A randomized study of effects of obesity framing on weight stigma

Moving beyond eat less, move more using willpower: Reframing obesity as a chronic disease impact of the 2020 Canadian obesity guidelines reframed narrative on perceptions of self and the patient-provider relationship

Obesity is becoming recognized as a complex, chronic medical condition. However, the dominant treatment narrative remains that goal weight can be achieved by eating less, moving more using willpower, placing responsibility for change on the person with obesity (PwO). This study evaluated the impact of revising this narrative, to viewing obesity as a treatable medical condition, on internalized weight bias and perceived patient-provider relationship. PwO were recruited into an online study in which two videos were presented; the first showing a traditional doctor endorsing the eat less, move more approach, and the second showing a doctor describing obesity as a treatable medical condition. After each video participants were asked to imagine that they were being treated by that doctor and completed the Weight Bias Internalization Scale (WBIS) and the Patient-Health Care Provider Communication Scale (PHCPCS). A total of 61 PwO (52% response rate) completed the protocol. Compared to the traditional narrative video, the revised narrative video resulted in significant reductions in WBIS scores and significant increases in the PHCPCS scores and was preferred by participants. Within the context of this small-scale study evidence supports that the revised narrative promoting obesity as a complex, chronic but treatable medical condition that is not the result of personal failure has a positive impact on the perceived patient-provider relationship and is associated with reductions in internalized weight bias. This evidence supports the need to help PwO reframe obesity from a personal failure to a legitimate medical condition worthy of care.

Sequentially mediated effects of weight-related self-stigma and psychological distress in the association between perceived weight stigma and food addiction among Taiwanese university students: A cross-sectional study

BACKGROUND

Weight-related stigma has negative physiological and psychological impacts on individuals' quality of life. Stigmatized individuals may experience higher psychological distress and therefore increase the potential risk to develop obesity and/or food addiction. The present study examined the associations and mediated effect between perceived weight stigma, weight-related self-stigma, and psychological distress in explaining food addiction among Taiwanese university students.

METHODS

All participants (n = 968) completed an online survey which included the Perceived Weight Stigma Questionnaire, Weight Self-Stigma Questionnaire, Depression, Anxiety, Stress Scale-21, and Yale Food Addiction Scale Version 2.

RESULTS

After controlling for demographic variables, significant associations were found in the paths from (1) perceived weight stigma to weight-related self-stigma ([Formula: see text] = 0.23), psychological distress ([Formula: see text] = 0.35), and food addiction ([Formula: see text] = 0.23); (2) weight-related self-stigma to psychological distress ([Formula: see text] = 0.52) and food addiction ([Formula: see text] = 0.59); and (3) psychological distress to food addiction ([Formula: see text] = 0.59) (all p-values < 0.001). The mediation model showed the sequential mediated effect of weight-related self-stigma and psychological distress in the association between perceived weight stigma and food addiction.

CONCLUSIONS

The results provide novel insights that weight-related self-stigma and psychological distress sequentially mediated the relationship between perceived weight stigma and food addiction among Taiwanese university students. The findings of the present study could be implemented into interventions that aim to reduce food addiction derived from weight-related stigma. Future studies should consider group analysis to consider confounding factors or other populations to provide more evidence regarding the mechanism of weight-related stigma.

Designing an online intervention for adults with addictive eating: a qualitative integrated knowledge translation approach

INTRODUCTION

Codesign is a meaningful end-user engagement in research design. The integrated knowledge translation (IKT) framework involves adopting a collaborative research approach to produce and apply knowledge to address real-world needs, resulting in useful and useable recommendations that will more likely be applied in policy and practice. In the field of food addiction (FA), there are limited treatment options that have been reported to show improvements in FA symptoms.

OBJECTIVES

The primary aim of this paper is to describe the step-by-step codesign and refinement of a complex intervention delivered via telehealth for adults with FA using an IKT approach. The secondary aim is to describe our intervention in detail according to the TIDieR checklist.

DESIGN

This study applies the IKT process and describes the codesign and refinement of an intervention through a series of online meetings, workshops and interviews.

PARTICIPANTS

This study included researchers, clinicians, consumers and health professionals.

PRIMARY OUTCOME MEASURE

The primary outcome was a refined intervention for use in adults with symptoms of FA for a research trial.

RESULTS

A total of six female health professionals and five consumers (n=4 female) with lived overeating experience participated in two interviews lasting 60 min each. This process resulted in the identification of eight barriers and three facilitators to providing and receiving treatment for FA, eight components needed or missing from current treatments, telehealth as a feasible delivery platform, and refinement of key elements to ensure the intervention met the needs of both health professionals and possible patients.

CONCLUSION

Using an IKT approach allowed for a range of viewpoints and enabled multiple professions and disciplines to engage in a semiformalised way to bring expertise to formulate a possible intervention for FA. Mapping the intervention plan to the TIDieR checklist for complex interventions, allowed for detailed description of the intervention and the identification of a number of areas that needed to be refined before development of the finalised intervention protocol.