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Abstract
Purpose
The purpose of this paper is to investigate the relationship between body mass index (BMI) and chronic job discrimination. Additionally, the authors explore the contribution of various forms of social support to that relationship.
Design/methodology/approach
The data for this study were obtained from the National Survey of Midlife Development in the USA (MIDUS). Only those who reported being employed participated in the study (n = 1,150). The variables of interest included BMI, supervisor support, coworker support, family support, friend support, religious support and chronic job discrimination. Analysis included correlations, ANOVA’s and hierarchical linear regression.
Findings
BMI was positively associated with chronic job discrimination. Respondents in the obese and morbidly obese categories reported higher job discrimination compared to normal weight respondents. Family support, supervisor support and coworker support were associated with less reported chronic job discrimination.
Practical implications
Organizational leaders should acknowledge that obesity is associated with discrimination. Organizations should thus create anti-discrimination policies covering weight-based discrimination, conduct sensitivity training for all employees and train and coach supervisors on effective ways of offering support to employees.
Originality/value
This study contributes to the understanding of the role various forms of social support can play in reducing perceptions of chronic job discrimination. The paper is unique in that it considers several sources from which people draw support in managing for stressors.
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202
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Abstract
Sizeism has a negative impact on women and perpetuates fat shaming. Conventional therapeutic suggestions for addressing weight concerns focuses on self-discipline rather than on the larger social, cultural, or political contexts of weight stigma. Feminist scholars, therapists, and activists have encouraged social activism to promote psychological well-being and challenge systemic weight prejudice. Results of research on health prevention and promotion efforts have begun to shift thinking away from weight loss and toward deconstructing and changing anti-fat attitudes. We highlight some individual and community-based fat activists to illustrate how their strategies and ideas challenge sizeism in a variety of areas including: the rhetoric of fat; body positivity; photography/art; nutrition/exercise; and diversity/intersectionality. Fat activism has utility within a therapeutic context especially for those who have been recipients of sizeism. We strongly encourage therapists to work closely with clients on finding sources and types of fat activism that represent their unique identities which may be more difficult for those with marginalized identities.
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Affiliation(s)
- Mala L Matacin
- University of Hartford; Department of Psychology; 200 Bloomfield Avenue, West Hartford, CT 06117
| | - Melissa Simone
- Utah State University; Department of Psychology; 2810 Old Main Hill, Logan, UT 84322-2810
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203
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Govender RD, Al-Shamsi S, Regmi D. Weight bias and eating behaviours of persons with overweight and obesity attending a general medical practice in Durban, South Africa. S Afr Fam Pract (2004) 2019. [DOI: 10.1080/20786190.2018.1554305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- RD Govender
- Department of Family Medicine, United Arab Emirates University, Al Ain, United Arab Emirates
| | - S Al-Shamsi
- Department of Internal Medicine, United Arab Emirates University, Al Ain, United Arab Emirates
| | - D Regmi
- Department of Family Medicine, United Arab Emirates University, Al Ain, United Arab Emirates
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204
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Makowski AC, Kim TJ, Luck-Sikorski C, von dem Knesebeck O. Social deprivation, gender and obesity: multiple stigma? Results of a population survey from Germany. BMJ Open 2019; 9:e023389. [PMID: 30948564 PMCID: PMC6500240 DOI: 10.1136/bmjopen-2018-023389] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 02/14/2019] [Accepted: 02/22/2019] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Individuals with obesity are subject to stigmatisation, resulting in discrimination. Studies focusing on obesity stigma often do not account for social conditions that also may be associated with stigmatisation. Following an intersectional approach, social categories such as gender and socioeconomic status (SES) can interact and form a basis for multiple stigma. The present study analyses differences in public obesity stigma depending on gender and SES, as well as possible interdependencies between these social categories. DESIGN Representative cross-sectional telephone survey. PARTICIPANTS 692 randomly selected adults (≥ 18 years) in Germany. METHODS Different vignettes were presented, depicting a lawyer (male/female) or a janitor/cleaner (male/female) with obesity. Following the vignette, different components of stigma were assessed: (1) fat phobia, (2) emotional reactions to a person with obesity and (3) desire for social distance. Associations between gender, SES and stigma components were tested in multiple linear regression analyses. RESULTS A low SES in the obesity vignette (janitor/cleaner) was significantly associated with higher fat phobia scores as well as desire for social distance, compared with the vignette with a person with obesity and a high SES (lawyer). Being a male with obesity was significantly associated with more pronounced negative emotional reactions and greater desire for social distance. There were no significant interaction effects between gender and SES. CONCLUSIONS Results support the hypothesis of multiple stigma. Being male or of low SES was significantly associated with more pronounced negative attitudes in the German public. Following the concept of intersectionality, our findings indicate that obesity stigma can exacerbate pre-existing inequalities. This needs to be considered in development and implementation of prevention and anti-stigma measures.
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Affiliation(s)
- Anna Christin Makowski
- Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tae Jun Kim
- Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Claudia Luck-Sikorski
- Integrated Research and Treatment Center (IFB) Adiposity Diseases, University of Leipzig, Leipzig, Germany
- SRH University of Applied Health Sciences, Gera, Germany
| | - Olaf von dem Knesebeck
- Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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205
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McCleary-Gaddy AT, Miller CT, Grover KW, Hodge JJ, Major B. Weight Stigma and Hypothalamic-Pituitary-Adrenocortical Axis Reactivity in Individuals Who Are Overweight. Ann Behav Med 2019; 53:392-398. [PMID: 29917036 PMCID: PMC6426042 DOI: 10.1093/abm/kay042] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Stigmatized people exhibit blunted cortisol responses to many stressors. PURPOSE To examine the cortisol responses of individuals who are overweight to a stigma-related stressor involving interviewing for a weight-discriminatory company. METHODS We recruited 170 men and women (mean age = 35.01) from towns located within about a 30-min drive of the study center. Weight was assessed using body mass index (BMI) and self-perceptions about being overweight. Participants were exposed to a laboratory stressor, modeled after the Trier Social Stress Test. In the stigmatizing condition, participants gave a supposedly videotaped speech about what makes them a good candidate for a job at a company that was described as having a weight-discriminatory health insurance benefit. Participants in the nonstigmatizing condition made a supposedly audiotaped speech for a company whose health insurance benefit was not described. Cortisol reactivity was then assessed. RESULTS Participants who rated themselves as overweight or who were overweight according to their BMI evidenced a blunted cortisol response in the weight-stigmatizing condition, whereas lean participants in the weight-stigmatizing condition showed the rise in cortisol levels that typically occurs following the Trier Social Stress Test. CONCLUSIONS People who experience the chronic stress of being stigmatized due to their weight show blunted cortisol responses just as other chronically stressed people do.
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Affiliation(s)
| | - Carol T Miller
- Department of Psychological Science, University of Vermont, Burlington, VT, USA
| | - Kristie W Grover
- Department of Psychological Science, University of Vermont, Burlington, VT, USA
| | - James J Hodge
- Department of Psychological Science, University of Vermont, Burlington, VT, USA
| | - Brenda Major
- Department of Psychology, University of California, Santa Barbara, CA, USA
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206
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Sexual orientation and mental health among adults in four U.S. cities. Psychiatry Res 2019; 273:134-140. [PMID: 30641343 DOI: 10.1016/j.psychres.2018.12.092] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 12/17/2018] [Accepted: 12/17/2018] [Indexed: 11/24/2022]
Abstract
Sexual minorities have higher risk for psychological distress than heterosexual populations. However, this disparity remains under-studied in urban settings, and there likewise has been minimal prior research of potential interactions with gender and race/ethnicity. The present study aimed to examine mental health correlates of sexual minority identification in conjunction with gender and race/ethnicity. A community sample of 1,615 adults from four eastern cities in the United States was used. A series of regression analyses were conducted to examine differences in psychological distress and suicidal ideation across different sexual orientation populations. The results showed that only bisexual individuals had significantly higher psychological distress and risk for suicidal ideation than heterosexual individuals even after adjusting for age and income. The associations were consistent across gender and race/ethnicity. No significant differences between homosexual and heterosexual individuals were found. Health professionals working with people of bisexual orientation in urban settings should attend to potential psychological distress and recent suicidal ideation.
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207
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Shank LM, Schvey NA, Ekundayo K, Schreiber-Gregory D, Bates D, Maurer D, Spieker E, Stephens M, Tanofsky-Kraff M, Sbrocco T. The relationship between weight stigma, weight bias internalization, and physical health in military personnel with or at high-risk of overweight/obesity. Body Image 2019; 28:25-33. [PMID: 30481680 DOI: 10.1016/j.bodyim.2018.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 11/17/2018] [Accepted: 11/17/2018] [Indexed: 12/20/2022]
Abstract
Perceived weight stigma is associated with adverse health indices, such as elevated cortisol, lipid/glucose dysregulation, and poorer self-rated health. This relationship may be particularly relevant for military personnel, given the cultural emphasis on fitness and weight/shape. Therefore, we investigated the relationship between weight stigma and physical health in 117 active duty personnel (66.7% male; 56.4% non-Hispanic White; age: 30.8 ± 7.4 years; BMI: 29.5 ± 2.5 kg/m2). Participants reported weight stigma (general and military-specific), weight bias internalization, and the presence (≥1; n = 55) or absence (n = 62) of medical conditions. Logistic regressions were conducted examining the ability of weight stigma (general or military-specific) and weight bias internalization to predict the presence or absence of medical conditions. General weight stigma was not significantly associated with the presence of a medical condition (p > .05). However, individuals with military-specific weight stigma scores twice that of their peers were over three times more likely (p = .04) to report a medical condition. Weight bias internalization was not significant in any model (ps > .20). Longitudinal studies should prospectively examine the relationship between weight stigma in the military setting and health among service members.
