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Smith ML, Brimhall AS, Didericksen KW, Jensen JF. Words matter: The role of family weight talk in anxiety and depression. JOURNAL OF MARITAL AND FAMILY THERAPY 2024; 50:726-743. [PMID: 38605530 DOI: 10.1111/jmft.12704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 03/18/2024] [Accepted: 03/20/2024] [Indexed: 04/13/2024]
Abstract
Family weight talk, in the forms of both family weight teasing and encouragement to diet, has been linked to numerous adverse outcomes, including increased disordered eating, unhealthy weight control behaviors, and body mass index. However, little is known about its role in mental health outcomes, especially for emerging adults. Utilizing structural equation modeling, we examined the role of family weight teasing (FWT) and parental encouragement to diet in anxiety and depression and explored body weight perception as a moderator within a sample of 292 emerging adults. Results indicated that FWT was significantly associated with increased anxiety and depression. No significant relationships were found between parental encouragement to diet and the outcome variables, and no group differences emerged across body weight perception. Findings of this pilot study can be used to inform future research to decrease family weight talk and improve psychosocial outcomes for emerging adults.
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Affiliation(s)
- Maggie L Smith
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Andrew S Brimhall
- Department of Human Development and Family Studies, East Carolina University, Greenville, North Carolina, USA
| | | | - Jakob F Jensen
- Department of Human Development and Family Studies, East Carolina University, Greenville, North Carolina, USA
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2
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Goldfield GS, Cameron JD, Sigal RJ, Kenny GP, Prud'homme D, Ngu M, Alberga AS, Doucette S, Goldfield DB, Tulloch H, Thai H, Simas KR, Walsh J. The BDNF Val66Met polymorphism and health-related quality of life in youth with obesity. Physiol Rep 2024; 12:e16140. [PMID: 38997217 PMCID: PMC11245332 DOI: 10.14814/phy2.16140] [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: 03/05/2024] [Revised: 06/24/2024] [Accepted: 06/28/2024] [Indexed: 07/14/2024] Open
Abstract
The brain derived-neurotrophic factor (BDNF) Val66Met polymorphism causes functional changes in BDNF, and is associated with obesity and some psychiatric disorders, but its relationship to health-related quality of life (HRQoL) remains unknown. This study examined, in youth with obesity, whether carriers of the BDNF Val66met polymorphism Met-alleles (A/A or G/A) differed from noncarriers (G/G) on HRQoL. The participants were 187 adolescents with obesity. Ninety-nine youth were carriers of the homozygous Val/Val (G/G) alleles, and 88 were carriers of the Val/Met (G/A) or Met/Met (A/A) alleles. Blood samples were drawn in the morning after an overnight fast for genotyping. HRQoL was measured using the Pediatric-Quality of Life core version. Compared to carriers of the Val66Met Val (G/G) alleles, carriers of the Met-Alleles reported significantly higher physical -HRQoL (p = 0.02), school-related HRQoL, (p = 0.05), social-related HRQoL (p = 0.05), and total HRQoL (p = 0.03), and a trend for Psychosocial-HRQoL. Research is needed to confirm our findings and determine whether carriers of the BDNF Val66Met homozygous Val (G/G) alleles may be at risk of diminished HRQoL, information that can influence interventions in a high-risk population of inactive youth with obesity.
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Affiliation(s)
- Gary S Goldfield
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
| | - Jameason D Cameron
- Department of Pharmacy, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Ronald J Sigal
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
- Department of Medicine, Cardiac Sciences and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Glen P Kenny
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Denis Prud'homme
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
- University of Moncton, Moncton, New Brunswick, Canada
| | - Mathew Ngu
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Angela S Alberga
- Department of Exercise Science, Concordia University, Montreal, Quebec, Canada
| | - Steve Doucette
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Heather Tulloch
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Helen Thai
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
- Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Kevin R Simas
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada
| | - Jeremy Walsh
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
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3
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Sjunnestrand M, Neuman N, Järvholm K, Ek A, Nordin K, Salas XR, Eli K, Nowicka P. "A balancing act": parents' longitudinal perspectives of weight-related discussions with their children following obesity treatment. BMC Public Health 2024; 24:1695. [PMID: 38918803 PMCID: PMC11202376 DOI: 10.1186/s12889-024-19195-1] [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: 01/03/2024] [Accepted: 06/19/2024] [Indexed: 06/27/2024] Open
Abstract
Weight-related discussions during childhood may have long-lasting effects on children's body image and well-being. However, little is known about how parents frame these discussions with children who have undergone treatment for obesity. Our study aimed to explore how parents perceive weight-related discussions, several years after their children started obesity treatment. This qualitative study is part of the 4-year follow-up of the More and Less study, a randomized controlled trial examining the effectiveness of a parental support program as part of obesity treatment for preschool-aged children in Stockholm, Sweden. Semi-structured interviews were conducted with 33 parents (79% mothers, 48% with a university degree, 47% with foreign background) of 33 children (mean age 9.3 years (SD 0.7), 46% girls), transcribed and analyzed using realist informed thematic analysis. Three main themes, encompassing three subthemes were developed. Under the first theme, Parental attitudes and concerns, parents emphasized the importance of discussing weight and health behaviors with their children, yet found it challenging due to uncertainties about how to approach it safely and sensitively. A few parents found the conversation manageable, citing their own experiences of having overweight or their style of communication with the child as facilitating the conversation. Under the second theme, The significance of time and context, parents said they engaged in weight-related conversations with their children more frequently as the children matured, driven by their growing self-awareness. Parents also expressed how contextual factors, such as gender and the presence of others, shaped conversations. Parents perceived boys as more resilient, thus exposing them to more negative weight talk. The third theme, Navigating weight stigma, revealed how parents employed strategies such as nurturing their children's self-confidence, downplaying the significance of appearance and emphasizing health when discussing weight to shield their children from weight stigma. Taken together, we found that many parents need support to navigate weight-related discussions. Addressing weight stigma is part of children's obesity management process, as children may be bullied, teased, or experience discrimination in different social settings. More research is needed to explore how young children undergoing obesity treatment experience weight stigma and to understand gendered differences in these experiences.
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Affiliation(s)
- My Sjunnestrand
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden.
| | - Nicklas Neuman
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | | | - Anna Ek
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Karin Nordin
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Ximena Ramos Salas
- European Association for the Study of Obesity, United Kingdom and Bias 180, Ottawa, Canada
| | - Karin Eli
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Paulina Nowicka
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
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4
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Levinson JA, Kinkel-Ram S, Myers B, Hunger JM. A systematic review of weight stigma and disordered eating cognitions and behaviors. Body Image 2024; 48:101678. [PMID: 38278088 PMCID: PMC11180546 DOI: 10.1016/j.bodyim.2023.101678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 12/23/2023] [Accepted: 12/27/2023] [Indexed: 01/28/2024]
Abstract
Weight stigma is persistent across contexts and is associated with disordered eating cognitions and behaviors. This systematic review aimed to examine the existing literature that has explored the relationship between weight stigma and disordered eating cognitions and behaviors. We specifically examined three dimensions of weight stigma - experienced, anticipated, and internalized - and adopted an inclusive conceptualization of outcomes related to disordered eating (including constructs such as binge eating, body dissatisfaction, and other cognitions and behaviors such as dietary restraint, unhealthy weight control behaviors, and drive for thinness). We searched PubMed, Embase, CINAHL, Web of Science, Sociological Abstracts, and PsycINFO for English-language, peer-reviewed articles and dissertations with quantitative methodology published through October 2023. The search resulted in 242 articles meeting inclusion criteria. A narrative review found a consistent relationship between greater weight stigma and more disordered eating cognitions and behaviors. Methodological and theoretical limitations are discussed, as are critical avenues for future research and potential clinical implications stemming from this body of research. Given the widespread nature and impact of weight stigma on disordered eating, it is imperative that we intervene to address weight stigma at all levels, from the structural to the intrapersonal.
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Affiliation(s)
- Jordan A Levinson
- Department of Psychology, University of California Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095, United States
| | - Shruti Kinkel-Ram
- Department of Psychology, Miami University, 90 N Patterson Avenue, Oxford, OH 45056, United States
| | - Bethany Myers
- University of California Los Angeles, Los Angeles, CA 90095, United States
| | - Jeffrey M Hunger
- Department of Psychology, Miami University, 90 N Patterson Avenue, Oxford, OH 45056, United States.
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5
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Sonneville KR, Thurston IB, Gordon AR, Richmond TK, Weeks HM, Lipson SK. Weight Stigma Associated With Mental Health Concerns Among College Students. Am J Prev Med 2024; 66:260-268. [PMID: 37758003 DOI: 10.1016/j.amepre.2023.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 09/21/2023] [Accepted: 09/21/2023] [Indexed: 09/29/2023]
Abstract
INTRODUCTION Weight stigma is widespread and exists across numerous domains including health care, educational institutions, workplaces, mass media, and interpersonal relationships. Weight stigma experienced during the college years may be particularly consequential because the college years are a period of increased vulnerability for the development of mental health concerns. The purpose of the present study was to examine how experiences of weight stigma relate to mental health concerns, including symptoms of eating disorders, anxiety, and depression, among college students. METHODS Prevalence of interpersonal and anticipated weight stigma was examined among 2,707 students participating in the 2018-2019 and 2019-2020 Healthy Minds Study and tested for differences in prevalence across student characteristics. Logistic regression was used to explore relationships between measures of weight stigma and student mental health. Analyses were conducted in 2021-2023. RESULTS Interpersonal and anticipated weight stigma were reported by 12.3% and 15.3% of students, respectively. Experiences of interpersonal and anticipated weight stigma were generally lowest among cisgender male students, heterosexual students, those with the fewest financial concerns, and those who did not perceive themselves to be "overweight." Both interpersonal and anticipated weight stigma were associated with elevated odds of high weight concerns, past-month binge eating, past-month purging, high eating disorder risk, moderate/severe anxiety symptoms, and moderate/severe depressive symptoms. CONCLUSIONS Findings implicate interpersonal and anticipated weight stigma as potential risk factors for a range of mental health concerns. Weight stigma is an under-recognized and under-funded public health problem.
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Affiliation(s)
- Kendrin R Sonneville
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan.
| | - Idia B Thurston
- Departments of Health Sciences and Applied Psychology, Institute for Health Equity and Social Justice Research, Northeastern University, Boston, Massachusetts
| | - Allegra R Gordon
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts
| | - Tracy K Richmond
- Division of Adolescent/Young Adult Medicine, Department of Pediatrics, Harvard Medical School, Boston Children's Hospital, Boston, Massachusetts
| | - Heidi M Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Sarah K Lipson
- Department of Health Law Policy and Management, Boston University School of Public Health, Boston, Massachusetts
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6
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Rutsztein G, Scappatura ML, Elizathe L, Leonardelli E, Murawski B, Lievendag L, Sanday J, Falivelli MBB, Bidacovich G, Keegan E. Efficacy of an integrated program (PIA-2) to reduce the risk for problems related to eating, weight and body image in female adolescents from Argentina. Int J Eat Disord 2023; 56:758-769. [PMID: 36757140 DOI: 10.1002/eat.23900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 01/10/2023] [Accepted: 01/10/2023] [Indexed: 02/10/2023]
Abstract
OBJECTIVE This study aimed to examine the efficacy of an integrated program (PIA-2) to reduce the risk for problems related to eating, weight and body image in female adolescents from Argentina. METHOD A quasi-experimental study was conducted by comparing an experimental group versus a control group. The final sample included 509 girls aged 13-18 (M = 15.39 and SD = 1.30) from nine schools located in three geographical regions. They provided data at three assessment time points: baseline, post-intervention and a 3-month follow-up. Dependent variables included skipping breakfast, physical activity, eating disorder risk and thin-ideal internalization. The program was carried out in three 90-minute sessions within usual school hours, at 1-week intervals. RESULTS Participants who received the intervention decreased more than the control group in skipping breakfast month by month. However, a significant effect of the intervention was not found on physical activity, eating disorder risk, and thin-ideal internalization. DISCUSSION The presence of mixed findings shows the need to adjust the intervention to enhance the results. The importance of working jointly with other Latin American countries is emphasized, in order to promote the growth of the field of prevention, regarding cultural particularities shared by our societies. PUBLIC SIGNIFICANCE Integrated programs aimed at reducing risk factors for the entire spectrum of problems related to eating, weight and body image could lead to beneficial and more efficient effects. However, their development is still incipient in Latin America. PIA-2 Program, designed for female adolescents, produced positive results in one of the four variables studied, decreasing the weekly frequency of skipping breakfast among adolescents. This is pioneering research in Argentina and the region since very few studies on integrated prevention have been published in Latin America. It is crucial to continue with efforts aimed at developing programs that are suited to the specific needs of the population of Latin American countries. In this aspect, our study is undoubtedly an important contribution.
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Affiliation(s)
| | | | - Luciana Elizathe
- Facultad de Psicología, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Eduardo Leonardelli
- Facultad de Psicología, Universidad de Buenos Aires, Buenos Aires, Argentina.,Pontificia Universidad Católica, Buenos Aires, Argentina.,Universidad Favaloro, Buenos Aires, Argentina
| | - Brenda Murawski
- Facultad de Psicología, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Leonora Lievendag
- Facultad de Psicología, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Julieta Sanday
- Facultad de Psicología, Universidad de Buenos Aires, Buenos Aires, Argentina
| | | | - Germán Bidacovich
- Facultad de Psicología, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Eduardo Keegan
- Facultad de Psicología, Universidad de Buenos Aires, Buenos Aires, Argentina
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7
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Lucibello KM, Sabiston CM, Pila E, Arbour-Nicitopoulos K. An integrative model of weight stigma, body image, and physical activity in adolescents. Body Image 2023; 45:1-10. [PMID: 36731346 DOI: 10.1016/j.bodyim.2023.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 01/12/2023] [Accepted: 01/12/2023] [Indexed: 02/03/2023]
Abstract
Negative weight-related experiences and internalized weight stigma have been associated with poorer body image and reduced physical activity in adolescents. However, exploring body image and physical activity as discrete weight stigma outcomes fails to consider the theoretically- and empirically-supported covariation between the two. The present study tested a novel integrated model of the associations among negative weight-related experiences and internalized weight stigma (via weight-related distress), body image (shame, authentic pride, body appreciation), and physical activity. Canadian adolescents (N = 311, Mage ± SD = 16.00 ± 1.01, 75.5% girls) completed a cross-sectional self-report survey. A structural equation model with maximum likelihood robust estimation was tested. Higher negative weight-related experiences were indirectly associated with poorer body image (i.e., higher shame; lower authentic pride and appreciation) through higher weight-related distress. Authentic pride was associated with moderate-to-vigorous physical activity. Higher negative weight-related experiences were indirectly associated with lower physical activity through higher weight-related distress and lower body-related authentic pride. These findings elucidate targetable individual mechanisms and larger systems that could improve body image and foster physical activity among adolescents who encounter negative weight-related experiences and internalized weight stigma.
