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Puhl RM, Lessard LM, Foster GD, Cardel MI. Patient and Family Perspectives on Terms for Obesity. Pediatrics 2022; 150:190093. [PMID: 36404759 DOI: 10.1542/peds.2022-058204] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/15/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Parent communication about body weight is a sensitive topic, but limited research has studied youth preferences for words used to talk about their weight with parents. We assessed perspectives of weight-based terminology in 2 racially/ethnically diverse samples of youth and parents. METHODS We collected online survey data from 2 panel survey samples between September and December 2021: youth aged 10 to 17 years (n = 2032) and parents of youth aged 10 to 17 years (n = 1936). Participants rated 27 different terms and phrases to describe body weight; parents reported on their usage of this terminology and youth reported their preferences for and emotional responses to terminology. Patterns were examined across sex, race/ethnicity, sexual orientation, and weight status. RESULTS Youth reported preferences for words such as "healthy weight" and dislike of terms such as "obese," "fat," and "large," which induced feelings of sadness, shame, and embarrassment. Differences in youth preferences and emotional reactions were present across sex, sexual orientation, race/ethnicity, and weight status. This included a general pattern of lower preference ratings among girls (versus boys) and sexual minority (versus heterosexual) youth, and stronger preferences for words such as "thick" or "curvy" among racial/ethnic minority, sexual minority, and higher-weight youth. Use of most weight terms was higher among fathers compared with mothers, and by Hispanic/Latinx parents compared with white and Black/African American parents. CONCLUSIONS Our findings underscore diversity of youth preferences and the need for individualized approaches that support effective parent and youth communication by using their preferred terms when discussing weight-related health.
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Affiliation(s)
- Rebecca M Puhl
- Rudd Center for Food Policy & Health, University of Connecticut, Hartford, Connecticut.,Department of Human Development & Family Sciences, University of Connecticut, Storrs, Connecticut
| | - Leah M Lessard
- Department of Human Development & Family Sciences, University of Connecticut, Storrs, Connecticut
| | - Gary D Foster
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,WW International, Inc, New York, New York
| | - Michelle I Cardel
- WW International, Inc, New York, New York.,Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida
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2
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Boutté RL, Burnette CB, Mazzeo SE. BMI and Disordered Eating in Black College Women: The Potential Mediating Role of Body Appreciation and Moderating Role of Ethnic Identity. JOURNAL OF BLACK PSYCHOLOGY 2022; 48:604-630. [PMID: 36817849 PMCID: PMC9933245 DOI: 10.1177/00957984211069064] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Multiple studies indicate Black American women have disproportionately higher rates of obesity compared with other groups in United States. Although body image is associated with obesity, this relation is understudied among Black women. The purpose of the current study was to (1) examine the relations among body appreciation, body dissatisfaction and disordered eating; (2) assess body appreciation as a mediator of the relation between body mass index (BMI) and disordered eating, and (3) explore ethnic identity as a moderator in this association. Participants were 191 Black women recruited from a mid-Atlantic university. Participants' mean age was 19.16 years (SD = 1.95). Body appreciation partially mediated the relation between BMI and disordered eating behaviors and attitudes, such that women with higher BMIs reported lower body appreciation, which was associated with greater disordered eating symptoms. Ethnic identity was not a significant moderator of the association between BMI and body appreciation. Results support screening Black women with higher BMIs for disordered eating symptomatology and suggest it might be helpful to include body appreciation in interventions for Black women.