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Affiliation(s)
- Lisa M Shank
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA; The Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF), 6720A Rockledge Drive #100, Bethesda, MD, 20817, USA.
| | - Natasha A Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Kendra Ekundayo
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA; The Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF), 6720A Rockledge Drive #100, Bethesda, MD, 20817, USA
| | - Deanna Schreiber-Gregory
- The Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF), 6720A Rockledge Drive #100, Bethesda, MD, 20817, USA; Department of Internal Medicine, USUHS, DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Dawn Bates
- Madigan Army Medical Center, 9040 Jackson Ave, Tacoma, WA, 98431, USA
| | - Douglas Maurer
- Madigan Army Medical Center, 9040 Jackson Ave, Tacoma, WA, 98431, USA
| | - Elena Spieker
- Madigan Army Medical Center, 9040 Jackson Ave, Tacoma, WA, 98431, USA
| | - Mark Stephens
- Department of Family and Community Medicine, Penn State University College of Medicine, 1850 E. Park Avenue, Suite 207 State College, PA, 16803, USA
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Tracy Sbrocco
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
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208
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Stickley A, Oh H, Koyanagi A, Leinsalu M, Narita Z, Roberts B, McKee M. Perceived discrimination and psychological distress in nine countries of the former Soviet Union. Int J Soc Psychiatry 2019; 65:158-168. [PMID: 30755059 DOI: 10.1177/0020764019827982] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Perceived discrimination has been linked to worse mental health. However, little is known about this association in the countries of the former Soviet Union (fSU). AIM To address this deficit, this study examined the link between perceived discrimination and psychological distress in nine fSU countries. METHODS Data were analyzed from 18,000 adults aged ⩾18 years obtained during the Health in Times of Transition (HITT) survey undertaken in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine in 2010 and 2011. A single-item measure was used to assess discrimination. Psychological distress was measured with a 12-item scale. Logistic regression analysis and meta-analysis were used to examine associations. RESULTS After adjusting for all potential confounders, when using none/little discrimination as the reference category, moderate and strong discrimination were associated with significantly increased odds for psychological distress in the total population and in men and women separately with odds ratios ranging from 1.93 to 2.64. Meta-analysis based on country-wise estimates showed that the level of between-country heterogeneity was negligible. CONCLUSION Perceived discrimination is associated with psychological distress in countries throughout the fSU. Quantitative and qualitative research is now warranted to determine its specific forms and impact on population health in individual fSU countries.
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Affiliation(s)
- Andrew Stickley
- 1 Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- 2 The Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden
| | - Hans Oh
- 3 University of Southern California Suzanne Dworak-Peck School of Social Work, Los Angeles, CA, USA
| | - Ai Koyanagi
- 4 Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain
- 5 Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Mall Leinsalu
- 2 The Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden
- 6 Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Zui Narita
- 7 Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Bayard Roberts
- 8 Centre for Global Chronic Conditions, London School of Hygiene & Tropical Medicine, London, UK
| | - Martin McKee
- 9 Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
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209
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Miller K, Kelly A, Stephen E. Exposure to body focused and non-body focused others over a week: A preliminary investigation of their unique contributions to college women's eating and body image. Body Image 2019; 28:44-52. [PMID: 30580168 DOI: 10.1016/j.bodyim.2018.12.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 12/07/2018] [Accepted: 12/07/2018] [Indexed: 01/25/2023]
Abstract
This study investigated how exposure to non-body focused others (i.e., those who are not preoccupied with their body weight/shape or appearance) and exposure to body focused others uniquely affect young women's eating and body image over a week, within a day, and from one day to the next. For seven consecutive days, 92 female college students completed nightly online questionnaires about their daily experiences. Between-persons, multilevel modelling revealed that higher average levels of exposure to non-body focused others over the week uniquely predicted greater intuitive eating, greater body appreciation, and less dietary restraint, whereas higher average exposure to body focused others predicted these outcomes in the opposite direction. Within-persons, exposure to body focused others did not predict eating and body image, but exposure to non-body focused others did. On days when women had more exposure to non-body focused others than their personal average level or than the previous day's level, eating and body image were better. These findings are the first to suggest that independent of exposure to body focused others, level of exposure to non-body focused others - within and across days - contribute positively to eating and body image.
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Affiliation(s)
- Kathryn Miller
- Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
| | - Allison Kelly
- Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Elizabeth Stephen
- Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
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210
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Jackson SE, Holter L, Beeken RJ. 'Just because I'm old it doesn't mean I have to be fat': a qualitative study exploring older adults' views and experiences of weight management. BMJ Open 2019; 9:e025680. [PMID: 30782939 PMCID: PMC6377572 DOI: 10.1136/bmjopen-2018-025680] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES The aim of this study was to explore older adults' beliefs about the appropriateness of weight management, and how their experiences and expectations of weight management have changed as they have got older. DESIGN Qualitative semistructured interview study. SETTING UK. PARTICIPANTS Older adults (≥65 years) in the UK who had recent (<5 years) experience of trying to manage their weight (n=15; 12 women; 73% white British). RESULTS Data were analysed using thematic analysis. Emergent themes highlighted that weight remained a concern for many older adults, although having a high body weight was seen to be more acceptable at older than younger ages. Excess weight was reported to have negative consequences for health and well-being which participants felt could be alleviated by losing weight. Participants were motivated to lose weight for appearance and health reasons, but mentioned finding it harder to lose weight as they had got older and generally felt they had received limited guidance on weight management from health professionals. CONCLUSIONS The views of our participants highlight the need for further research into safe and effective methods of weight loss for older people and indicate that advice and support from health professionals would be welcomed.
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Affiliation(s)
- Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, UK
| | - Linn Holter
- Department of Behavioural Science and Health, University College London, London, UK
| | - Rebecca J Beeken
- Department of Behavioural Science and Health, University College London, London, UK
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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211
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The effects of a teaching intervention on weight bias among kinesiology undergraduate students. Int J Obes (Lond) 2019; 43:2273-2281. [PMID: 30755698 DOI: 10.1038/s41366-019-0325-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 11/23/2018] [Accepted: 12/26/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Weight bias is present among kinesiology professionals and this may cause a significant negative impact on their clients with obesity. Thus, our objective was to test if learning about uncontrollable cause of obesity and about weight bias would reduce explicit and implicit weight bias among kinesiology undergraduate students compared to the traditional curriculum which is more focused on controllable causes of weight gain. METHODS We recruited undergraduates from two classes of the same kinesiology major course taught by the same instructor. In-class teaching activities consisted of 80 min lecture on day 1, video watching session and a group activity on day 3 for both groups. Intervention group (n = 33) learned about uncontrollable causes of obesity and about weight bias and had activities to evoke empathy. Control group (n = 34) learned the traditional curriculum where they learned the role of exercise and diet in weight management. We measured explicit and implicit weight bias using Anti-Fat Attitude Test (AFAT) and Implicit Association Test (IAT), respectively pre-intervention, immediate post intervention and 1 month later. RESULTS In mixed model analysis, AFAT Blame scores had significant group by time interaction (p < 0.001). Blame scores significantly reduced with mean differences (standard error (SE)) of -0.35 (0.08) post intervention (p < 0.001) and persisted to be reduced with mean differences (SE) of -0.39 (0.08) even after 4-week follow-up (p < 0.001) only in the intervention group. Odds of having less implicit weight bias was significantly lower at 4-week follow-up than pre-intervention (odds ratio = 0.4; 95% CI: 0.22-0.73) in the control group but no changes were seen in the intervention group. CONCLUSIONS "Blame" component of explicit weight bias significantly decreased when students learned about controllable causes of obesity and weight bias, but implicit bias did not reduce. However, implicit weight bias appears to increase when education on obesity is limited to diet and exercise interventions as taught in the traditional curriculum.
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212
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Pearl RL, Wadden TA, Walton K, Allison KC, Tronieri JS, Williams NN. Health and appearance: Factors motivating the decision to seek bariatric surgery. Surg Obes Relat Dis 2019; 15:636-642. [PMID: 30803880 DOI: 10.1016/j.soard.2019.01.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 12/19/2018] [Accepted: 01/21/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Few studies have examined the motivating factors and people that lead patients to seek bariatric surgery. Bariatric surgery helps to improve body image, but little is known about patients' desired changes in the appearance of specific body parts. OBJECTIVES To identify key factors and people motivating patients' decision to seek bariatric surgery, and to assess body dissatisfaction and desire for surgery to change the appearance of specific body parts. SETTING U.S. university-based hospital clinic. METHODS Patients seeking bariatric surgery (N = 208, 78.4% women, 52.4% black, mean age = 42.0 ± 12.3 yr, mean body mass index = 46.7 ± 8.5 kg/m2) completed the Reasons for Bariatric Surgery questionnaire before their preoperative Psychosocial-behavioral evaluation. Participants rated (1-10) the importance of 15 potential reasons and 7 potential people motivating their decision to seek bariatric surgery. Participants also rated their dissatisfaction and desire for surgery to change the appearance of 11 body parts. RESULTS Mean scores of motivating factors were highest for Physical Health (9.9 ± .4), followed by Longevity (9.7 ± .9). Patients reported high body dissatisfaction and desire for surgery to change the appearance of several body parts, including stomach and thighs. "Myself" was the highest-rated motivating person, followed by healthcare providers, family, and someone who had undergone bariatric surgery. CONCLUSIONS Health is the primary reason reported by patients for seeking bariatric surgery. Patients also report a strong desire for surgery to change the appearance of their body. Patients are self-driven to pursue surgery but are also influenced by healthcare providers, family, and people who have undergone surgery. (Surg Obes Relat Dis 2019;X:XXX-XXX.) © 2019 American Society for Metabolic and Bariatric Surgery. All rights reserved.
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Affiliation(s)
- Rebecca L Pearl
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Thomas A Wadden
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kaylah Walton
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kelly C Allison
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jena Shaw Tronieri
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Noel N Williams
- Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
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213
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Bergen M, Mollen D. Teaching Sizeism: Integrating Size into Multicultural Education and Clinical Training. WOMEN & THERAPY 2019. [DOI: 10.1080/02703149.2018.1524065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Martha Bergen
- Counseling and Psychological Services, Texas Woman’s University, Denton, Texas
| | - Debra Mollen
- Department of Psychology and Philosophy, Texas Woman’s University, Denton, Texas
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214
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Yamamoto S, Maeder EM, Mossière A, Brown D. The influence of defendant body size and defendant gender on mock juror decision-making. COGENT PSYCHOLOGY 2019. [DOI: 10.1080/23311908.2019.1674091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Susan Yamamoto
- Department of Psychology, Carleton University, Ottawa, Canada
| | - Evelyn M. Maeder
- Institute of Criminology and Criminal Justice, Carleton University, Ottawa, Canada
| | - Annik Mossière
- Department of Psychology, Carleton University, Ottawa, Canada
| | - Dylan Brown
- Institute of Criminology and Criminal Justice, Carleton University, Ottawa, Canada
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215
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Mayer-Brown S, Basch MC, Robinson ME, Janicke DM. Impact of Child and Maternal Weight on Healthcare Trainee Clinical Assessment Decision Making: A Virtual Human Study. Child Obes 2019; 15:63-70. [PMID: 30388042 DOI: 10.1089/chi.2018.0136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Adult literature documents that healthcare providers rely on patient characteristics, such as age, race, and weight, when making clinical decisions. However, little research has examined these biases among pediatric populations. This study aimed to examine the impact of child and maternal weight and race on clinical decision-making of healthcare trainees in the context of a pediatric pain assessment using standardized virtual pediatric patients and mothers. METHODS Ninety-two healthcare trainees read a standardized clinical vignette describing a child with chronic pain, which was accompanied by eight virtual human (VH) scenes-each with a child and mother. Scenes varied by the dyad's race, child's weight status, and mother's weight status. For each scene, participants were asked to make six healthcare assessment ratings. RESULTS Participants rated children (M = 42.44 vs. 48.69; p < 0.001) and mothers (M = 51.06 vs. 65.31; p < 0.001) with obesity as being less likely to adhere to physician recommendations compared with healthy weight children and mothers. Child patients with obesity (M = 38.88 vs. 30.08; p < 0.001) and mothers with obesity (M = 49.71 vs. 43.71; p < 0.001) were also rated as bearing more responsibility for the child's health status compared with healthy weight peers. CONCLUSIONS This study provides evidence that child and mother weight can impact clinical decision-making, as well as for the utility of VH technology in studying decision-making among healthcare trainees and providers.