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Affiliation(s)
| | | | - Eva Pila
- School of Kinesiology, Western University, London, Ontario, Canada
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8
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Day S, Bussey K, Trompeter N, Mitchison D. The Impact of Teasing and Bullying Victimization on Disordered Eating and Body Image Disturbance Among Adolescents: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2022; 23:985-1006. [PMID: 33461439 DOI: 10.1177/1524838020985534] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Adolescence is a developmental period in which disordered eating and negative body image are highly prevalent, yet their risk factors are insufficiently understood and targeted. Despite research implicating both teasing and bullying victimization in the development of eating disorders, these strands of research are yet to be integrated. This systematic review hence aimed to identify whether teasing and bullying victimization are associated with greater risk of eating disorders and body image disturbance for adolescents. Systematic searches of PsycINFO and PubMed databases identified 79 papers that included quantitative analyses of the relationship between weight-related or nonspecific teasing or bullying victimization and disordered eating or body image disturbance. Overall, studies indicated that adolescents who are teased or bullied are more likely to experience disordered eating and negative body image compared to nonvictimized adolescents. This was more consistently observed in cross-sectional studies than in longitudinal findings. We identify several methodological limitations of the literature, including the infrequent consideration of potential mediating and moderating variables. Finally, we outline future directions such as temporal sequencing of the complex interrelationships among teasing and bullying, disordered eating, and body image disturbance in adolescents.
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Affiliation(s)
- Sinead Day
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Kay Bussey
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia
| | - Nora Trompeter
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia
| | - Deborah Mitchison
- School of Medicine, Blacktown Clinical School, Translational Health Research Institute, Western Sydney University, Penrith, Australia
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9
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Obeid N, Flament MF, Buchholz A, Henderson KA, Schubert N, Tasca G, Thai H, Goldfield G. Examining Shared Pathways for Eating Disorders and Obesity in a Community Sample of Adolescents: The REAL Study. Front Psychol 2022; 13:805596. [PMID: 35432146 PMCID: PMC9008728 DOI: 10.3389/fpsyg.2022.805596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 02/16/2022] [Indexed: 11/21/2022] Open
Abstract
Several psychosocial models have been proposed to explain the etiology of eating disorders (EDs) and obesity separately despite research suggesting they should be conceptualized within a shared theoretical framework. The objective of the current study was to test an integrated comprehensive model consisting of a host of common risk and protective factors (socio-environmental, psychological, and behavioral) expected to explain both eating and weight disorders simultaneously in a large school-based sample of adolescents. Data were collected from 3,043 youth (60% female, 14.00 ± 1.61) from 41 schools in the Ottawa region, Canada. Working with interested school staff, validated self-report scales in the form of a questionnaire booklet were administered to participating students to assess several understood risk and protective factors common to both eating disorders and obesity. Anthropometric measurements of weight and height were taken at the end of the questionnaire administration period by trained research staff. Structural equation modeling with cross-validation was used to test the hypothesized model. Findings demonstrated that dysregulated eating was associated with both eating disorder and weight status with diet culture and emotion dysregulation directly associated with some of these disordered eating patterns. It equally pointed to how lifestyle made up of high sedentary behaviors, low vigorous exercise and varied eating patterns contributed to both emotion dysregulation and poor body image which subsequently affected eating issues and weight status simultaneously, signaling the complex interplay of psychosocial factors that underlie these concerns. This study provides evidence for an integrated psychosocial model consisting of socio-environmental, psychological, and behavioral factors may best explain the complex interplay of risk and protective factors influencing eating disorders and obesity. It equally highlights understanding the direct and indirect effects of some of the most salient risk factors involved in eating and weight-related concerns, including the strong effects of diet culture and stressors such as weight-based teasing, providing interventionalists evidence of important risk factors to consider targeting in eating disorder and weight-based prevention efforts.
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Affiliation(s)
- Nicole Obeid
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
- *Correspondence: Nicole Obeid,
| | | | - Annick Buchholz
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Centre for Healthy Active Living, Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada
- Department of Psychology, Carleton University, Ottawa, ON, Canada
| | - Katherine A. Henderson
- Department of Psychology, Carleton University, Ottawa, ON, Canada
- Anchor Psychological Services, Ottawa, ON, Canada
| | - Nick Schubert
- Institute of Mental Health Research, Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | - Giorgio Tasca
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
| | - Helen Thai
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Gary Goldfield
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Department of Psychology, Carleton University, Ottawa, ON, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
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10
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Dougherty EN, Goldschmidt AB, Johnson NK, Badillo K, Engel SG, Haedt-Matt AA. Gender differences in the relation between interpersonal stress and momentary shape and weight concerns in youth with overweight/obesity. Body Image 2022; 40:249-255. [PMID: 35074653 PMCID: PMC8891090 DOI: 10.1016/j.bodyim.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 01/17/2022] [Accepted: 01/17/2022] [Indexed: 10/19/2022]
Abstract
The purpose of this study was to examine relations between interpersonal stress and momentary shape and weight concerns among pre-adolescent and early adolescent boys and girls with overweight/obesity, using ecological momentary assessment (EMA). We also aimed to determine whether interpersonal stress was differentially related to shape/weight concerns in boys versus girls. Forty youth, ages 8-14 years (53% female), with overweight or obesity reported their state-level shape/weight concerns and negative affect and their recent interpersonal stress (i.e., stress experienced since the last EMA assessment) multiple times a day, for two weeks. Results indicated that interpersonal stress predicted shape/weight concerns in girls but was not related to shape/weight concerns in boys. At the between-person level, higher overall feelings of loneliness and social rejection and a higher overall desire for more friends predicted higher average levels of shape/weight concerns. At the within-person level, higher momentary ratings of loneliness, social rejection, and desire for more friends predicted lower shape/weight concerns. These data suggest that the tendency to experience interpersonal stress may be more detrimental to body satisfaction for girls with overweight/obesity than for boys with overweight/obesity. Interventions that focus on reducing interpersonal stress may be effective in ameliorating shape/weight concerns in girls with overweight/obesity.
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Affiliation(s)
| | | | | | | | - Scott G. Engel
- Sanford Research,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine & Health Sciences
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11
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Warnick JL, Darling KE, West CE, Jones L, Jelalian E. Weight Stigma and Mental Health in Youth: A Systematic Review and Meta-Analysis. J Pediatr Psychol 2021; 47:237-255. [PMID: 34791368 DOI: 10.1093/jpepsy/jsab110] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 09/23/2021] [Accepted: 09/29/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE Over the past two decades, there has been a steady increase in research focused on the association between weight-based stigma and mental health outcomes in children and adolescents. The present study is a systematic review and meta-analysis of the associations between weight stigma and mental health in youth. METHODS A systematic search of PubMed, PsychInfo, and Embase databases was conducted in January 2020. Inclusion criteria included the following: (a) examined an association between weight stigma and a mental health outcome, (b) mean sample age <18 (+1 standard deviation) years, (c) written in English, and (d) peer reviewed. Forty eligible articles were identified. The moderating effects of age, sex (percent female), weight status (percent with overweight/obesity), and study quality were examined. RESULTS Overall, meta-analytic findings using a random-effects model indicated a statistically significant moderate association between weight stigma and poorer mental health outcomes (r = .32, 95% confidence interval [0.292, 0.347], p < .001). Age and study quality each moderated the association between weight stigma and mental health. Generally, the study quality was fair to poor, with many studies lacking validated measurement of weight stigma. CONCLUSIONS Although there was a significant association between weight stigma and mental health in youth, study quality hinders the current body of literature. Furthermore, findings highlight the lack of consideration of internalized weight stigma in child populations, the importance of using validated measures of weight stigma, and the need for increased awareness of how these associations affect populations of diverse backgrounds.
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Affiliation(s)
- Jennifer L Warnick
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, USA.,Weight Control and Diabetes Research Center, The Miriam Hospital, USA
| | - Katherine E Darling
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, USA.,Weight Control and Diabetes Research Center, The Miriam Hospital, USA
| | - Caroline E West
- Department of Psychological Sciences, Kent State University, USA
| | - Laura Jones
- Department of Clinical and Health Psychology, University of Florida, USA
| | - Elissa Jelalian
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, USA.,Weight Control and Diabetes Research Center, The Miriam Hospital, USA
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12
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Williamson G, Osa ML, Budd E, Kelly NR. Weight-related teasing is associated with body concerns, disordered eating, and health diagnoses in racially and ethnically diverse young men. Body Image 2021; 38:37-48. [PMID: 33831652 DOI: 10.1016/j.bodyim.2021.03.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 03/15/2021] [Accepted: 03/15/2021] [Indexed: 12/12/2022]
Abstract
Research suggests that weight-related teasing is associated with body concerns and disordered eating in male and female adolescents and women. Yet, little is known about these associations for young men with diverse racial and ethnic identities. This study examined the association of weight-related teasing frequency and distress with body concerns, loss of control (LOC) eating, dietary restraint, and history of psychiatric and medical diagnoses in racially and ethnically diverse young men. Racial and ethnic identity was examined as a potential moderator. Participants (N = 1,069; 18-30 years; Mage = 24.1 ± 3.6 years) completed an online survey and reported on general demographics; weight-related teasing; body concerns; LOC eating frequency in the last 28 days; dietary restraint; and history of psychiatric and medical diagnoses. All models adjusted for BMI, income, education, and history of psychiatric diagnoses (when not the dependent variable). Both weight-related teasing frequency and distress were significantly and positively linked with all dependent variables, and these associations did not significantly vary by racial and ethnic identity. These findings suggest that, much like in prior research with adolescents and women, experiences with weight-related teasing are associated with body concerns, disordered eating, and poorer health in racially and ethnically diverse young men, regardless of body size.
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Affiliation(s)
- Gina Williamson
- Counseling Psychology and Human Services, University of Oregon, 1215 University of Oregon, Eugene, OR 97403, United States; The Prevention Science Institute, University of Oregon, 1600 Millrace Dr, Eugene, OR 97403, United States
| | - Maggie L Osa
- Counseling Psychology and Human Services, University of Oregon, 1215 University of Oregon, Eugene, OR 97403, United States; The Prevention Science Institute, University of Oregon, 1600 Millrace Dr, Eugene, OR 97403, United States
| | - Elizabeth Budd
- Counseling Psychology and Human Services, University of Oregon, 1215 University of Oregon, Eugene, OR 97403, United States; The Prevention Science Institute, University of Oregon, 1600 Millrace Dr, Eugene, OR 97403, United States
| | - Nichole R Kelly
- Counseling Psychology and Human Services, University of Oregon, 1215 University of Oregon, Eugene, OR 97403, United States; The Prevention Science Institute, University of Oregon, 1600 Millrace Dr, Eugene, OR 97403, United States.
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13
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Weight stigma and disordered eating behaviors in Pakistani overweight adolescents: the mediating role of body esteem. Eat Weight Disord 2021; 26:1939-1948. [PMID: 33068276 DOI: 10.1007/s40519-020-01038-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Accepted: 09/29/2020] [Indexed: 10/23/2022] Open
Abstract
PURPOSE Weight stigma has been described as social devaluation of people on the basis of their weight and it is associated with negative consequences. The present study was designed to investigate weight stigma and its relationship with disordered eating behaviors in overweight adolescents. One of the main objectives of this study is to investigate the mediating role of body esteem between weight stigma and disordered eating behaviors in overweight adolescent girls. METHODS Through cross-sectional research design and purposive sampling technique, a sample of 200 overweight adolescent girls was recruited from Lahore, Pakistan. Participants were asked to fill self-report measures related to weight stigma, body esteem, and disordered eating behaviors. RESULTS SPSS and AMOS were used to analyze the data. Pearson product moment correlation showed that experiences of weight stigma were negatively related to body esteem and positively related to disordered eating behaviors in overweight adolescent girls. Furthermore, structural equation modeling (SEM) showed that body esteem was significantly mediating the relationship between weight stigma and disordered eating behaviors in adolescent girls. CONCLUSION It is concluded that weight stigma and body esteem play a significant role in the development and maintenance of disordered eating behaviors in overweight adolescents. Awareness/educational programs could be designed to empower adolescent girls in combating negative consequences of weight stigma. Furthermore, specific programs could be designed at college or university level to boost one's body esteem and reduce disordered eating behaviors. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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14
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Walsh Ó, Dettmer E, Regina A, Ye L, Christian J, Hamilton J, Toulany A. "I don't want them to think that what they said matters": How treatment - seeking adolescents with severe obesity cope with weight-based victimization. Clin Obes 2021; 11:e12437. [PMID: 33448124 PMCID: PMC8244044 DOI: 10.1111/cob.12437] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 11/07/2020] [Accepted: 12/08/2020] [Indexed: 11/28/2022]
Abstract
Adolescents with severe obesity are subject to a high prevalence of weight-based victimization that may lead to pervasive mental health symptoms. However, different coping strategies could potentially modulate these psychological consequences. This study aims to explore how treatment-seeking adolescents with severe obesity cope with weight-based victimization. This was a qualitative research study using an interpretive phenomenological analytic approach. One-on-one semi structured interviews were completed with 19 adolescents (63% female) enrolled in a weight management program. The interviews were transcribed and sequentially analysed until data saturation was attained. The majority of participants (89.5%) described being a victim of weight-based victimization and highlighted a significant emotional toll. Two key themes were identified that captured the various coping strategies used by participants. Over half (52.9%) described approach coping strategies where they acted on the source to invoke change by standing up for themselves, helping others in similar situations or becoming a bully themselves. Whilst the majority (94.1%) used avoidant coping strategies such as feigning a strong exterior façade, denial, isolation and self-harm. Nearly half (47.1%) used both strategies. Treatment-seeking adolescents with severe obesity commonly use avoidant coping strategies to deal with weight-based victimization. These strategies are associated with negative mental health outcomes and should be evaluated when counselling adolescents with obesity who have experienced weight-based victimization.
