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Wagner BE, Cook S. Weight Bias and Stigma in Pediatric Obesity. Pediatr Clin North Am 2024; 71:819-830. [PMID: 39343495 DOI: 10.1016/j.pcl.2024.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/01/2024]
Abstract
Weight stigma is pervasive during childhood and adolescent years. Well-established physical and psychosocial health consequences of weight stigma, like disordered eating behaviors, low self-esteem, and higher depressive symptoms, make it especially harmful during a critical period of development for youth. Lasting negative health impacts of these experiences highlight the importance of addressing weight stigma early on. The pediatric health care setting, both physical and social components, can be one of many sources of weight-stigmatizing experiences for youth. This observation has prompted calls for action in the health care setting to reduce weight biases and stigmatizing behavior among pediatric providers.
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Affiliation(s)
- Brooke E Wagner
- Department of Population Health Sciences, Duke Center for Childhood Obesity Research, Duke University School of Medicine, 215 Morris Street, Durham, NC, USA
| | - Stephen Cook
- Nationwide Children's Hospital, 700 Children's Drive, LA 5F, Columbus, OH, USA.
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2
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Wu R, Puhl RM, Lessard LM, Foster GD, Cardel MI. Exploring the interplay of weight-based teasing and sociodemographic factors in adolescent weight bias internalization. J Pediatr Psychol 2024; 49:547-558. [PMID: 38853703 DOI: 10.1093/jpepsy/jsae042] [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: 02/23/2024] [Revised: 05/21/2024] [Accepted: 05/24/2024] [Indexed: 06/11/2024] Open
Abstract
OBJECTIVE Research has highlighted the potential adverse effects of weight bias internalization (WBI) on adolescents, but there has been little examination of WBI and sources of weight teasing (family, peers, or both) or across racial/ethnic diversity of adolescents. We aimed to examine the relationship between WBI and sources of weight teasing across sociodemographic characteristics and weight status in a diverse community sample of adolescents. METHODS Data were collected from a U.S. sample of 1859 adolescents aged 10-17 years (59% female; 43% White, 27% Black or African American, and 25% Latino). An online questionnaire was used to assess participants' experiences of weight teasing from family members, peers, or both, and their weight status, weight-related goals, WBI, and sociodemographic characteristics. RESULTS Adolescents experiencing weight teasing from both family and peers reported the highest levels of WBI, while those reporting no teasing exhibited the lowest levels. These patterns were observed across sex, race/ethnicity, weight status, and weight goals, and persisted after controlling for depressive symptoms. Notably, family influences played a salient role, with adolescents reporting higher WBI if teased by family only compared to teasing from peers only. Sex and racial differences were also observed in adolescents' experiences with weight-based teasing. CONCLUSION Our study reveals associations between adolescent weight-based teasing, WBI, and sociodemographic factors. Weight-based teasing, whether from family and peers or from family only, was associated with increased WBI. Interventions targeting weight stigma in youth should not be limited to peer-focused efforts, but should also emphasize supportive family communication.
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Affiliation(s)
- Rui Wu
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, United States
| | - Rebecca M Puhl
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, United States
- Rudd Center for Food Policy and Health, University of Connecticut, Hartford, CT, United States
| | - Leah M Lessard
- Rudd Center for Food Policy and Health, University of Connecticut, Hartford, CT, United States
| | - Gary D Foster
- WW International, Inc, New York, NY, United States
- Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Michelle I Cardel
- Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL, United States
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL, United States
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Cheon BK, Smith MR, Bittner JMP, Loch LK, Haynes HE, Bloomer BF, Te-Vazquez JA, Bowling AI, Brady SM, Tanofsky-Kraff M, Chen KY, Yanovski JA. Lower subjective social status is associated with increased adiposity and self-reported eating in the absence of hunger due to negative affect among children reporting teasing distress. J Pediatr Psychol 2024; 49:462-472. [PMID: 38637284 PMCID: PMC11258810 DOI: 10.1093/jpepsy/jsae024] [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: 11/20/2023] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 04/20/2024] Open
Abstract
OBJECTIVES Low social standing and teasing are independently associated with increased body mass index (BMI) and overeating in children. However, children with low social status may be vulnerable to teasing. METHODS We tested the statistical interaction of subjective social status (SSS) and subjective socioeconomic status (SSES) and teasing distress on BMI, fat mass index (FMI), and eating in the absence of hunger (EAH) in children (Mage = 13.09 years, SD = 2.50 years; 27.8% overweight/obese). Multiple linear regressions identified the main effects of self-reported SSS (compared to peers in school), distress due to teasing, and their interaction on BMI (n = 115), FMI (n = 114), and child- (n = 100) and parent-reported (n = 97) EAH. RESULTS Teasing distress was associated with greater BMI, FMI, and child-reported EAH due to negative affect (a subscale of EAH) and total EAH scores. There were no associations of SSS with these outcomes. However, there was an interaction between SSS and teasing distress for BMI, FMI, and EAH from negative affect such that lower SSS was associated with higher BMI, FMI, and EAH from negative affect in the presence of teasing distress. However, there were no main effects or interactions (with teasing distress) of SSES on the outcomes. CONCLUSIONS These findings suggest that the relationship between lower SSS and increased adiposity and overeating behaviors may be exacerbated by other threats to social standing, such as teasing. Children exposed to multiple social threats may be more susceptible to eating beyond physiological need and obesity than those who experience a single form of perceived social disadvantage.
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Affiliation(s)
- Bobby K Cheon
- Social and Behavioral Sciences Branch, Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, United States
| | - Meegan R Smith
- Social and Behavioral Sciences Branch, Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, United States
| | - Julia M P Bittner
- Social and Behavioral Sciences Branch, Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, United States
| | - Lucy K Loch
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, United States
| | - Hannah E Haynes
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, United States
- Military Cardiovascular Outcomes Research Program, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
- Metis Foundation, San Antonio, TX, United States
| | - Bess F Bloomer
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, United States
| | - Jennifer A Te-Vazquez
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, United States
| | - Andrea I Bowling
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, United States
| | - Sheila M Brady
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, United States
| | - Marian Tanofsky-Kraff
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, United States
- Military Cardiovascular Outcomes Research Program, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Kong Y Chen
- Diabetes, Endocrinology, and Obesity Branch, Division of Intramural Research, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, United States
| | - 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, Bethesda, MD, United States
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Kühnen P, Argente J, Clément K, Dollfus H, Dubern B, Farooqi S, de Groot C, Grüters A, Holm JC, Hopkins M, Kleinendorst L, Körner A, Meeker D, Rydén M, von Schnurbein J, Tschöp M, Yeo GSH, Zorn S, Wabitsch M. IMPROVE 2022 International Meeting on Pathway-Related Obesity: Vision of Excellence. Clin Obes 2024; 14:e12659. [PMID: 38602039 DOI: 10.1111/cob.12659] [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: 02/22/2024] [Accepted: 03/08/2024] [Indexed: 04/12/2024]
Abstract
Nearly 90 clinicians and researchers from around the world attended the first IMPROVE 2022 International Meeting on Pathway-Related Obesity. Delegates attended in person or online from across Europe, Argentina and Israel to hear the latest scientific and clinical developments in hyperphagia and severe, early-onset obesity, and set out a vision of excellence for the future for improving the diagnosis, treatment, and care of patients with melanocortin-4 receptor (MC4R) pathway-related obesity. The meeting co-chair Peter Kühnen, Charité Universitätsmedizin Berlin, Germany, indicated that change was needed with the rapidly increasing prevalence of obesity and the associated complications to improve the understanding of the underlying mechanisms and acknowledge that monogenic forms of obesity can play an important role, providing insights that can be applied to a wider group of patients with obesity. World-leading experts presented the latest research and led discussions on the underlying science of obesity, diagnosis (including clinical and genetic approaches such as the role of defective MC4R signalling), and emerging clinical data and research with targeted pharmacological approaches. The aim of the meeting was to agree on the questions that needed to be addressed in future research and to ensure that optimised diagnostic work-up was used with new genetic testing tools becoming available. This should aid the planning of new evidence-based treatment strategies for the future, as explained by co-chair Martin Wabitsch, Ulm University Medical Center, Germany.
