by association in a parent-child relationship using a large, community-based sample. METHODS We conducted a randomized experiment on Amazon Mechanical Turk using an online survey. Participants were randomly assigned to view a picture of a parent-child dyad, for which the parent and child's gender (male vs. female) and weight status (with obesity vs. without obesity) were manipulated. Participants read identical parenting descriptions that adhered to the American Academy of Pediatrics' parenting recommendations, then rated the parent's perceived effectiveness, helpfulness, and level of caring using a parenting questionnaire based on Barnhart et al (2013). RESULTS Participants (N = 1862; Mage = 36.8 [11.2] years) rated parents of children with obesity as less effective compared to parents of children without obesity (P = .010) and parents with obesity as less effective compared to parents without obesity (P = .033). Participants also rated parents with obesity as less helpful compared to parents without obesity (P = .021). No differences emerged in perceived caring. Parenting evaluations did not differ across daughters versus sons or mothers versus fathers. CONCLUSIONS Parents of children with obesity may experience weight stigma by association, which could have direct consequences for the parents, the children, and the parent-child relationship.
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Affiliation(s)
- Kristen M Lee
- Department of Psychology, University of California, Los Angeles (KM Lee, L Arriola-Sanchez, and AJ Tomiyama)
| | - Lauren Arriola-Sanchez
- Department of Psychology, University of California, Los Angeles (KM Lee, L Arriola-Sanchez, and AJ Tomiyama)
| | - Julie C Lumeng
- Department of Pediatrics, Medical School, and Department of Nutritional Sciences, School of Public Health, University of Michigan (JC Lumeng), Ann Arbor, Mich
| | - Ashley Gearhardt
- Department of Psychology, University of Michigan (A Gearhardt), Ann Arbor, Mich
| | - A Janet Tomiyama
- Department of Psychology, University of California, Los Angeles (KM Lee, L Arriola-Sanchez, and AJ Tomiyama).
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78
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Martin-Wagar CA, Weigold IK. Internalized Stigma as a Transdiagnostic Factor for Women with Eating Disorders. Eat Disord 2022; 31:173-190. [PMID: 35770871 DOI: 10.1080/10640266.2022.2095481] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
This study aimed to examine how internalized weight bias (IWB), body surveillance, and body shame relate to eating pathology in women with diagnosed eating disorders (EDs) across the weight spectrum. Previous research has examined these variables in primarily non-clinical populations, binge eating disorder, and higher weight populations. In a sample of 98 women with diagnosed EDs, the association of IWB, body surveillance, and body shame on the severity of ED symptoms was examined with hierarchical multiple regression analyses. Results indicate that IWB, body surveillance, and body shame significantly predicted global eating pathology, F (4, 93) = 40.74, p < .001. IWB, body surveillance, and body shame related to global eating pathology, even after controlling for previous weight bias experiences. Analyses with specific symptom clusters found that only body surveillance predicted dietary restraint, only IWB and body shame predicted overvaluation of shape/weight, and only IWB predicted body dissatisfaction. The findings in this study provide initial support for internalized stigma variables (IWB, body surveillance, and body shame) related to ED pathology in a transdiagnostic clinical eating disorder sample across the weight spectrum. Results suggest that further examination of internalized stigma is needed within ED treatment.
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Bombak A, Robinson E, Hughes K, Riediger N, Thomson L. “Mommy-see, mommy-do”: perceptions of intergenerational “obesity” transmission among lower-income, higher-weight, rural midwestern American women. FOOD AND FOODWAYS 2022. [DOI: 10.1080/07409710.2022.2089825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Andrea Bombak
- Department of Sociology, University of New Brunswick, Fredericton, Canada
| | - Emma Robinson
- Department of Sociology, University of New Brunswick, Fredericton, Canada
| | - Katherine Hughes
- School of Health Sciences, Central Michigan University, Mount Pleasant, Michigan, USA
| | - Natalie Riediger
- Departments of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Canada
| | - Lisa Thomson
- Department of Sociology, University of New Brunswick, Fredericton, Canada
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80
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Wellman JD, Araiza AM, Nguyen TVC, Beam AJ, Pal S. Identifying as fat: Examining weight discrimination and the rejection-identification model. Body Image 2022; 41:46-51. [PMID: 35220025 DOI: 10.1016/j.bodyim.2022.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 02/07/2022] [Indexed: 10/19/2022]
Abstract
Discrimination towards fat individuals is pervasive in the United States, and perceptions of weight discrimination are associated with poor physical and mental health outcomes (e.g., low well-being). The rejection-identification model theorizes that perceptions of group-based discrimination may lead people to identify with their stigmatized group, subsequently helping them maintain well-being. We applied the rejection-identification model to weight discrimination to understand whether positively identifying as fat may mediate the impact of perceived weight-group discrimination on well-being. Across two samples (N = 739), fat-group identification, ingroup affiliation, and body affirmation were tested as mediators of the association between perceived weight discrimination and well-being. We also examined support for weight-related social change. Results showed that fat identification was a significant mediator, associated positively with discrimination but negatively with well-being; fat identification also was positively associated with greater support for weight-related social change. Body affirmation was a significant mediator of well-being and support for weight-related social change. Identifying as fat does not seem to provide the same benefits to well-being observed for other social identities (e.g., ethnicity); perceiving one's own body positively, however, may be a potential pathway through which weight discrimination's consequences can be reduced. Implications for well-being, identity, and the rejection-identification model are discussed.