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Affiliation(s)
- Rachel L. Boutté
- Department of Psychology, Richmond, Virginia Commonwealth University, Richmond, VA, USA,Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - C. Blair Burnette
- Department of Psychology, Richmond, Virginia Commonwealth University, Richmond, VA, USA,Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Suzanne E. Mazzeo
- Department of Psychology, Richmond, Virginia Commonwealth University, Richmond, VA, USA
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3
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Jayne M. 'Playing the game': Contemporary landscapes of alcohol policy and faith-based service-users everyday lives. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 99:103451. [PMID: 34624733 DOI: 10.1016/j.drugpo.2021.103451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/10/2021] [Accepted: 08/30/2021] [Indexed: 10/20/2022]
Abstract
Against a backdrop of faith-based alcohol treatment 'filling the gaps' left by long term restructuring of service provision, funding cuts and marketisation of health and social care this paper makes connections between critical geographies of alcohol policy and service-users everyday lives in England and Wales. Presenting ethnographic research I highlight strategies, practices and performances - 'playing the game'- as service users navigate the multi-scalar impacts of 'austerity' policies, rollback neoliberal governance and 'recovery citizenship' focused on notions of vulnerablity, responsibilisation and 'underclass' behavioural politics. More specifically, the study foregrounds 'fitting in'; 'faking it'; 'conspiracy theories'; and/or 'spiritual journeys' to evidence service-users complex and sophisticated knowledges and experiences of contemporary landscapes of alcohol policy and treatment regimes. The conclusion signposts future directions for research.
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Affiliation(s)
- Mark Jayne
- School of Geography and Planning, Sun Yat-Sen University, 135 West Xingang Road, Guangzhou, Guangdong 510275, PR China.
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4
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Faith-based alcohol treatment in England and Wales: New evidence for policy and practice. Health Place 2020; 66:102457. [PMID: 33120067 DOI: 10.1016/j.healthplace.2020.102457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 09/30/2020] [Accepted: 10/01/2020] [Indexed: 11/22/2022]
Abstract
While the historical importance of religion in alcohol treatment is well known, the size, scope and significance of contemporary activities remain unclear. Here we begin to address this gap in knowledge by presenting results from a mixed methods study of faith-based alcohol treatment in England and Wales. The paper begins by mapping location, religious affiliation, organisational structure and service provision. We then discuss evidence regarding challenges, opportunities and tensions bound up with faith-based organisations 'filling gaps' left by long term restructuring of alcohol service provision, recent 'austerity' funding cuts and relationships between secular and faith-based organisations. In the final substantive section, we engage with questions of ethics and care by focusing on the internal workings of a subset of faith-based programs that make requirements for religious participation. Drawing on the variegated experiences of service-users, we reflect on the ethics of religious conversion in faith-based alcohol treatment. The conclusion offers policy and practice relevant insights and outlines areas for future research on religion, austerity, and alcohol treatment.
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Puhl RM. What words should we use to talk about weight? A systematic review of quantitative and qualitative studies examining preferences for weight-related terminology. Obes Rev 2020; 21:e13008. [PMID: 32048465 DOI: 10.1111/obr.13008] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/06/2020] [Accepted: 01/27/2020] [Indexed: 12/18/2022]
Abstract
Evidence of weight stigma and its harmful consequences have led to increased attention to the words that are used to talk about obesity and body weight, including calls for efforts to carefully consider weight-related terminology and promote respectful language in the obesity and medical fields. Despite increased research studies examining people's preferences for specific words that describe body weight, there has been no systematic review to synthesize existing evidence on perceptions of and preferences for weight-related terminology. To address this gap, the current systematic review identified 33 studies (23 quantitative, 10 qualitative) that examined people's preferences for weight-related terminology in the current research literature (from 1999 to 2019). Across studies, findings generally suggest that neutral terminology (eg, "weight" or "unhealthy weight") is preferred and that words like "obese" and "fat" are least acceptable, particularly in provider-patient conversations about weight. However, individual variation in language preferences is evident across demographic characteristics like race/ethnicity, gender, and weight status. Of priority is future research that can improve upon the limited diversity of the existing literature, both with respect to sample diversity and the use of culturally relevant weight-related terminology, which is currently lacking in measurement. Implications for patient-provider communication and public health communication are discussed.