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Affiliation(s)
- Peter Kühnen
- Department of Pediatric Endocrinology and Diabetology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Jesús Argente
- Departments of Pediatrics & Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Karine Clément
- Assistance Publique-Hôpitaux de Paris, Nutrition Department, Pitié-Salpêtrière Hospital, Paris, France
- INSERM, Nutrition and Obesity: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, Paris, France
| | - Hélène Dollfus
- CARGO and Department of Medical Genetics, University of Strasbourg, Strasbourg, France
| | - Béatrice Dubern
- INSERM, Nutrition and Obesity: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, Paris, France
- Sorbonne Université, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Sadaf Farooqi
- Wellcome-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Corjan de Groot
- Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Annette Grüters
- Department of Pediatric Endocrinology and Diabetes, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Jens-Christian Holm
- The Children's Obesity Clinic, accredited European Centre for Obesity Management, Department of Pediatrics, Copenhagen University Hospital Holbæk, Copenhagen, Denmark
| | - Mark Hopkins
- School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Lotte Kleinendorst
- Department of Clinical Genetics, Amsterdam UMC, Amsterdam, The Netherlands
| | - Antje Körner
- Center for Pediatric Research, Department of Pediatrics, LIFE Research Center for Civilization Diseases, University Hospital Leipzig, Leipzig, Germany
| | - David Meeker
- Rhythm Pharmaceuticals, Boston, Massachusetts, USA
| | - Mikael Rydén
- Department of Medicine H7, Karolinska Institute, Stockholm, Sweden
- Department of Endocrinology and Metabolism, Karolinska University Hospital, Stockholm, Sweden
| | - Julia von Schnurbein
- Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm, Germany
| | - Matthias Tschöp
- Institute for Diabetes and Obesity, Helmholtz Zentrum, Munich, Germany
| | - Giles S H Yeo
- Wellcome-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Stefanie Zorn
- Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm, Germany
| | - Martin Wabitsch
- Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm, Germany
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Gu W, Yu X, Tan Y, Yu Z, Zhu J. Association between weight, weight perception, weight teasing and mental health among adolescents. Child Adolesc Psychiatry Ment Health 2024; 18:39. [PMID: 38521915 PMCID: PMC10960988 DOI: 10.1186/s13034-024-00730-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 03/11/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Adolescent mental health problems are becoming increasingly prevalent, and there are correlations between weight-related concerns and adolescent mental health. The aim of this study is to explore the association between three weight-related factors (actual weight, weight perception, and weight teasing) and mental health problems (depressive symptoms, anxiety symptoms, and loneliness) in Chinese adolescents. METHODS 10,070 adolescents between the ages of 11-18 from schools in Shanghai, China were selected using a stratified random cluster sampling method. Self-reported questionnaires were collected to investigate weight-related factors and mental health problems. Logistic regression analysis was used to examine the relationship. RESULTS The prevalence of depressive symptoms, loneliness, mild anxiety symptoms, and moderate to severe anxiety symptoms among adolescents were 18.0%, 53.8%, 26.5%, and 12.3%, respectively, with a higher prevalence found in females. After adjusting for weight perception and weight teasing, actual weight had no harmful impact on adolescents' mental health. Adolescents' perception of being overweight increased the risk of depressive symptoms, loneliness, mild anxiety symptoms, and moderate to severe anxiety symptoms, while the perception of being underweight had a similar but more profound impact (depressive symptoms OR = 1.590, 95% CI: 1.342-1.883; loneliness OR = 1.537, 95% CI: 1.353-1.746; mild anxiety symptoms OR = 1.368, 95% CI: 1.178-1.589; moderate to severe anxiety symptoms OR = 1.780, 95% CI: 1.449-2.186). Experiencing weight teasing more than once a year had a greater effect on adolescents' mental health, especially among adolescents with overweight/obesity (depressive symptoms OR = 2.970, 95% CI: 2.325-3.793; loneliness OR = 3.839, 95% CI: 3.119-4.727; mild anxiety symptoms OR = 2.822, 95% CI: 2.236-3.562; moderate to severe anxiety symptoms OR = 5.212, 95% CI: 3.846-7.065). CONCLUSIONS The prevalence of mental health problems among adolescents was high, especially loneliness. Weight perception and weight teasing, but not the actual weight, independently influenced adolescent mental health.
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Affiliation(s)
- Wenxin Gu
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaoyan Yu
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Yinliang Tan
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Zhiping Yu
- Department of Nutrition and Dietetics, University of North Florida, Jacksonville, FL, USA
| | - Jingfen Zhu
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China.
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TROMBETTA CLAUDIAMARIA, MARCONI DOMITILLA, LIPARI DARIO, PAMMOLLI ANDREA, ZAGRA LUIGI, MANINI ILARIA, MEONI VERONICA, SIMI RITA, GALEOTTI TOMMASO, LAZZERI GIACOMO. There is a correlation between nutritional status, Self-Rated Health and Life Satisfaction? Evidence from 2018 Health Behaviour in School-aged Children cross sectional study in a sample of Italian adolescents living in Tuscany Region. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2024; 65:E43-E49. [PMID: 38706769 PMCID: PMC11066822 DOI: 10.15167/2421-4248/jpmh2024.65.1.3178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 01/30/2024] [Indexed: 05/07/2024]
Abstract
Background Overweight has been associated with several social and phycological problems and is perceived as one of the major health care challenges to focus on in the future. The purpose of the study is to investigate the correlations among nutritional status, assessed by the Body Mass Index, the perception of one's own health status and Life Satisfaction, detected in Italian adolescents living in Tuscany Region, and to investigate the influence of gender on them. Methods A statistically representative sample of 2760 Tuscan adolescents aged 11, 13 and 15 was involved in the 2018 Health Behaviours at School-aged Children survey. The participants were divided into three nutritional status class: underweight, normal weight and overweight (overweight + obese). Results The results show that there is a statistically significant difference in all categories between boys and girls aged 13 and 15 years; in girls aged 11 and 13 years, the Life Satisfaction of the overweight group is statistically lower than that of normal and underweight groups; Self-Rated Health is statistically lower in all age groups for overweight individuals compared to normal weight children, except for 11-year-old females. Conclusions Viewing the psychosocial problems related to overweight, more attention and care must be placed on adolescents to ensure their healthier development.
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Affiliation(s)
- CLAUDIA MARIA TROMBETTA
- Correspondence: Claudia Maria Trombetta, University of Siena, Via Aldo Moro 2, Siena 53100, Italy. E-mail:
| | - DOMITILLA MARCONI
- Post Graduate School of Public Health, University of Siena, Siena, Italy
| | - DARIO LIPARI
- Post Graduate School of Public Health, University of Siena, Siena, Italy
| | - ANDREA PAMMOLLI
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
- Research Center on Health Prevention and Promotion (CREPS), University of Siena, Siena, Italy
| | - LUIGI ZAGRA
- Post Graduate School of Public Health, University of Palermo, Palermo, Italy
| | | | | | - RITA SIMI
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
- Research Center on Health Prevention and Promotion (CREPS), University of Siena, Siena, Italy
| | - TOMMASO GALEOTTI
- Department of Developmental Psychology and Socialisation, University of Padua, Padua, Italy
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Howes EM, Parker MK, Misyak SA, DiFeliceantonio AG, Davy BM, Brown LEC, Hedrick VE. The Impact of Weight Bias and Stigma on the 24 h Dietary Recall Process in Adults with Overweight and Obesity: A Pilot Study. Nutrients 2024; 16:191. [PMID: 38257084 PMCID: PMC10818297 DOI: 10.3390/nu16020191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/07/2023] [Accepted: 01/03/2024] [Indexed: 01/24/2024] Open
Abstract
People with overweight and obesity tend to both underreport dietary energy intake and experience weight stigma. This exploratory pilot study aimed to determine the relationship between weight bias and weight stigma and energy intake reporting accuracy. Thirty-nine weight-stable adults with BMI ≥ 25 completed three 24 h dietary recalls; indirect calorimetry to measure resting metabolic rate; a survey measuring weight stigma, psychosocial constructs, and physical activity; and a semi-structured qualitative interview. Multiple linear regression was used to determine if weight bias internalization, weight bias toward others, and experiences of weight stigma were predictive of the accuracy of energy reporting. A thematic analysis was conducted for the qualitative interviews. Weight stigma was reported by 64.1% of the sample. Weight stigma constructs did not predict the accuracy of energy intake reporting. People with obesity underreported by a mean of 477 kcals (p = 0.02). People classified as overweight overreported by a mean of 144 kcals, but this was not significant (p = 0.18). Participants reported a desire to report accurate data despite concerns about reporting socially undesirable foods. Future research should quantify the impact of weight stigma on energy reporting in 24 h recalls using a larger, more diverse sample size and objective measures like doubly labeled water for validation.
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Affiliation(s)
- Erica M. Howes
- Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA 24061, USA; (M.K.P.); (S.A.M.); (A.G.D.); (B.M.D.); (V.E.H.)
| | - Molly K. Parker
- Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA 24061, USA; (M.K.P.); (S.A.M.); (A.G.D.); (B.M.D.); (V.E.H.)
| | - Sarah A. Misyak
- Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA 24061, USA; (M.K.P.); (S.A.M.); (A.G.D.); (B.M.D.); (V.E.H.)
| | - Alexandra G. DiFeliceantonio
- Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA 24061, USA; (M.K.P.); (S.A.M.); (A.G.D.); (B.M.D.); (V.E.H.)
- Fralin Biomedical Research Institute at VTC, Virginia Tech, Roanoke, VA 24016, USA
| | - Brenda M. Davy
- Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA 24061, USA; (M.K.P.); (S.A.M.); (A.G.D.); (B.M.D.); (V.E.H.)
| | | | - Valisa E. Hedrick
- Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA 24061, USA; (M.K.P.); (S.A.M.); (A.G.D.); (B.M.D.); (V.E.H.)
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Madsen M, Michaelsen L, DeCosta P, Grabowski D. Stigma-Generating Mechanisms in Families Enrolled in a Pediatric Weight Management Program: A Qualitative Study of Health Identities and Healthcare Authenticity. CHILDREN (BASEL, SWITZERLAND) 2023; 11:46. [PMID: 38255360 PMCID: PMC10813986 DOI: 10.3390/children11010046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/20/2023] [Accepted: 12/25/2023] [Indexed: 01/24/2024]
Abstract
In recent years, there has been increased awareness of obesity as a condition that carries a high level of stigma, as well as growing recognition of its prevalence and harm. Despite the increasing body of research on this topic, there is a gap in the literature regarding mechanisms that generate or exacerbate perceptions of weight stigma, especially within families and pediatric healthcare settings. The present study aims to identify potential stigma-generating mechanisms by focusing on inter-relational dynamics within these contexts. We conducted in-depth, semi-structured interviews with 11 families and analyzed the data by applying sociological theories on health identities and authenticity. Our study found four themes that represent potential stigma-generating mechanisms by being explicitly related to familial health identities and healthcare authenticity: (1) negotiating and reconstruction familial self-understanding, (2) between guilt, shame and conflicts, (3) navigating weight perceptions, and (4) the necessity of positivity and relevance. Our study shows the complexities of weight stigma within family and pediatric healthcare settings, emphasizing the need for sensitive and tailored support, as well as the value of working authentically as crucial aspects in preventing and/or reducing stigma.