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Affiliation(s)
- Órla Walsh
- Department of General PaediatricsChildren's Health Ireland at Temple StreetDublinIreland
| | - Elizabeth Dettmer
- Department of PsychologyThe Hospital for Sick ChildrenTorontoOntarioCanada
- Department of PaediatricsUniversity of TorontoTorontoOntarioCanada
| | - Andrea Regina
- Department of PsychologyThe Hospital for Sick ChildrenTorontoOntarioCanada
| | - Linlei Ye
- Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
| | | | - Jill Hamilton
- Department of PaediatricsUniversity of TorontoTorontoOntarioCanada
- Division of EndocrinologyThe Hospital for Sick Children, University of TorontoTorontoOntarioCanada
| | - Alene Toulany
- Department of PaediatricsUniversity of TorontoTorontoOntarioCanada
- Institute for Clinical Evaluative SciencesTorontoOntarioCanada
- Division of Adolescent MedicineThe Hospital for Sick Children, University of TorontoTorontoOntarioCanada
- Institute for Health Policy, Management, and Evaluation, Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
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15
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Ma L, Chu M, Li Y, Wu Y, Yan AF, Johnson B, Wang Y. Bidirectional relationships between weight stigma and pediatric obesity: A systematic review and meta-analysis. Obes Rev 2021; 22:e13178. [PMID: 33533189 DOI: 10.1111/obr.13178] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 11/02/2020] [Accepted: 11/09/2020] [Indexed: 01/04/2023]
Abstract
This study for the first time quantified concurrent and bidirectional relationships between weight stigma and weight status in children, with age and gender as moderators. A literature search was conducted in PubMed, Web of Science, and PsycINFO for studies examined associations between weight stigma and weight status among children aged 6-18 years. Twenty-five studies (20 cross-sectional studies and five longitudinal studies) from six countries with 101,036 participants were included in review, and 18 were included in meta-analysis. Weight and height were self-reported in nine studies, otherwise objectively measured. With data from 17 cross-sectional studies and baseline portions of four longitudinal studies, meta-analysis showed weight stigma and overweight/obesity were associated (pooled OR = 3.12, 95% CI: 2.71, 3.60), they were also associated across age and gender. Body mass index (BMI) was associated with greater weight stigma (pooled r = 0.38, 95% CI: 0.32, 0.43). Age modified such association. Weight stigma predicted increased BMI from three longitudinal studies (pooled β = 1.12, 95% CI: 0.78, 1.45); another two longitudinal studies reported BMI predicted greater weight stigma. Data were inadequate for age- or gender-stratified analyses. Findings supported positive concurrent and bidirectional relationships between weight stigma and weight status. Timely obesity and weight stigma interventions to protect children well-being are needed.
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Affiliation(s)
- Lu Ma
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Meng Chu
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Yixuan Li
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Yang Wu
- Department of Sociology, Center for Asian & Pacific Economic & Social Development, Research Institute for Female Culture, Jiangxi University of Finance and Economics, Nanchang, China
| | - Alice Fang Yan
- Division of General Internal Medicine, Department of Medicine, Center of Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Blair Johnson
- Department of Psychological Sciences and Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, Connecticut, USA
| | - Youfa Wang
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China.,Fisher Institute of Health and Well-Being, Department of Nutrition and Health Science, College of Health, Ball State University, Muncie, Indiana, USA
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16
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Rubin AG, Schvey NA, Shank LM, Altman DR, Swanson TN, Ramirez E, Moore NA, Jaramillo M, Ramirez S, Davis EK, Broadney MM, LeMay-Russell S, Byrne ME, Parker MK, Brady SM, Kelly NR, Tanofsky-Kraff M, Yanovski JA. Associations between weight-based teasing and disordered eating behaviors among youth. Eat Behav 2021; 41:101504. [PMID: 33831812 PMCID: PMC8131258 DOI: 10.1016/j.eatbeh.2021.101504] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 03/10/2021] [Accepted: 03/24/2021] [Indexed: 11/30/2022]
Abstract
Weight-based teasing (WBT) is commonly reported among youth and is associated with disinhibited and disordered eating. Specifically, youth who experience WBT may engage in disordered eating behaviors to cope with the resultant negative affect. Therefore, we examined associations between WBT and disordered eating behaviors among youth and assessed whether negative affect mediated these relationships. Two hundred one non-treatment seeking youth (8-17y) completed questionnaires assessing WBT, disinhibited eating, depression, and anxiety. Disordered eating and loss-of-control (LOC) eating were assessed via semi-structured interview. Analyses of covariance were conducted to examine relationships between WBT and eating-related variables, and bootstrapping mediation models were used to evaluate negative affect (a composite of depressive and anxiety symptoms) as a mediator of these associations. All models were adjusted for sex, race, age, and adiposity. Among 201 participants (13.1 ± 2.8y; 54.2% female; 30.3% Black; 32.8% with overweight/obesity), WBT was associated with emotional eating, eating in the absence of hunger, and disordered eating attitudes and behaviors (ps ≤ 0.02). These associations were all mediated by negative affect. WBT was also associated with a threefold greater likelihood of reporting a recent LOC eating episode (p = .049). Among boys and girls across weight strata, WBT was associated with multiple aspects of disordered eating and these relationships were mediated by negative affect. Longitudinal studies are needed to clarify the directionality of these associations and to identify subgroups of youth that may be particularly vulnerable to WBT and its sequelae.
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Affiliation(s)
- Alex G Rubin
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA
| | - Natasha A Schvey
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA; Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD 20814, USA.
| | - Lisa M Shank
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA; Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Metis Foundation, 300 Convent Street, Suite 1330, San Antonio, TX 78205, USA
| | - Deborah R Altman
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA; Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Taylor N Swanson
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA; Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Metis Foundation, 300 Convent Street, Suite 1330, San Antonio, TX 78205, USA
| | - Eliana Ramirez
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA
| | - Nia A Moore
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA
| | - Manuela Jaramillo
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA
| | - Sophie Ramirez
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA
| | - Elisabeth K Davis
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA
| | - Miranda M Broadney
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA
| | - Sarah LeMay-Russell
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA; Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Meghan E Byrne
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA; Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Megan K Parker
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA; Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Sheila M Brady
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA
| | - Nichole R Kelly
- Department of Counseling Psychology and Human Services, University of Oregon, 5207 University of Oregon, Eugene, OR 97403-5207, USA
| | - Marian Tanofsky-Kraff
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA; Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Jack A Yanovski
- Section on Growth and Obesity, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA
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17
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Dahill LM, Touyz S, Morrison NMV, Hay P. Parental appearance teasing in adolescence and associations with eating problems: a systematic review. BMC Public Health 2021; 21:450. [PMID: 33676473 PMCID: PMC7936414 DOI: 10.1186/s12889-021-10416-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 02/09/2021] [Indexed: 01/29/2023] Open
Abstract
Background The adolescent years see significant physical and emotional development that lay foundations for patterns of behaviour that can continue into adult life, including the shaping of eating behaviours. Given parents are key socio-environmental drivers and influencers of adolescent behaviours around physical health and wellbeing, it is critical to consider if specific forms of parental communication are potentially contributing to the associated emotional difficulties experienced in the adolescent years. The aim of this research was to systematically review the myriad of literature pertaining to the prevalence of parental weight or appearance-based teasing and adolescent eating problems to examine how the scientific and clinical community currently understands the relationship between these domains. Methods A systematic search of the literature, using the SCOPUS, APA PsycINFO, Medline, CINAHL databases, reference lists and Google Scholar, was undertaken to identify relevant literature for parental teasing and problem eating in adolescents aged 10–19 years, published between January 1980 to October 2020, in English or French. Results Six studies met criteria for inclusion, all were cross-sectional studies and two included additional prospective data. Although parents were not the most common perpetrators of teasing, often subsidiary to that of peers and siblings, the influence and impact of parental teasing remained significant, and in some cases, appeared to interact with sibling-based teasing. This teasing was associated with problem eating behaviours for adolescents. Conclusions There is evidence in the literature to suggest the existence of an association between ‘eating problems’ amongst adolescents and exposure to parental appearance or weight teasing. Parents are unlikely to be aware of the perception or impact of the words they use or the wider influence these words may have. Future research should employ representative longitudinal designs to develop a greater understanding of the relationships between parental communications around their adolescent’s appearance or weight and how that communication is perceived by adolescents within complex family processes. Trial registration PROSPERO 2018 CRD42018109623. Prospectively registered 15th October 2018. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10416-5.
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Affiliation(s)
- Lucy M Dahill
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
| | - Stephen Touyz
- Department of Psychology, University of Sydney, Sydney, Australia
| | - Natalie M V Morrison
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.,School of Medicine, Western Sydney University, Penrith, Australia
| | - Phillipa Hay
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.,School of Medicine, Western Sydney University, Penrith, Australia
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18
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Rice AJ, Schvey NA, Shank LM, Neyland MH, Lavender JM, Solomon S, Hennigan K, Schindler R, Sbrocco T, Jorgensen S, Stephens M, Haigney M, Klein DA, Quinlan J, Yanovski JA, Tanofsky-Kraff M. Weight-Based Teasing and Metabolic Syndrome Components among Adolescent Military Dependents at Risk for Adult Obesity. Child Obes 2021; 17:116-124. [PMID: 33434443 PMCID: PMC7984651 DOI: 10.1089/chi.2020.0256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Among adults, weight stigma is associated with markers of poor cardiometabolic health. Although weight-based teasing (WBT) is common among youth with high body weight, few studies have examined its associations with cardiometabolic markers. Owing to unique stressors (e.g., parental deployment and frequent moves), military-dependent youth may be at particularly high risk for obesity, WBT, and poor cardiometabolic health. We, therefore, assessed associations between WBT and cardiometabolic health markers among adolescent military dependents presenting for a weight gain prevention trial. Methods: Participants underwent fasting phlebotomy; had fasting weight, height, and waist circumference measured; and completed assessments of WBT, anxiety, and loss-of-control eating. Multivariate analysis of covariance, adjusting for relevant covariates including demographics and body composition, was used to examine differences in metabolic syndrome (MetS) components (waist circumference, systolic and diastolic blood pressure, high-density lipoprotein cholesterol, triglycerides, and glucose) between youth reporting WBT and youth reporting no WBT. Bootstrapped models examined whether WBT mediated the relationship between BMIz and MetS components. Results: Data from 142 youth (57.7% female; 14.4 ± 1.6 years; 51.2% non-Hispanic White, 20.9% non-Hispanic Black; BMIz: 1.9 ± 0.4) were analyzed. WBT was not significantly associated with any MetS component. Relationships were observed between BMIz and all MetS components (except systolic blood pressure and glucose), although WBT did not significantly mediate these relationships (p's > 0.05). Conclusions: This study did not find support for a relationship between WBT and MetS components in adolescent military dependents at risk for adult obesity. Prospective research is needed to determine whether associations between WBT and adverse cardiometabolic outcomes emerge primarily in adulthood.
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Affiliation(s)
- Alexander J. Rice
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University, Bethesda, MD, USA.,Metis Foundation, San Antonio, TX, USA
| | - Natasha A. Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University, Bethesda, MD, USA.,Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, MD, USA.,Address correspondence to: Natasha A. Schvey, PhD, Department of Medical and Clinical Psychology, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Lisa M. Shank
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University, Bethesda, MD, USA.,Metis Foundation, San Antonio, TX, USA.,Department of Medical and Clinical Psychology, Uniformed Services University, Bethesda, MD, USA.,Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, MD, USA
| | - M.K. Higgins Neyland
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University, Bethesda, MD, USA.,Metis Foundation, San Antonio, TX, USA
| | - Jason M. Lavender
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University, Bethesda, MD, USA.,Metis Foundation, San Antonio, TX, USA
| | - Senait Solomon
- Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University, Bethesda, MD, USA.,Department of Medical and Clinical Psychology, Uniformed Services University, Bethesda, MD, USA.,The Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF), Bethesda, MD, USA
| | - Kathrin Hennigan
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University, Bethesda, MD, USA.,Metis Foundation, San Antonio, TX, USA
| | - Rachel Schindler
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University, Bethesda, MD, USA.,Metis Foundation, San Antonio, TX, USA
| | - Tracy Sbrocco
- Department of Medical and Clinical Psychology, Uniformed Services University, Bethesda, MD, USA
| | | | - Mark Stephens
- Pennsylvania State University, Old Main, State College, PA, USA
| | - Mark Haigney
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University, Bethesda, MD, USA
| | - David A. Klein
- Department of Family Medicine, Uniformed Services University, Bethesda, MD, USA.,Department of Pediatrics, Uniformed Services University, Bethesda, MD, USA
| | - Jeffrey Quinlan
- Department of Family Medicine, Uniformed Services University, Bethesda, MD, USA
| | - Jack A. Yanovski
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, MD, USA
| | - Marian Tanofsky-Kraff
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University, Bethesda, MD, USA.,Department of Medical and Clinical Psychology, Uniformed Services University, Bethesda, MD, USA.,Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, MD, USA
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19
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Critical Evaluation of the Case for Pausing California's School-based Fitness Testing. HEALTH BEHAVIOR AND POLICY REVIEW 2021; 8:168-183. [PMID: 34017882 DOI: 10.14485/hbpr.8.2.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Objective We undertook a literature review to evaluate the evidence for an association among school-based fitness testing and bullying, weight-based teasing (WBT), and/or gender discrimination. Methods We searched the peer-reviewed literature using PubMed, ERIC and GOOGLE Scholar to identify articles related to school-based physical fitness testing (K-12) on the one hand and bullying, WBT, and/or gender discrimination on the other. Results We identified 12 studies on the impact of school-based physical fitness testing (PFT) on bullying and WBT. These studies do not support the assertion that PFT places students at elevated risk for bullying and/or WBT as compared to other school settings. There is a dearth of studies investigating an association between PFT and gender discrimination. Conclusions The concerns about PFT as a widespread cause of bullying and WBT are not supported by the evidence. It is likely that school climate is a stronger determinant overall of these negative student interactions and that more rigorous teacher training would ameliorate student concerns about fitness testing. Nevertheless, more rigorous research is warranted to determine with confidence that PFT does not elevate students' risks for bullying and WBT and to examine the risks for students with non-binary gender.