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Affiliation(s)
- Sarah Mayer-Brown
- 1 Department of Child Psychiatry, Hasbro Children's Hospital, Providence, RI
| | - Molly C Basch
- 2 Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
| | - Michael E Robinson
- 2 Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
| | - David M Janicke
- 2 Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
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216
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Affiliation(s)
- Ashley E. Kasardo
- Carruth Center for Psychological and Psychiatric Services, West Virginia University, Morgantown, West Virginia
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217
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Veillette LAS, Serrano JM, Brochu PM. What's Weight Got to Do With It? Mental Health Trainees' Perceptions of a Client With Anorexia Nervosa Symptoms. Front Psychol 2018; 9:2574. [PMID: 30618990 PMCID: PMC6304369 DOI: 10.3389/fpsyg.2018.02574] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 11/30/2018] [Indexed: 12/28/2022] Open
Abstract
This study examined the effect of client body mass index (BMI) on diagnostic impressions and perceptions of mental health trainees. Participants read a vignette of a mock female client presenting for treatment with symptoms of anorexia nervosa. Participants were randomly assigned to one of three conditions in which the client was described as “underweight,” “normal weight,” or “overweight.” Results revealed that participants assigned to the “underweight” condition diagnosed the client with anorexia nervosa or atypical anorexia nervosa more frequently than participants assigned to the “overweight” or “normal weight” conditions. There was no difference based on client BMI when the more general diagnosis of other specified feeding or eating disorder (OSFED; previously known as eating disorder not otherwise specified [EDNOS]) was included, however. Participants in the “overweight” and “normal weight” conditions recommended fewer therapy sessions for the client than participants in the “underweight” condition. Furthermore, participants more strongly endorsed weight-based stereotypes to describe the client when she was “overweight” than “normal weight” or “underweight.” Contrary to hypotheses, however, participants reported moderately positive attitudes toward treating the client regardless of BMI. These preliminary findings support initiatives aimed at providing training on weight stigma and eating disorders to mental health professionals.
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Affiliation(s)
- Laurie A S Veillette
- College of Psychology, Nova Southeastern University, Fort Lauderdale, FL, United States
| | - Jose Martinez Serrano
- College of Psychology, Nova Southeastern University, Fort Lauderdale, FL, United States
| | - Paula M Brochu
- College of Psychology, Nova Southeastern University, Fort Lauderdale, FL, United States
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218
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Sutin AR, Robinson E, Daly M, Terracciano A. Perceived Body Discrimination and Intentional Self-Harm and Suicidal Behavior in Adolescence. Child Obes 2018; 14:528-536. [PMID: 30226995 PMCID: PMC6249665 DOI: 10.1089/chi.2018.0096] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND This study examines whether discrimination based on the body is associated with intentional self-harm and suicidal behavior in adolescence. METHODS Participants were from the Longitudinal Study of Australian Children (N = 2948; 48% female). Discrimination and items on self-harm and suicidal behavior were measured in the Wave 6 assessment, when study participants were 14-15 years old. BMI, depressive symptoms, peer victimization, and weight self-perception were also assessed. RESULTS Discrimination was associated with increased risk of thoughts of self-harm (OR = 2.41, 95% CI = 1.88-3.10), hurting the self on purpose (OR = 2.27, 95% CI = 1.67-3.08), considering suicide (OR = 2.17, 95% CI = 1.59-2.96), having a suicide plan (OR = 2.50, 95% CI = 1.81-2.47), attempting suicide (OR = 1.96, 95% CI = 1.30-2.96), controlling for sociodemographic factors, BMI, and depressive symptoms. These associations generally held adjusting for peer victimization or weight self-perception. CONCLUSIONS Weight discrimination has been associated consistently with poor outcomes in adulthood. The present research indicates these associations extend to adolescence and an extremely consequential outcome: the social experience of weight increases risk of intentional self-harm and suicidal behavior.
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Affiliation(s)
- Angelina R. Sutin
- Florida State University College of Medicine, Tallahassee, FL.,Address correspondence to: Angelina R. Sutin, PhD, Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, 1115 W. Call Street, Tallahassee, FL 32306
| | - Eric Robinson
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom
| | - Michael Daly
- Behavioural Science Centre, University of Stirling, Stirling, United Kingdom.,UCD Geary Institute, University College Dublin, Dublin, Ireland.,Department of Psychology, Maynooth University, National University of Ireland, Maynooth, Ireland
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219
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Pesch MH, Appugliese DP, Miller AL, Rosenblum KL, Lumeng JC, Bauer KW. Approaches to restrictive feeding: Associations with child weight and eating behavior. Eat Behav 2018; 31:74-79. [PMID: 30153545 PMCID: PMC6226350 DOI: 10.1016/j.eatbeh.2018.08.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 08/09/2018] [Accepted: 08/22/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Identifying differences in how mothers communicate restriction of their children's eating may be important to understanding the effects of restriction on children's intake and weight status. OBJECTIVES To characterize mothers' restrictive statements by affect and directness, and examine cross-sectional associations between restrictive statement types and children's body mass index and eating behaviors. METHODS Mother-child dyads (N = 223, mean child age 5.9 years) participated in a structured eating task. A coding scheme reliably characterized mothers' restrictive statements. Mothers completed measures of child enjoyment of food, food responsiveness, and satiety responsiveness, and child anthropometrics were measured. Poisson regression was used to test associations between type of restrictive statements and child BMI z-score (BMIz) and eating behaviors, adjusting for covariates. RESULTS Higher child BMIz was associated with mothers' more frequent use of negative direct restrictive statements, but not other types of statements. This association was stronger among girls (RR (95% CI) = 2.28 (1.45-3.59)) than boys (RR (95% CI) = 1.49 (1.05-2.10)). Among girls, but not boys, higher enjoyment of food and lower satiety responsiveness were associated with more frequent positive direct restrictive statements (RR (95% CI) = 1.63 (1.20-2.21) and RR (95% CI) = 1.94 (1.29-2.92), respectively). For both sexes, mothers' use of positive indirect restrictive statements was more frequent among children with higher enjoyment of food (RR (95% CI) = 1.38 (1.11-1.72). CONCLUSIONS The statements mothers use to restrict their children's eating vary in affect and directness. Child characteristics, such as sex, BMI, and the presence of specific eating behaviors, are associated with differing approaches to restriction by mothers.
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Affiliation(s)
- Megan H. Pesch
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics and Communicable Diseases, and the Center for Human Growth and Development, University of Michigan, 300 N. Ingalls Street, 1109 SE, Ann Arbor, MI 48109-5456, USA.
| | | | - Alison L. Miller
- Center for Human Growth and Development and Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 3718 SPH Building I, Ann Arbor, MI 48109-2029, USA.
| | - Katherine L. Rosenblum
- Department of Psychiatry, Medical School and Center for Human Growth and Development, University of Michigan, 4250 Plymouth Road, Rachel Upjohn Building, Ann Arbor, MI 48109, USA.
| | - Julie C. Lumeng
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics and Communicable Diseases; the Center for Human Growth and Development, and the Department of Nutritional Sciences, School of Public Health at the University of Michigan, 300 N. Ingalls Street, 300 North Ingalls Street, Ann Arbor, MI 48109-0406, USA.
| | - Katherine W. Bauer
- Department of Nutritional Sciences, School of Public Health, University of Michigan, and Center for Human Growth and Development, 3845 SPH 1, 1415 Washington Heights, Ann Arbor MI, 48109-2029, USA.
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220
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Obesity, perceived weight discrimination, and hair cortisol: a population-based study. Psychoneuroendocrinology 2018; 98:67-73. [PMID: 30118922 DOI: 10.1016/j.psyneuen.2018.08.018] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 08/09/2018] [Accepted: 08/10/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND PURPOSE Stigmatization of individuals with obesity is pervasive and may act as a psychological stressor. The present study examined whether perceived weight discrimination mediated the relationship between obesity and cortisol, an objective marker of chronic stress, in a population-based sample. METHODS Data were from the English Longitudinal Study of Ageing (n = 1872). Height and weight were objectively measured in 2008/09. Experiences of weight-related discrimination were reported via questionnaire in 2010/11. Hair cortisol concentrations were determined from the scalp-nearest 2 cm hair segment in 2012/13. Mediation analyses tested the role of perceived weight discrimination in the associations between obesity and BMI and hair cortisol concentration, adjusting for age, sex, ethnicity, socio-economic status, smoking status, depression and hair-related factors. RESULTS Obesity, BMI and perceived weight discrimination were positively related to hair cortisol (all p < .01). Perceived weight discrimination significantly mediated associations between obesity and hair cortisol (β = 0.021, SE = 0.007, 95% CI 0.007-0.036) and BMI and hair cortisol (β = 0.001, SE = 0.0004, 95% CI 0.0004-0.002), accounting for 19% of the total effect of obesity and 23% of the total effect of BMI on hair cortisol. CONCLUSIONS Perceived weight discrimination is an important mediator of the association between obesity and cortisol. Interventions combating weight stigma and discrimination or promoting strategies for coping with stress could help to lessen the psychological and physiological burden of obesity.