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Affiliation(s)
- Mie Madsen
- Department of Prevention, Health Promotion and Community Care, Copenhagen University Hospital—Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark; (P.D.); (D.G.)
| | - Lene Michaelsen
- The Centre for Children and Youths Health, Mimersgade 47A, 2nd Floor, 2200 Copenhagen, Denmark;
| | - Patricia DeCosta
- Department of Prevention, Health Promotion and Community Care, Copenhagen University Hospital—Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark; (P.D.); (D.G.)
| | - Dan Grabowski
- Department of Prevention, Health Promotion and Community Care, Copenhagen University Hospital—Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark; (P.D.); (D.G.)
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Byrne ME, Tanofsky-Kraff M, Liuzzi L, Holroyd T, Parker MN, Bloomer BF, Nugent A, Brady SM, Yang SB, Turner SA, Pine DS, Yanovski JA. Neural underpinnings of threat bias in relation to loss-of-control eating behaviors among adolescent girls with high weight. Front Psychiatry 2023; 14:1276300. [PMID: 37965354 PMCID: PMC10642175 DOI: 10.3389/fpsyt.2023.1276300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 09/22/2023] [Indexed: 11/16/2023] Open
Abstract
Introduction Loss-of-control (LOC) eating, a key feature of binge-eating disorder, may relate attentional bias (AB) to highly salient interpersonal stimuli. The current pilot study used magnetoencephalography (MEG) to explore neural features of AB to socially threatening cues in adolescent girls with and without LOC-eating. Methods Girls (12-17 years old) with overweight or obesity (BMI >85th percentile) completed an AB measure on an affective dot-probe AB task during MEG and evoked neural responses to angry or happy (vs. neutral) face cues were captured. A laboratory test meal paradigm measured energy intake and macronutrient consumption patterns. Results Girls (N = 34; Mage = 15.5 ± 1.5 years; BMI-z = 1.7 ± 0.4) showed a blunted evoked response to the presentation of angry face compared with neutral face cues in the left dorsolateral prefrontal cortex, a neural region implicated in executive control and regulation processes, during attention deployment (p < 0.01). Compared with those without LOC-eating (N = 21), girls with LOC-eating (N = 13) demonstrated a stronger evoked response to angry faces in the visual cortex during attention deployment (p < 0.001). Visual and cognitive control ROIs had trends suggesting interaction with test meal intake patterns among girls with LOC-eating (ps = 0.01). Discussion These findings suggest that girls with overweight or obesity may fail to adaptively engage neural regions implicated in higher-order executive processes. This difficulty may relate to disinhibited eating patterns that could lead to excess weight gain.
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Affiliation(s)
- Meghan E. Byrne
- Section on Development and Affective Neuroscience, Emotion and Development Branch, National Institute of Mental Health (NIMH), Bethesda, MD, United States
- Division of Intramural Research, National Institutes of Health (NIH), Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, MD, United States
| | - Marian Tanofsky-Kraff
- Division of Intramural Research, National Institutes of Health (NIH), Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, MD, United States
- Department of Medical and Clinical Psychology, USUHS, Bethesda, MD, United States
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD, United States
| | - Lucrezia Liuzzi
- Section on Development and Affective Neuroscience, Emotion and Development Branch, National Institute of Mental Health (NIMH), Bethesda, MD, United States
| | - Tom Holroyd
- MEG Core Facility, National Institute of Mental Health (NIMH), Bethesda, MD, United States
| | - Megan N. Parker
- Division of Intramural Research, National Institutes of Health (NIH), Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, MD, United States
- Department of Medical and Clinical Psychology, USUHS, Bethesda, MD, United States
| | - Bess F. Bloomer
- Division of Intramural Research, National Institutes of Health (NIH), Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, MD, United States
| | - Allison Nugent
- MEG Core Facility, National Institute of Mental Health (NIMH), Bethesda, MD, United States
| | - Sheila M. Brady
- Division of Intramural Research, National Institutes of Health (NIH), Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, MD, United States
| | - Shanna B. Yang
- Nutrition Department, Clinical Center, NIH, Bethesda, MD, United States
| | - Sara A. Turner
- Nutrition Department, Clinical Center, NIH, Bethesda, MD, United States
| | - Daniel S. Pine
- Section on Development and Affective Neuroscience, Emotion and Development Branch, National Institute of Mental Health (NIMH), Bethesda, MD, United States
| | - Jack A. Yanovski
- Division of Intramural Research, National Institutes of Health (NIH), Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, MD, United States
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10
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Darling KE, West C, Jelalian E, Putt GE, Sato AF. The buffering effect of family support on the association between weight-based teasing and adolescent weight management outcomes. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2023; 37:942-946. [PMID: 37126031 PMCID: PMC10523870 DOI: 10.1037/fam0001084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Weight-based victimization (WBV) is associated with poor weight-related outcomes in adolescence. Family support may be one protective factor against the negative impact of WBV. The goal of this study is to examine the moderating effect of family support on the association between WBV and early weight loss for adolescents in a clinical weight management program. Parents of adolescents (N = 78) completed psychosocial measures at baseline. Objective height and weight were measured at baseline and follow-up (Visit 3). The overall model was significant (p = .02), explaining 12.76% of the variance in weight change over the first 2 months of treatment. As hypothesized, there was a significant moderating effect of family support on the association between WBV and weight change (p = .04), accounting 5.0% of the variance in weight change. Increased support from the family buffered the negative impact of WBV on early treatment outcomes for adolescents in a weight management program. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Katherine E. Darling
- Weight Control and Diabetes Research Center, The Miriam Hospital; Alpert Medical School of Brown University
| | - Caroline West
- Department of Psychological Sciences, Kent State University
| | - Elissa Jelalian
- Weight Control and Diabetes Research Center, The Miriam Hospital; Alpert Medical School of Brown University
| | | | - Amy F. Sato
- Department of Psychological Sciences, Kent State University
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11
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Pearlman AT, Murphy MA, Raiciulescu S, Gray JC, Klein DA, Schvey NA. The prospective relationship between weight-based discrimination and eating pathology among youth. Eat Behav 2023; 49:101746. [PMID: 37196505 DOI: 10.1016/j.eatbeh.2023.101746] [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: 12/01/2022] [Revised: 04/25/2023] [Accepted: 05/05/2023] [Indexed: 05/19/2023]
Abstract
Among adults and adolescents, weight-based discrimination is associated with disordered eating. However, these relationships remain understudied in children. Given that weight-based discrimination is commonly reported among youth, and that childhood is a crucial developmental period for the onset of disordered eating, the current study assessed prospective associations between weight-based discrimination and eating pathology among participants in the Adolescent Brain Cognitive Development Study. At the one-year visit, children indicated whether they had experienced discrimination due to their weight within the past year. Parents completed a computerized clinical interview to determine the presence of sub-or-full threshold eating disorders (AN, BN, and BED) among their children. At the two-year visit, children completed the same assessment. Height and fasting weight were obtained. Logistic regressions, adjusting for age, sex, race/ethnicity, family income, BMI%ile, and parent-reported presence of the respective eating disorder at one-year, were conducted to assess the associations between weight-based discrimination and eating pathology. Participants were 10,299 children who completed measures at both the one- and two-year visits (Mage at one-year: 10.92 ± 0.64, 47.6 % female, 45.9 % racial/ethnic minority). The presence of weight-based discrimination, reported by 5.6 % (n = 574) of children, was significantly associated with a greater likelihood of reporting AN, BN, and BED one-year later (ORs: 1.94-4.91). Findings suggest that weight-based discrimination may confer additional risk for the onset of disordered eating, above and beyond the contribution of body weight. Intersectional research is needed to examine the role of multiple forms of discrimination in relation to the development of eating pathology.
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Affiliation(s)
- Arielle T Pearlman
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD, United States of America.
| | - Mikela A Murphy
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD, United States of America; The Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF), Bethesda, MD, United States of America
| | - Sorana Raiciulescu
- Department of Preventive Medicine and Biostatistics, USU, Bethesda, MD, United States of America
| | - Joshua C Gray
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD, United States of America
| | - David A Klein
- Department of Pediatrics, USU, Bethesda, MD, United States of America; Department of Family Medicine, USU, Bethesda, MD, United States of America
| | - Natasha A Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD, United States of America
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12
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Cullin JM. Biological normalcy and body fat: Obesity prevalence, fat stigma, and allostatic load among late adolescents and young adults. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2023. [PMID: 37096804 DOI: 10.1002/ajpa.24752] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 03/17/2023] [Accepted: 04/16/2023] [Indexed: 04/26/2023]
Abstract
OBJECTIVES Biological normalcy provides a framework to assess tensions between clinical definitions of "normal," statistical norms, and normative beliefs. A prevailing cultural belief is obesity directly causes poor health, but research has demonstrated consequences of fat stigma. Previous research linked fat stigma and allostatic load (AL) in adults, but this has not been demonstrated in youth, and the role of obesity prevalence is unknown. This study assesses the relationship between fat stigma and AL among youth from counties varying by obesity prevalence. MATERIALS AND METHODS Undergraduates from 38 counties across the US state of Indiana (n = 175) were recruited. Fat stigma was measured using the brief stigmatizing situations inventory (SSI). AL was calculated using eight biomarkers representing cardiovascular, metabolic, and immune function. Poisson regression assessed relationships of interest and adjusted for potential confounding. An interaction term and stratified analyses were used to assess moderation. RESULTS SSI was not statistically associated with obesity prevalence (RR = 0.96, p = 0.173) but did statistically significantly predict AL (RR = 1.019, p = 0.045) when adjusting for confounders. Obesity prevalence moderated the relationship between SSI and AL (RR = 0.993, p = 0.001). DISCUSSION Results suggest that fat stigma, regardless of body fat percentage, is associated with physiologic wear and tear on the late adolescent body, and that exposure to obesity during earlier adolescence moderates this relationship. Those most at risk for high AL reported high fat stigma and lived in counties with relatively low obesity prevalence during earlier adolescence, suggesting vulnerability to fat stigma may be heightened where obesity is less common.
