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Fabrig A, Schmidt R, Mansfeld T, Sander J, Seyfried F, Kaiser S, Stroh C, Dietrich A, Hilbert A. Depressive Symptoms among Bariatric Surgery Candidates: Associations with Stigmatization and Weight and Shape Concern. Nutrients 2024; 16:510. [PMID: 38398834 PMCID: PMC10891665 DOI: 10.3390/nu16040510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/03/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
Bariatric surgery candidates (BSC) are a highly vulnerable group for mental health impairments. According to the theoretical model of weight stigma, weight-related experienced stigmatization (ES) negatively influences mental health through weight bias internalization (WBI). This study tested this model among BSC and investigated whether this association depends on a negative body image in terms of weight and shape concern as a potential moderator. As part of a German multicenter study, ES, WBI, weight and shape concern, and depressive symptoms were assessed via self-report questionnaires among n = 854 BSC. Simple and moderated mediation analyses were applied to analyze whether WBI influences the relationship between ES and depressive symptoms, and whether this influence depends on weight and shape concern. WBI significantly mediated the relationship between ES and depressive symptoms by partially reducing the association of ES with depressive symptoms. Weight and shape concern emerged as significant moderators in the overall model and specifically for associations between WBI and depressive symptoms. The results suggest that the association between ES and depressive symptoms among BSC is stronger in those with high WBI. This association is strengthened by weight and shape concern, especially at low and mean levels. Studies evaluating longitudinal associations between weight-related stigmatization and mental health are indicated, as well as intervention studies targeting WBI in order to reduce adverse effects of ES on mental health in BSC.
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Affiliation(s)
- Alexandra Fabrig
- Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, Integrated Research and Treatment Center AdiposityDiseases, University of Leipzig Medical Center, Stephanstrasse 9a, 04103 Leipzig, Germany; (A.F.)
| | - Ricarda Schmidt
- Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, Integrated Research and Treatment Center AdiposityDiseases, University of Leipzig Medical Center, Stephanstrasse 9a, 04103 Leipzig, Germany; (A.F.)
| | - Thomas Mansfeld
- Department of General Surgery, Asklepios Clinic, 22559 Hamburg, Germany
| | - Johannes Sander
- Schön Klinik Hamburg Eilbek, Obesity Clinic, 22081 Hamburg, Germany
| | - Florian Seyfried
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital, University of Würzburg, 97080 Würzburg, Germany
| | - Stefan Kaiser
- Department of Visceral, Pediatric and Vascular Surgery, Hospital Konstanz, 78464 Konstanz, Germany
| | - Christine Stroh
- Department of Surgery, SRH Wald-Klinikum, Adipositas Zentrum, 07548 Gera, Germany
| | - Arne Dietrich
- Department of Surgery, Clinic for Visceral, Transplantation, Thoracic and Vascular Surgery, University Hospital Leipzig, 04103 Leipzig, Germany
| | - Anja Hilbert
- Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, Integrated Research and Treatment Center AdiposityDiseases, University of Leipzig Medical Center, Stephanstrasse 9a, 04103 Leipzig, Germany; (A.F.)
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Atlas SJ, Kim K, Nhan E, Touchette DR, Moradi A, Agboola F, Rind DM, Beaudoin FL, Pearson SD. Medications for obesity management: Effectiveness and value. J Manag Care Spec Pharm 2023; 29:569-575. [PMID: 37121254 PMCID: PMC10387935 DOI: 10.18553/jmcp.2023.29.5.569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Affiliation(s)
- Steven J Atlas
- Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Kibum Kim
- Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago
| | - Emily Nhan
- Institute for Clinical and Economic Review (ICER), Boston, MA
| | - Daniel R Touchette
- Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago
| | - Ashton Moradi
- Institute for Clinical and Economic Review (ICER), Boston, MA
| | - Foluso Agboola
- Institute for Clinical and Economic Review (ICER), Boston, MA
| | - David M Rind
- Institute for Clinical and Economic Review (ICER), Boston, MA
| | - Francesca L Beaudoin
- Institute for Clinical and Economic Review (ICER), Boston, MA
- Department of Epidemiology, Brown University, Providence, RI
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Seibert AM, Hersh AL, Patel PK, Matheu M, Stanfield V, Fino N, Hicks LA, Tsay SV, Kabbani S, Stenehjem E. Urgent-care antibiotic prescribing: An exploratory analysis to evaluate health inequities. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2022; 2:e184. [PMID: 36406162 PMCID: PMC9672912 DOI: 10.1017/ash.2022.329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 06/16/2023]
Abstract
Healthcare disparities and inequities exist in a variety of environments and manifest in diagnostic and therapeutic measures. In this commentary, we highlight our experience examining our organization's urgent care respiratory encounter antibiotic prescribing practices. We identified differences in prescribing based on several individual characteristics including patient age, race, ethnicity, preferred language, and patient and/or clinician gender. Our approach can serve as an electronic health record (EHR)-based methodology for disparity and inequity audits in other systems and for other conditions.
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Affiliation(s)
- Allan M. Seibert
- Division of Infectious Diseases and Clinical Epidemiology, Intermountain Healthcare, Murray, Utah
| | - Adam L. Hersh
- Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | - Payal K. Patel
- Division of Infectious Diseases and Clinical Epidemiology, Intermountain Healthcare, Murray, Utah
| | - Michelle Matheu
- Division of Infectious Diseases and Clinical Epidemiology, Intermountain Healthcare, Murray, Utah
| | | | - Nora Fino
- Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Lauri A. Hicks
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sharon V. Tsay
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sarah Kabbani
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Edward Stenehjem
- Division of Infectious Diseases and Clinical Epidemiology, Intermountain Healthcare, Murray, Utah
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