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81
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Kite J, Huang BH, Laird Y, Grunseit A, McGill B, Williams K, Bellew B, Thomas M. Influence and effects of weight stigmatisation in media: A systematic. EClinicalMedicine 2022; 48:101464. [PMID: 35706492 PMCID: PMC9125650 DOI: 10.1016/j.eclinm.2022.101464] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 04/26/2022] [Accepted: 05/05/2022] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The lack of a comprehensive understanding of the role of mass media in perpetuating weight stigma hinders policy formulation. We reviewed the influence of mass media on weight stigmatisation and the effectiveness of media-based interventions designed to prevent or reduce stigma. METHODS We conducted a systematic review across seven databases from inception to December 2021. Included studies assessed exposure to or impact of weight stigma in mass media or examined interventions to reduce stigma through media in populations 12+ years. We synthesised data narratively, categorising studies based on similarity in focus to produce a set of integrated findings. The systematic review is registered in PROSPERO (No. CRD42020176306). FINDINGS One-hundred-and-thirteen records were eligible for inclusion from 2402 identified; 95 examined the prevalence of stigmatising content in mass media and its impact on stigma. Weight stigma was prevalent across media types, with the dominant discourse viewing overweight and obesity as an individual responsibility and overlooking systemic factors. Exposure to stigmatising content was found to negatively influence attitudes towards people with overweight or obesity. Few studies considered methods of reducing stigma in the media, with only two testing media-based interventions; their results were promising but limited. INTERPRETATION Weight stigma in media content is prevalent and harmful, but there is little guidance on reducing it. Future research focus needs to shift from assessing prevalence and impacts to weight stigma interventions. FUNDING None.
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Affiliation(s)
- James Kite
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, NSW, Australia
- Corresponding author.
| | - Bo-Huei Huang
- Charles Perkins Centre, The University of Sydney, NSW, Australia
| | - Yvonne Laird
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, NSW, Australia
| | - Anne Grunseit
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, NSW, Australia
| | - Bronwyn McGill
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, NSW, Australia
| | - Kathryn Williams
- Charles Perkins Centre, The University of Sydney, NSW, Australia
- Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
- Nepean Blue Mountains Local Health District, Kingswood, NSW, Australia
| | - Bill Bellew
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, NSW, Australia
| | - Margaret Thomas
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, NSW, Australia
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82
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Kanagasingam D, Norman M, Hurd L. 'It's not just to treat everybody the same': A social justice framework for caring for larger patients in healthcare practice. SOCIOLOGY OF HEALTH & ILLNESS 2022; 44:899-918. [PMID: 35434819 DOI: 10.1111/1467-9566.13470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 03/24/2022] [Indexed: 06/14/2023]
Abstract
Drawing on semi-structured interviews with larger bodied patients (n = 20) and their healthcare practitioners (n = 22) in Canada, this paper combines micro and macro approaches in outlining a social justice approach to caring for larger patients in healthcare practice. Theoretically, we draw upon structural competency and critical consciousness to address the question of how social justice is enacted, experienced, and understood in interactions between clinicians and larger patients. Our findings highlight four key themes that provide a framework for integrating social justice into healthcare practice: (1) an awareness of one's simultaneous experience of marginalisation and privilege in the clinical interaction; (2) navigating between additive and interactive understandings of intersectionality; (3) micro and macro approaches to change; and (4) straddling the line between equity and equality. The synergies in participants' perspectives across social identities suggests that the cultivation of social justice awareness potentially mitigates some blinders of privilege. Furthermore, practitioners' social justice orientation positively impacted patient experience, with most patients expressing appreciation for having their various histories of trauma and social challenges handled compassionately during appointments.
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Affiliation(s)
- Deana Kanagasingam
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Moss Norman
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Laura Hurd
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
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83
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Frederick DA, Crerand CE, Brown TA, Perez M, Best CR, Cook-Cottone CP, Compte EJ, Convertino L, Gordon AR, Malcarne VL, Nagata JM, Parent MC, Pennesi JL, Pila E, Rodgers RF, Schaefer LM, Thompson JK, Tylka TL, Murray SB. Demographic predictors of body image satisfaction: The U.S. Body Project I. Body Image 2022; 41:17-31. [PMID: 35220024 PMCID: PMC9744633 DOI: 10.1016/j.bodyim.2022.01.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 12/22/2021] [Accepted: 01/26/2022] [Indexed: 12/15/2022]
Abstract
We examined how gender, body mass, race, age, and sexual orientation were linked to appearance evaluation, overweight preoccupation, and body image-related quality of life among 11,620 adults recruited via Mechanical Turk. Men were less likely than women to report low appearance evaluation, high overweight preoccupation, negative effects of body image on their quality of life, being on a weight-loss diet, and trying to lose weight with crash diets/fasting. Racial differences were generally small, but greater appearance evaluation was reported by Black men versus other groups and Black women versus White women. Across all measures, gay and bisexual men reported poorer body image than heterosexual men, with only small effect sizes observed for sexual orientation differences among women. Body mass, but not age, was strongly associated with body image. The prevalence of poor body image highlights the need for interventions. On the positive side, half of men and women reported high appearance evaluation. Examination of this group could identify factors promoting positive body image.