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221
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Tischner I. Tomorrow is the start of the rest of their life — so who cares about health? Exploring constructions of weight-loss motivations and health using story completion. QUALITATIVE RESEARCH IN PSYCHOLOGY 2018. [DOI: 10.1080/14780887.2018.1536385] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Irmgard Tischner
- Technische Hochschule Deggendorf (THD), Applied Healthcare Sciences, Germany
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222
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Panza GA, Armstrong LE, Taylor BA, Puhl RM, Livingston J, Pescatello LS. Weight bias among exercise and nutrition professionals: a systematic review. Obes Rev 2018; 19:1492-1503. [PMID: 30176183 DOI: 10.1111/obr.12743] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 06/20/2018] [Accepted: 06/28/2018] [Indexed: 12/16/2022]
Abstract
Obesity affects approximately one-third of American adults. Recent evidence suggests that weight bias may be pervasive among both exercise and nutrition professionals working with adults who have obesity. However, the published literature on this topic is limited. This review aimed to (i) systematically review existing literature examining weight bias among exercise and nutrition professionals; (ii) discuss the implications of this evidence for exercise and nutrition professionals and their clients; (iii) address gaps and limitations of this literature; and (iv) identify future research directions. Of the 31 studies that met the criteria for this review, 20 examined weight bias among exercise professionals, of which 17 (85%) found evidence of weight bias among professionals practicing physical therapy (n = 4), physical education (n = 8) and personal/group fitness training (n = 5). Of 11 studies examining weight bias among nutrition professionals, eight (73%) found evidence of weight bias. These findings demonstrate fairly consistent evidence of weight bias among exercise and nutrition professionals. However, the majority of studies were cross-sectional (90%). Given that weight bias may compromise quality of care and potentially reinforce weight gain and associated negative health consequences in patients with obesity, it is imperative for future work to examine the causes and consequences of weight bias within exercise and nutrition professions using more rigorous study designs.
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Affiliation(s)
- G A Panza
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA.,Department of Cardiology, Hartford Hospital, Hartford, CT, USA
| | - L E Armstrong
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA
| | - B A Taylor
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA.,Department of Cardiology, Hartford Hospital, Hartford, CT, USA
| | - R M Puhl
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT, USA.,Department of Human Development and Family Studies, University of Connecticut, Storrs, CT, USA
| | - J Livingston
- Department of Research Services, University of Connecticut, Storrs, CT, USA
| | - L S Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA
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223
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Zhou Q, Wang T, Basu K. Negative association between BMI and depressive symptoms in middle aged and elderly Chinese: Results from a national household survey. Psychiatry Res 2018; 269:571-578. [PMID: 30199699 DOI: 10.1016/j.psychres.2018.08.107] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 05/23/2018] [Accepted: 08/27/2018] [Indexed: 01/20/2023]
Abstract
The association between body size and mental health has been the focus of many studies. Results, however, varies between studies. This study aimed to investigate the association between BMI and depressive symptoms among Chinese adults. We also further explored childhood starvation as a potential mediator of this association. The China Health and Retirement Longitudinal Study data, a representative national survey of adults age 45 and older was used in this study. Results showed that the prevalence of overweight and obesity were 28.8% and 11.6%. There was a negative association between BMI and depressive symptoms for males. Obese male adults had the lowest CES-D scores, followed by overweight male adults, and underweight male adults had the highest CES-D scores. These associations also exist but are not significant for females. Furthermore, these associations were significant among males who had been exposed to food shortage during their childhood. Our results suggested a significant positive association between BMI and depression in middle aged and elderly males in China, while this association is weak in females. Childhood food shortage experience was a potential causative factor accounting for this association.
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Affiliation(s)
- Qin Zhou
- School of Public Administration, University of International Business and Economics, Ningyuan Building, No. 10 Huixin Dongjie, Chaoyang District, Beijing 100029, China.
| | - Tianyu Wang
- School of Labor and Human Resources, Renmin University of China, Qiushi Building, No. 59 Zhongguancun Street, Beijing 100871, China.
| | - Kisalaya Basu
- Health Canada, Brooke Claxton Building, AL-0908B, Tunney's Pasture, 70 Colu`mbine Driveway, Ottawa, Ontario K1A 0K9, Canada.
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224
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Sex differences in the relationships among weight stigma, depression, and binge eating. Appetite 2018; 133:166-173. [PMID: 30385263 DOI: 10.1016/j.appet.2018.10.029] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 09/08/2018] [Indexed: 11/22/2022]
Abstract
Weight stigma and weight discrimination are prevalent in the United States and binge eating has been found to be associated with these experiences in numerous studies. One issue with the current literature on weight stigma and binge eating, however, is that study samples are primarily female, resulting in a lack of understanding of this relationship among males. To address this gap, we examined potential sex differences in the association between weight stigma and binge eating, as well as mediators of this relationship. Specifically, we examined experiences of weight discrimination and weight stigma consciousness as predictors of binge eating, and we assessed whether these relationships were mediated by depression, perceived stress, and/or perceived control. Results showed that, among females and males, experiences of weight discrimination significantly predicted binge eating and depression mediated this relationship; perceived stress also mediated this association, but only among males, and perceived control did not mediate for either sex. Results also showed that, among males, the relationship between weight stigma consciousness and binge eating was mediated by depression and perceived control, but not perceived stress. Weight stigma consciousness was unrelated to binge eating among females. Together, these findings suggest that weight stigma constructs differentially impact females and males, thereby illuminating the possible need for consideration of sex as an important component of efforts to reduce weight stigma.
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225
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Huibregtse BM, Boardman JD. Provider bias as a function of patient genotype: polygenic score analysis among diabetics from the Health and Retirement Study. Obes Sci Pract 2018; 4:448-454. [PMID: 30338115 PMCID: PMC6180716 DOI: 10.1002/osp4.293] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 07/10/2018] [Accepted: 07/12/2018] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE Poor patient-provider interactions due to provider bias are associated with worse physiological and behavioural health outcomes for patients. Prior research has shown that patients with obesity perceive less favourable interactions compared with those with lower weights. This paper explores whether this association depends on patients' cumulative polygenic score with respect to genes linked to obesity (i.e. a single variable quantifying the individual's genome-wide risk factors for high body mass index [BMI] or genetic liability) and whether providers react differentially to patients whose obesity is more genetic in nature compared with patients with diabetes caused by environmental factors. METHODS The association between patients' BMI category, their polygenic score for high BMI and their interaction was assessed for two measures of the patient-provider interaction within a sample of 521 older patients with diabetes from the Health and Retirement Study. RESULTS Particularly for patients with obesity, the quality of the patient-provider interaction depended on genetic liability for high BMI controlling for demographic and clinical covariates. Providers responded less favourably to patients with diabetes influenced by environmental factors compared with individuals with high genetic liability. CONCLUSIONS Results of this study suggest that a patient's genotype may elicit particular responses from their healthcare provider. When a provider judges a patient's high BMI to be environmentally driven rather than genetically oriented, patients receive reduced quality of care.
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Affiliation(s)
- B. M. Huibregtse
- Institute of Behavioral ScienceUniversity of Colorado BoulderBoulderCOUSA
- Institute for Behavioral GeneticsUniversity of Colorado BoulderBoulderCOUSA
| | - J. D. Boardman
- Institute of Behavioral ScienceUniversity of Colorado BoulderBoulderCOUSA
- Department of SociologyUniversity of Colorado BoulderBoulderCOUSA
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226
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Oldham M, Tomiyama AJ, Robinson E. The psychosocial experience of feeling overweight promotes increased snack food consumption in women but not men. Appetite 2018; 128:283-293. [PMID: 29883685 DOI: 10.1016/j.appet.2018.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Revised: 03/06/2018] [Accepted: 05/02/2018] [Indexed: 12/19/2022]
Abstract
Self-identification of being overweight has been associated with overeating and weight gain in observational studies, irrespective of whether the individual in question is objectively overweight. The aims of the present studies were to examine whether experimentally manipulating the psychosocial experience of feeling overweight impacted on snack food consumption and to identify mechanisms explaining this effect. In Study 1, to manipulate the psychosocial experience of feeling overweight, 120 women wore an obese body suit or control clothing in public or private settings, before consuming snack foods. Wearing the obese body suit resulted in an increase in snack food consumption and this effect was not moderated by whether participants wore the obese body suit in public or in private. In Study 2, we aimed to replicate the effect of the obese body suit on snack food consumption and also examined whether the effect of the body suit on eating behaviour was moderated by participant sex (n = 150; 80 women). Women who wore the obese body suit ate significantly more than women who wore the control clothing, but this effect was not observed in men. Across both studies we examined a number of potential mechanisms that could explain the effect that wearing the obese body suit had on snack food consumption, but did not find supporting evidence. The psychosocial experience of feeling overweight may lead to increased snack food consumption in women, but the psychological mechanism explaining this effect is unclear.
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Affiliation(s)
- Melissa Oldham
- Psychological Sciences, University of Liverpool, Liverpool, UK.
| | - A Janet Tomiyama
- Department of Psychology, University of California Los Angeles, Los Angeles, USA
| | - Eric Robinson
- Psychological Sciences, University of Liverpool, Liverpool, UK
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227
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French SA, Wall M, Corbeil T, Sherwood NE, Berge JM, Neumark-Sztainer D. Obesity in Adolescence Predicts Lower Educational Attainment and Income in Adulthood: The Project EAT Longitudinal Study. Obesity (Silver Spring) 2018; 26:1467-1473. [PMID: 30226010 PMCID: PMC6146410 DOI: 10.1002/oby.22273] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 06/21/2018] [Accepted: 07/07/2018] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Prospective associations between obesity in adolescence and adult socioeconomic outcomes, and potential mediators, were examined in a contemporary cohort. METHODS Longitudinal data collected in 1998 to 1999 (Project EAT-I) and 2015 to 2016 (EAT-IV) were analyzed for 1,796 participants who provided data at both time points. Adolescents (mean age = 14.8 years) self-reported demographic and psychosocial variables (EAT-I) and follow-up outcomes (EAT-IV). Body weight and height were directly measured. Bachelor's degree or more education, income ≥ US $50,000, and partnered status at follow-up were examined by baseline obesity (>95th BMI percentile) using logistic regression. Self-esteem, depression, and weight-related teasing were examined as mediators using multivariate probit regressions. All analyses were adjusted for race, baseline age, and parent socioeconomic status. RESULTS Girls with obesity were significantly less likely to have achieved a bachelor's degree (OR 0.32, 95% CI [0.18, 0.58]; P < 0.001), earn ≥ $50,000 annually (OR 0.57, 95% CI [0.33, 0.99]; P < 0.04), or be partnered (OR 0.45, 95% CI [0.27, 0.75]; P < 0.002) in adulthood. No associations were observed among boys. Among girls, depression mediated 8.5% and 23.6% of the association between adolescent obesity and adult education and income, respectively. CONCLUSIONS Adolescent girls with obesity have lower educational attainment and income and are less likely to be partnered in later adulthood. Depression may partly mediate the associations.