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20
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Fields LC, Brown C, Skelton JA, Cain KS, Cohen GM. Internalized Weight Bias, Teasing, and Self-Esteem in Children with Overweight or Obesity. Child Obes 2021; 17:43-50. [PMID: 33351706 PMCID: PMC7815063 DOI: 10.1089/chi.2020.0150] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background: Although 2/3 of US adults and nearly 1/3 of US children have overweight or obesity, weight stigma is common. Many with overweight or obesity ascribe negative ideas to themselves, resulting in internalized weight bias (IWB). In adults, IWB has been associated with psychosocial problems; however, this relationship has been studied little in children. This study aims to describe IWB in children with overweight and obesity and to study the association of children's IWB with experienced weight bias, self-esteem, and their parents' IWB. Methods: Children ages 9-18 with overweight or obesity completed the Weight Bias Internalization Scale (WBIS), Rosenberg Self-Esteem Scale, and Perception of Teasing Scale; parents completed the Weight Bias Internalization Scale-Modified and the Perceived Weight Discrimination Scale. Descriptive statistics were used to assess IWB, self-esteem, and experienced weight stigma. Chi-square and t-tests were used to examine associations between categorical and continuous variables, respectively. Multivariate linear regression was used to identify correlates of IWB in children. Results: Of 111 child participants, the median WBIS score was 2.8 out of 7. Higher IWB was associated with more peer teasing (p < 0.001) and lower self-esteem (p < 0.001). IWB in children was not associated with child BMI z-score (p = 0.590) or higher parent IWB (p = 0.287). Conclusions: Children with overweight and obesity who have experienced more teasing by peers or who have lower self-esteem are more likely to have a higher IWB. However, increasing child BMI z-score and parent IWB are not associated with higher child IWB.
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Affiliation(s)
- Lauren C. Fields
- Bowman Gray Center, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Callie Brown
- Department of Pediatrics, and Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Brenner FIT (Families in Training) Program, Brenner Children's Hospital, Winston-Salem, NC, USA
- Division of Public Health Sciences, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Joseph A. Skelton
- Department of Pediatrics, and Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Brenner FIT (Families in Training) Program, Brenner Children's Hospital, Winston-Salem, NC, USA
- Division of Public Health Sciences, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Kathryn S. Cain
- Bowman Gray Center, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Gail M. Cohen
- Department of Pediatrics, and Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Brenner FIT (Families in Training) Program, Brenner Children's Hospital, Winston-Salem, NC, USA
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21
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Blanco M, Solano S, Alcántara AI, Parks M, Román FJ, Sepúlveda AR. Psychological well-being and weight-related teasing in childhood obesity: a case-control study. Eat Weight Disord 2020; 25:751-759. [PMID: 31077019 DOI: 10.1007/s40519-019-00683-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 03/20/2019] [Indexed: 12/24/2022] Open
Abstract
PURPOSE The prevalence of childhood obesity continues to increase worldwide. The aims of this study were to (1) assess the psychological well-being and rates of teasing of Spanish children with obesity (OG) and compare them with their non-overweight peers (NG), and (2) analyze the mediating role of weight-related teasing on the relation between children's BMI z score and psychological well-being. METHODS The cross-sectional study included 50 preadolescents with obesity, matched with non-overweight children according to age, sex, and socioeconomic status, who were assessed via self-report instruments measuring anxiety, depression, self-esteem, and teasing. RESULTS The OG reported higher anxiety, depression, and teasing, and lower self-esteem. SEM revealed that children who scored worse on instruments assessing psychological well-being had higher BMI z scores. Weight-related teasing predicted poor psychological well-being scores and weight-related teasing mediated the relation between BMI and psychological well-being. CONCLUSIONS The high rates of anxiety, depression, and weight-related teasing, as well as the low self-esteem, which was observed amongst the children with obesity, raise concerns about the quality of life of this population. Furthermore, the finding that weight-related teasing mediated the relationship between BMI and psychological well-being adds to a growing body of research, highlighting the harmful effects of weight-related stigma. Overall, these results highlight the importance of early intervention to assess for, and address, the presence of weight-related teasing and psychological well-being difficulties in preadolescents with obesity. LEVEL OF EVIDENCE Level III, case-control study.
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Affiliation(s)
- M Blanco
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Cantoblanco Campus, 28049, Madrid, Spain.
| | - S Solano
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Cantoblanco Campus, 28049, Madrid, Spain
| | - A I Alcántara
- Pediatric Service, Daroca Primary Health Care Center, Madrid, Spain
| | - M Parks
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Cantoblanco Campus, 28049, Madrid, Spain
| | - F J Román
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Cantoblanco Campus, 28049, Madrid, Spain
| | - A R Sepúlveda
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Cantoblanco Campus, 28049, Madrid, Spain
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22
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Elia C, Karamanos A, Silva MJ, O’Connor M, Lu Y, Dregan A, Huang P, O’Keeffe M, Cruickshank JK, Enayat EZ, Cassidy A, Molaodi OR, Maynard M, Harding S. Weight misperception and psychological symptoms from adolescence to young adulthood: longitudinal study of an ethnically diverse UK cohort. BMC Public Health 2020; 20:712. [PMID: 32423390 PMCID: PMC7236343 DOI: 10.1186/s12889-020-08823-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 05/01/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND To evaluate the association between weight misperception and psychological symptoms in the Determinants of young Adults Social well-being and Health (DASH) longitudinal study. METHODS A longitudinal sample of 3227 adolescents, in 49 secondary schools in London, aged 11-16 years participated in 2002/2003 and were followed up in 2005/2006. A sub-sample (N = 595) was followed up again at ages 21-23 years in 2012/2013. An index of weight misperception was derived from weight perception and measured weight. Psychological well- being was measured using the Strengths and Difficulties Questionnaire at 11-16 years and the General Health Questionnaire at 21-23 years. Associations with weight misperception was assessed using regression models, adjusted for socio-economic and lifestyle factors. RESULTS White British males and females were more likely than ethnic minority peers to report accurate perceptions of measured weight. At 11-13y, 46% females and 38% males did not have an accurate perception of their measured weight. The comparable figures at 14-16y were 42 and 40%. Compared with male adolescents, more females perceived themselves as overweight or were unsure of their weight but measured normal weight, and this was more pronounced among Indians, Pakistanis and Bangladeshis. At 14-16y, more males perceived themselves as underweight but measured normal weight, and this was more pronounced among Indians. Compared with those who had an accurate perception of their normal weight, a higher likelihood of probable clinically-relevant psychological symptoms was observed among those who measured normal weight but perceived themselves to be underweight (females Odds Ratio (OR) = 1.87 95% CI 1.03-3.40; males OR = 2.34 95% CI 1.47-3.71), overweight (females only OR = 2.06 95% CI 1.10-3.87), or unsure of their weight (males only OR = 1.61 95% CI 1.04-2.49). Among females, the association was driven by internalising rather than externalising symptoms. An accurate perception of overweight was associated with higher psychological symptoms in adolescence and early 20s. Ethnic specific effects were not evident. CONCLUSION Weight misperception may be an important determinant of psychological symptoms in young people, with an accurate perception of normal weight status being protective. Culturally targeted interventions should be considered to promote healthy perceptions of body image.
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Affiliation(s)
- Christelle Elia
- grid.13097.3c0000 0001 2322 6764Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King’s College London, Franklin Wilkins Building, London, SE1 9NH UK
| | - Alexis Karamanos
- grid.83440.3b0000000121901201ESRC International Centre for Life Course Studies in Society and Health, Department of Epidemiology and Health, University College London, London, WC1 6BT UK
| | - Maria João Silva
- grid.13097.3c0000 0001 2322 6764Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King’s College London, Franklin Wilkins Building, London, SE1 9NH UK
| | - Maeve O’Connor
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology and Neuroscience, Faculty of Life Sciences & Medicine, King’s College London, Denmark Hill Campus, London, SE5 9RJ UK
| | - Yao Lu
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology and Neuroscience, Faculty of Life Sciences & Medicine, King’s College London, Denmark Hill Campus, London, SE5 9RJ UK
| | - Alexandru Dregan
- grid.13097.3c0000 0001 2322 6764Department of Population Health Sciences, School of Population Health & Environmental Sciences, Faculty of Life Sciences & Medicine, King’s College London, Addison House, Guy’s Campus, London, SE11UL UK
| | - Peiyuan Huang
- grid.13097.3c0000 0001 2322 6764Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King’s College London, Franklin Wilkins Building, London, SE1 9NH UK
| | - Majella O’Keeffe
- grid.13097.3c0000 0001 2322 6764Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King’s College London, Franklin Wilkins Building, London, SE1 9NH UK
| | - J. Kennedy Cruickshank
- grid.13097.3c0000 0001 2322 6764Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King’s College London, Franklin Wilkins Building, London, SE1 9NH UK
| | - Elli Z. Enayat
- grid.13097.3c0000 0001 2322 6764Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King’s College London, Franklin Wilkins Building, London, SE1 9NH UK
| | - Aidan Cassidy
- grid.13097.3c0000 0001 2322 6764Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King’s College London, Franklin Wilkins Building, London, SE1 9NH UK
| | - Oarabile R. Molaodi
- grid.8756.c0000 0001 2193 314XMRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Maria Maynard
- grid.10346.300000 0001 0745 8880School of Clinical & Applied Sciences, Leeds Beckett University, CL 413 Calverley Building, City Campus, Leeds, LS1 3HE UK
| | - Seeromanie Harding
- Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, Franklin Wilkins Building, London, SE1 9NH, UK. .,Department of Population Health Sciences, School of Population Health & Environmental Sciences, Faculty of Life Sciences & Medicine, King's College London, Addison House, Guy's Campus, London, SE11UL, UK.
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23
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Wang Z, Wang B, Hu Y, Cheng L, Zhang S, Chen Y, Li R. Relationships among weight stigma, eating behaviors and stress in adolescents in Wuhan, China. Glob Health Res Policy 2020; 5:8. [PMID: 32161815 PMCID: PMC7060634 DOI: 10.1186/s41256-020-00138-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 02/24/2020] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of this study was to examine the relationships among weight stigma, eating behaviors, and stress, as well as to analyze the effect of stress in mediating the association between weight stigma and eating behaviors. Methods The study involved 1818 adolescents between 14 to 19 years of age and was conducted in Wuhan, China in 2019. Weight stigma, eating behaviors (cognitive restraint, uncontrolled eating, and emotional eating), and stress were assessed by self-report questionnaires. Hierarchical linear regression analyses were used to examine the predictors of cognitive restraint, uncontrolled eating, and emotional eating; the serial mediation models analyses were conducted to analyze the effect of stress in mediating the association between weight stigma and eating behaviors for the whole non-overweight (normal and underweight) and overweight or obese participants, respectively. Results Hierarchical linear regression analyses showed that experiences of weight stigma significantly predicted uncontrolled eating and emotional eating regardless of body mass index (BMI) (non-overweight adolescents: uncontrolled eating: β [SE] = 0.161 [0.017]; emotional eating: β [SE] = 0.199 [0.008], p < 0.05; overweight or obese adolescents: uncontrolled eating: β [SE] = 0.286 [0.030]; emotional eating: β [SE] = 0.267 [0.014], p < 0.05); experiences of weight stigma significantly predicted cognitive restraint among non-overweight adolescents (β [SE] = 0.204 [0.013], p < 0.05). Mediation analyses showed that stress mediated the associations between weight stigma and uncontrolled eating and emotional eating among non-overweight adolescents (uncontrolled eating: indirect effect coefficient = 0.0352, 95% CI = 0.0241, 0.0478; emotional eating: indirect effect coefficient = 0.0133, 95% CI = 0.0085, 0.0186). Conclusions These findings suggest that non-overweight individuals can still experience weight stigma and its associated negative consequences; the relationship between weight stigma and eating behaviors is modulated by weight status; stress mediated the associations between weight stigma and uncontrolled and emotional eating among non-overweight adolescents.