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Affiliation(s)
- David A. Frederick
- Crean College of Health and Behavioral Sciences, Chapman University, Orange, CA, USA,Corresponding author. (D.A. Frederick)
| | - Canice E. Crerand
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA,Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH USA
| | - Tiffany A. Brown
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | - Marisol Perez
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Cassidy R. Best
- Crean College of Health and Behavioral Sciences, Chapman University, Orange, CA, USA
| | - Catherine P. Cook-Cottone
- Department of Counseling, School, and Educational Psychology, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Emilio J. Compte
- School of Psychology, Adolfo Ibáñez University, Santiago, Chile,Research Department, Comenzar de Nuevo Treatment Center, Monterrey, Mexico
| | - Lexie Convertino
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Allegra R. Gordon
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA,Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA,Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | | | - Jason M. Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Michael C. Parent
- Department of Educational Psychology, University of Texas at Austin, Austin, TX, USA
| | - Jamie-Lee Pennesi
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Eva Pila
- School of Kinesiology, Western University, London, ON, Canada
| | - Rachel F. Rodgers
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, MA, USA
| | | | | | - Tracy L. Tylka
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Stuart B. Murray
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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84
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Gisch UA, Robert M, Berlin N, Nebout A, Etilé F, Teyssier S, Andreeva VA, Hercberg S, Touvier M, Péneau S. Mastery Is Associated With Weight Status, Food Intake, Snacking, and Eating Disorder Symptoms in the NutriNet-Santé Cohort Study. Front Nutr 2022; 9:871669. [PMID: 35694168 PMCID: PMC9174750 DOI: 10.3389/fnut.2022.871669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/15/2022] [Indexed: 11/20/2022] Open
Abstract
Mastery is a psychological resource that is defined as the extent to which individuals perceive having control over important circumstances of their lives. Although mastery has been associated with various physical and psychological health outcomes, studies assessing its relationship with weight status and dietary behavior are lacking. The aim of this cross-sectional study was to assess the relationship between mastery and weight status, food intake, snacking, and eating disorder (ED) symptoms in the NutriNet-Santé cohort study. Mastery was measured with the Pearlin Mastery Scale (PMS) in 32,588 adults (77.45% female), the mean age was 50.04 (14.53) years. Height and weight were self-reported. Overall diet quality and food group consumption were evaluated with ≥3 self-reported 24-h dietary records (range: 3-27). Snacking was assessed with an ad-hoc question. ED symptoms were assessed with the Sick-Control-One-Fat-Food Questionnaire (SCOFF). Linear and logistic regression analyses were conducted to assess the relationship between mastery and weight status, food intake, snacking, and ED symptoms, controlling for sociodemographic and lifestyle characteristics. Females with a higher level of mastery were less likely to be underweight (OR: 0.88; 95%CI: 0.84, 0.93), overweight [OR: 0.94 (0.91, 0.97)], or obese [class I: OR: 0.86 (0.82, 0.90); class II: OR: 0.76 (0.71, 0.82); class III: OR: 0.77 (0.69, 0.86)]. Males with a higher level of mastery were less likely to be obese [class III: OR: 0.75 (0.57, 0.99)]. Mastery was associated with better diet quality overall, a higher consumption of fruit and vegetables, seafood, wholegrain foods, legumes, non-salted oleaginous fruits, and alcoholic beverages and with a lower consumption of meat and poultry, dairy products, sugary and fatty products, milk-based desserts, and sweetened beverages. Mastery was also associated with lower snacking frequency [OR: 0.89 (0.86, 0.91)] and less ED symptoms [OR: 0.73 (0.71, 0.75)]. As mastery was associated with favorable dietary behavior and weight status, targeting mastery might be a promising approach in promoting healthy behaviors. Clinical Trial Registry Number NCT03335644 at Clinicaltrials.gov.