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Affiliation(s)
- Simone A French
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Melanie Wall
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Thomas Corbeil
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Nancy E Sherwood
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jerica M Berge
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
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228
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Griffiths S, Brennan L, O'Gorman B, Goedel WC, Sheffield J, Bastian B, Barlow FK. Experiences of weightism among sexual minority men: Relationships with Body Mass Index, body dissatisfaction, and psychological quality of life. Soc Sci Med 2018; 214:35-40. [PMID: 30145438 DOI: 10.1016/j.socscimed.2018.08.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 08/09/2018] [Accepted: 08/19/2018] [Indexed: 11/17/2022]
Abstract
RATIONALE Experiences of weightism are associated with reduced psychological quality of life among heterosexual men and women. However, despite noted vulnerability to body image pressures, weightism has not been quantitatively examined among sexual minority men. We tested two hypotheses: first, that Body Mass Index (BMI) and weightism would evidence a curvilinear relationship, such that underweight and overweight men would report experiencing more weightism than men in the "normal" weight range; and second, that a negative association between BMI and quality of life would be explained by experiences of weightism and body dissatisfaction. METHOD Sexual minority men living in Australia and New Zealand (N = 2733) completed an online survey and provided data on their height, weight, experiences of weightism, body dissatisfaction, and psychological quality of life. RESULTS Participants' BMIs ranged from 14.15 to 68.12 with 3.0% classified as underweight, 50.5% as "normal" weight, 28.0% as overweight, and 17.4% as obese. Weightism was experienced by 38.9% of participants. As predicted, weightism evidenced a curvilinear relationship with BMI, such that underweight and overweight participants reported experiencing more weightism relative to "normal" weight participants. Yet, this curvilinear relationship evidenced a dominant linear component: Overall, weightism markedly increased as BMI increased, and obese participants reported experiencing the most weightism. In addition, we found evidence supporting our hypothesis that men with higher BMIs would report experiencing more weightism and higher body dissatisfaction, and through these variables, reduced quality of life. Adjusted for body dissatisfaction and weightism, the formerly negative association of BMI with psychological quality of life became (weakly) positive. CONCLUSIONS Weightism is a salient phenomenon experienced by sexual minority men in smaller and larger bodies with potential direct and indirect adverse effects on psychological quality of life. Whilst BMI and weightism evidenced a curvilinear relationship, the burden of weightism is disproportionately borne by sexual minority men with higher BMIs.
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Affiliation(s)
- Scott Griffiths
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.
| | - Leah Brennan
- School of Psychology, Australian Catholic University, Melbourne, Australia
| | - Beth O'Gorman
- School of Psychology, University of Queensland, Brisbane, Australia
| | - William C Goedel
- School of Medicine, New York University, New York, United States of America; School of Public Health, Brown University, Providence, United States of America
| | - Jeanie Sheffield
- School of Psychology, University of Queensland, Brisbane, Australia
| | - Brock Bastian
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
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229
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Tomiyama AJ, Carr D, Granberg EM, Major B, Robinson E, Sutin AR, Brewis A. How and why weight stigma drives the obesity 'epidemic' and harms health. BMC Med 2018; 16:123. [PMID: 30107800 PMCID: PMC6092785 DOI: 10.1186/s12916-018-1116-5] [Citation(s) in RCA: 306] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 07/03/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND In an era when obesity prevalence is high throughout much of the world, there is a correspondingly pervasive and strong culture of weight stigma. For example, representative studies show that some forms of weight discrimination are more prevalent even than discrimination based on race or ethnicity. DISCUSSION In this Opinion article, we review compelling evidence that weight stigma is harmful to health, over and above objective body mass index. Weight stigma is prospectively related to heightened mortality and other chronic diseases and conditions. Most ironically, it actually begets heightened risk of obesity through multiple obesogenic pathways. Weight stigma is particularly prevalent and detrimental in healthcare settings, with documented high levels of 'anti-fat' bias in healthcare providers, patients with obesity receiving poorer care and having worse outcomes, and medical students with obesity reporting high levels of alcohol and substance use to cope with internalized weight stigma. In terms of solutions, the most effective and ethical approaches should be aimed at changing the behaviors and attitudes of those who stigmatize, rather than towards the targets of weight stigma. Medical training must address weight bias, training healthcare professionals about how it is perpetuated and on its potentially harmful effects on their patients. CONCLUSION Weight stigma is likely to drive weight gain and poor health and thus should be eradicated. This effort can begin by training compassionate and knowledgeable healthcare providers who will deliver better care and ultimately lessen the negative effects of weight stigma.
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Affiliation(s)
- A Janet Tomiyama
- Department of Psychology, University of California Los Angeles, 1285 Franz Hall, Los Angeles, CA, 90095, USA.
| | - Deborah Carr
- Department of Sociology, Boston University, Boston, MA, USA
| | - Ellen M Granberg
- Department of Sociology, Anthropology, and Criminal Justice, Clemson University, Clemson, SC, USA
| | - Brenda Major
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, CA, USA
| | - Eric Robinson
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - Angelina R Sutin
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, FL, USA
| | - Alexandra Brewis
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA
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230
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Bächler T, Geary N, Bueter M, Leeners B, Rehfeld JF, Lutz TA, Asarian L. RYGB increases the satiating effect of intrajejunal lipid infusions in female rats. Appetite 2018; 131:94-99. [PMID: 30118785 DOI: 10.1016/j.appet.2018.08.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 07/30/2018] [Accepted: 08/13/2018] [Indexed: 11/16/2022]
Abstract
We used a novel rat model to investigate the physiological bases of early satiation after Roux-en-Y gastric bypass surgery (RYGB). Female rats were subjected to RYGB or sham surgery. Chronic infusion catheters were placed in the Roux limb of RYGB rats and the corresponding anatomical locus of the jejuna of sham-RYGB rats. Rats were also ovariectomized and chronically treated with either estradiol (E2; 2 μg each 4th day SC) or the oil vehicle. Testing was begun 10-12 wk after surgery. Intrajejunal lipid infusions (10 min, 4.4 mL, 8.8 kcal) were performed just before test meals of a low-energy artificially sweetened gel diet (0.1 kcal/g) that RYGB rats ingest avidly. Intrajejunal lipid infusions reduced test-meal size more in RYGB rats than sham-operated rats, indicating that, at least after prolonged adaptation to surgery, the satiating actions of lipids acting intra- or post-jejunally are increased by RYGB and that accelerated meal appearance in the intestines after RYGB is not necessary for this effect. The satiating effects of intrajejunal lipid infusions were similar in E2-and oil-treated rats, suggesting that the effect was not dependent on an activational effect of estrogens. In a second experiment, pretreatment with the cholecystokinin A-receptor antagonist devazepide reduced the satiating effect of intrajejunal lipid infusions in E2-treated RYGB rats. Although these data are preliminary due to the smaller numbers of rats than in the first experiment, they suggest that cholecystokinin-mediated jejunal satiation contributes to early satiation after RYGB in ovariectomized rats with peri-ovulatory levels of estradiol. The results of these experiments may be relevant to understanding RYGB outcome in pre- and postmenopausal women.
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Affiliation(s)
- Thomas Bächler
- Institute of Veterinary Physiology, Vetsuisse Faculty University of Zurich, Winterthurerstrasse 260, 8057, Zurich, Switzerland
| | - Nori Geary
- Department of Psychiatry, Weill Medical College of Cornell University, New York, NY, 10025, USA
| | - Marco Bueter
- Department of Visceral and Transplant Surgery Research, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland; Center for Integrative Human Physiology (ZIHP), University of Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland
| | - Brigitte Leeners
- Center for Integrative Human Physiology (ZIHP), University of Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland; Clinic for Reproductive Endocrinology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Jens F Rehfeld
- Department of Clinical Biochemistry (KB3011), Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
| | - Thomas A Lutz
- Institute of Veterinary Physiology, Vetsuisse Faculty University of Zurich, Winterthurerstrasse 260, 8057, Zurich, Switzerland; Center for Integrative Human Physiology (ZIHP), University of Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland
| | - Lori Asarian
- Institute of Veterinary Physiology, Vetsuisse Faculty University of Zurich, Winterthurerstrasse 260, 8057, Zurich, Switzerland; Center for Integrative Human Physiology (ZIHP), University of Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland.
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231
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Johnstone G, Grant SL. Weight stigmatisation in antiobesity campaigns: The role of images. Health Promot J Austr 2018; 30:37-46. [PMID: 29956413 DOI: 10.1002/hpja.183] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 06/26/2018] [Indexed: 01/21/2023] Open
Abstract
ISSUE ADDRESSED Antiobesity campaigns may inadvertently stigmatise individuals with obesity via the use of images that portray negative obesity stereotypes. This study investigated the impact of images on weight stigma using mock antiobesity campaigns featuring different types of images. METHODS Participants (N = 240) were randomly assigned to one of four campaign conditions: stereotypical images, counter-stereotypical images, neutral images, or no images. All four conditions used the same nonstigmatising message text. Participants indicated their attitudes towards being in social situations (desired social distance) with the target featured in the images, or individuals with obesity (no images), rated the target or individuals with obesity on various traits, and indicated to what extent the campaign was motivating and stigmatising. RESULTS Analysis of variance revealed that the stereotypical images were rated as the most stigmatising and were also associated with higher negative and lower positive trait ratings of the target and more desired social distance from the target. Neutral images generally produced the least weight stigma. CONCLUSION It is important to consider the impact of antiobesity campaign images that depict common obesity stereotypes. Developing, testing and disseminating nonstigmatising campaigns is important to reduce stigma and better engage individuals with antiobesity public health messages. SO WHAT?: Weight stigma has negative consequences for physical and psychological health, which may undermine obesity intervention efforts. Stereotypical images that blame individuals for their weight reinforce obesity stigma and are likely to be in-effective in increasing healthier behaviour and reducing obesity. The development of effective antiobesity campaigns should be a public health priority.
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Affiliation(s)
| | - Sharon L Grant
- Swinburne University of Technology, Hawthorn, Vic., Australia
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Keel PK, Jean Forney K, Buchman-Schmitt JM, Kennedy GA, Joiner TE. Examining the link between weight suppression and non-suicidal self-injurious behaviors. Eat Behav 2018; 30:66-71. [PMID: 29885591 DOI: 10.1016/j.eatbeh.2018.06.001] [Citation(s) in RCA: 3] [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: 10/17/2017] [Revised: 04/13/2018] [Accepted: 06/01/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Given the negative consequences of excess weight, a large portion of the US population is seeking to obtain and maintain weight loss. Weight Suppression (WS) represents the difference between previous highest adult weight and current weight and may have negative psychological consequences. The current study examined the link between WS and lifetime non-suicidal self-injurious (NSSI) behavior and explored indirect effects in this link using survey data in two large samples. METHODS Sample 1 included 1011 college students (67% female, mean age = 19 years); Sample 2 included 2461 participants from an epidemiological study (68% female, mean age = 34 years). Models of direct and indirect effects were tested in MPlus using bootstrapping. RESULTS As hypothesized, greater WS was associated with increased likelihood of lifetime NSSI in both samples (OR = 1.05 and 1.02). In both samples, significant indirect effects of drive for thinness (Total R2 = 0.06 and 0.09) and depressive symptoms (Total R2 = 0.13 and 0.29) accounted for this association. Alternative models in which the indirect effect of WS was tested in associations between drive for thinness or depressive symptoms and NSSI were not supported. CONCLUSION Results suggest that the link between WS and lifetime NSSI may be accounted for by eating or mood-related pathology. Future research should test whether addressing associated eating and mood problems would eliminate the link between WS and NSSI as a means for reducing suicide risk.