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Affiliation(s)
- Rebecca M Puhl
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT.,Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT
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6
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Bauer AG, Berkley-Patton J, Bowe-Thompson C, Ruhland-Petty T, Berman M, Lister S, Christensen K. Do Black Women's Religious Beliefs About Body Image Influence Their Confidence in Their Ability to Lose Weight? Prev Chronic Dis 2017; 14:E98. [PMID: 29049021 PMCID: PMC5652238 DOI: 10.5888/pcd14.170153] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Black women are disproportionately burdened by obesity but maintain body satisfaction and strong religious commitment. Although faith-based weight-loss interventions have been effective at promoting weight loss among blacks, little is known about how body image and religious views contribute to weight-related beliefs among religious black women. The purpose of this study was to examine whether demographic and health history factors, religious involvement, and beliefs about body image could explain motivation and confidence to lose weight among a church-affiliated sample of black women. METHODS We recruited 240 church-affiliated black women aged 18 to 80 years (average age, 55 y; SD, 12.3) in 2014 from 6 black churches that participated in a larger study, Project FIT (Faith Influencing Transformation), a clustered, diabetes/heart disease/stroke intervention among black women and men. We used baseline data from Project FIT to conduct a cross-sectional study consisting of a survey. Variables approaching significance in preliminary correlation and χ2 analyses were included in 2 multiple linear regression models examining motivation and confidence in ability to lose weight. RESULTS In final regression models, body mass index was associated with motivation to lose weight (β = 0.283, P < .001), and beliefs about body image in relation to God predicted confidence to lose weight (β = 0.180, P = .01). CONCLUSION Faith-based, weight-loss interventions targeting black women should emphasize physical well-being and highlight the health benefits of weight management rather than the benefits of altering physical appearance and should promote positive beliefs about body image, particularly relating to God.
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Affiliation(s)
- Alexandria G Bauer
- University of Missouri-Kansas City, School of Medicine, 5030 Cherry St, Kansas City, MO 64110.
- University of Missouri-Kansas City, Department of Psychology, Kansas City, Missouri
| | - Jannette Berkley-Patton
- University of Missouri-Kansas City, School of Medicine, Kansas City, Missouri
- University of Missouri-Kansas City, Department of Psychology, Kansas City, Missouri
| | | | | | - Marcie Berman
- University of Missouri-Kansas City, Department of Psychology, Kansas City, Missouri
| | - Sheila Lister
- University of Missouri-Kansas City, School of Medicine, Kansas City, Missouri
| | - Kelsey Christensen
- University of Missouri-Kansas City, School of Medicine, Kansas City, Missouri
- University of Missouri-Kansas City, Department of Psychology, Kansas City, Missouri
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Story CR, Gross TT, Harvey IS, Whitt-Glover MC. Pastoral perceptions of the learning and developing individual exercise skills (L.A.D.I.E.S.) intervention: a qualitative study. HEALTH EDUCATION RESEARCH 2017; 32:81-95. [PMID: 28052931 PMCID: PMC5914337 DOI: 10.1093/her/cyw054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 11/29/2016] [Indexed: 06/06/2023]
Abstract
African-American women experience higher rates of obesity compared to other racial/ethnic groups. High levels of reported church attendance among African-Americans have led to the proliferation of faith-based health programs. Pastors can influence success for faith-based programs. The purpose of this study was to assess pastors' perceptions of the L.A.D.I.E.S. intervention, designed to increase physical activity levels in sedentary African-American women. For the L.A.D.I.E.S. intervention, 31 churches (n = 418 women) were randomized at the church level to a faith-based, non-faith-based or self-guided program. All 31 pastors were invited by telephone to participate in the current study. Using a qualitative design, semi-structured interviews were conducted with 11 pastors from participating churches. Thematic analysis and the ecological model were used to examine the findings. According to the pastors, women showed heightened awareness of the importance of health and physical activity, and increased levels of fellowship. L.A.D.I.E.S. also encouraged healthy church climates and new health ministries. Lessons learned included the need for an expanded participant base and curriculum. Pastors expressed appreciation for the culturally fitting approach of L.A.D.I.E.S. Findings have implications for faith-based and public agency partnerships.