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Affiliation(s)
- Ulrike A. Gisch
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Centre of Research in Epidemiology and Statistics - University of Paris (CRESS), Bobigny, France
- Counseling Psychology, Department of Psychology, University of Potsdam, Potsdam, Germany
| | - Margaux Robert
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Centre of Research in Epidemiology and Statistics - University of Paris (CRESS), Bobigny, France
| | - Noémi Berlin
- CNRS, EconomiX – UMR 7235, University of Paris Nanterre, Ivry-sur-Seine, France
| | | | - Fabrice Etilé
- INRAE, UR 1303 ALISS, Ivry-sur-Seine, France
- Paris School of Economics and INRAE, UMR1393 PjSE, Paris, France
| | - Sabrina Teyssier
- Grenoble Alpes University, INRAE, CNRS, Grenoble INP, GAEL, Grenoble, France
| | - Valentina A. Andreeva
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Centre of Research in Epidemiology and Statistics - University of Paris (CRESS), Bobigny, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Centre of Research in Epidemiology and Statistics - University of Paris (CRESS), Bobigny, France
- Department of Public Health, AP-HP Avicenne Hospital, Bobigny, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Centre of Research in Epidemiology and Statistics - University of Paris (CRESS), Bobigny, France
| | - Sandrine Péneau
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Centre of Research in Epidemiology and Statistics - University of Paris (CRESS), Bobigny, France
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85
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Weight stigma from media: Its associations with coping responses and health outcomes. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03179-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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86
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Turner R, Wildschut T, Sedikides C. Reducing social distance caused by weight stigma: Nostalgia changes behavior toward overweight individuals. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2022. [DOI: 10.1111/jasp.12869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Rhiannon Turner
- Centre for Identity and Intergroup Relations, School of Psychology Queen's University Belfast Belfast UK
| | - Tim Wildschut
- Centre for Research on Self and Identity, School of Psychology University of Southampton Southampton UK
| | - Constantine Sedikides
- Centre for Research on Self and Identity, School of Psychology University of Southampton Southampton UK
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87
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Genetically-predicted trait-BMI, everyday discrimination and life satisfaction among older U.S. adults. ADAPTIVE HUMAN BEHAVIOR AND PHYSIOLOGY 2022. [DOI: 10.1007/s40750-022-00189-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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88
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Myre M, Glenn NM, Berry TR. Experiences of Size Inclusive Physical Activity Settings Among Women With Larger Bodies. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2022:1-10. [PMID: 35344473 DOI: 10.1080/02701367.2021.1983515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 09/17/2021] [Indexed: 06/14/2023]
Abstract
Purpose: Size inclusive physical activity settings may help mitigate the impact of physical activity-related weight stigma. In this interpretive description study, we aimed to understand how women with larger bodies experienced size inclusive physical activity settings. The study was informed by a settings-based approach to health promotion. Method: We interviewed nine women with larger bodies who participated in size inclusive physical activity and used an inductive approach to analyze the data. Findings: At the individual level, size inclusion was experienced as an enhancement of well-being, self-worth, and belonging. This was closely tied to the interpersonal level, whereby weight-neutral practices used by fitness instructors and lack of judgment from other exercisers contributed to experiences of size inclusion. At the organizational level, the organization's culture, marketing, programs, and physical spaces could enhance or limit inclusion and participation. However, weight stigma was prevalent in women's experiences outside the physical activity setting. Conclusion: We provide recommendations to improve size inclusion in physical activity settings.
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89
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Jones A, Hardman CA, Devlin N, Pennington CR, Robinson E. Weight-based discrimination in financial reward and punishment decision making: causal evidence using a novel experimental paradigm. Int J Obes (Lond) 2022; 46:1288-1294. [PMID: 35338259 PMCID: PMC9239905 DOI: 10.1038/s41366-022-01109-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 02/23/2022] [Accepted: 02/25/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Cross-sectional research has demonstrated weight-related stigma and discrimination, however experimental research providing causal evidence of financial-based weight discrimination is lacking. The aim of these preregistered experiments was to examine whether a novel paradigm in which participants attributed financial rewards and punishments could be used to detect weight bias. SUBJECTS/METHODS One-hundred and twenty-one individuals participated in experiment 1 and one-hundred and sixty-six individuals participated in experiment 2. Both studies were conducted online, and participants were provided with biographies of hypothetical individuals in which weight-status was manipulated (normal weight vs. overweight/obesity) before being asked to provide rewards and punishments on their cognitive performance. In experiment 1 (within-participants design) participants observed one individual they believed to be normal weight and one individual they believed to be overweight/have obesity. In experiment 2 (between-participants design) participants observed one individual whilst also being provided with information about food addiction (Food addiction is real + individual with overweight/obesity vs. food addiction is a myth + individual with overweight/obesity vs control + individual with normal weight). RESULTS In experiment 1, participants punished individuals who were described as having overweight/obesity to a greater extent to individuals who were normal weight (Hedge's g = -0.21 [95% CI: -0.02 to -0.41], p = 0.026), but there was no effect on rewards. They were also less likely to recommend individuals with overweight/obesity to pass the tasks (X2(1) = 10.05, p = 0.002). In experiment 2, participants rewarded individuals whom they believed were overweight/obese to a lesser extent than normal-weight individuals (g = 0.49 [95% CI: 0.16 to 0.83]. There was no effect on punishment, nor any impact of information regarding food addiction as real vs a myth. CONCLUSION Using a novel discrimination task, these two experiments demonstrate causal evidence of weight-based discrimination in financial decision making.