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Affiliation(s)
- Zhanxia Wang
- 1Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan, 430071 China
| | - Bowen Wang
- 1Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan, 430071 China
| | - Yiluan Hu
- 1Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan, 430071 China
| | - Lei Cheng
- 1Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan, 430071 China
| | - Siqi Zhang
- 1Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan, 430071 China
| | - Yanan Chen
- 1Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan, 430071 China
| | - Rui Li
- 1Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan, 430071 China.,2Global Health Institute, School of Health Sciences, Wuhan University, Wuhan, 430071 China
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24
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Szwimer E, Mougharbel F, Goldfield GS, Alberga AS. The Association Between Weight-Based Teasing from Peers and Family in Childhood and Depressive Symptoms in Childhood and Adulthood: A Systematic Review. Curr Obes Rep 2020; 9:15-29. [PMID: 32002762 DOI: 10.1007/s13679-020-00367-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
RECENT FINDINGS Depressive symptoms may be a psychological correlate of weight-based teasing from peers and/or family. However, it is unclear whether the association of weight-based teasing with depressive symptoms differs by time (short term vs. long term), sex (males vs. females), or source (family vs. peers). PURPOSE The purpose of this systematic review was to (1) examine whether the frequency of weight-based teasing differs according to sex and source and; (2) examine whether the association of weight-based teasing with depressive symptoms varies according to time, sex, and source. METHODS On February 16, 2018, a combination of keywords within three concepts, (i) children and adults, (ii) weight-based teasing source, and (iii) mental health outcomes, were searched in four databases (PubMed, PsycINFO, Scopus, and Web of Science) for relevant articles. Cross-sectional and longitudinal original research articles were included, and studies were excluded if the relationship between weight-based teasing and depressive symptoms was not explicitly measured. RESULTS The search yielded 3572 articles, and nineteen studies were included in the final analysis. Experiences of weight-based teasing occurred significantly more among girls than boys. Weight-based teasing was significantly associated with depressive symptoms in both short and long term. Weight-based teasing exhibited a greater association with depressive symptoms in girls vs. boys and when it came from multiple sources than from either source alone. However, it remains uncertain whether one source of teasing is more common than the other, since only two studies found peers to be a more common source of weight-based teasing compared to family. Weight-based teasing from peers and family is associated with depressive symptoms, and girls are more psychologically vulnerable than boys. Interventions are required to reduce weight-based teasing and its harmful psychological effects.
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Affiliation(s)
- Erica Szwimer
- Department of Health, Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke Street West, Montreal, Quebec, H4B1R6, Canada
| | - Fatima Mougharbel
- School of Human Kinetics, Psychology and Population Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Gary S Goldfield
- School of Human Kinetics, Psychology and Population Health, University of Ottawa, Ottawa, Ontario, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Angela S Alberga
- Department of Health, Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke Street West, Montreal, Quebec, H4B1R6, Canada.
- Department of Pediatrics, Faculty of Medicine, McGill University, Montreal, Canada.
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25
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Pearlman AT, Schvey NA, Higgins Neyland MK, Solomon S, Hennigan K, Schindler R, Leu W, Gillmore D, Shank LM, Lavender JM, Burke NL, Wilfley DE, Sbrocco T, Stephens M, Jorgensen S, Klein D, Quinlan J, Tanofsky-Kraff M. Associations between Family Weight-Based Teasing, Eating Pathology, and Psychosocial Functioning among Adolescent Military Dependents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:E24. [PMID: 31861426 PMCID: PMC6982056 DOI: 10.3390/ijerph17010024] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 12/13/2019] [Accepted: 12/15/2019] [Indexed: 01/25/2023]
Abstract
Weight-based teasing (WBT) by family members is commonly reported among youth and is associated with eating and mood-related psychopathology. Military dependents may be particularly vulnerable to family WBT and its sequelae due to factors associated with their parents' careers, such as weight and fitness standards and an emphasis on maintaining one's military appearance; however, no studies to date have examined family WBT and its associations within this population. Therefore, adolescent military dependents at-risk for adult obesity and binge-eating disorder were studied prior to entry in a weight gain prevention trial. Youth completed items from the Weight-Based Victimization Scale (to assess WBT by parents and/or siblings) and measures of psychosocial functioning, including the Beck Depression Inventory-II, The Rosenberg Self-Esteem Scale, and the Social Adjustment Scale. Eating pathology was assessed via the Eating Disorder Examination interview, and height and fasting weight were measured to calculate BMIz. Analyses of covariance, adjusting for relevant covariates including BMIz, were conducted to assess relationships between family WBT, eating pathology, and psychosocial functioning. Participants were 128 adolescent military dependents (mean age: 14.35 years old, 54% female, 42% non-Hispanic White, mean BMIz: 1.95). Nearly half the sample (47.7%) reported family WBT. Adjusting for covariates, including BMIz, family WBT was associated with greater eating pathology, poorer social functioning and self-esteem, and more depressive symptoms (ps ≤ 0.02). Among military dependents with overweight and obesity, family WBT is prevalent and may be linked with eating pathology and impaired psychosocial functioning; prospective research is needed to elucidate the temporal nature of these associations.
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Affiliation(s)
- Arielle T. Pearlman
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (A.T.P.); (M.K.H.N.); (S.S.); (K.H.); (R.S.); (W.L.); (D.G.); (J.M.L.); (T.S.); (M.T.-K.)
| | - Natasha A. Schvey
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (A.T.P.); (M.K.H.N.); (S.S.); (K.H.); (R.S.); (W.L.); (D.G.); (J.M.L.); (T.S.); (M.T.-K.)
| | - M. K. Higgins Neyland
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (A.T.P.); (M.K.H.N.); (S.S.); (K.H.); (R.S.); (W.L.); (D.G.); (J.M.L.); (T.S.); (M.T.-K.)
- Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (D.K.); (J.Q.)
- Military Cardiovascular Outcomes Research Program (MiCOR), Bethesda, MD 20814, USA;
- Metis Foundation, 300 Convent St #1330, San Antonio, TX 78205, USA
| | - Senait Solomon
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (A.T.P.); (M.K.H.N.); (S.S.); (K.H.); (R.S.); (W.L.); (D.G.); (J.M.L.); (T.S.); (M.T.-K.)
- Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (D.K.); (J.Q.)
- Military Cardiovascular Outcomes Research Program (MiCOR), Bethesda, MD 20814, USA;
- Metis Foundation, 300 Convent St #1330, San Antonio, TX 78205, USA
| | - Kathrin Hennigan
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (A.T.P.); (M.K.H.N.); (S.S.); (K.H.); (R.S.); (W.L.); (D.G.); (J.M.L.); (T.S.); (M.T.-K.)
- Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (D.K.); (J.Q.)
- Military Cardiovascular Outcomes Research Program (MiCOR), Bethesda, MD 20814, USA;
- Metis Foundation, 300 Convent St #1330, San Antonio, TX 78205, USA
| | - Rachel Schindler
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (A.T.P.); (M.K.H.N.); (S.S.); (K.H.); (R.S.); (W.L.); (D.G.); (J.M.L.); (T.S.); (M.T.-K.)
- Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (D.K.); (J.Q.)
- Military Cardiovascular Outcomes Research Program (MiCOR), Bethesda, MD 20814, USA;
- Metis Foundation, 300 Convent St #1330, San Antonio, TX 78205, USA
| | - William Leu
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (A.T.P.); (M.K.H.N.); (S.S.); (K.H.); (R.S.); (W.L.); (D.G.); (J.M.L.); (T.S.); (M.T.-K.)
| | - Dakota Gillmore
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (A.T.P.); (M.K.H.N.); (S.S.); (K.H.); (R.S.); (W.L.); (D.G.); (J.M.L.); (T.S.); (M.T.-K.)
| | - Lisa M. Shank
- Military Cardiovascular Outcomes Research Program (MiCOR), Bethesda, MD 20814, USA;
- Metis Foundation, 300 Convent St #1330, San Antonio, TX 78205, USA
| | - Jason M. Lavender
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (A.T.P.); (M.K.H.N.); (S.S.); (K.H.); (R.S.); (W.L.); (D.G.); (J.M.L.); (T.S.); (M.T.-K.)
- Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (D.K.); (J.Q.)
- Military Cardiovascular Outcomes Research Program (MiCOR), Bethesda, MD 20814, USA;
- Metis Foundation, 300 Convent St #1330, San Antonio, TX 78205, USA
| | - Natasha L. Burke
- Department of Psychology, Fordham University, Bronx, NY 10458, USA;
| | - Denise E. Wilfley
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO 63110, USA;
| | - Tracy Sbrocco
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (A.T.P.); (M.K.H.N.); (S.S.); (K.H.); (R.S.); (W.L.); (D.G.); (J.M.L.); (T.S.); (M.T.-K.)
| | - Mark Stephens
- Department of Family and Community Medicine, Pennsylvania State University, Old Main, State College, PA 16801, USA;
| | - Sarah Jorgensen
- Fort Belvoir Community Hospital, Fort Belvoir, VA 22060, USA;
| | - David Klein
- Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (D.K.); (J.Q.)
- Malcolm Grow Medical Clinics and Surgery Center, Joint Base Andrews, MD 20762, USA
| | - Jeffrey Quinlan
- Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (D.K.); (J.Q.)
| | - Marian Tanofsky-Kraff
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (A.T.P.); (M.K.H.N.); (S.S.); (K.H.); (R.S.); (W.L.); (D.G.); (J.M.L.); (T.S.); (M.T.-K.)
- Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (D.K.); (J.Q.)
- Military Cardiovascular Outcomes Research Program (MiCOR), Bethesda, MD 20814, USA;
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26
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Schvey NA, Marwitz SE, Mi SJ, Galescu OA, Broadney MM, Young-Hyman D, Brady SM, Reynolds JC, Tanofsky-Kraff M, Yanovski SZ, Yanovski JA. Weight-based teasing is associated with gain in BMI and fat mass among children and adolescents at-risk for obesity: A longitudinal study. Pediatr Obes 2019; 14:e12538. [PMID: 31144471 PMCID: PMC6728169 DOI: 10.1111/ijpo.12538] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 04/12/2019] [Accepted: 04/20/2019] [Indexed: 01/16/2023]
Abstract
BACKGROUND Youths with overweight and obesity report frequent instances of weight-based teasing. However, little is known about the prospective associations between weight-based teasing and changes in body composition among youth. OBJECTIVE To assess associations between weight-based teasing and changes in body mass index (BMI) and fat mass in a longitudinal study of youths with, or at-risk for, overweight and obesity. METHODS One hundred ten youths with, or at-risk for, overweight participated in a longitudinal observational study. The Perception of Teasing Scale was administered at baseline. Height, weight, and body composition were obtained at baseline and at follow-ups (range: 1-15 years). RESULTS Mean age at baseline was 11.8 years; 53% had overweight/obesity; 36% were non-Hispanic Black; 55% were female; mean follow-up from baseline: 8.5 years. Adjusting for covariates and repeated measures of BMI or fat mass, linear mixed models revealed that weight-based teasing was associated with greater gain of BMI and fat mass across the follow-up period (ps ≤ .007). Adjusting for covariates, youths reporting high weight-based teasing (two standard deviations above the mean) experienced a 33% greater gain in BMI (an additional 0.20 kg/m2 ) and a 91% greater gain in fat mass (an additional 0.65 kg) per year compared with peers who reported no weight-based teasing. CONCLUSIONS Among youths with, and at-risk for, overweight and obesity, weight-based teasing was associated with greater weight and fat gain.
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Affiliation(s)
- Natasha A. Schvey
- Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road Bethesda, MD 20814, USA,Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, 10 Center Drive, Building 10, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA
| | - Shannon E. Marwitz
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, 10 Center Drive, Building 10, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA
| | - Sarah J. Mi
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, 10 Center Drive, Building 10, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA
| | - Ovidiu A. Galescu
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, 10 Center Drive, Building 10, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA
| | - Miranda M. Broadney
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, 10 Center Drive, Building 10, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA
| | - Deborah Young-Hyman
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, 10 Center Drive, Building 10, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA
| | - Sheila M. Brady
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, 10 Center Drive, Building 10, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA
| | - James C. Reynolds
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, 10 Center Drive, Building 10, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA
| | - Marian Tanofsky-Kraff
- Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road Bethesda, MD 20814, USA,Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, 10 Center Drive, Building 10, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA
| | - Susan Z. Yanovski
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, 10 Center Drive, Building 10, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA
| | - Jack A. Yanovski
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, 10 Center Drive, Building 10, Room 1-3330, MSC 1103, Bethesda, MD 20892-1103, USA
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Buchholz A, Howard AL, Baldwin K, Hammond NG, Mohipp C, Rutherford J, Kazoun F, Clark L, Adamo K, Goldfield G, Hadjiyannakis S. Health trajectories of children with severe obesity attending a weight management program. Paediatr Child Health 2019; 25:439-446. [PMID: 33173555 DOI: 10.1093/pch/pxz088] [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: 11/28/2018] [Accepted: 04/27/2019] [Indexed: 11/14/2022] Open
Abstract
Purpose The objective of the present study is to examine physical and mental health trajectories of change in youth with severe obesity attending a tertiary care weight management program. It was predicted that younger children would show favourable changes in body mass index (BMI), markers of cardiovascular health, quality of life, and mental health. Methods This 2-year longitudinal study examined health trajectories of children referred to a weight management program at a Canadian paediatric tertiary care centre from November 2010 to December 2013. Participants were 209 of 217 consecutive referred paediatric patients (families) aged 3 to 17 years who met criteria for severe obesity and consented to participate. To maximize generalizability of results, there were no exclusion criteria. Primary outcomes were children's quality of life and BMI. Secondary outcomes included anxiety, depression, and non-high-density lipoprotein cholesterol levels. Results The findings suggest an improvement in mental health, quality of life, and cardiometabolic health of children and adolescents of all ages over the 2 years of programming. These positive findings were consistent across gender, age, and distance to the program. BMI trajectory changes varied across age cohorts such that younger children showed more favourable outcomes. The retention rate over the 2 years was high at 82.9%. Conclusions This is the first study to show improvements in both physical and mental health outcomes beyond 1 year in a tertiary care setting with a high-risk population of children and youth with severe obesity. Findings highlight the need to examine both mental and physical health outcomes beyond 1 year.