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Affiliation(s)
- Jennifer M Cullin
- Department of Anthropology, Indiana University, Bloomington, Indiana, USA
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13
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Roberts KJ, Chaves E. Beyond Binge Eating: The Impact of Implicit Biases in Healthcare on Youth with Disordered Eating and Obesity. Nutrients 2023; 15:nu15081861. [PMID: 37111080 PMCID: PMC10146797 DOI: 10.3390/nu15081861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 03/30/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
(1) Background: Obesity and eating disorders (ED) can coexist resulting in worse health outcomes. Youth with ED are more likely to have obesity relative to peers with a healthy weight. Pediatric providers deliver first-line care to children and youth of all sizes and body shapes from infancy to adolescents. As healthcare providers (HCPs), we bring biases into our practice. Learning to recognize and address these biases is needed to provide the best care for youth with obesity. (2) Purpose: This paper aims to summarize the literature regarding the prevalence of ED beyond binge eating in youth with obesity and discuss how the intersection of weight, gender, and racial biases impact the assessment, diagnosis, and treatment of ED. We provide recommendations for practice and considerations for research and policy. (3) Conclusions: The assessment and treatment of ED and disordered eating behaviors (DEBs) in youth with obesity is complex and requires a holistic approach. This approach begins with identifying and understanding how one's implicit biases impact care. Providing care from a patient-centers lens, which considers how the intersection of multiple stigmatized identities increases the risk for DEBs in youth with obesity may improve long-term health outcomes.
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Affiliation(s)
- Karyn J Roberts
- College of Nursing, University of Wisconsin-Milwaukee, 1921 E Hartford Avenue, Milwaukee, WI 53211, USA
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Eileen Chaves
- Nationwide Children's Hospital, The Ohio State University, 700 Children's Drive, Jwest 3rd Floor Columbus, Columbus, OH 43205, USA
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14
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Cardiovascular endurance and psychosocial health predict short- and long-term BMI-SDS reduction: results from the CHILT III program. Eur J Pediatr 2023; 182:2225-2234. [PMID: 36867234 PMCID: PMC9982786 DOI: 10.1007/s00431-023-04876-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 02/09/2023] [Accepted: 02/11/2023] [Indexed: 03/04/2023]
Abstract
This longitudinal study analyzes data from the Children's Health Interventional Trial (CHILT) III, an 11-month juvenile multicomponent weight management program. The objective is to identify predictors of changes in body mass index standard deviation scores (BMI-SDS), so as to further enable the advancement of existing interventions with sustained impact. This study's sample consists of 237 children and adolescents with obesity (8-17 years, 54% girls) participating in the CHILT III program between 2003 and 2021. Anthropometrics, demographics, relative cardiovascular endurance (W/kg), and psychosocial health (i.e., physical self-concept and self-worth) were assessed at program entry ([Formula: see text]), end ([Formula: see text]), and one-year follow-up ([Formula: see text]; n = 83). From [Formula: see text] to [Formula: see text], the mean BMI-SDS was reduced by -0.16 ± 0.26 units (p < 0.001). Media use and cardiovascular endurance at baseline and improvements in endurance and self-worth over the course of the program predicted changes in BMI-SDS (adj. R2 = 0.22, p < 0.001). From [Formula: see text] to [Formula: see text], mean BMI-SDS increased ([Formula: see text], p = 0.005). Changes in BMI-SDS from [Formula: see text] to [Formula: see text] were associated with parental education, improvements in cardiovascular endurance and physical self-concept, and BMI-SDS, media use, physical self-concept, and endurance level at program end (adj. R2 = 0.39, p < 0.001). Conclusions: This study highlights the need for comprehensive, sustainable weight management approaches, in order to sustain the initial treatment benefits. In this context, improvements in cardiovascular endurance and psychosocial health could be essential strategies to pursue in practice, as they significantly predicted reductions in BMI-SDS - both pre- to post-intervention and at follow-up. TRIAL REGISTRATION DRKS00026785; date of registration: 13.10.202, retrospectively registered. WHAT IS KNOWN • Childhood obesity is associated with the onset of noncommunicable diseases, many of which are likely to carry into adulthood. Thus, effective weight management strategies for affected children and their families are vital. However, achieving lasting positive health outcomes with multidisciplinary weight management programs remains challenging. WHAT IS NEW • According to this study, short- and longer-term BMI-SDS reductions are associated to cardiovascular endurance and psychosocial health. These factors should therefore be given even greater consideration in weight management strategies, as they may be important not only in themselves but also for long-term weight loss (maintenance).
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15
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Styk W, Wojtowicz E, Zmorzynski S. Reliable Knowledge about Obesity Risk, Rather Than Personality, Is Associated with Positive Beliefs towards Obese People: Investigating Attitudes and Beliefs about Obesity, and Validating the Polish Versions of ATOP, BAOP and ORK-10 Scales. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14977. [PMID: 36429694 PMCID: PMC9690218 DOI: 10.3390/ijerph192214977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 11/06/2022] [Accepted: 11/10/2022] [Indexed: 06/16/2023]
Abstract
UNLABELLED Obesity has reached epidemic proportions. With the increase in the number of obese people, we have also witnessed a rise in the stigmatisation of this population. The aim of our study was to: (I) validate Polish versions of the attitude toward obese people (ATOP) scale, the beliefs about obese persons (BAOP) scale, and translate the obesity risk knowledge scale (ORK-10); (II) analyse the relationship between personality and the knowledge about obesity, as well as attitudes and beliefs towards obese people. METHODS The translation procedure was based on the principles of intercultural validation scales. The study was conducted on a group of 306 individuals, including 189 females and 117 males. RESULTS The original three-factor structure of the ATOP scale was confirmed in the Polish version. Factor analysis confirmed the one-factor structure of the BAOP scale in the Polish version. A very strong correlation was found between ATOP/BAOP and ORK-10. The correlation of personality with ATOP/BAOP scales was at a low level. Regression analysis indicated that knowledge of obesity risk predicted ATOP and BAOP by more than 58% and 50%, in turn, personality only 20% and 3.7%, respectively. CONCLUSION The polish versions of ATOP, BAOP and ORK-10 scales are fully useful measurement tools. The knowledge about obesity risk is associated with beliefs and attitudes about obese people.
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Affiliation(s)
- Wojciech Styk
- Department of Psychology, Medical University of Lublin, 20-059 Lublin, Poland
| | - Ewa Wojtowicz
- Department of Psychology, Institute of Pedagogy and Psychology, Warsaw Management University, 03-772 Warszawa, Poland
| | - Szymon Zmorzynski
- Department of Cancer Genetics with Cytogenetic Laboratory, Medical University of Lublin, 20-059 Lublin, Poland
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16
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Hahn SL, Hazzard VM, Larson N, Klein L, Loth KA, Neumark-Sztainer D. Correlates of weight-related self-monitoring application use during emerging adulthood in a population-based sample. Eat Weight Disord 2022; 27:2107-2119. [PMID: 35040079 PMCID: PMC9288498 DOI: 10.1007/s40519-021-01349-4] [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: 08/09/2021] [Accepted: 12/17/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study was designed to examine (1) the types of technologies or other applications (apps) emerging adults use to track their eating, physical activity, or weight; (2) who uses these apps and (3) whether eating and weight-related concerns during adolescence predict app use in emerging adulthood. METHODS Longitudinal survey data were obtained from EAT 2010-2018 (Eating and Activity over Time study, N = 1428), a population-based sample of ethnically/racially and socioeconomically diverse adolescents (mean age: 14.5 ± 2.0 years), who were followed into emerging adulthood (mean age: 22.0 ± 2.0 years). Data were used to examine sociodemographic correlates of physical activity- and dietary-focused app use. Adjusted, gender-stratified logistic regressions were used to investigate longitudinal relationships between eating and weight-related concerns in adolescence and app use in emerging adulthood. RESULTS Compared to men, women were more likely to use physical activity- (23.2 versus 12.5%, p < 0.001) and dietary-focused apps (16.1 versus 5.5%, p < 0.001). Among women, eating and weight-related concerns in adolescence, particularly unhealthy muscle-building behaviors (OR = 1.73, 95% CI 1.03-2.92), were associated with later dietary-focused app use. Among men, use of other muscle-building behaviors and body dissatisfaction in adolescence predicted use of physical activity- (ORother muscle-building = 1.60, 95% CI 1.03-2.49 and ORbody dissatisfaction = 1.67, 95% CI 1.06-2.65) and dietary-focused (ORother muscle-building = 2.18, 95% CI 1.07-4.47 and ORbody dissatisfaction = 2.35, 95% CI 1.12-4.92) apps 8 years later. CONCLUSIONS Eating and weight-related concerns may predict later use of physical activity- and dietary-focused apps; future research is needed to understand whether use of such apps further increases eating and weight-related concerns. LEVEL OF EVIDENCE III, well-designed longitudinal cohort study.