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Affiliation(s)
- Andrew Jones
- Psychology, University of Liverpool, Liverpool, UK.
| | | | - Niamh Devlin
- Psychology, University of Liverpool, Liverpool, UK
| | - Charlotte R Pennington
- School of Psychology, Aston University, Birmingham, UK.,Institute of Health & Neurodevelopment, Aston University, Birmingham, England
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90
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Adil O, Kuk JL, Ardern CI. Associations between weight discrimination and metabolic health: A cross sectional analysis of middle aged adults. Obes Res Clin Pract 2022; 16:151-157. [PMID: 35227638 DOI: 10.1016/j.orcp.2022.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 02/08/2022] [Accepted: 02/15/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Concurrent with the recent rise in overweight and obesity, concerns with weight discrimination have arisen. Individuals who have experienced weight discrimination report a host of deteriorations related to physical and psychological health, which may co-exist with behaviours such as increased food consumption and decreases in physical activity that make weight management difficult. What remains less clear, however, is the extent to which metabolic health may be specifically affected, and how this may vary by setting and perceived intensity of the lifetime history of weight discrimination. METHOD To address this, a secondary data analysis was performed on 1365 participants from year 25 of the Coronary Artery Disease in Young Adults (CARDIA) study who were living with overweight and obesity. Descriptive statistics and logistic regression analyses were performed on the presence of metabolic syndrome, diabetes, and abdominal obesity, as well as their experience of the weight discrimination. RESULTS Prevalence of the metabolic syndrome, diabetes, and abdominal obesity was higher among those reporting low and high stress weight discrimination compared to those with no history of weight discrimination. In the adjusted analyses, weight discrimination was associated with a 65% greater likelihood for having metabolic syndrome, 85% greater likelihood of diabetes, and between a 2.5- and 3.9-times greater likelihood of abdominal obesity for low and high stress experiences, respectively. CONCLUSION Exposure to weight discrimination may worsen metabolic health, as characterized by higher rates of metabolic syndrome and abdominal obesity. These associations may be greater with levels of stress experienced from weight discrimination. Further longitudinal work is necessary to understand the temporal sequence, time lag, and any possible critical periods for weight discrimination on metabolic health.
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Affiliation(s)
- Omar Adil
- School of Kinesiology and Health Sciences, York University, 4700 Keele St, Toronto, Ontario M3J 1P3, Canada.
| | - Jennifer L Kuk
- School of Kinesiology and Health Sciences, York University, 4700 Keele St, Toronto, Ontario M3J 1P3, Canada.
| | - Chris I Ardern
- School of Kinesiology and Health Sciences, York University, 4700 Keele St, Toronto, Ontario M3J 1P3, Canada.
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91
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Cassiano GS, Carvalho-Ferreira JP, Buckland NJ, Ulian MD, da Cunha DT. Are Dietitians With Obesity Perceived as Competent and Warm? Applying the Stereotype Content Model to Weight Stigma in Brazil. Front Nutr 2022; 9:813344. [PMID: 35284459 PMCID: PMC8916106 DOI: 10.3389/fnut.2022.813344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 01/31/2022] [Indexed: 11/20/2022] Open
Abstract
The aim of this study was to understand how dietitians' body size influences perceived competence and warmth, based on the Stereotype Content Model (SCM). Online data were collected from 1,039 Brazilians, who were either laypeople, registered dietitians, or nutrition students. Participants rated the competence and warmth dimensions of three dietitians who differed in sex, body weight, and age. Participants also indicated how likelythey would consult or recommend each dietitian for nutritional advice, and indicated their attitudes toward people with obesity (PWO) [using The Antifat Attitudes Test (AFAT)]. Laypeople attributed less competence and warmth to all profiles compared to dietitians and students (p < 0.001). Three clusters occupied the SCM warmth-by-competence space. However, the clusters were different among groups (laypeople, dietitians, and students). For lay participants, the woman without overweight, the older woman, and the older man were located in the high competence/medium warmth cluster. Meanwhile, the woman with obesity was located in the medium competence/high warmth cluster. The dietitians and students map found the woman with obesity and the older woman in a high competence and warmth cluster. In general, the woman with obesity, the man without obesity, and the older man can be classified as ambivalent stereotypes, the woman being perceived as more warm than competent and the men more competent than warm. Participants with high AFAT scores were less likely to consult or recommend to a family member a dietitian with obesity. This study contributes to identifying ambivalent stereotypes for dietitians. Dietitians with obesity can be seen as warm but less competent. Also, although less intense than laypeople, dietitians, and students exhibited weight stigma. These findings can foster important discussions about weight stigma and emphasize the need to increase population awareness about the causes of obesity.