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Affiliation(s)
- Pamela K Keel
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, USA.
| | - K Jean Forney
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, USA.
| | | | - Grace A Kennedy
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, USA.
| | - Thomas E Joiner
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, USA.
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233
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Elsayed G, Erwood MS, Davis MC, Dupépé EC, McClugage SG, Szerlip P, Walters BC, Hadley MN. Association between preoperative activity level and functional outcome at 12 months following surgical decompression for lumbar spinal stenosis. J Neurosurg Spine 2018; 29:388-396. [PMID: 29979140 DOI: 10.3171/2018.2.spine171028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study defines the association of preoperative physical activity level with functional outcomes at 3 and 12 months following surgical decompression for lumbar spinal stenosis. METHODS Data were collected as a prospective observational registry at a single institution from 2012 through 2015, and then analyzed with a retrospective cohort design. Patients who were able to participate in activities outside the home preoperatively were compared to patients who did not participate in such activities, with respect to 3-month and 12-month functional outcomes postintervention, adjusted for relevant confounders. RESULTS Ninety-nine patients were included. At baseline, sedentary/inactive patients (n = 55) reported greater back pain, lower quality of life, and higher disability than similarly treated patients who were active preoperatively. Both cohorts experienced significant improvement from baseline in back pain, leg pain, disability, and quality of life at both 3 and 12 months after lumbar decompression surgery. At 3 months postintervention, sedentary/inactive patients reported more leg pain and worse disability than patients who performed activities outside the home preoperatively. However, at 12 months postintervention, there were no statistically significant differences between the two cohorts in back pain, leg pain, quality of life, or disability. Multivariate analysis revealed that sedentary/inactive patients had improved disability and higher quality of life after surgery compared to baseline. Active patients experienced greater overall improvement in disability compared to inactive patients. CONCLUSIONS Sedentary/inactive patients have a more protracted recovery after lumbar decompression surgery for spinal stenosis, but at 12 months postintervention can expect to reach similar long-term outcomes as patients who are active/perform activities outside the home preoperatively.
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Affiliation(s)
- Galal Elsayed
- 1Department of Neurosurgery, University of Alabama at Birmingham, Alabama; and
| | - Matthew S Erwood
- 1Department of Neurosurgery, University of Alabama at Birmingham, Alabama; and
| | - Matthew C Davis
- 1Department of Neurosurgery, University of Alabama at Birmingham, Alabama; and
| | - Esther C Dupépé
- 1Department of Neurosurgery, University of Alabama at Birmingham, Alabama; and
| | - Samuel G McClugage
- 1Department of Neurosurgery, University of Alabama at Birmingham, Alabama; and
| | - Paul Szerlip
- 2Department of Computer Science, University of Central Florida, Orlando, Florida
| | - Beverly C Walters
- 1Department of Neurosurgery, University of Alabama at Birmingham, Alabama; and
| | - Mark N Hadley
- 1Department of Neurosurgery, University of Alabama at Birmingham, Alabama; and
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Abstract
Many pathways connect stress and obesity, two highly prevalent problems facing society today. First, stress interferes with cognitive processes such as executive function and self-regulation. Second, stress can affect behavior by inducing overeating and consumption of foods that are high in calories, fat, or sugar; by decreasing physical activity; and by shortening sleep. Third, stress triggers physiological changes in the hypothalamic-pituitary-adrenal axis, reward processing in the brain, and possibly the gut microbiome. Finally, stress can stimulate production of biochemical hormones and peptides such as leptin, ghrelin, and neuropeptide Y. Obesity itself can be a stressful state due to the high prevalence of weight stigma. This article therefore traces the contribution of weight stigma to stress and obesogenic processes, ultimately describing a vicious cycle of stress to obesity to stigma to stress. Current obesity prevention efforts focus solely on eating and exercise; the evidence reviewed in this article points to stress as an important but currently overlooked public policy target.
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Affiliation(s)
- A Janet Tomiyama
- Department of Psychology, University of California, Los Angeles, California 90095, USA;
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235
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Reber KC, König HH, Hajek A. Obesity and sickness absence: results from a longitudinal nationally representative sample from Germany. BMJ Open 2018; 8:e019839. [PMID: 29880564 PMCID: PMC6009453 DOI: 10.1136/bmjopen-2017-019839] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 04/17/2018] [Accepted: 04/27/2018] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES The current study aimed at investigating the longitudinal association between obesity and sickness absence in women and men in Germany. METHODS Data were derived from the German Socio-Economic Panel (GSOEP) which is a nationally representative, longitudinal study of private households in Germany. We draw on data from 2002 to 2012. Information on self-rated body mass index has been collected every second wave since 2002. Sick leave days (total number of working days missed due to illness in the past calendar year) and sick from work for more than 6 weeks in the preceding 12 months (yes/no) were used as outcome measures. Fixed-effects (FE) regression models were used for the total sample and stratified by sex. Gender differences were examined using interaction terms (sex × weight category). RESULTS Controlling for several potential confounders, Poisson FE regression analysis showed that transitions from normal weight to obesity were associated with an increase in sick leave days in women (incidence rate ratio (IRR) 1.27, 95% CI 1.02 to 1.57) but not in men (IRR 0.85, 95 % CI 0.68 to 1.06)-with significant gender differences (sex × obesity, p<0.01). Moreover, conditional FE logistic regressions showed that transitions from normal weight to overweight were associated with an increase in the probability of long-term absenteeism in women (overweight, OR 1.41, 95% CI 1.08 to 1.85) but not in men (overweight, OR 0.84, 95% CI 0.65 to 1.09). Gender differences were significant (sex × overweight, p<0.01). CONCLUSIONS Our findings stress the longitudinal association between excess weight and increased likelihood of sick leave days as well as long-term absenteeism in women.
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Affiliation(s)
- Katrin Christiane Reber
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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236
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Himmelstein MS, Puhl RM, Quinn DM. Weight Stigma in Men: What, When, and by Whom? Obesity (Silver Spring) 2018; 26:968-976. [PMID: 29687615 DOI: 10.1002/oby.22162] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 01/26/2018] [Accepted: 02/16/2018] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study assessed the weight stigma experiences of men, examining characteristics of men who experienced weight stigma versus men who did not. METHODS Data from three samples of men were examined (N = 1,513). Sample 1 consisted of men with obesity at elevated risk for weight stigma. Sample 2 comprised a convenience online panel. Sample 3 included men from a national online panel of US adults. Men in all samples completed almost identical questionnaires assessing demographics, anthropometrics, weight stigma, and dieting. RESULTS Approximately 40% of men reported experiencing weight stigma. Weight stigma was associated with increased odds of having a BMI consistent with underweight or obesity relative to normal weight. Verbal mistreatment was the most common form of weight stigma experienced across all life stages for men. The most common sources of weight stigma were peers, family members, and strangers. Men reporting weight stigma were younger and less likely to be married, had higher BMIs, and were more likely to have tried to lose weight in the past year relative to men not reporting weight stigma. CONCLUSIONS Understanding differences among men as a function of weight stigma is important for practitioners, as it can identify men who may most benefit from intervention.
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Affiliation(s)
- Mary S Himmelstein
- Rudd Center for Food Policy & Obesity, University of Connecticut, Hartford, Connecticut, USA
| | - Rebecca M Puhl
- Rudd Center for Food Policy & Obesity, University of Connecticut, Hartford, Connecticut, USA
- Department of Human Development & Family Studies, University of Connecticut, Storrs, Connecticut, USA
| | - Diane M Quinn
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
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Sharma AM, Ramos Salas X. Obesity Prevention and Management Strategies in Canada: Shifting Paradigms and Putting People First. Curr Obes Rep 2018; 7:89-96. [PMID: 29667158 DOI: 10.1007/s13679-018-0309-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE OF REVIEW The purpose of this study was to review public and private sector obesity policies in Canada and to make recommendations for future evidence-based obesity prevention and management strategies. RECENT FINDINGS Synthesis of obesity prevention and management policies and research studies are presented in three primary themes: (1) Increased awareness about the impact of weight bias and obesity stigma in Canada; (2) Inadequate government obesity prevention and management policies and strategies; and (3) Lack of comprehensive private sector obesity prevention and management policies. Findings suggest that in Canada, obesity continues to be treated as a self-inflicted risk factor, which affects the type of interventions and approaches that are implemented by governments or covered by private health plans. The lack of recognition of obesity as a chronic disease by Canadian public and private payers, health systems, employers, and the public, has a trickle-down effect on access to evidence-based prevention and treatment. Although there is increasing recognition and awareness about the impact of weight bias and obesity stigma on the health and social well-being of Canadians, interventions are urgently needed in education, healthcare, and public policy sectors. We conclude by making recommendations for the advancement of evidence-based obesity prevention and management policies that can improve the lives of Canadians affected by obesity.
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Affiliation(s)
- Arya M Sharma
- University of Alberta, Li Ka Shing Building, Rm 1-116, 87th Avenue and 112th Street, Edmonton, AB, T6G 2E1, Canada
| | - Ximena Ramos Salas
- Canadian Obesity Network, University of Alberta, Li Ka Shing Building, Rm 2-126, 87th Avenue and 112th Street, Edmonton, AB, T6G 2E1, Canada.
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238
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Kamody RC, Thurston IB, Decker KM, Kaufman CC, Sonneville KR, Richmond TK. Relating shape/weight based self-esteem, depression, and anxiety with weight and perceived physical health among young adults. Body Image 2018; 25:168-176. [PMID: 29677688 DOI: 10.1016/j.bodyim.2018.04.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 04/08/2018] [Accepted: 04/09/2018] [Indexed: 11/29/2022]
Abstract
Simultaneous contributions of self-esteem, depression, and anxiety to weight and perceived physical health in young adults is understudied. A diverse sample of 424 young adults completed measures of shape/weight based self-esteem, depression, anxiety, and perceived physical health. Height and weight were measured to calculate body mass index (BMI). Latent profile analysis was conducted to derive patterns of depression, anxiety, and shape/weight based self-esteem. Then, we examined the association of the profiles with weight status and perceived physical health. Three profiles emerged: (1) High Shape/Weight Influence (HSWI); (2) Low Shape/Weight, Depression, & Anxiety Influence (LSWDAI); and (3) High Depression & Anxiety Influence (HDAI). The HSWI profile had significantly higher BMI than the LSWDAI and HDAI profiles, and significantly lower perceived physical health than the LSWDAI profile. Over emphasis on shape/weight, regardless of depression and anxiety, is associated with elevated weight and negative internalized health views.