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Affiliation(s)
- Annick Buchholz
- Centre for Healthy Active Living, Children's Hospital of Eastern Ontario, Ottawa, Ontario.,Department of Psychology, Carleton University, Ottawa, Ontario
| | - Andrea L Howard
- Department of Psychology, Carleton University, Ottawa, Ontario
| | - Katherine Baldwin
- Centre for Healthy Active Living, Children's Hospital of Eastern Ontario, Ottawa, Ontario.,Department of Pediatrics, University of Ottawa, Ottawa, Ontario
| | - Nicole G Hammond
- Centre for Healthy Active Living, Children's Hospital of Eastern Ontario, Ottawa, Ontario
| | - Charmaine Mohipp
- Centre for Healthy Active Living, Children's Hospital of Eastern Ontario, Ottawa, Ontario
| | - Jane Rutherford
- Centre for Healthy Active Living, Children's Hospital of Eastern Ontario, Ottawa, Ontario
| | - Fatima Kazoun
- Centre for Healthy Active Living, Children's Hospital of Eastern Ontario, Ottawa, Ontario
| | - Laurie Clark
- Centre for Healthy Active Living, Children's Hospital of Eastern Ontario, Ottawa, Ontario
| | - Kristi Adamo
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario.,Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON
| | - Gary Goldfield
- Department of Psychology, Carleton University, Ottawa, Ontario.,Department of Pediatrics, University of Ottawa, Ottawa, Ontario.,Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON
| | - Stasia Hadjiyannakis
- Centre for Healthy Active Living, Children's Hospital of Eastern Ontario, Ottawa, Ontario.,Department of Pediatrics, University of Ottawa, Ottawa, Ontario
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28
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Juvonen J, Lessard LM, Schacter HL, Enders C. The Effects of Middle School Weight Climate on Youth With Higher Body Weight. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2019; 29:466-479. [PMID: 29532971 PMCID: PMC6136981 DOI: 10.1111/jora.12386] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This study examines whether social-emotional difficulties associated with higher body weight vary across schools as a function of the school's weight climate. Weight climate, characterized by weight-policing, was assessed indirectly by examining how strongly self-reported weight predicts victim reputation within 26 ethnically diverse middle schools. Social-emotional indicators included self-reported loneliness, school belonging, and self-esteem. In schools with stronger weight-policing at seventh grade, loneliness was intensified by eighth grade among both girls (n = 2,101) and boys (n = 1,985) with higher weight. Similar effects were found for low self-esteem among girls. Additionally, boys-regardless of their weight-reported lower sense of belonging in schools with stronger weight-policing. The study offers a new method to estimate school weight climate, and the findings provide insights for interventions.
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29
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Valois DD, Davis CG, Buchholz A, Obeid N, Henderson K, Flament M, Goldfield GS. Effects of weight teasing and gender on body esteem in youth: A longitudinal analysis from the REAL study. Body Image 2019; 29:65-73. [PMID: 30849704 DOI: 10.1016/j.bodyim.2019.02.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 02/19/2019] [Accepted: 02/19/2019] [Indexed: 12/31/2022]
Abstract
Weight teasing is associated with body dissatisfaction, but no study has examined the differential impact of the teasing source's gender. This study examined whether the longitudinal relationship between weight teasing (by peers), weight-related comments (by parents) and body esteem differed by the teasing sources' gender, and whether these relationships were moderated by victims' weight status and demographic factors. A school-based sample (N = 1197 at Time 1; 60% female) of adolescents completed surveys over approximately 2 years (Time 1-Time 3). Multilevel modeling showed that teasing from a male peer had a stronger, negative association with appearance esteem for female victims than males. Although weight teasing was more prevalent among youth with overweight/obesity, teasing from female peers had a stronger negative association with weight esteem for adolescents of average weight. Results suggest the weight teasing sources' gender may differentially impact the victims' body esteem, and highlights the need to consider these factors in weight teasing prevention strategies.
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Affiliation(s)
- Darcie D Valois
- Carleton University Department of Psychology, Ottawa, ON, Canada; Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.
| | | | - Annick Buchholz
- Carleton University Department of Psychology, Ottawa, ON, Canada; Centre for Healthy Active Living, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.
| | - Nicole Obeid
- Eating Disorders Program, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.
| | | | | | - Gary S Goldfield
- Carleton University Department of Psychology, Ottawa, ON, Canada; Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.
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30
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Meadows A, Higgs S. Internalised Weight Stigma Moderates the Impact of a Stigmatising Prime on Eating in the Absence of Hunger in Higher- but Not Lower-Weight Individuals. Front Psychol 2019; 10:1022. [PMID: 31139111 PMCID: PMC6519002 DOI: 10.3389/fpsyg.2019.01022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 04/17/2019] [Indexed: 11/23/2022] Open
Abstract
A considerable body of evidence links internalised weight stigma with higher levels of disordered eating behaviour and cognitions in both normative- and higher-weight populations. However, to date, the impact of internalised weight stigma on objectively measured food intake has not been explored. In the present study, a weight-diverse sample of 158 non-smoking adults (BMI ≥ 25 kg/m2 n = 72, BMI < 25 kg/m2 n = 86) were recruited to a study on "The effects of hunger and satiety on information processing." Participants first completed a series of online questionnaires, then attended a lab visit in a fed state. Participants were randomised to read a sham news article on the negative consequences of either weight (stigma condition) or smoking (control condition) and answer some questions about the article. Then, under the pretence of a non-study-relevant break, participants were exposed to a pre-weighed selection of sweet and savoury snacks for 15 min. Mood and hunger levels were assessed prior to and after reading the vignette, and after the break. In contrast to the relationship with self-report eating behaviour, internalised weight stigma was not a significant independent predictor of total energy intake and did not moderate the relationship between exposure to the stigma prime and calories consumed. However, differences emerged on the basis of participants' weight status. Higher-weight participants with high levels of internalised weight stigma consumed fewer snack calories following exposure to a weight-stigma prime compared with a neutral prime (B = -137, SE = 58, t = -2.35, p = 0.020, 95% CI -252, -22) whereas those with low levels of internalised weight stigma tended to eat more in the weight stigma condition (B = 118, SE = 62, t = 1.91, p = 0.059, 95% CI -4, 241). In normative-weight participants, no differences in energy intake by levels of internalised weight stigma were observed. These findings suggest differences in the relationships between internalised weight stigma and self-reported disordered eating behaviour versus eating in the absence of hunger (EAH) measured under laboratory conditions. Additionally, internalised weight stigma appears to have differential effects on response to stigma in higher-weight and normative-weight individuals.
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Affiliation(s)
- Angela Meadows
- School of Psychology, University of Exeter, Exeter, United Kingdom
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Suzanne Higgs
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
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31
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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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32
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Puhl RM, Himmelstein MS. Weight Bias Internalization Among Adolescents Seeking Weight Loss: Implications for Eating Behaviors and Parental Communication. Front Psychol 2018; 9:2271. [PMID: 30519207 PMCID: PMC6258789 DOI: 10.3389/fpsyg.2018.02271] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 11/01/2018] [Indexed: 12/21/2022] Open
Abstract
Background: Emerging evidence has demonstrated a high prevalence of weight bias internalization (WBI) among adults, as well as consistent links between internalization and adverse psychological and physical health. However, research examining WBI in youth and its impact on their health is scarce, especially among youth seeking weight loss treatment who may be particularly vulnerable to weight stigma from peers and parents. To address this research gap, the present study assessed WBI in a weight loss treatment-seeking sample of adolescents, examining associations between internalization and adolescents' eating behaviors and parental weight-related communication. Methods: Adolescents (N = 148, M age = 15.97 years), completed online self-report measures to assess WBI (using the modified version of the WBI Scale), body weight, binge eating, eating as a coping strategy, and weight teasing from peers and family members. Adolescents also reported on the frequency of parental comments about body weight, parental dieting, and parental encouragement of adolescent dieting. Results: Adolescents expressed a high mean level of internalized weight bias (M = 5.45, SD = 0.88). Higher levels of internalization were observed across increasing body weight categories; no differences were observed for gender or history of weight teasing. WBI was significantly higher among adolescents who reported binge eating and eating to cope with distress. Regression analyses showed that weight-related comments from mothers (but not fathers) significantly predicted adolescents' WBI (including frequency of mothers' comments about adolescents' body weight, comments about their own body weight, and encouragement of their adolescent to diet), as did increased dieting frequency among mothers. Conclusion: The present study provides novel insights to the scant literature on WBI in youth. Findings indicate that WBI is high in both girls and boys engaged in weight loss, and is associated with maladaptive eating behaviors, higher frequency of maternal dieting, and mothers' comments about body weight. These findings have important clinical implications for youth and families engaged in weight loss treatment, and underscore the need for research to clarify adverse effects of internalization on weight-related health in youth and to better understand the role that parental weight communication may have on adolescents' internalization.
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Affiliation(s)
- Rebecca M Puhl
- Department of Human Development and Family Studies, Rudd Center for Food Policy and Obesity, Hartford, CT, United States
| | - Mary S Himmelstein
- Mary Himmelstein, Rudd Center for Food Policy and Obesity, Hartford, CT, United States
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33
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Cheng MY, Wang SM, Lam YY, Luk HT, Man YC, Lin CY. The Relationships Between Weight Bias, Perceived Weight Stigma, Eating Behavior, and Psychological Distress Among Undergraduate Students in Hong Kong. J Nerv Ment Dis 2018; 206:705-710. [PMID: 30124569 DOI: 10.1097/nmd.0000000000000869] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Weight bias issues are rarely discussed in Asian. Therefore, we examined the relationships between weight bias, perceived weight stigma (PWS), eating behavior, and psychological distress among Hong Kong people. Using cross-sectional design, 400 undergraduate students (175 men) completed questionnaires and were assigned into a self-reported overweight (n = 61) or nonoverweight group (n = 339) using body mass index, and a self-perceived overweight (n = 84) or nonoverweight group (n = 316) based on self-perception. For self-reported and self-perceived overweight groups, more weight bias was related to higher depression (β = -0.403; p = 0.004). Self-perceived group additionally showed that weight bias was related to PWS and inappropriate eating behaviors; PWS related to inappropriate eating behaviors. For self-reported and self-perceived nonoverweight groups, weight bias was related to PWS, inappropriate eating behaviors, anxiety, and depression (β = -0.228 to -0.148; p's < 0.05); PWS was associated with inappropriate eating behaviors, anxiety, and depression. Thus, weight bias issues should not be ignored for both overweight and nonoverweight people.
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Affiliation(s)
- Man Yan Cheng
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
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34
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Kohlmann CW, Eschenbeck H, Heim-Dreger U, Hock M, Platt T, Ruch W. Fear of Being Laughed at in Children and Adolescents: Exploring the Importance of Overweight, Underweight, and Teasing. Front Psychol 2018; 9:1447. [PMID: 30154751 PMCID: PMC6102344 DOI: 10.3389/fpsyg.2018.01447] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 07/23/2018] [Indexed: 11/13/2022] Open
Abstract
Weight bias toward obese youths is often accompanied by the experience of psychological stress in those affected. Therefore, the fear of being laughed at (i.e., gelotophobia) in overweight children and adolescents can be rather serious. In four explorative studies, the importance of relative weight, self-awareness of weight (incl. satisfaction with weight), experiences of teasing and ridicule, as well as the role of social-evaluative situations in school were analyzed with regard to gelotophobia. In two online interviews of adults with pronounced gelotophobia (Study I: 102 English-speaking participants, Study II: 22 German-speaking participants) relating to reasons they assumed for their development of gelotophobia, there was evidence of injurious appearance-related experiences during childhood and adolescence. In Study III (75 Swiss adolescents) associations between the experience of weight-related teasing and mockery with overweight, self-perceptions of weight, and gelotophobia were analyzed. Especially in girls, overweight was associated with the experience of weight-related teasing and ridicule, which in turn was accompanied by gelotophobia. Study IV included 178 German adolescents who were asked to report their body image (“Do you think you are… too thin, just the right weight, or too fat?”). In addition, gelotophobia, teasing, BMI based on self-reports, and joy at school were measured. In particular, girls who felt too fat and boys who felt too thin reported teasing. Teasing was related to diminished joy at school and to gelotophobia. Among boys, underweight mediated by weight-related teasing contributed to gelotophobia. The results suggest that more research should be devoted to gelotophobia and the experience of weight-related teasing and mocking to better understand factors contributing to the well-being of children and adolescents with weight problems.
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Affiliation(s)
| | - Heike Eschenbeck
- Psychology, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Uwe Heim-Dreger
- Psychology, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Michael Hock
- Psychology, University of Bamberg, Bamberg, Germany
| | - Tracey Platt
- Institute of Sport and Human Sciences, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Willibald Ruch
- Department of Psychology, University of Zurich, Zurich, Switzerland
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35
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FONTANA FABIO, BOPES JONATHAN, BENDIXEN SETH, SPEED TYLER, GEORGE MEGAN, MACK MICK. Discrimination against Obese Exercise Clients: An Experimental Study of Personal Trainers. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2018; 11:116-128. [PMID: 29795735 PMCID: PMC5955305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of the study was to compare exercise recommendations, attitudes, and behaviors of personal trainers toward clients of different weight statuses. Fifty-two personal trainers participated in the study. The data collection was organized into two phases. In phase one, trainers read a profile and watched the video displaying an interview of either an obese or an average-weight client. Profiles and video interviews were identical except for weight status. Then, trainers provided exercise recommendations and rated their attitude toward the client. In phase two, trainers personally met an obese or an average-weight mock client. Measures were duration and number of advices provided by the trainer to a question posed by the client and sitting distance between trainer and client. There were no significant differences in exercise intensity (p = .94), duration of first session (p = .65), and total exercise duration of first week (p = .76) prescribed to the obese and average-weight clients. The attitude of the personal trainers toward the obese client were not significantly different from the attitude of personal trainers toward the average-weight client (p = .58). The number of advices provided (p = .49), the duration of the answer (p = .55), and the distance personal trainers sat from the obese client (p = .68) were not significantly different from the behaviors displayed toward the average-weight client. Personal trainers did not discriminate against obese clients in professional settings.