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Affiliation(s)
- Giovana Santarosa Cassiano
- Multidisciplinary Food and Health Laboratory, School of Applied Sciences, State University of Campinas, Campinas, Brazil
| | | | - Nicola J. Buckland
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Mariana Dimitrov Ulian
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Diogo Thimoteo da Cunha
- Multidisciplinary Food and Health Laboratory, School of Applied Sciences, State University of Campinas, Campinas, Brazil
- *Correspondence: Diogo Thimoteo da Cunha
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92
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Horn F, Jongenelis MI. Outcomes of exposure to healthy weight and lifestyle advertising: An experimental study of adults from the United Kingdom. Prev Med Rep 2022; 25:101679. [PMID: 35127358 PMCID: PMC8800051 DOI: 10.1016/j.pmedr.2021.101679] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 10/31/2021] [Accepted: 12/24/2021] [Indexed: 11/16/2022] Open
Abstract
Mass media advertising promoting healthy weight and lifestyles represents an important approach to the prevention of non-communicable diseases. However, concerns have been raised that advertisements promoting a healthy weight may be stigmatizing and contribute to negative outcomes. This study explored the potential negative and positive cognitive, psychological, and behavioral intention outcomes of exposure to different public health campaign advertisements that promote positive behavior change and healthy weight. A total of 1,098 adult residents of the United Kingdom (50% female, Mage = 35.21 years) viewed one of four video advertisements: one control advertisement and three healthy weight and lifestyle advertisements that differed in message content (negative health impacts, support/encouragement, and social norms) and execution style (graphic, animation, and depicted scene). Participants then responded to items assessing a variety of cognitive, psychological, and behavioral intention outcomes. Compared to those in the control condition, those exposed to a healthy weight and lifestyle advertisement reported significantly higher scores for (i) perceptions of weight stigma, (ii) negative emotions, and (iii) intentions to engage in adaptive lifestyle behaviors. There were no differences observed between conditions for maladaptive behavioral intentions, internalized weight bias, anti-fat attitudes, and body dissatisfaction. The advertisement featuring a supportive/encouraging message and animation style performed most favorably. Results suggest that healthy weight and lifestyle advertisements have the potential to promote positive behavior change but may be associated with some negative outcomes. Of the assessed communication approaches, a supportive/encouraging message with animation style appears least likely to induce negative emotions and is preferred for minimizing weight stigma.
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Affiliation(s)
- Freya Horn
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, The University of Melbourne, Redmond Barry Building, Parkville Campus, Melbourne, VIC 3010, Australia
- Turning Point, Eastern Health, 110 Church Street, Richmond, VIC 3121, Australia
| | - Michelle I. Jongenelis
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, The University of Melbourne, Redmond Barry Building, Parkville Campus, Melbourne, VIC 3010, Australia
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93
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Aldhahi MI, Al Khalil WK, Almutiri RB, Alyousefi MM, Alharkan BS, AnNasban H. Effect of Weight Self-Stigma and Self-Esteem on Aerobic Exercise Capacity in Adult Women with Different Body Compositions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020873. [PMID: 35055699 PMCID: PMC8776112 DOI: 10.3390/ijerph19020873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/07/2022] [Accepted: 01/10/2022] [Indexed: 02/05/2023]
Abstract
Background: Overweight individuals face weight-related stigmatization, driving self-exclusion from exercise and physical activity. The extent to which weight self-stigma and self-esteem are associated with aerobic capacity remains unclear. Therefore, this study aimed to characterize the cardiopulmonary fitness, weight self-stigma, and self-esteem of overweight women and examine whether weight self-stigma and self-esteem predict cardiopulmonary aerobic capacity. Methods: A cross-sectional study was conducted with 66 women stratified into two groups: a normal weight (NW) group and an overweight (OW) group. The mean body mass indexes and ages of the NW and OW groups were 20.4 ± 0.36 kg/m2 and 29.5 ± 0.8 kg/m2, and 24 ± 7 years and 21 ± 3 years, respectively. Submaximal exercise testing using the modified Bruce treadmill protocol was conducted to measure the predicted oxygen uptake (VO2 peak) and energy expenditure. The Weight Self-Stigma Questionnaire and the Rosenberg Self-Esteem Scale were used. Results: Significantly lower mean of predicted VO2 peak and higher mean of energy expenditure were reported in the OW group compared with the NW group (25.8 ± 5.3 mL/kg/min vs. 28.7 ± 4.8 mL/kg/min, p = 0.001 and 9.7 ± 1.9 kcal/min vs. 7.5 ± 1.8 kcal, p = 0.03, respectively). There was a significant difference in weight self-stigma and self-esteem between the groups. Regression model analysis indicated that weight self-stigma and self-esteem explained 45% of the variance in the predicted VO2 peak. Conclusion: Strategies enhancing self-esteem and avoiding stigmatization should be embraced to promote fitness and engagement in physical activity among OW women.
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94
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Bograd S, Chen B, Kavuluru R. Tracking sentiments toward fat acceptance over a decade on Twitter. Health Informatics J 2022; 28:14604582211065702. [PMID: 34986689 DOI: 10.1177/14604582211065702] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The fat acceptance (FA) movement aims to counteract weight stigma and discrimination against individuals who are overweight/obese. We developed a supervised neural network model to classify sentiment toward the FA movement in tweets and identify links between FA sentiment and various Twitter user characteristics. We collected any tweet containing either "fat acceptance" or "#fatacceptance" from 2010-2019 and obtained 48,974 unique tweets. We independently labeled 2000 of them and implemented/trained an Average stochastic gradient descent Weight-Dropped Long Short-Term Memory (AWD-LSTM) neural network that incorporates transfer learning from language modeling to automatically identify each tweet's stance toward the FA movement. Our model achieved nearly 80% average precision and recall in classifying "supporting" and "opposing" tweets. Applying this model to the complete dataset, we observed that the majority of tweets at the beginning of the last decade supported FA, but sentiment trended downward until 2016, when support was at its lowest. Overall, public sentiment is negative across Twitter. Users who tweet more about FA or use FA-related hashtags are more supportive than general users. Our findings reveal both challenges to and strengths of the modern FA movement, with implications for those who wish to reduce societal weight stigma.