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Affiliation(s)
- Samantha L Hahn
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 S 2nd St, 300 Block West Bank Office Building, Minneapolis, MN, 55454, USA. .,Department of Psychiatry and Behavioral Health, University of Minnesota Medical School, 2450 Riverside Ave, Minneapolis, MN, 55454, USA.
| | - Vivienne M Hazzard
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 S 2nd St, 300 Block West Bank Office Building, Minneapolis, MN, 55454, USA.,Department of Psychiatry and Behavioral Health, University of Minnesota Medical School, 2450 Riverside Ave, Minneapolis, MN, 55454, USA.,Sanford Center for Biobehavioral Research, 120 Eighth St S, Fargo, ND, 58103, USA
| | - Nicole Larson
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 S 2nd St, 300 Block West Bank Office Building, Minneapolis, MN, 55454, USA
| | - Laura Klein
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 S 2nd St, 300 Block West Bank Office Building, Minneapolis, MN, 55454, USA
| | - Katie A Loth
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware St SE, Minneapolis, MN, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 S 2nd St, 300 Block West Bank Office Building, Minneapolis, MN, 55454, USA
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17
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Higgins Neyland MK, Shank LM, Lavender JM, Burke NL, Rice A, Gallagher-Teske J, Markos B, Faulkner LM, Djan KG, Kwarteng EA, LeMay-Russell S, Parker MN, Schvey NA, Sbrocco T, Wilfley DE, Ford B, Ford C, Haigney M, Klein DA, Olsen CH, Quinlan J, Jorgensen S, Brady S, Shomaker LB, Yanovski JA, Tanofsky-Kraff M. Examination of the Interaction between Parental Military-Status and Race among Non-Hispanic Black and Non-Hispanic White Adolescents with Overweight/Obesity. J Pediatr Psychol 2022; 47:743-753. [PMID: 35238941 PMCID: PMC9297095 DOI: 10.1093/jpepsy/jsac008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 01/27/2022] [Accepted: 01/31/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Adolescent military-dependents experience distinct risk and protective factors, which may necessitate additional clinical considerations. In civilian youth, overweight/obesity is associated with eating, internalizing, and externalizing difficulties, with some studies reporting more difficulties among non-Hispanic White (vs. non-Hispanic Black) youth. It is unknown if these disparities exist among adolescent military-dependents, or between civilian and military-dependent youth. METHODS Non-Hispanic Black (187 civilian, 38 military-dependent) and non-Hispanic White (205 civilian, 84 military-dependent) adolescents with overweight/obesity (14.7 ± 1.6 years; 73.9% girls; body mass index adjusted for age and sex 1.9 ± 0.5) completed a disordered-eating interview; parents completed a measure assessing their child's internalizing and externalizing difficulties. Multiple linear regressions examined parental military-status as a moderator of the relationship of participant race with eating, internalizing, and externalizing difficulties. RESULTS White civilian youth with overweight/obesity reported significantly greater disordered-eating than their Black peers (p < .001); there were no other significant racial differences. In all regressions, parental military-status significantly moderated the association between race and each dependent variable (ps < .047). Black military-dependents (vs. civilians) reported more disordered-eating and internalizing difficulties (ps = .01). White military-dependents (vs. civilians) reported fewer externalizing difficulties (p = .01). CONCLUSIONS Black adolescent military-dependents with overweight/obesity may experience more eating and internalizing difficulties (vs. civilians), a pattern not observed among White participants. Future work should examine if being a military-dependent and a historically marginalized racial group member accounts for these findings. Such data may inform providers of youth with intersecting minority identities.
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Affiliation(s)
- M K Higgins Neyland
- Military Cardiovascular Outcomes Research (MiCOR), Department of Medicine, Uniformed Services University of the Health Sciences (USU), USA
| | - Lisa M Shank
- Military Cardiovascular Outcomes Research (MiCOR), Department of Medicine, Uniformed Services University of the Health Sciences (USU), USA
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), USA
| | - Jason M Lavender
- Military Cardiovascular Outcomes Research (MiCOR), Department of Medicine, Uniformed Services University of the Health Sciences (USU), USA
| | | | - Alexander Rice
- Military Cardiovascular Outcomes Research (MiCOR), Department of Medicine, Uniformed Services University of the Health Sciences (USU), USA
| | - Julia Gallagher-Teske
- Military Cardiovascular Outcomes Research (MiCOR), Department of Medicine, Uniformed Services University of the Health Sciences (USU), USA
| | - Bethelhem Markos
- Military Cardiovascular Outcomes Research (MiCOR), Department of Medicine, Uniformed Services University of the Health Sciences (USU), USA
| | - Loie M Faulkner
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), USA
| | - Kweku G Djan
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), USA
| | - Esther A Kwarteng
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), USA
| | - Sarah LeMay-Russell
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), USA
- Department of Medical and Clinical Psychology, USU, USA
| | - Megan N Parker
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), USA
- Department of Medical and Clinical Psychology, USU, USA
| | - Natasha A Schvey
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), USA
- Department of Medical and Clinical Psychology, USU, USA
| | - Tracy Sbrocco
- Department of Medical and Clinical Psychology, USU, USA
| | | | | | - Caitlin Ford
- Department of Family Medicine, Fort Belvoir Community Hospital, USA
| | - Mark Haigney
- Military Cardiovascular Outcomes Research (MiCOR), Department of Medicine, Uniformed Services University of the Health Sciences (USU), USA
| | - David A Klein
- Department of Family Medicine, USU, USA
- Department of Pediatrics, USU, USA
| | - Cara H Olsen
- Preventative Medicine and Biometrics Department, USU, USA
| | - Jeffrey Quinlan
- Department of Family Medicine, University of Iowa Hospitals & Clinics, USA
| | - Sarah Jorgensen
- Department of Family Medicine, University of Iowa Hospitals & Clinics, USA
| | - Sheila Brady
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), USA
| | - Lauren B Shomaker
- Department of Human Development and Family Studies, Colorado State University, 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 (NICHD), National Institutes of Health (NIH), USA
| | - Marian Tanofsky-Kraff
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), USA
- Department of Medical and Clinical Psychology, USU, USA
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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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19
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Hooper L, Puhl R, Eisenberg ME, Reicks M, Neumark-Sztainer D. How is weight teasing cross-sectionally and longitudinally associated with health behaviors and weight status among ethnically/racially and socioeconomically diverse young people? Int J Behav Nutr Phys Act 2022; 19:71. [PMID: 35739552 PMCID: PMC9219184 DOI: 10.1186/s12966-022-01307-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 05/31/2022] [Indexed: 11/24/2022] Open
Abstract
Background Weight stigma is prevalent among young people and harmful to health. The current study used a health equity lens to examine cross-sectional and longitudinal associations between experiencing weight teasing (a form of weight stigma) with a range of weight-related health behaviors and weight status in an ethnically/racially and socioeconomically diverse sample of young people. We also assessed whether ethnicity/race and adolescent socioeconomic status (SES) operated as effect modifiers in these relationships. Methods Adolescents (n = 1568) were enrolled in EAT 2010–2018 (Eating and Activity over Time) and followed into young adulthood. Weight teasing; screen time; moderate-to-vigorous physical activity (MVPA); sleep duration; breakfast frequency; fruit, vegetable, sugar-sweetened beverage (SSB), and fast-food intake; and body mass index (BMI) were assessed at baseline (mean age = 14.4 years) and eight-year follow-up (mean age = 22.2 years). Multivariate linear regression estimated marginal means and 95% confidence intervals. All analyses adjusted for BMI and sociodemographic characteristics. Results Weight teasing was cross-sectionally associated with longer screen time, shorter sleep duration, and higher BMI during adolescence; and cross-sectionally associated with shorter sleep duration, lower breakfast frequency, higher fast-food intake, higher SSB intake, and higher BMI during young adulthood. In the longitudinal analyses, weight teasing was not associated with health behaviors but did predict higher BMI (teased: 28.2 kg/m2, not teased: 26.4 kg/m2, p < 0.001). White and higher adolescent SES subgroups had higher MVPA, more frequent breakfast intake, lower fast-food intake, and lower BMI than their respective counterparts. The relationships between weight teasing and health behaviors and weight status were largely consistent across ethnic/racial and adolescent SES subgroups. Conclusions Findings add to growing evidence that weight-based mistreatment poses a threat to weight-related health and that young people across ethnic/racial and SES subgroups are vulnerable to the negative effects of weight teasing. Limitations include attrition at follow-up and the self-reported nature of many measures. Results suggest a need for increased attention to existing recommendations to reduce weight stigma in young people from diverse ethnic/racial and socioeconomic backgrounds including training for healthcare providers to better equip them to address the harms of weight teasing and foster more compassionate care to promote health-supporting behaviors in young people. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01307-y.
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Affiliation(s)
- Laura Hooper
- Division of Epidemiology and Community Health, University of Minnesota, Suite 300, 1300 S, 2nd St., Minneapolis, MN, 55454-1015, USA. .,Department of Food Science and Nutrition, University of Minnesota, 225 Food Science and Nutrition, 1334 Eckles Ave, St. Paul, MN, 55108, USA.
| | - Rebecca Puhl
- Department of Human Development & Family Sciences, College of Liberal Arts and Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT, 06269-1058, USA
| | - Marla E Eisenberg
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, 717 Delaware Street SE, 3rd Floor, Minneapolis, MN, 55414, USA
| | - Marla Reicks
- Department of Food Science and Nutrition, University of Minnesota, 225 Food Science and Nutrition, 1334 Eckles Ave, St. Paul, MN, 55108, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, University of Minnesota, Suite 300, 1300 S, 2nd St., Minneapolis, MN, 55454-1015, USA
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Marshall TA, Curtis AM, Cavanaugh JE, Warren JJ, Levy SM. Associations between body mass index and body composition measures in a birth cohort. Pediatr Res 2022; 91:1606-1615. [PMID: 33972687 PMCID: PMC8578575 DOI: 10.1038/s41390-021-01562-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 04/15/2021] [Accepted: 04/20/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Associations among body composition measures have been limited to cross-sectional analyses of different subjects. We identified cross-sectional relationships between body mass index (BMI) and other body composition measures and predicted body composition measures from BMI throughout childhood and adolescence. METHODS BMI was calculated and % body fat (%BF), fat mass index (FMI), and fat-free mass index (FFMI) were measured using dual-energy x-ray absorptiometry at ages 5, 9, 11, 13, 15, and 17 years in a birth cohort (n = 629). Sex-specific body composition measures were calculated for BMI-for-age percentiles; associations between BMI and body composition measures were characterized; and body composition measures were predicted from BMI. RESULTS %BF, FMI, and FFMI generally increased with BMI-for-age percentiles at each age. Correlations between BMI and %BF or FMI were generally higher at BMI-for-age percentiles ≥95% than for lower BMI-for-age percentiles. Correlations between BMI and FFMI were generally higher for participants at very low and very high BMI-for-age percentiles than at moderate BMI-for-age percentiles. Age- and sex-specific predictions from BMI are provided for %BF, FM, and FFMI. CONCLUSIONS Sex-specific body composition measures throughout childhood and adolescence are presented. BMI is a better indicator of adiposity at higher than at lower BMI values. IMPACT Sex-specific body composition measures throughout childhood and adolescence are described. % BF, FMI, and FFMI generally increased with BMI-for-age percentiles for both sexes throughout childhood and adolescence. BMI is a better indicator of adiposity at higher BMI levels than at lower BMI values throughout childhood and adolescence.