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Almuhlafi M, Jamilah KA, Almutairi AF, Salam M. Relationship between early menarche, obesity, and disordered eating behaviors: a school-based cross-sectional survey in Northern Saudi Arabia. Diabetes Metab Syndr Obes 2018; 11:743-751. [PMID: 30532574 PMCID: PMC6244586 DOI: 10.2147/dmso.s180697] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Obesity and disordered eating (DE) behaviors are serious health concerns, regularly observed among female adolescents, which could progress to adverse psychological and nutritional sequels. AIM The aim of this study was to determine the prevalence of obesity and the self-reported DE behaviors among high school female students and to evaluate their self-perception of body image, peer pressures, and need for dietary consultation. METHODS This is a school-based cross-sectional study conducted in 2018. Self-administered surveys and anthropometric measurements were obtained from adolescent females, randomly selected from eight schools in northern Saudi Arabia. Sample characteristics were age, menarche, and DE behaviors (binge eating, self-induced vomiting, and usage of laxatives). Body mass index was converted to percentiles using the age-to-gender scale. Self-perception of body image, perceived peer pressures, and the Eating Attitude Test-26 (EAT-26) were scored, summated, and then presented in percentage mean scores (PMSs) and mean scores (MSs). RESULTS Sample comprised 399 participants. One hundred twenty-eight (32.1%) participants reported early age of menarche (≤12 years). Sixty-five (16.3%) participants reported the prevalence of overweight/obesity, 123 (30.8%) participants reported binge eating, 28 (7.0%) participants reported self-induced vomiting, and 21 (5.3%) participants reported usage of laxatives. The PMS of self-perception of body weight and peer pressure was 68.7±27.1 and 41.9±23.5, respectively. One hundred ninety-two (48.1%) participants needed professional dietary help. Students with early age of menarche were 1.7 times more likely to be overweight/obese (adjusted [adj] P=0.018) compared to others. Overweight/obese participants had significantly poorer self-perception of body image (PMS =47.4±25.0) and higher perceived peer pressure (PMS =49.5±23.1) compared to underweight/normal weight students (PMS =72.8±25.6 [P<0.001] and PMS =40.5±23.3 [P=0.005], respectively). Participants with early age of menarche complained of higher perceived peer pressure compared to others (P=0.045). Participants with DE behaviors had higher peer pressure (PMS =46.8±23.5) and higher scores on E-26 (MS =22.2±11.4) compared to their counter groups (P=0.002 and 0.016, respectively). CONCLUSION The high rate of overweight/obesity and DE behaviors among female adolescents is alarming. Special consideration should be made for those with early menarche who were more prone to overweight/obesity.
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Affiliation(s)
- Mashael Almuhlafi
- Department of Family Medicine, North West Armed Forces Hospital, Tabuk, Saudi Arabia
| | - Khalil Abu Jamilah
- Department of Family Medicine, North West Armed Forces Hospital, Tabuk, Saudi Arabia
| | - Adel F Almutairi
- Science and Technology Unit, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia,
| | - Mahmoud Salam
- Science and Technology Unit, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia,
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Pont SJ, Puhl R, Cook SR, Slusser W. Stigma Experienced by Children and Adolescents With Obesity. Pediatrics 2017; 140:peds.2017-3034. [PMID: 29158228 DOI: 10.1542/peds.2017-3034] [Citation(s) in RCA: 300] [Impact Index Per Article: 42.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The stigmatization of people with obesity is widespread and causes harm. Weight stigma is often propagated and tolerated in society because of beliefs that stigma and shame will motivate people to lose weight. However, rather than motivating positive change, this stigma contributes to behaviors such as binge eating, social isolation, avoidance of health care services, decreased physical activity, and increased weight gain, which worsen obesity and create additional barriers to healthy behavior change. Furthermore, experiences of weight stigma also dramatically impair quality of life, especially for youth. Health care professionals continue to seek effective strategies and resources to address the obesity epidemic; however, they also frequently exhibit weight bias and stigmatizing behaviors. This policy statement seeks to raise awareness regarding the prevalence and negative effects of weight stigma on pediatric patients and their families and provides 6 clinical practice and 4 advocacy recommendations regarding the role of pediatricians in addressing weight stigma. In summary, these recommendations include improving the clinical setting by modeling best practices for nonbiased behaviors and language; using empathetic and empowering counseling techniques, such as motivational interviewing, and addressing weight stigma and bullying in the clinic visit; advocating for inclusion of training and education about weight stigma in medical schools, residency programs, and continuing medical education programs; and empowering families to be advocates to address weight stigma in the home environment and school setting.
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Affiliation(s)
- Stephen J Pont
- Texas Center for the Prevention and Treatment of Childhood Obesity, Dell Children's Medical Center of Central Texas, Ascension, Austin, Texas; .,Department of Pediatrics, Dell Medical School; Center for Health Communication, Moody College of Communication; Department of Nutritional Sciences; University of Texas at Austin, Austin Texas
| | - Rebecca Puhl
- Rudd Center for Food Policy and Obesity and Department of Human Development and Family Studies, University of Connecticut, Storrs, Connecticut
| | - Stephen R Cook
- Department of Pediatrics, Golisano Children's Hospital, University of Rochester Medical Center, Rochester, New York; and
| | - Wendelin Slusser
- Jane and Terry Semel Healthy Campus Initiative, David Geffen School of Medicine and Jonathan and Karin Fielding School of Public Health, University of Los Angeles, Los Angeles, California
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Watanabe PI, Fontana FE, Silva MPD, Mazzardo O, Bacil EDA, Campos WD. ASSOCIATION BETWEEN WEIGHT-TEASING AND PHYSICAL ACTIVITY IN ADOLESCENTS. ACTA ACUST UNITED AC 2017; 35:309-315. [PMID: 28977290 PMCID: PMC5606173 DOI: 10.1590/1984-0462/;2017;35;3;00005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 10/30/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of the study was to determine the association between weight-teasing and physical activity in students from public schools of Curitiba, Paraná (Southern Brazil). METHODS The sample consisted of 95 students (48 boys and 47 girls) aged 12 to 14 years old. The Perception of Weight Teasing (POTS) and The Perception of Weight Teasing during Physical Activity Scale assessed the frequency of weight-teasing experienced by the participants. Accelerometers measured physical activity. BMI assessed the weight status of the participants. Pearson correlations analyzed the association between the teasing and physical activity variables at a significance level of 0.05. RESULTS The relationship between teasing variables and physical activity was not significant. A large proportion of participants failed to meet the recommended levels of physical activity regardless of sex (72%), and girls were significantly less physically active than boys (56.3% of boys and 89.4% of girls; p<0.01). CONCLUSIONS Some participants were targets of weight-teasing, but teasing was not related to physical activity. Interventions are necessary to educate middle school students about the harmful consequences of weight teasing.
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Affiliation(s)
| | | | | | - Oldemar Mazzardo
- Universidade Estadual do Oeste do Paraná, Marechal Cândido Rondon, PR, Brasil
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Zuba A, Warschburger P. The role of weight teasing and weight bias internalization in psychological functioning: a prospective study among school-aged children. Eur Child Adolesc Psychiatry 2017; 26:1245-1255. [PMID: 28361259 DOI: 10.1007/s00787-017-0982-2] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 03/22/2017] [Indexed: 11/25/2022]
Abstract
Weight-related teasing is a widespread phenomenon in childhood, and might foster the internalization of weight bias. The goal of this study was to examine the role of weight teasing and weight bias internalization as mediators between weight status and negative psychological sequelae, such as restrained eating and emotional and conduct problems in childhood. Participants included 546 female (52%) and 501 (48%) male children aged 7-11 and their parents, who completed surveys assessing weight teasing, weight bias internalization, restrained eating behaviors, and emotional and conduct problems at two points of measurement, approximately 2 years apart. To examine the hypothesized mediation, a prospective design using structural equation modeling was applied. As expected, the experience of weight teasing and the internalization of weight bias were mediators in the relationship between weight status and psychosocial problems. This pattern was observed independently of gender or weight status. Our findings suggest that the experience of weight teasing and internalization of weight bias is more important than weight status in explaining psychological functioning among children and indicate a need for appropriate prevention and intervention approaches.
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Affiliation(s)
- Anna Zuba
- Department of Psychology, University of Potsdam, Karl-Liebknecht-Str. 24/25, 14476, Potsdam, Germany
| | - Petra Warschburger
- Department of Psychology, University of Potsdam, Karl-Liebknecht-Str. 24/25, 14476, Potsdam, Germany.
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Abstract
PURPOSE OF REVIEW The purposes of this study were to examine the relationships between obesity and a wide range of mental health issues and to identify where sex differences exist and may vary across disorders. RECENT FINDINGS Research on sex differences in the relationship between obesity and psychiatric disorders is more abundant in some areas, such as depression and eating disorders, than others, such as anxiety, trauma, and substance use. However, for most of the disorders, their relationships with obesity and sex are complex and are usually moderated by additional variables. Thus, studies that find stronger relationships for women between depression and obesity cross-sectionally do not tell the whole story, as longitudinal studies suggest that this relationship may also be present among men, particularly when confounders are considered. For those with eating disorders, men and women with obesity are fairly equally affected, and weight and shape concerns may play a role in maintaining these behaviors for both sexes. Weight stigma, though, seems to have worse consequences for women than men with obesity. Sex differences exist in relation to the associations between mental health and obesity. However, these differences vary by disorder, with disorder-specific moderators playing a role, such as age for depressive disorders, comorbid depression for anxiety disorders, and weight and shape concerns for eating disorders. More work is needed to understand if sex differences play a role in the relationship between obesity and anxiety, trauma, and substance use disorders.
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Affiliation(s)
- Jena Shaw Tronieri
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, 3rd Floor, Philadelphia, PA, 19104, USA
| | - Courtney McCuen Wurst
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, 3rd Floor, Philadelphia, PA, 19104, USA
| | - Rebecca L Pearl
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, 3rd Floor, Philadelphia, PA, 19104, USA
| | - Kelly C Allison
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, 3rd Floor, Philadelphia, PA, 19104, USA.
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Goldfield GS, Kenny GP, Alberga AS, Tulloch HE, Doucette S, Cameron JD, Sigal RJ. Effects of aerobic or resistance training or both on health-related quality of life in youth with obesity: the HEARTY Trial. Appl Physiol Nutr Metab 2017; 42:361-370. [PMID: 28177739 DOI: 10.1139/apnm-2016-0386] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2023]
Abstract
This study examined the effects of aerobic and resistance training, and their combination on health-related quality of life (HRQoL) in adolescents with overweight or obesity. After a 4-week run-in period, 304 (91 males, 213 females) post-pubertal adolescents aged 14-18 years, were randomized to 4 groups for 22 weeks of: aerobic training (n = 75), resistance training (n = 78), combined aerobic and resistance training (n = 75), or nonexercising control (n = 76). All participants received dietary counseling with a daily energy deficit of 250 kcal. Indicators of HRQoL such as overall HRQoL, and physical and psychosocial (an aggregate of emotional, social, and school functioning) HRQoL at baseline and 6 months postintervention were measured by the Pediatric Quality of Life questionnaire. The trial began in March 2005 and was completed in June 2011. In the intention-to-treat analyses, all groups showed significant improvements at 6 months on all HRQoL indicators. The aerobic group showed greater improvements than controls on physical HRQoL (mean differences of 5.5; 95% CI; 1.4-9.6, p = 0.009). In participants with ≥70% adherence, combined training produced greater improvements than control on overall HRQoL (mean differences of 4.8, 95% CI; 0.7-9.0, p = 0.02), physical HRQoL (mean differences of 5.8; 95% CI: 0.6-10.7; p = 0.03), social HRQoL (mean differences of 7.6; 95% CI: 1.0-14.2; p = 0.02), and school-based HRQoL (mean differences of 7.6; 95% CI: 1.0-14.2; p = 0.02). These findings highlight the potential importance of including resistance exercise into traditional aerobic exercise programs to maximize HRQoL in adolescents with obesity.
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Affiliation(s)
- Gary S Goldfield
- a Healthy Active Living & Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- b School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Glen P Kenny
- b School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- c Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Angela S Alberga
- d Werklund School of Education, University of Calgary, Calgary, AB, Canada
| | - Heather E Tulloch
- e Prevention and Rehabilitation Centre, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Steve Doucette
- f Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jameason D Cameron
- a Healthy Active Living & Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Ronald J Sigal
- b School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- c Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- g Departments of Medicine, Cardiac Sciences and Community Health Sciences, Faculties of Medicine and Kinesiology, University of Calgary, Calgary, AB, Canada
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Warkentin T, Borghese MM, Janssen I. Associations between weight-related teasing and psychosomatic symptoms by weight status among school-aged youth. Obes Sci Pract 2016; 3:44-50. [PMID: 28392931 PMCID: PMC5358070 DOI: 10.1002/osp4.87] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 11/10/2016] [Accepted: 11/11/2016] [Indexed: 11/16/2022] Open
Abstract
Objective Weight‐related teasing (WT) is associated with poor mental health. This study examined whether weight status moderates the relationship between WT and psychosomatic symptoms within a representative sample of school‐aged youth. Methods Data are from the Canadian 2013/2014 Health Behaviour in School‐aged Children Survey, a nationally representative sample of youth in Grades 6–10. WT, psychosomatic symptoms and body mass index (BMI) were self‐reported. Results The final sample consisted of 20,277 youth (mean age = 14.2 years; 50.2% female). The prevalence who reported being WT at least once a week was 4.6%, 8.1% and 17.3% among youth with normal weight, overweight, and obesity, respectively (p < 0.001). There was a gradient relationship between the frequency of WT and psychosomatic symptoms (p < 0.001). By comparison to youth that were not WT, psychosomatic symptom z‐scores were significantly (p < 0.05) higher in youth that were WT one to two times in the past few months (0.47, 95% CI: 0.41–0.53), two to three times per month (0.65, 0.52–0.77), about once a week (0.82, 0.71–0.93) and several times a week (0.98, 0.84–1.12). However, the WT * BMI category interaction term was not significant (p = 0.86). Conclusions Victims of WT experienced more psychosomatic symptoms independent of BMI category; however, BMI category did not moderate the association between WT and psychosomatic symptoms.