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Affiliation(s)
- Sadie Bograd
- 326741Paul Laurence Dunbar High School, Lexington, KY USA
| | - Benjamin Chen
- 326741Paul Laurence Dunbar High School, Lexington, KY, USA
| | - Ramakanth Kavuluru
- Department of Internal Medicine, 4530University of Kentucky, Lexington, KY, USA
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95
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de la Torre-Pérez L, Oliver-Parra A, Torres X, Bertran MJ. How do we measure gender discrimination? Proposing a construct of gender discrimination through a systematic scoping review. Int J Equity Health 2022; 21:1. [PMID: 34980116 PMCID: PMC8722302 DOI: 10.1186/s12939-021-01581-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 10/31/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Gender discrimination (GD) has been frequently linked to mental health. The heterogeneity of how GD is defined has led to variation around the analysis of GD. This might affect the study of the association between GD and health outcomes. The main goal of this systematic scoping review is to operationalize the definition of the GD construct. METHODS Three search strategies were set in Pubmed, CINAHL and PsycINFO. The first strategy obtained results mainly about women, while the second focused on men. The third strategy focused on the identification of GD questionnaires. The prevalence of GD, factors and consequences associated with GD perception, and forms of discrimination were the principal variables collected. Risk of bias was assessed (PROSPERO:CRD42019120719). RESULTS Of the 925 studies obtained, 84 were finally included. 60 GD questionnaires were identified. GD prevalence varied between 3.4 and 67 %. Female gender and a younger age were the factors most frequently related to GD. Poorer mental health was the most frequent consequence. Two components of the GD construct were identified: undervaluation (different recognition, opportunities in access, evaluation standards and expectations) and different treatment (verbal abuse and behaviour). CONCLUSIONS Two-component GD definition can add order and precision to the measurement, increase response rates and reported GD.
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Affiliation(s)
- Laura de la Torre-Pérez
- Preventive Medicine and Epidemiology Department, Hospital Clínic de Barcelona, C/ Villarroel 170, 08036 Barcelona, Spain
| | - Alba Oliver-Parra
- Consorci Sanitari de Barcelona, Carrer d’Esteve Terradas, 08023 Barcelona, Spain
| | - Xavier Torres
- Clinical Health Psychology Section of the Institute Clinic of Neuroscience, Hospital Clínic de Barcelona, C/ Villarroel 170, 08036 Barcelona, Spain
| | - Maria Jesús Bertran
- Preventive Medicine and Epidemiology Department, Hospital Clínic de Barcelona, C/ Villarroel 170, 08036 Barcelona, Spain
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96
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Yu M, Shi Y, Gu L, Wang W. "Jolly fat" or "sad fat": a systematic review and meta-analysis of the association between obesity and depression among community-dwelling older adults. Aging Ment Health 2022; 26:13-25. [PMID: 33300393 DOI: 10.1080/13607863.2020.1857687] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To review the evidence and explore the association between obesity and depression in community-dwelling older adults. METHODS We searched 6 electronic databases from inception to November 28, 2019. Observational studies investigating the association between obesity and depression among community-dwelling older adults aged 60 years or older were included. Two reviewers independently screened the studies, extracted the data and assessed the quality of the studies. The eligible studies were meta-analysed using the Comprehensive Meta-analysis Version 3.0. RESULTS Among the 16,059 studies identified from these databases, 19 studies meeting the inclusion criteria were included, of which 14 were meta-analysed. Meta-analyses showed that older adults who were overweight (pooled odds ratio: 0.847, 95% CI:0.789-0.908, p < 0.001) or obesity (pooled odds ratio: 0.795, 95% CI:0.658-0.960, p = 0.017) - assessed using the body mass index - were significantly less likely to be depressed than their counterparts with a normal weight. No significant association between obesity (as measured via waist circumference) and depression was detected (pooled odds ratio: 0.722, 95% CI:0.465-1.119, p = 0.145) in this group population. The subgroup analyses demonstrated that both female and male older adults with overweight/obesity were significantly less likely to have depression. CONCLUSIONS The "jolly fat" hypothesis is deemed to be applicable among community-dwelling older adults. Older adults might, therefore, be encouraged to increase their body weight above the normal level to be mentally healthy. Monitoring intentional weight loss among older adults should be reinforced for public health strategies.