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Affiliation(s)
- Chandra R. Story
- School of Applied Health and Educational Psychology, Oklahoma State University, Stillwater, OK, USA
| | - Tyra T. Gross
- Public Health Sciences, Xavier University of Louisiana, New Orleans, LA, USA
| | - Idethia S. Harvey
- Transdisciplinary Center for Health Equity Research, Texas A&M University, College Station, TX, USA and
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Pavela G. Is Childhood Socioeconomic Status Independently Associated with Adult BMI after Accounting for Adult and Neighborhood Socioeconomic Status? PLoS One 2017; 12:e0168481. [PMID: 28095430 PMCID: PMC5241009 DOI: 10.1371/journal.pone.0168481] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 12/01/2016] [Indexed: 01/03/2023] Open
Abstract
Childhood socioeconomic status (SES) is inversely associated with adult weight in high income countries. Whether the influence of childhood SES on adult weight is best described using a critical period model or an accumulation of risk model is not yet settled. This research tests whether childhood SES is associated with adult BMI and likelihood of obesity independent of adult socioeconomic status and neighborhood characteristics. Data on individual childhood and adult characteristics come from the Health and Retirement Study (N = 13,545). Data on neighborhood characteristics come from the 2000 Decennial Census and American Community Survey (2005-2009). In the fully adjusted models, perceived financial hardship before the age of sixteen and having a father who was unemployed are associated with higher BMI among males and, among females, paternal education remains associated with adult BMI. However, childhood SES is not associated with likelihood of obesity after fully adjusting for adult SES and neighborhood characteristics, suggesting that the direct effects of early childhood SES on BMI are small relative to the other factors associated with obesity in adulthood.
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Affiliation(s)
- Gregory Pavela
- School of Public Health, University of Alabama, Birmingham, Alabama, United States of America
- * E-mail:
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9
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Parsons AA, Walsemann KM, Jones SJ, Knopf H, Blake CE. The influence of dominant obesity discourse on child health narratives: a qualitative study. CRITICAL PUBLIC HEALTH 2016. [DOI: 10.1080/09581596.2016.1164298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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10
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Eliason MJ, Ingraham N, Fogel SC, McElroy JA, Lorvick J, Mauery DR, Haynes S. A systematic review of the literature on weight in sexual minority women. Womens Health Issues 2015; 25:162-75. [PMID: 25747521 DOI: 10.1016/j.whi.2014.12.001] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 12/01/2014] [Accepted: 12/01/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Over the past 20 years, a growing literature has demonstrated that sexual minority women have greater weight than heterosexual women, prompting concern that they may be at high risk for disparities in physical disorders. In 2008, Bowen et al. published a review of the existing research on sexual minority women and obesity, finding no methodologically strong studies with representative sampling procedures. METHOD We conducted a systematic review of the literature covering the period of July 2006 to February 2014 on the relationship between sexual orientation and weight. The review includes 20 population-based and 17 nonprobability sample studies. CONCLUSIONS The majority of these studies found that lesbian and bisexual women had significantly greater body mass index (BMI) or a higher percentage with a BMI over 30 than heterosexual women. The difference in BMI was fairly consistent across the lifespan, with the weight differences beginning in adolescence. The studies, however, did not show a higher prevalence of physical disorders thought to be associated with weight. This potentially paradoxical finding warrants further research to compare prevalence of chronic disease by BMI category and sexual orientation.
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Affiliation(s)
- Michele J Eliason
- Department of Health Education, San Francisco State University, San Francisco, California.
| | | | - Sarah C Fogel
- Vanderbilt University School of Nursing, Nashville, Tennessee
| | - Jane A McElroy
- Family and Community Medicine Department, University of Missouri, School of Medicine, Columbia, Missouri
| | - Jennifer Lorvick
- Urban Health Program, RTI International, San Francisco, California
| | - D Richard Mauery
- Department of Health Policy, George Washington School of Public Health and Health Services, Washington, DC
| | - Suzanne Haynes
- U.S. Department of Health and Human Services, Office on Women's Health, Washington, DC
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11
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DeJoy SB, Bittner K. Obesity Stigma as a Determinant of Poor Birth Outcomes in Women with High BMI: A Conceptual Framework. Matern Child Health J 2014; 19:693-9. [DOI: 10.1007/s10995-014-1577-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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12
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Throsby K, Evans B. ‘Must I seize every opportunity?’ Complicity, confrontation and the problem of researching (anti-) fatness. CRITICAL PUBLIC HEALTH 2013. [DOI: 10.1080/09581596.2013.802290] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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