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21
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Yourell JL, Doty JL. Associations Between Weight-Based Bullying, Developmental Internal Assets, and Perceived Social Support Among Youth. THE JOURNAL OF SCHOOL HEALTH 2022; 92:42-51. [PMID: 34786727 DOI: 10.1111/josh.13101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 03/19/2021] [Accepted: 03/22/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Youth with obesity are likely to experience weight-based bullying victimization, and adolescents have the highest obesity rates among children. Factors that protect youth from traditional bullying victimization may protect youth from weight-based bullying victimization: internal assets such as positive identity and social competence, and external assets such as perceived support from parents and friends. METHODS To examine this proposition, data from 8th, 9th, and 11th graders were obtained from the 2016 Minnesota Student Survey (N = 126,495). Logistic regressions were conducted to identify the relationship between assets and weight-based bullying and to determine possible moderation by weight status. RESULTS Results demonstrate that positive identity, parent support, and friend support were associated with lower odds of experiencing weight-based bullying victimization. Moderation analyses revealed that perceived parent support was most protective against experiencing weight-based bullying victimization among youth with obesity compared to youth with overweight, normal weight, or underweight. CONCLUSION School administrators, counselors, and teachers should be aware of the increased risk of weight-based bullying for youth with obesity and underweight. Results underscore the need to foster youth's internal assets like positive identity to promote a strength-based approach for prevention. Parent involvement is warranted in weight-based bullying prevention efforts.
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Affiliation(s)
- Jacqlyn L Yourell
- Department of Family, Youth and Community Sciences, University of Florida, 3001 McCarty Hall D, P.O. Box 110310, Gainesville, FL, 32611-0310, USA
| | - Jennifer L Doty
- Department of Family, Youth and Community Sciences, University of Florida, 3001 McCarty Hall D, P.O. Box 110310, Gainesville, FL, 32611-0310, USA
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22
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Interrelation between weight and weight stigma in youth: is there evidence for an obesogenic vicious cycle? Eur Child Adolesc Psychiatry 2021; 32:697-704. [PMID: 34853910 PMCID: PMC10115675 DOI: 10.1007/s00787-021-01922-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 11/21/2021] [Indexed: 10/19/2022]
Abstract
Many children and adolescents are confronted with weight stigma, which can cause psychological and physical burden. While theoretical frameworks postulate a vicious cycle linking stigma and weight status, there is a lack of empirical evidence. The aim was to analyze the longitudinal bidirectional relationship between body weight and weight stigma among children and adolescents. The sample consisted of 1381 children and adolescents, aged 9-19 years at baseline (49.2% female; 78% normal weight), from a prospective study encompassing three measurement points over 6 years. Participants provided self-reported data on experienced weight-related teasing and weight/height (as indicators for weight status). Latent structural equation modelling was used to examine the relationship between weight-related teasing experiences and weight. Additionally, gender-related differences were analyzed. Between the first two waves, there was evidence for a bidirectional relationship between weight and weight-related teasing. Between the last two waves, teasing predicted weight, but there was no reverse association. No gender-related differences were found. The data indicate a reciprocal association between weight stigma and body weight across weight groups and independent of gender. To prevent vicious cycles, approaches that simultaneously promote healthy weight and reduce weight stigma are required.
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23
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Randhawa S, Randhawa N, Hassanin E, Yi‐Frazier JP, Briggs Early K. Pilot evaluation of obesity-specific health-related quality of life following a 12-week non-randomized lifestyle intervention in youth. Obes Sci Pract 2021; 7:803-807. [PMID: 34877016 PMCID: PMC8633934 DOI: 10.1002/osp4.535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 05/06/2021] [Accepted: 05/16/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Health-related quality of life (HRQOL), a multifaceted construct for understanding health and healthcare outcomes, is comprised of eight domains of well-being and functioning over time and has become an essential factor in assessing outcomes for youth with obesity. AIMS To evaluate the effect of a community based, lifestyle intervention, on obesity-specific HRQOL using the Sizing Me Up (SMU) in this group of Latino and White youth. MATERIALS AND METHODS For this 12-week family and community-based intervention (ACT; Actively Changing Together), HRQOL was measured before and after the intervention concluded using the obesity-specific HRQOL tool, SMU. This study enrolled 68 youth (10.9 ± 2 years; 54% male; 50% non-Hispanic white). Paired t-tests were used to examine the Sizing Me Up sub-scales: Emotion, Physical, Social Avoidance, Positive Attributes, Teasing, and the total score. A greater change score indicated a larger increase in quality of life sub-scale. RESULTS Significant improvements from baseline to follow-up were found in the total SMU (mean change = 5.27, SD 10.76, p = 0.00) and for the sub-scores of: emotion (mean change = 8.06, SD 16.85, p ≤ 0.00), teasing (mean change = 5.65, SD 16.79, p = 0.01), and social avoidance (mean change = 3.92, SD 11.21, p = 0.01). CONCLUSIONS Sizing Me Up provided a clinically meaningful tool for this research study to evaluate obesity-specific HRQOL among Hispanic and non-Hispanic White youth with obesity.
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Affiliation(s)
| | - Navkiran Randhawa
- Franciscan Health Internal Medicine Residency Olympia FieldsOlympia FieldsIllinoisUSA
| | - Es‐Haq Hassanin
- Department of Internal MedicineThe University of Texas Health Science Center at TylerTylerTexasUSA
| | - Joyce P. Yi‐Frazier
- Center for Clinical and Translational ResearchSeattle Children's Research Institute SeattleSeattleWashingtonUSA
| | - Kathaleen Briggs Early
- Department of Biomedical SciencesCollege of Osteopathic MedicinePacific Northwest UniversityYakimaWashingtonUSA
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24
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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: 25] [Impact Index Per Article: 8.3] [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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25
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Valero-García AV, Olmos-Soria M, Madrid-Garrido J, Martínez-Hernández I, Haycraft E. The Role of Regulation and Emotional Eating Behaviour in the Early Development of Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211884. [PMID: 34831637 PMCID: PMC8622852 DOI: 10.3390/ijerph182211884] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/02/2021] [Accepted: 11/05/2021] [Indexed: 11/23/2022]
Abstract
The purpose of our research was to explore the role of both parents’ use of behavioural regulation with food and children’s emotional self-regulation in young children with and without overweight/obesity. For this purpose, 123 participants (n = 62 boys and n = 61 girls) were recruited and classified into two groups by their Body Mass Index (BMI, non-overweight vs. overweight/obese) and into two age groups (four years and seven years). The children’s parents/primary caregivers completed two scales of the Childhood Obesogenic Behaviours’ Questionnaire (COBQ). The participants were measured and weighed to calculate their BMI to identify overweight, obesity, and non-overweight. The results showed that the means for children who were obese/overweight were significantly higher than those of children who were non-overweight for both the parents’ behavioural regulation scale (non-overweight: M = 1.80, SD = 0.69; overweight/obesity: M = 2.94, SD = 0.85) and the child’s emotional overeating scale (non-overweight: M = 1.47, SD = 0.56; overweight/obesity: M = 2.65, SD = 0.87). No statistically significant differences were found related to age (4 and 7 years), indicating that the potential impact of obesogenic behaviours starts early in development. Similarly, no differences by gender were found. Due to the implications of obesity for physical and mental health, and the high probability of maintaining this overweight status in the long term, family-based interventions to prevent obesity are highly advisable from birth.
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Affiliation(s)
- Ana V. Valero-García
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Murcia, 30100 Murcia, Spain;
- Correspondence: ; Tel.: +34-868-884-069
| | - Marina Olmos-Soria
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Murcia, 30100 Murcia, Spain;
| | - Julia Madrid-Garrido
- Pre-anaesthesia Unit, General University Hospital Santa Lucía, 30202 Cartagena, Spain;
| | | | - Emma Haycraft
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK;
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26
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Roberts KJ, Polfuss ML, Marston EC, Davis RL. Experiences of weight stigma in adolescents with severe obesity and their families. J Adv Nurs 2021; 77:4184-4194. [PMID: 34435701 DOI: 10.1111/jan.15012] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/05/2021] [Accepted: 07/29/2021] [Indexed: 01/25/2023]
Abstract
AIM To describe the experiences of weight stigma in adolescents with severe obesity and their parents. DESIGN Qualitative descriptive secondary analysis. METHODS A secondary analysis on 31 transcripts from a larger study of 46 transcripts conducted between February 2019 and June 2020. Semi-structured interviews were conducted with 19 parents (n = 17 mothers, n = 2 fathers) and 12 adolescents (n = 7 male, n = 5 female). Interviews were digitally audio recorded, transcribed and analysed using conventional content analysis. RESULTS Four common themes were identified reflecting experiences of weight stigma: weight-based teasing and bullying, interactions with healthcare providers (HCPs), family interactions and blame. Subthemes were fairness and impact on mental health. CONCLUSION This secondary analysis adds to the sparse literature documenting the experiences of weight stigma from adolescents with severe obesity and their families. It is important to understand the experiences of weight stigma from the adolescent and parent perspective as it can inform healthcare, education and policies across communities and facilitate holistic health for this vulnerable population. IMPACT The need for research to better understand how experiences of weight stigma correlate with physiological and psychological outcomes and inform innovative interventions are critical to improve treatment of severe obesity. Healthcare providers across disciplines are in a strategic position to change the paradigm through which we provide care to youth with severe obesity and guide families in supporting their children's weight management efforts without contributing to weight stigma.