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Affiliation(s)
- T Warkentin
- School of Kinesiology and Health Studies Queen's University Kingston ON Canada
| | - M M Borghese
- School of Kinesiology and Health Studies Queen's University Kingston ON Canada
| | - I Janssen
- School of Kinesiology and Health Studies Queen's University Kingston ON Canada; Department of Public Health Sciences Queen's University Kingston ON Canada
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Bennett DS, Hersh J, Herres J, Foster J. HIV-Related Stigma, Shame, and Avoidant Coping: Risk Factors for Internalizing Symptoms Among Youth Living with HIV? Child Psychiatry Hum Dev 2016; 47:657-64. [PMID: 26458909 DOI: 10.1007/s10578-015-0599-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Youth living with HIV (YLH) are at elevated risk of internalizing symptoms, although there is substantial individual variability in adjustment. We examined perceived HIV-related stigma, shame-proneness, and avoidant coping as risk factors of internalizing symptoms among YLH. Participants (N = 88; ages 12-24) completed self-report measures of these potential risk factors and three domains of internalizing symptoms (depressive, anxiety, and PTSD) during a regularly scheduled HIV clinic visit. Hierarchical regressions were conducted for each internalizing symptoms domain, examining the effects of age, gender, and maternal education (step 1), HIV-related stigma (step 2), shame- and guilt-proneness (step 3), and avoidant coping (step 4). HIV-related stigma, shame-proneness, and avoidant coping were each correlated with greater depressive, anxiety, and PTSD symptoms. Specificity was observed in that shame-proneness, but not guilt-proneness, was associated with greater internalizing symptoms. In multivariable analyses, HIV-related stigma and shame-proneness were each related to greater depressive and PTSD symptoms. Controlling for the effects of HIV-related stigma and shame-proneness, avoidant coping was associated with PTSD symptoms. The current findings highlight the potential importance of HIV-related stigma, shame, and avoidant coping on the adjustment of YLH, as interventions addressing these risk factors could lead to decreased internalizing symptoms among YLH.
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Affiliation(s)
- David S Bennett
- Department of Psychiatry, GLAD Program, Drexel University, 4700 Wissahickon Avenue, Philadelphia, PA, 19144, USA.
| | - Jill Hersh
- Psychology Department, Immaculata University, Immaculata, PA, USA
| | - Joanna Herres
- Center for Family Intervention Science, Drexel University, Philadelphia, PA, USA
| | - Jill Foster
- Government Affairs, Gilead Sciences Inc., Philadelphia, PA, USA
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Hübner C, Baldofski S, Crosby RD, Müller A, de Zwaan M, Hilbert A. Weight-related teasing and non-normative eating behaviors as predictors of weight loss maintenance. A longitudinal mediation analysis. Appetite 2016; 102:25-31. [DOI: 10.1016/j.appet.2016.02.017] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 01/26/2016] [Accepted: 02/09/2016] [Indexed: 02/05/2023]
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Mannan M, Mamun A, Doi S, Clavarino A. Prospective Associations between Depression and Obesity for Adolescent Males and Females- A Systematic Review and Meta-Analysis of Longitudinal Studies. PLoS One 2016; 11:e0157240. [PMID: 27285386 PMCID: PMC4902254 DOI: 10.1371/journal.pone.0157240] [Citation(s) in RCA: 229] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 05/26/2016] [Indexed: 11/30/2022] Open
Abstract
Adolescent obesity and depression are increasingly prevalent and are currently recognised as major public health concerns worldwide. The aim of this study is to evaluate the bi-directional associations between obesity and depression in adolescents using longitudinal studies. A systematic literature search was conducted using Pubmed (including Medline), PsycINFO, Embase, CINAHL, BIOSIS Preview and the Cochrane Library databases. According to the inclusion criteria, 13 studies were found where seven studies evaluated depression leading to obesity and six other studies examined obesity leading to depression. Using a bias-adjusted quality effects model for the meta-analysis, we found that adolescents who were depressed had a 70% (RR 1.70, 95% CI: 1.40, 2.07) increased risk of being obese, conversely obese adolescents had an increased risk of 40% (RR 1.40, 95% CI: 1.16, 1.70) of being depressed. The risk difference (RD) of early adolescent depression leading to obesity is 3% higher risk than it is for obesity leading to depression. In sensitivity analysis, the association between depression leading to obesity was greater than that of obesity leading to depression for females in early adulthood compared with females in late adolescence. Overall, the findings of this study suggest a bi-directional association between depression and obesity that was stronger for female adolescents. However, this finding also underscores the importance of early detection and treatment strategies to inhibit the development of reciprocal disorders.
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Affiliation(s)
- Munim Mannan
- School of Pharmacy, The University of Queensland, 20 Cornwall Street, Woolloongabba, 4102, Queensland, Australia
- * E-mail:
| | - Abdullah Mamun
- School of Population Health, The University of Queensland, Herston Road, Herston, 4006, Queensland, Australia
| | - Suhail Doi
- Research School of Population Health, ANU College of Medicine, Biology and Environment, Australian National University, Acton, ACT 2601, Australia
| | - Alexandra Clavarino
- School of Pharmacy, The University of Queensland, 20 Cornwall Street, Woolloongabba, 4102, Queensland, Australia
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Jendrzyca A, Warschburger P. Weight stigma and eating behaviours in elementary school children: A prospective population-based study. Appetite 2016; 102:51-9. [PMID: 26851574 DOI: 10.1016/j.appet.2016.02.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 01/29/2016] [Accepted: 02/02/2016] [Indexed: 11/19/2022]
Abstract
The relevance of weight stigma as an important factor in disordered eating has been supported by research. However, because most of the studies were cross-sectional and focussed on older children, the causal relationships could not be fully determined in childhood. The current study explores the role of weight stigma in body dissatisfaction and eating behaviours. The sample consisted of 773 girls and 713 boys, aged 6-11 years, who completed surveys assessing weight stigma experiences, body dissatisfaction and eating behaviours at two points of measurement, approximately one year apart. The children's external and disordered eating was rated via parental questionnaires. As expected, the pattern of the associations between weight status, weight stigma, body dissatisfaction and eating behaviours differed by gender. Experience of weight stigma in girls led to external and restrained eating one year later, whereas in boys no such association was observed. Body dissatisfaction mediated the association between weight stigma and restrained eating behaviours in girls, whereas in boys, body dissatisfaction directly influenced restrained eating behaviours. However, in both girls and boys weight status predicted body dissatisfaction and disordered eating, while weight stigma did not have a direct effect on disordered eating. Results suggest that interventions involving weight stigma should be a part of eating disorder prevention programmes, and gender-specific pathways should be considered.
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Affiliation(s)
- Anna Jendrzyca
- Department of Psychology, University of Potsdam, Karl-Liebknecht-Str. 24/25, 14476, Potsdam, Germany.
| | - Petra Warschburger
- Department of Psychology, University of Potsdam, Karl-Liebknecht-Str. 24/25, 14476, Potsdam, Germany.
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47
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Weight stigma and eating behavior: A review of the literature. Appetite 2016; 102:3-14. [PMID: 26829371 DOI: 10.1016/j.appet.2016.01.034] [Citation(s) in RCA: 170] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 12/19/2015] [Accepted: 01/28/2016] [Indexed: 01/17/2023]
Abstract
Weight stigma is a pervasive social problem, and this paper reviews the evidence linking weight stigma to eating behavior. Correlational studies consistently find that experiences with weight stigma are associated with unhealthy eating behaviors and eating pathology (such as binge eating, skipping meals), although results vary somewhat depending on the sample being studied and the specific stigma/eating constructs being assessed. Experimental studies consistently find that manipulations such as priming overweight stereotypes, exposure to stigmatizing content, and social exclusion all lead to increased food intake, but whether or not those manipulations capture the impact of weight stigma experiences per se is less clear. Finally, studies of stigma experiences in daily life show that more frequent stigma experiences are associated with decreased motivation to diet and with less healthy eating behaviors. Overall, this research highlights the potential for weight stigma to negatively impact individuals' eating behavior, which in turn could have consequences for their overall health and well-being.
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48
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Goldfield GS, Cameron JD, Murray M, Maras D, Wilson AL, Phillips P, Kenny GP, Hadjiyannakis S, Alberga AS, Tulloch H, Doucette S, Sigal RJ. Screen time is independently associated with health-related quality of life in overweight and obese adolescents. Acta Paediatr 2015; 104:e448-54. [PMID: 26096064 DOI: 10.1111/apa.13073] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 03/16/2015] [Accepted: 06/03/2015] [Indexed: 11/29/2022]
Abstract
AIM Excessive screen time and diminished health-related quality of life (HRQoL) are greater problems for obese than nonobese adolescents, but no research has examined the relationship between these two variables. This study examined the association between screen time and HRQoL in overweight and obese adolescents. METHODS A sample of 358 overweight and obese adolescents aged 14-18 years were assessed at baseline between 2005 and 2010 as part of the Canadian Healthy Eating, Aerobic and Resistance Training in Youth (HEARTY) trial. We used the Pediatric Quality of Life (PEDS-QL) and other self-report measures to assess HRQoL and screen time, defined as how long the 261 females and 97 males spent viewing TV, using the computer and playing video games. RESULTS After adjusting for socio-demographic variables, adiposity, physical activity and diet, screen time duration was associated with reduced overall HRQoL (adjusted r = -0.16, ß = -0.16, p = 0.009) and psychosocial HRQoL (adjusted r = -0.16, ß = -0.18, p = 0.004), but not physical HRQoL. No differences were found between males and females. CONCLUSION Screen time was associated with reduced overall and psychosocial HRQoL in overweight and obese adolescents. Future research should determine whether reducing screen time improves overall and psychosocial HRQoL in obese adolescents.
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Affiliation(s)
- Gary S. Goldfield
- Healthy Active Living and Obesity Research Group; Children's Hospital Of Eastern Ontario Research Institute; Ottawa ON Canada
- Department of Paediatrics; University of Ottawa; Ottawa ON Canada
- School of Human Kinetics; University of Ottawa; Ottawa ON Canada
- School of Psychology; University of Ottawa; Ottawa ON Canada
- Department of Psychology; Carleton University; Ottawa ON Canada
| | - Jameason D. Cameron
- Healthy Active Living and Obesity Research Group; Children's Hospital Of Eastern Ontario Research Institute; Ottawa ON Canada
- School of Human Kinetics; University of Ottawa; Ottawa ON Canada
| | - Marisa Murray
- School of Psychology; University of Ottawa; Ottawa ON Canada
| | - Danijela Maras
- School of Psychology; University of Ottawa; Ottawa ON Canada
| | | | | | - Glen P. Kenny
- School of Human Kinetics; University of Ottawa; Ottawa ON Canada
- Ottawa Hospital Research Institute; Ottawa ON Canada
| | - Stasia Hadjiyannakis
- Healthy Active Living and Obesity Research Group; Children's Hospital Of Eastern Ontario Research Institute; Ottawa ON Canada
- Centre for Healthy Active living (CHAL); Children's Hospital of Eastern Ontario; Ottawa ON Canada
| | | | - Heather Tulloch
- Prevention and Rehabilitation Centre; University of Ottawa Heart Institute; Ottawa ON Canada
| | - Steve Doucette
- Department of Community Health & Epidemiology; Dalhousie University; Halifax NS Canada
| | - Ronald J. Sigal
- Department of Medicine; Cardiac Sciences and Community Health Sciences; Faculties of Medicine and Kinesiology; University of Calgary; Calgary AL Canada
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Dalen J, Brody JL, Staples JK, Sedillo D. A Conceptual Framework for the Expansion of Behavioral Interventions for Youth Obesity: A Family-Based Mindful Eating Approach. Child Obes 2015; 11:577-84. [PMID: 26325143 PMCID: PMC4599132 DOI: 10.1089/chi.2014.0150] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Currently, over 30% of US youth are overweight and 1 in 6 have metabolic syndrome, making youth obesity one of the major global health challenges of the 21st century. Few enduring treatment strategies have been identified in youth populations, and the majority of standard weight loss programs fail to adequately address the impact of psychological factors on eating behavior and the beneficial contribution of parental involvement in youth behavior change. METHODS A critical need exists to expand treatment development efforts beyond traditional education and cognitive-behavioral programs and explore alternative treatment models for youth obesity. Meditation-based mindful eating programs represent a unique and novel scientific approach to the current youth obesity epidemic given that they address key psychological variables affecting weight. RESULTS The recent expansion of mindfulness programs to include family relationships shows the immense potential for broadening the customarily individual focus of this intervention to include contextual factors thought to influence youth health outcomes. CONCLUSIONS This article provides an overview of how both mindful eating and family systems theory fits within a conceptual framework in order to guide development of a comprehensive family-based mindful eating program for overweight youth.
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Affiliation(s)
- Jeanne Dalen
- Oregon Research Institute, Center for Family and Adolescent Research, Albuquerque, NM.,University of New Mexico Health Sciences Center, Albuquerque, NM
| | - Janet L. Brody
- Oregon Research Institute, Center for Family and Adolescent Research, Albuquerque, NM
| | | | - Donna Sedillo
- Oregon Research Institute, Center for Family and Adolescent Research, Albuquerque, NM
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Abstract
Despite decades of research documenting consistent stigma and discrimination against individuals with obesity, weight stigma is rarely considered in obesity prevention and treatment efforts. In recent years, evidence has examined weight stigmatization as a unique contributor to negative health outcomes and behaviors that can promote and exacerbate obesity. This review summarizes findings from published studies within the past 4 years examining the relationship between weight stigma and maladaptive eating behaviors (binge eating and increased food consumption), physical activity, weight status (weight gain and loss and development of obesity), and physiological stress responses. Research evaluating the effects of weight stigma present in obesity-related public health campaigns is also highlighted. Evidence collectively demonstrates negative implications of stigmatization for weight-related health correlates and behaviors and suggests that addressing weight stigma in obesity prevention and treatment is warranted. Key questions for future research to further delineate the health effects of weight stigmatization are summarized.
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Affiliation(s)
- Rebecca Puhl
- Rudd Center for Food Policy and Obesity, University of Connecticut, One Constitution Plaza, Suite 600, Hartford, CT, 06103, USA.
| | - Young Suh
- Rudd Center for Food Policy and Obesity, University of Connecticut, One Constitution Plaza, Suite 600, Hartford, CT, 06103, USA.
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