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Affiliation(s)
- Mingming Yu
- School of Nursing, Peking University, Beijing, P.R. China
| | - Yuexian Shi
- School of Nursing, Peking University, Beijing, P.R. China
| | - Libin Gu
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, P.R. China
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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97
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Wanniarachchi VU, Scogings C, Susnjak T, Mathrani A. Fat stigma and body objectification: A text analysis approach using social media content. Digit Health 2022; 8:20552076221117404. [PMID: 35990109 PMCID: PMC9386857 DOI: 10.1177/20552076221117404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 07/15/2022] [Indexed: 11/21/2022] Open
Abstract
This study investigates how female and male genders are positioned in fat stigmatising discourses that are being conducted over social media. Weight-based linguistic data corpus, extracted from three popular social media (SM) outlets, Twitter, YouTube and Reddit, was examined for fat stigmatising content. A mixed-method analysis comprising sentiment analysis, word co-occurrences and qualitative analysis, assisted our investigation of the corpus for body objectification themes and gender-based differences. Objectification theory provided the underlying framework to examine the experiential consequences of being fat across both genders. Five objectifying themes, namely, attractiveness, physical appearance, lifestyle choices, health and psychological well-being, emerged from the analysis. A deeper investigation into more facets of the social interaction data revealed overall positive and negative attitudes towards obesity, which informed on existing notions of gendered body objectification and weight/fat stigmatisation. Our findings have provided a holistic outlook on weight/fat stigmatising content that is posted online which can further inform policymakers in planning suitable props to facilitate more inclusive SM spaces. This study showcases how lexical analytics can be conducted by combining a variety of data mining methods to draw out insightful subject-related themes that add to the existing knowledge base; therefore, has both practical and theoretical implications.
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Affiliation(s)
| | - Chris Scogings
- School of Mathematical and Computational Sciences, Massey University, Auckland, New Zealand
| | - Teo Susnjak
- School of Mathematical and Computational Sciences, Massey University, Auckland, New Zealand
| | - Anuradha Mathrani
- School of Mathematical and Computational Sciences, Massey University, Auckland, New Zealand
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98
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KAYA CEBIOĞLU İ=, DUMLU BILGIN G, OKAN BAKIR B, GÜL KOYUNCU A. Weight bias among dietitians: does the weight status of the patients change the dietary approaches? REV NUTR 2022. [DOI: 10.1590/1678-9865202235e210214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
ABSTRACT Objective Since obesity is a multifactorial disease, some health professionals may esteem that weight control is a matter of personal willpower and stigmatize individuals. These weight-based attitudes seem quite common even among dietitians. This study aimed to determine whether the level of weight bias affects the dietary approaches of the dietitians. Methods Two hypothetical cases with obese and normal weight vignettes were created to be evaluated, and the explicit weight bias was assessed by the fat phobia scale among 99 dietitians via an online questionnaire. Results The majority of the dietitians demonstrated mild or moderate levels of weight bias (59.6% and 32.3%, respectively). The obese vignette had the highest agreement for nearly all adjectives and was perceived as having poorer diet quality, general health status, and insufficient physical activity level. Conclusion Overall, as weight bias is a concerning issue among most dietitians, necessary steps are required for the reduction of prejudice and thus protect the patients from stigmatizing attitudes.
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99
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Jalaba S, Trudeau H, Carlson S. Obesity Prevention. PHYSICIAN ASSISTANT CLINICS 2022. [DOI: 10.1016/j.cpha.2021.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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100
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Lu P, Kong D, Shelley M, Davitt JK. Intersectional Discrimination Attributions and Health Outcomes Among American Older Adults: A Latent Class Analysis. Int J Aging Hum Dev 2021; 95:267-285. [PMID: 34931874 DOI: 10.1177/00914150211066560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Guided by an intersectionality framework, this study examined intersectional discrimination attributions and their associations with health outcomes. Older respondents (aged ≥50) from the Health and Retirement Study in 2014-2015 were included (N = 6286). Their reasons for discrimination (age, gender, sexual orientation, race, national origin, religion, financial status, weight, physical appearance, disability, and others) were examined. Latent class analysis examined the subgroup profiles. Six classes were identified: class 1 (54.52% of the sample) had no/minimal discrimination; Class 2 (21.89%) experienced primarily ageism; class 3 (8.81%) reported discrimination based on age/gender/national origin/race; class 4 (7.99%) attributed discrimination to financial/other reasons; class 5 (5.87%) experienced discrimination based on age/weight/physical appearance/disability; and class 6 (0.92%) perceived high discrimination. Intersectional discrimination was associated with poorer self-rated health and higher depressive symptoms compared to the no/minimal discrimination group. Multiple marginalized identities co-occur and contribute to discrimination. An intersectional approach is recommended to understand discrimination in later life.
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Affiliation(s)
- Peiyi Lu
- Departments of Statistics & Political Science, 1177Iowa State University, Ames, IA, USA.,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.,Peiyi Lu and Dexia Kong contributed equally to this work
| | - Dexia Kong
- Department of Social Work, 26451The Chinese University of Hong Kong, Hong Kong, Hong Kong.,Peiyi Lu and Dexia Kong contributed equally to this work
| | - Mack Shelley
- Department of Political Science, Department of Statistics, and School of Education, 1177Iowa State University, Ames, IA, USA
| | - Joan K Davitt
- School of Social Work, 12265University of Maryland, Baltimore, MD, USA
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