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Affiliation(s)
- Rebecca C Kamody
- Department of Psychology, The University of Memphis, United States; Yale University Child Study Center, United States.
| | - Idia B Thurston
- Department of Psychology, The University of Memphis, United States; University of Tennessee Health Science Center, United States; Le Bonheur Children's Foundation Research Institute, United States
| | | | | | | | - Tracy K Richmond
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital/Harvard Medical School, United States
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Goldring MR, Persky S. Preferences for physician weight status among women with overweight. Obes Sci Pract 2018; 4:250-258. [PMID: 29951215 PMCID: PMC6009989 DOI: 10.1002/osp4.162] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 01/19/2018] [Accepted: 01/27/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Women with overweight experience stigma in clinical interactions. Emerging evidence suggests that one near-term approach to offset the negative consequences of weight stigma could be to capitalize on benefits of patient-physician weight concordance. However, it is likely that patient attitudes towards physicians with overweight are complicated and multifaceted and may include stigmatization of providers with overweight. METHODS Two-hundred ninety-eight women with overweight completed an online questionnaire and indicated preference for a physician who is 'overweight', 'not overweight', or indicated no preference. Participants provided reasons for their choice and answered questions about their weight-related beliefs and experiences. RESULTS The majority of women indicated no weight preference (63%), and a portion (36%) of the sample explicitly preferred physicians who are not overweight. Reasons provided for these preferences were primarily based on stereotyped notions of physician aptitude based on weight. Compared with having no preference, those who preferred physicians who are not overweight had fewer previous negative weight-related physician interactions and had increased beliefs about the controllability of weight. CONCLUSIONS These findings elucidate patient attitudes towards physicians with overweight in a sample at increased risk for weight stigmatization. Findings underscore the need for stigma-reducing interventions so that clinical experiences for both women and physicians with overweight can be improved.
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Affiliation(s)
| | - S. Persky
- Social and Behavioral Research BranchNational Human Genome Research InstituteBethesdaMDUSA
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240
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Spooner C, Jayasinghe UW, Faruqi N, Stocks N, Harris MF. Predictors of weight stigma experienced by middle-older aged, general-practice patients with obesity in disadvantaged areas of Australia: a cross-sectional study. BMC Public Health 2018; 18:640. [PMID: 29783962 PMCID: PMC5963137 DOI: 10.1186/s12889-018-5556-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 05/09/2018] [Indexed: 12/30/2022] Open
Abstract
Background Rates of obesity have increased globally and weight stigma is commonly experienced by people with obesity. Feeling stigmatised because of one’s weight can be a barrier to healthy eating, physical activity and to seeking help for weight management. The aim of this study was to identify predictors of perceived weight among middle-older aged patients with obesity attending general practices in socioeconomically disadvantaged urban areas of Australia. Methods As part of a randomised clinical trial in Australia, telephone interviews were conducted with 120 patients from 17 general practices in socioeconomically disadvantaged of Sydney and Adelaide. Patients were aged 40–70 years with a BMI ≥ 30 kg/m2. The interviews included questions relating to socio-demographic variables (e.g. gender, language spoken at home), experiences of weight-related discrimination, and the Health Literacy Questionnaire (HLQ). Multi-level logistic regression data analysis was undertaken to examine predictors of recent experiences of weight-related discrimination (“weight stigma”). Results The multi-level model showed that weight stigma was positively associated with obesity category 2 (BMI = 35 to < 40; OR 4.47 (95% CI 1.03 to 19.40)) and obesity category 3 (BMI = ≥ 40; OR 27.06 (95% CI 4.85 to 150.95)), not being employed (OR 7.70 (95% CI 2.17 to 27.25)), non-English speaking backgrounds (OR 5.74 (95% CI 1.35 to 24.45)) and negatively associated with the HLQ domain: ability to actively engage with healthcare providers (OR 0.12 (95% CI 0.05 to 0.28)). There was no association between weight stigma and gender, age, education or the other HLQ domains examined. Conclusions Weight stigma disproportionately affected the patients with obesity most in need of support to manage their weight: those with more severe obesity, from non-English speaking backgrounds and who were not in employment. Additionally, those who had experienced weight stigma were less able to actively engage with healthcare providers further compounding their disadvantage. This suggests the need for a more proactive approach to identify weight stigma by healthcare providers. Addressing weight stigma at the individual, system and population levels is recommended. Trial registration The trial was registered with the Australian Clinical Trials Registry ACTRN126400102162.
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Affiliation(s)
- Catherine Spooner
- UNSW Sydney, Centre for Primary Health Care and Equity, Sydney, NSW, 2052, Australia
| | - Upali W Jayasinghe
- UNSW Sydney, Centre for Primary Health Care and Equity, Sydney, NSW, 2052, Australia
| | - Nighat Faruqi
- UNSW Sydney, Centre for Primary Health Care and Equity, Sydney, NSW, 2052, Australia
| | - Nigel Stocks
- University of Adelaide, Discipline of General Practice, 178 North Terrace, Adelaide, 5005, Australia
| | - Mark F Harris
- UNSW Sydney, Centre for Primary Health Care and Equity, Sydney, NSW, 2052, Australia.
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Watts AW, Rydell SA, Eisenberg ME, Laska MN, Neumark-Sztainer D. Yoga's potential for promoting healthy eating and physical activity behaviors among young adults: a mixed-methods study. Int J Behav Nutr Phys Act 2018; 15:42. [PMID: 29720214 PMCID: PMC5932774 DOI: 10.1186/s12966-018-0674-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Accepted: 04/17/2018] [Indexed: 12/01/2022] Open
Abstract
Background A regular yoga practice may have benefits for young adult health, however, there is limited evidence available to guide yoga interventions targeting weight-related health. The present study explored the relationship between participation in yoga, healthy eating behaviors and physical activity among young adults. Methods The present mixed-methods study used data collected as part of wave 4 of Project EAT (Eating and Activity in Teens and Young Adults), a population-based cohort study in Minneapolis-St. Paul, Minnesota. Young adults (n = 1820) completed the Project EAT survey and a food frequency questionnaire, and a subset who reported practicing yoga additionally participated in semi-structured interviews (n = 46). Analyses of survey data were used to examine cross-sectional associations between the frequency of yoga practice, dietary behaviors (servings of fruits and vegetables (FV), sugar-sweetened beverages (SSBs) and snack foods and frequency of fast food consumption), and moderate-to-vigorous physical activity (MVPA). Thematic analysis of interview discussions further explored yoga’s perceived influence on eating and activity behaviors among interview participants. Results Regular yoga practice was associated with more servings of FV, fewer servings of SSBs and snack foods, less frequent fast food consumption, and more hours of MVPA. Interviews revealed that yoga supported healthy eating through motivation to eat healthfully, greater mindfulness, management of emotional eating, more healthy food cravings, and the influence of the yoga community. Yoga supported physical activity through activity as part of yoga practice, motivation to do other forms of activity, increased capacity to be active, and by complementing an active lifestyle. Conclusions Young adult yoga practitioners reported healthier eating behaviors and higher levels of physical activity than non-practitioners. Yoga should be investigated as an intervention for young adult health promotion and healthy weight management.
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Affiliation(s)
- Allison W Watts
- Division of Epidemiology and Community Health, University of Minnesota, Suite 300, 1300 S 2nd Ave, Minneapolis, MN, 55454, USA.
| | - Sarah A Rydell
- Division of Epidemiology and Community Health, University of Minnesota, Suite 300, 1300 S 2nd Ave, Minneapolis, MN, 55454, USA
| | - Marla E Eisenberg
- Department of Pediatrics, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN, 55414, USA
| | - Melissa N Laska
- Division of Epidemiology and Community Health, University of Minnesota, Suite 300, 1300 S 2nd Ave, Minneapolis, MN, 55454, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, University of Minnesota, Suite 300, 1300 S 2nd Ave, Minneapolis, MN, 55454, USA
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Hayward LE, Vartanian LR, Pinkus RT. Weight Stigma Predicts Poorer Psychological Well-Being Through Internalized Weight Bias and Maladaptive Coping Responses. Obesity (Silver Spring) 2018; 26:755-761. [PMID: 29427370 DOI: 10.1002/oby.22126] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 01/03/2018] [Accepted: 01/04/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Weight-based stigmatization is associated with negative psychological and behavioral consequences, but individuals respond to stigma in different ways. The present study aimed to understand some of the factors that predict how one will cope with weight stigma and how different coping responses predict psychological well-being. METHODS Across four samples, 1,391 individuals who identified as having overweight or obesity completed surveys assessing the frequency of weight stigma experiences, internalized weight bias, coping responses to weight stigma, and psychological distress. RESULTS Frequency of weight stigma predicted greater internalized weight bias, which predicted more frequent use of maladaptive coping responses ("disengagement coping") and less frequent use of adaptive coping responses ("reappraisal coping"), in turn predicting more depression, anxiety, and stress symptoms. CONCLUSIONS The more that individuals with overweight or obesity experience weight stigma and internalize weight bias, the more they report using maladaptive coping and the less they report using adaptive coping when dealing with weight stigma. Maladaptive coping is strongly associated with poorer psychological well-being. Thus, those who experience more frequent weight stigma may be more vulnerable to psychological distress because they appear to be at greater risk of employing maladaptive coping strategies.
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Affiliation(s)
- Lydia E Hayward
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Lenny R Vartanian
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Rebecca T Pinkus
- School of Psychology, The University of Sydney, New South Wales, Australia
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Satveit S. Addressing the unique healthcare needs of women: Opportunity for change exists at the intersection of precision health and learning health systems. Learn Health Syst 2018; 2:e10033. [PMID: 31245578 PMCID: PMC6508791 DOI: 10.1002/lrh2.10033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 04/28/2017] [Accepted: 05/24/2017] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Women have unique healthcare needs that are not well addressed by our current healthcare system and with healthcare transformation underway the opportunity exists to avoid weaving these age-old problems into the fabric of the new healthcare design. myAva is an example of a learning health system integrated into a cloud-based precision health platform. The goal of myAva is to integrate the tools of precision health and principals of a learning health system to improve care for women, starting with polycystic ovary syndrome (PCOS). METHODS Putting patients at the center in designing a new style of healthcare has been an important concept underlying the development of myAva since inception. Understanding the needs of patients and providers is key to the development of myAva. Surveys were collected from members of the PCOS patient community and patient and medical advisory boards were recruited. For the pilot group comprehensive omic data, biometric and self-reported data were collected and integrated into a personalized health dashboard enabling providers to formulate personalized treatment plans. The ongoing collection of data will create continuous improvement of healthcare. RESULTS Precision health for chronic issues faced is in its infancy and although myriad challenges exist the potential to improve health outcomes is great. myAva's providers, patients, and advisors are encouraged by the early outcomes of the program with improved health outcomes and an increased sense of empowerment reported. It is clear that designing and implementing this type of care requires collaboration, the involvement of all stakeholders, with patients at the center.