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Affiliation(s)
- Karyn J Roberts
- University of Wisconsin-Milwaukee College of Nursing, Milwaukee, Wisconsin, USA
| | - Michele L Polfuss
- University of Wisconsin-Milwaukee College of Nursing, Milwaukee, Wisconsin, USA
| | - Emma C Marston
- University of Wisconsin-Milwaukee College of Nursing, Milwaukee, Wisconsin, USA
| | - Renée L Davis
- Saint Louis University Trudy Busch Valentine School of Nursing, Saint Louis, Missouri, USA
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27
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Bullying experiences, body esteem, body dissatisfaction, and the moderating role of weight status among adolescents. J Adolesc 2021; 91:59-70. [PMID: 34333320 DOI: 10.1016/j.adolescence.2021.07.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 07/16/2021] [Accepted: 07/19/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The present study examined the relationships between bullying victimization experiences, body esteem (BE), and body dissatisfaction (BD) by obesity status. METHODS Using a cross-sectional design, adolescents (10-16y) from the U.S. completed surveys. Weight and height were objectively assessed. Bullying was assessed using the Personal Experiences Checklist, with a total score that included three subscales (cyber, verbal-relational, and physical). BE was assessed using total score on the BE Scale, and BD was assessed using the Body Image Assessment for Pre-Adolescents, operationalized as the discrepancy between current and ideal body figure. Linear regression models, controlling for sociodemographics, were used to examine obesity status (with vs. without obesity) and sex as moderators of the relationships between bullying, BE, and BD. RESULTS On average, adolescents (n = 328) were 12.6 ± 1.9 y, 45.4% male, 58.2% White, 35.7% Black, and 36.0% had obesity. Obesity status moderated the relationship between bullying experiences and BE, such that these relationships were only significant (B = -0.38, p<.05) among adolescents with obesity compared to adolescents without obesity. In both groups, greater verbal-relational bullying experiences were associated with lower BE, while greater physical bullying experiences were related to higher BE only among adolescents with obesity. In adolescent girls without obesity, greater cyberbullying experiences were associated with lower BD. CONCLUSIONS The findings suggest different associations between sub-types of bullying victimization experiences and BE and BD, highlighting the importance of examining these associations separately by obesity status.
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28
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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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29
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Abstract
Weight stigma is rooted in a fundamental misunderstanding of the origins of obesity, wherein the interplay of behavioral, environmental, genetic, and metabolic factors is deemphasized. Instead, the widespread societal and cultural presence of weight stigma fosters misconceptions of obesity being solely a result of unhealthy personal choices. Weight stigma is pervasive in childhood and adolescence and can affect individuals throughout their life. Although the prevalence of pediatric obesity remains high throughout the world, it becomes increasingly important to understand how weight stigma affects weight and health outcomes in children and adolescents with overweight or obesity, including in those with rare genetic diseases of obesity. We identified and reviewed recent literature (primarily published since 2000) on weight stigma in the pediatric setting. Articles were identified with search terms including pediatric obesity, weight bias, weight stigma, weight-based teasing and bullying, and weight bias in health care. In this narrative review, we discuss the stigma of pediatric obesity as it relates to the complex etiology of obesity as well as describe best practices for avoiding bias and perpetuating stigma in the health care setting.
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Affiliation(s)
- Andrea M. Haqq
- Department of Pediatrics, Division of Pediatric Endocrinology, University of Alberta, Edmonton, Alberta, Canada.,Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada.,Address correspondence to: Andrea M. Haqq, MD, MHS, FRCP(C), FAAP, Department of Pediatrics, Division of Pediatric Endocrinology, University of Alberta, 1C4 Walter C. Mackenzie Health Sciences Center, 8440 112 Street NW, Edmonton, Alberta T6G 2B7, Canada
| | - Maryam Kebbe
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Qiming Tan
- Department of Pediatrics, Division of Pediatric Endocrinology, University of Alberta, Edmonton, Alberta, Canada
| | - Melania Manco
- Unit for Multifactorial Diseases and Complex Phenotypes, Bambino Gesù Children's Hospital, Rome, Italy
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30
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Cullin JM. Implicit and explicit fat bias among adolescents from two US populations varying by obesity prevalence. Pediatr Obes 2021; 16:e12747. [PMID: 33191643 DOI: 10.1111/ijpo.12747] [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: 04/10/2020] [Revised: 10/12/2020] [Accepted: 10/14/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Research shows that explicit (reported) and implicit (unconscious) bias are distinct constructs varying by socioecological context. Implicit bias better predicts poor health outcomes related to chronic psychosocial stress. OBJECTIVES Variation in fat bias was identified in two populations of adolescents in Indiana counties with relatively high (Lawrence) and low (Monroe) obesity prevalence. METHODS Adolescents (n = 185) aged 14-18 years were recruited October 2017-2018. Explicit fat bias was measured using the Attitudes Towards Obese Persons (ATOP) scale. Implicit fat bias was measured using the obesity attitude implicit association test (IAT). RESULTS Both samples scored high on the ATOP, indicating more positive reported attitudes towards persons with obesity, and scores did not differ between counties (P > .05) after adjusting for age, sex, ethnicity, and BMI-for-age percentile. Both samples demonstrated unconscious anti-fat bias, with Monroe exhibiting significantly higher IAT scores (ie, greater anti-fat bias) than Lawrence after controlling for confounders (P = .039). CONCLUSION Differences between explicit and implicit fat-bias were observed. Both samples reported positive attitudes towards obesity but also demonstrated unconscious anti-fat bias. Unconscious anti-fat bias was significantly higher in the county with lower prevalence of obesity, suggesting epidemiological context may influence implicit fat bias. Higher obesity prevalence may reduce unconscious anti-fat bias in a population or, alternatively, lower obesity prevalence may increase such bias.
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Affiliation(s)
- Jennifer M Cullin
- Department of Anthropology, Indiana University, Bloomington, Indiana, USA
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31
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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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Schvey NA, Shank LM, Tanofsky-Kraff M, Ramirez S, Altman DR, Swanson T, Rubin AG, Kelly NR, LeMay-Russell S, Byrne ME, Parker MN, Broadney MM, Brady SM, Yanovski SZ, Yanovski JA. Weight-based teasing in youth: Associations with metabolic and inflammatory markers. Pediatr Obes 2021; 16:e12729. [PMID: 33059389 PMCID: PMC8209784 DOI: 10.1111/ijpo.12729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 08/04/2020] [Accepted: 08/24/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Research among adults suggests that weight stigma is associated with worsened cardiometabolic health. However, these relationships have not been examined among youth. OBJECTIVE Assess associations between weight-based teasing (WBT) and metabolic and inflammatory markers among two samples of youth: (1) a non-treatment-seeking sample and (2) a weight loss treatment-seeking sample with obesity. METHOD Weight, height, adiposity, waist circumference and blood pressure were measured. Fasting blood samples were collected for metabolic (triglycerides, glucose, high-density lipoprotein cholesterol) and inflammatory analytes (high-sensitivity C-reactive protein in Study 1 and erythrocyte sedimentation rate in both studies). Youths completed the Perception of Teasing Scale, a measure of WBT. Metabolic and inflammatory indices were compared between those with and without teasing, adjusting for demographics and body composition. RESULTS Study 1 enrolled 201 non-treatment-seeking youth (Mage = 13.1y; 54.2% female; 44.8% non-Hispanic White; 32.8% with overweight/obesity); 15.4% reported WBT. Study 2 enrolled 111 treatment-seeking adolescents with obesity (Mage = 14.0y; 66.7% female; 37.8% non-Hispanic White); 73.0% reported WBT. Adjusting for covariates, WBT was not associated with cardiometabolic risk factors in either study. CONCLUSIONS WBT was not associated with worsened cardiometabolic health. Longitudinal research is needed to elucidate associations between WBT and health in youth.