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Affiliation(s)
- Sonya Satveit
- CEO and Founder of Open Source HealthTorontoONCanada
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245
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Wedow R, Masters RK, Mollborn S, Schnabel L, Boardman JD. Body size reference norms and subjective weight status: A gender and life course approach. SOCIAL FORCES; A SCIENTIFIC MEDIUM OF SOCIAL STUDY AND INTERPRETATION 2018; 96:1377-1409. [PMID: 29681662 PMCID: PMC5905672 DOI: 10.1093/sf/sox073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This paper uses data from The National Longitudinal Study of Adolescent to Adult Health (Add Health) to describe county-level variation in norms regarding physical weight among adolescents in the United States. We demonstrate that regardless of one's physical size, those residing in counties with a heavier weight norm are significantly less likely to see themselves as overweight than those residing in counties with a light weight norm. We further show that the local weight norm during adolescence (Wave 1) is associated with individuals' weight perceptions through adolescence and into young adulthood (Wave 4), though these associations attenuate in strength as respondents age. Our results suggest that weight norms have a stronger influence on weight perceptions among women compared to men and that the role of gender is particularly important during adolescence. We encourage life course researchers to consider the normative health environment during adolescence as an important context for understanding disparities in health and health lifestyles as people age.
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Affiliation(s)
- Robbee Wedow
- Department of Sociology, University of Colorado, Boulder, Colorado
- Health and Society Program and Population Center, Institute of Behavioral Science, University of Colorado, Boulder, Colorado
- Institute for Behavioral Genetics, University of Colorado, Boulder, Colorado
| | - Ryan K. Masters
- Department of Sociology, University of Colorado, Boulder, Colorado
- Health and Society Program and Population Center, Institute of Behavioral Science, University of Colorado, Boulder, Colorado
| | - Stefanie Mollborn
- Department of Sociology, University of Colorado, Boulder, Colorado
- Health and Society Program and Population Center, Institute of Behavioral Science, University of Colorado, Boulder, Colorado
| | - Landon Schnabel
- Department of Sociology, Indiana University, Bloomington, Indiana
| | - Jason D. Boardman
- Department of Sociology, University of Colorado, Boulder, Colorado
- Health and Society Program and Population Center, Institute of Behavioral Science, University of Colorado, Boulder, Colorado
- Institute for Behavioral Genetics, University of Colorado, Boulder, Colorado
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246
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Early childhood BMI trajectories in monogenic obesity due to leptin, leptin receptor, and melanocortin 4 receptor deficiency. Int J Obes (Lond) 2018; 42:1602-1609. [PMID: 29568105 DOI: 10.1038/s41366-018-0049-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 12/01/2017] [Accepted: 01/22/2018] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To evaluate whether early childhood body mass index (BMI) is an appropriate indicator for monogenic obesity. METHODS A cohort of n = 21 children living in Germany or Austria with monogenic obesity due to congenital leptin deficiency (group LEP, n = 6), leptin receptor deficiency (group LEPR, n = 6) and primarily heterozygous MC4 receptor deficiency (group MC4R, n = 9) was analyzed. A control group (CTRL) was defined that consisted of n = 22 obese adolescents with no mutation in the above mentioned genes. Early childhood (0-5 years) BMI trajectories were compared between the groups at selected time points. RESULTS The LEP and LEPR group showed a tremendous increase in BMI during the first 2 years of life with all patients displaying a BMI >27 kg/m2 (27.2-38.4 kg/m2) and %BMIP95 (percentage of the 95th percentile BMI for age and sex) >140% (144.8-198.6%) at the age of 2 years and a BMI > 33 kg/m2 (33.3-45.9 kg/m2) and %BMIP95 > 184% (184.1-212.6%) at the age of 5 years. The MC4R and CTRL groups had a later onset of obesity with significantly lower BMI values at both time points (p < 0.01). CONCLUSION As result of the investigation of early childhood BMI trajectories in this pediatric cohort with monogenic obesity we suggest that BMI values >27.0 kg/m2 or %BMIP95 > 140% at the age of 2 years and BMI values >33.0 kg/m2 or %BMIP95 > 184% at the age of 5 years may be useful cut points to identify children who should undergo genetic screening for monogenic obesity due to functionally relevant mutations in the leptin gene or leptin receptor gene.
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Yamawaki N, Riley C, Rasmussen C, Cook M. The Effects of Obesity Myths on Perceptions of Sexual Assault Victims and Perpetrators' Credibility. JOURNAL OF INTERPERSONAL VIOLENCE 2018; 33:662-685. [PMID: 26663743 DOI: 10.1177/0886260515613343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This study investigated the effects of obesity myths on blame attribution and the perceived credibility of both an alleged sexual assault victim and her perpetrator. Participants were randomly assigned to one of three sexual assault scenarios (in which either the victim or the perpetrator was described as obese and one in which both were described as obese) and responded to questions measuring the blame attribution and perceived the credibility of both individuals. A main effect of scenario was found on the perpetrator's credibility, indicating that participants rated the obese perpetrator as more credible when the victim was obese in comparison with when the victim was nonobese. However, no main effect of scenario was found on the victim's credibility and blame attribution, denoting that the victim's or perpetrator's weight did not influence participants' perceptions of the victim's credibility or blame attribution. The belief in obesity myths was the most significant predictor of victim blaming. However, differing patterns of the effects of obesity myths were found on the victim's credibility and the perpetrator's credibility. The belief in obesity myths was a significant predictor only when the victim was obese, whereas it was not a significant predictor in the scenarios where both the victim and the perpetrator were obese or the perpetrator was obese and the victim was nonobese. As for the perpetrator's credibility, the belief of obesity myths was not a significant predictor. Instead, the scenario was a significant predictor. Implications of obesity-myth endorsement in relation to sexual assault are discussed.
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Affiliation(s)
| | | | | | - Mary Cook
- 1 Brigham Young University, Provo, UT, USA
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248
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Sattler KM, Deane FP, Tapsell L, Kelly PJ. Gender differences in the relationship of weight-based stigmatisation with motivation to exercise and physical activity in overweight individuals. Health Psychol Open 2018; 5:2055102918759691. [PMID: 29552349 PMCID: PMC5846936 DOI: 10.1177/2055102918759691] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Weight stigma is related to lower levels of motivation to exercise in overweight and obesity. This study explored the nature of the relationship between stigma, motivation to exercise and physical activity while accounting for gender differences. Participants were 439 adults with overweight and obesity (mean body mass index = 32.18 kg/m2, standard deviation = 4.09 kg/m2). Females reported significantly more frequent stigma experiences than males. Mediation models found a conditional direct effect of weight stigma for males, with higher frequency of stigma experiences related to higher levels of walking and vigorous physical activity. A conditional indirect effect was found for females for walking, moderate and vigorous levels of physical activity, with higher weight stigma related to lower autonomous motivation, and lower levels of physical activity. Findings suggest that males and females are affected differently by weight-stigma experiences.
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249
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Eating Behaviors, Weight Bias, and Psychological Functioning in Multi-ethnic Low-income Adolescents. J Pediatr Nurs 2018; 38:81-87. [PMID: 29167087 DOI: 10.1016/j.pedn.2017.11.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 11/10/2017] [Accepted: 11/11/2017] [Indexed: 11/22/2022]
Abstract
PURPOSE The purposes of this study were to: 1) Describe the incidence of disordered eating, weight bias, body dissatisfaction, and psychological distress, 2) Examine the relationship between sociodemographic variables (gender, ethnicity, and income) and disordered eating, weight bias, body dissatisfaction, and psychological distress in a sample of low-income adolescents. DESIGN AND METHODS A cross-sectional study was conducted with 105 adolescents from low-income neighborhoods. Participants completed self-report questionnaires to assess eating behaviors, weight bias, body dissatisfaction, and psychological functioning. Height and weight were measured, and information on household income was collected. RESULTS The participant's mean age was 16.31 (SD=2.8) years, 66% female, 47% Hispanic, and 46% African American. The mean annual income was $17,018 (SD=11,355). Twenty-eight percent self-reported having some form of disordered eating, and 15% reported an eating disorder. The group with eating disorder reported the highest levels of weight bias (M=93.4, SD=109.6), body dissatisfaction (M=94.6, SD=47.6), and psychological distress (M=1.4, SD=0.97). CONCLUSION This study found a high prevalence of eating disorders with eating disorder participants experiencing the highest levels of weight bias and psychological distress. Future studies are needed to identify and evaluate community and school-based interventions to minimize weight bias and disordered eating. PRACTICE IMPLICATIONS Nurses are at the forefront of healthcare and should collaborate with educators, school counselors, administrators, coaches, parents, and students, to address weight bias and disordered eating in schools by implementing school-based curriculum and policies.
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Ciciurkaite G, Perry BL. Body weight, perceived weight stigma and mental health among women at the intersection of race/ethnicity and socioeconomic status: insights from the modified labelling approach. SOCIOLOGY OF HEALTH & ILLNESS 2018; 40:18-37. [PMID: 28980335 DOI: 10.1111/1467-9566.12619] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
With increasing rates of obesity in the United States, attention to life chances and psychological consequences associated with weight stigma and weight-based discrimination has also intensified. While research has demonstrated the negative effects of weight-based discrimination on mental health, little is known about whether different social groups are disproportionately vulnerable to these experiences. Drawing on the modified labelling theory, the focus of this paper is to investigate the psychological correlates of body weight and self-perceived weight-based discrimination among American women at the intersection of race/ethnicity and socioeconomic status (SES). Analyses use data from the National Health Measurement Study (NHMS), a national multi-stage probability sample of non-institutional, English-speaking adults, ages 35 to 89 in 2005-2006. Our findings demonstrate that the effect of weight-based discrimination on psychological well-being is highly contingent on social status. Specifically, the psychological consequences of discrimination on Hispanic women and women in the lowest household income group is significantly greater relative to White women and women with higher household income, controlling for obesity status and self-rated health. These results suggest that higher social status has a buffering effect of weight stigma on psychological well-being.
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Affiliation(s)
- Gabriele Ciciurkaite
- Department of Sociology, Social Work and Anthropology, Utah State University, USA
| | - Brea L Perry
- IU Network Science Institute (IUNI), Department of Sociology, Indiana University, USA
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