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Affiliation(s)
- Natasha A. Schvey
- Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Lisa M. Shank
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA,Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Metis Foundation, 300 Convent St #1330, San Antonio, TX, 78205, USA
| | - Marian Tanofsky-Kraff
- Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA,Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Sophie Ramirez
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Deborah R. Altman
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Taylor Swanson
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Alex G. Rubin
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Nichole R. Kelly
- Department of Counseling Psychology and Human Services, and Prevention Science, College of Education, 5207 University of Oregon, Eugene, OR 97403-5207, USA
| | - Sarah LeMay-Russell
- Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Meghan E. Byrne
- Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Megan N. Parker
- Medical and Clinical Psychology Department, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Miranda M. Broadney
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Sheila M. Brady
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Susan Z. Yanovski
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA,Office of Obesity Research, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), DHHS, Bethesda, MD, 20892, USA
| | - Jack A. Yanovski
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
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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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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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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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Browne NT, Snethen JA, Greenberg CS, Frenn M, Kilanowski JF, Gance-Cleveland B, Burke PJ, Lewandowski L. When Pandemics Collide: The Impact of COVID-19 on Childhood Obesity. J Pediatr Nurs 2021; 56:90-98. [PMID: 33293199 PMCID: PMC7657263 DOI: 10.1016/j.pedn.2020.11.004] [Citation(s) in RCA: 100] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/28/2020] [Accepted: 11/06/2020] [Indexed: 02/07/2023]
Affiliation(s)
| | - Julia A Snethen
- University of Wisconsin-Milwaukee, College of Nursing, WI 53211, USA..
| | | | - Marilyn Frenn
- Marquette University, College of Nursing, WI 53201, USA.
| | - Jill F Kilanowski
- Department of Food, Agricultural and Biological Engineering, The Ohio State University, OH 43210, USA.
| | - Bonnie Gance-Cleveland
- Loretta C. Ford Professor, University of Colorado Anschutz Medical Campus, CO 80045, United States of America.
| | - Pamela J Burke
- Boston Children's Hospital, Division of Adolescent and Young Adult Medicine, MA 02115, United States of America.
| | - Linda Lewandowski
- University of Toledo, College of Nursing, Collier Building, OH 43614-2598, United States of America.
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Puhl RM, Lessard LM. Weight Stigma in Youth: Prevalence, Consequences, and Considerations for Clinical Practice. Curr Obes Rep 2020; 9:402-411. [PMID: 33079337 DOI: 10.1007/s13679-020-00408-8] [Citation(s) in RCA: 120] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/05/2020] [Indexed: 12/27/2022]
Abstract
PURPOSE OF REVIEW This review summarizes recent evidence on weight stigma experienced by youth with overweight or obesity. We examine the prevalence and sources of weight-based victimization targeting youth, consequences of these stigmatizing experiences for their psychological and physical health, and considerations for addressing weight stigma in clinical practice and pediatric care. RECENT FINDINGS Weight stigma is highly prevalent among youth with high body weight, who are targets of weight-based victimization from peers, parents, and teachers. These experiences place youth at risk for psychological distress (primarily depressive symptoms, low self-esteem, and suicidal ideation), worse social and academic outcomes, and adverse physical health consequences including maladaptive eating behaviors, lower physical activity, substance use, and weight gain. Healthcare professionals and clinicians have important roles to play in efforts to help reduce weight stigma and support youth with obesity. Fundamental to these efforts is the use of supportive, compassionate, and non-stigmatizing communication with youth and their families.
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Affiliation(s)
- Rebecca M Puhl
- Department of Human Development & Family Sciences, University of Connecticut, Storrs, CT, USA.
- Rudd Center for Food Policy and Obesity, University of Connecticut, One Constitution Plaza, Suite 600, Hartford, CT, 0610, USA.
| | - Leah M Lessard
- Rudd Center for Food Policy and Obesity, University of Connecticut, One Constitution Plaza, Suite 600, Hartford, CT, 0610, USA
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Gallardo LO, Abarca-Sos A, Doña AM. Expectancy-Value Model Related to Physical Activity Behaviors in Chilean and Spanish Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8219. [PMID: 33172156 PMCID: PMC7664329 DOI: 10.3390/ijerph17218219] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/30/2020] [Accepted: 11/04/2020] [Indexed: 01/22/2023]
Abstract
The purpose of the study is to comparatively test the expectancy-value model in Chilean and Spanish samples. The model proposes: a social world (composed of social support, physical activity teasing, and weight teasing), expectancy (composed of perceived competence and appearance), task values (composed of enjoyment and stress) to predict physical activity and intention to be physically active. Participants were 497 (Chilean) and 1365 (Spanish) adolescents. Structural equation models and multi-group modelling were used. All the models presented adequate fit to the data. The results show that physical activity teasing is a contextual and essential variable; perceived competence and enjoyment influenced physical activity and intentions to be physically active; some differences appeared in the prediction of physical activity and intentions to be physically active when the multi-group model was run. Culturally tailored interventions are key to improving physical activity (PA) behaviors.
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Affiliation(s)
- Laura O. Gallardo
- Faculty of Social Sciences and Humanities, University of Zaragoza, 44003 Teruel, Spain;
| | - Alberto Abarca-Sos
- Faculty of Social Sciences and Humanities, University of Zaragoza, 44003 Teruel, Spain;
| | - Alberto Moreno Doña
- Faculty of Medicine, Universidad de Valparaíso, 2520000 Viña del Mar, Chile;
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Stefansdottir R, Gundersen H, Rognvaldsdottir V, Lundervold AS, Gestsdottir S, Gudmundsdottir SL, Chen KY, Brychta RJ, Johannsson E. Association between free-living sleep and memory and attention in healthy adolescents. Sci Rep 2020; 10:16877. [PMID: 33037281 PMCID: PMC7547704 DOI: 10.1038/s41598-020-73774-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/15/2020] [Indexed: 11/25/2022] Open
Abstract
In laboratory studies, imposed sleep restriction consistently reduces cognitive performance. However, the association between objectively measured, free-living sleep and cognitive function has not been studied in older adolescents. To address this gap, we measured one week of sleep with a wrist-worn GT3X+ actigraph in 160 adolescents (96 girls, 17.7 ± 0.3 years) followed by assessment of working memory with an n-back task and visual attention with a Posner cue-target task. Over the week, participants spent 7.1 ± 0.8 h/night in bed and slept 6.2 ± 0.8 h/night with 88.5 ± 4.8% efficiency and considerable intra-participant night-to-night variation, with a standard deviation in sleep duration of 1.2 ± 0.7 h. Sleep measures the night before cognitive testing were similar to weekly averages. Time in bed the night before cognitive testing was negatively associated with response times during the most challenging memory task (3-back; p = 0.005). However, sleep measures the night before did not correlate with performance on the attention task and weekly sleep parameters were not associated with either cognitive task. Our data suggests shorter acute free-living sleep may negatively impact difficult memory tasks, however the relationship between free-living sleep and cognitive task performance in healthy adolescents is less clear than that of laboratory findings, perhaps due to high night-to-night sleep variation.
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Affiliation(s)
- Runa Stefansdottir
- Centre for Sports and Health Sciences, University of Iceland, Stakkahlid, 105, Reykjavík, Iceland
| | - Hilde Gundersen
- Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Vaka Rognvaldsdottir
- Centre for Sports and Health Sciences, University of Iceland, Stakkahlid, 105, Reykjavík, Iceland
| | - Alexander S Lundervold
- Department of Computer Science, Electrical Engineering, and Mathematical Sciences, Western Norway University of Applied Sciences, Bergen, Norway.,Mohn Medical Imaging and Visualization Centre, Haukeland University Hospital, Bergen, Norway
| | - Sunna Gestsdottir
- Centre for Sports and Health Sciences, University of Iceland, Stakkahlid, 105, Reykjavík, Iceland
| | | | - Kong Y Chen
- Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Robert J Brychta
- Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Erlingur Johannsson
- Centre for Sports and Health Sciences, University of Iceland, Stakkahlid, 105, Reykjavík, Iceland. .,Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences, Bergen, Norway.
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Orsso CE, Colin-Ramirez E, Field CJ, Madsen KL, Prado CM, Haqq AM. Adipose Tissue Development and Expansion from the Womb to Adolescence: An Overview. Nutrients 2020; 12:E2735. [PMID: 32911676 PMCID: PMC7551046 DOI: 10.3390/nu12092735] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 08/29/2020] [Accepted: 09/02/2020] [Indexed: 02/07/2023] Open
Abstract
Prevalence rates of pediatric obesity continue to rise worldwide. Adipose tissue (AT) development and expansion initiate in the fetus and extend throughout the lifespan. This paper presents an overview of the AT developmental trajectories from the intrauterine period to adolescence; factors determining adiposity expansion are also discussed. The greatest fetal increases in AT were observed in the third pregnancy trimester, with growing evidence suggesting that maternal health and nutrition, toxin exposure, and genetic defects impact AT development. From birth up to six months, healthy term newborns experience steep increases in AT; but a subsequent reduction in AT is observed during infancy. Important determinants of AT in infancy identified in this review included feeding practices and factors shaping the gut microbiome. Low AT accrual rates are maintained up to puberty onset, at which time, the pattern of adiposity expansion becomes sex dependent. As girls experience rapid increases and boys experience decreases in AT, sexual dimorphism in hormone secretion can be considered the main contributor for changes. Eating patterns/behaviors and interactions between dietary components, gut microbiome, and immune cells also influence AT expansion. Despite the plasticity of this tissue, substantial evidence supports that adiposity at birth and infancy highly influences its levels across subsequent life stages. Thus, a unique window of opportunity for the prevention and/or slowing down of the predisposition toward obesity, exists from pregnancy through childhood.
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Affiliation(s)
- Camila E. Orsso
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB T6G 2E1, Canada; (C.E.O.); (C.J.F.); (C.M.P.)
| | | | - Catherine J. Field
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB T6G 2E1, Canada; (C.E.O.); (C.J.F.); (C.M.P.)
| | - Karen L. Madsen
- Department of Medicine, University of Alberta, Edmonton, AB T6G 2C2, Canada;
| | - Carla M. Prado
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB T6G 2E1, Canada; (C.E.O.); (C.J.F.); (C.M.P.)
| | - Andrea M. Haqq
- Department of Pediatrics and Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB T6G 2R7, Canada
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Brown CL, Howard JB, Perrin EM. A randomized controlled trial examining an exam room poster to prompt communication about weight. Pediatr Obes 2020; 15:e12625. [PMID: 32072772 PMCID: PMC8394047 DOI: 10.1111/ijpo.12625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 12/19/2019] [Accepted: 01/20/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Recognition of childhood weight status is important to the adoption of healthy lifestyle behaviours. OBJECTIVES We assessed whether an exam room educational poster addressing weight and healthy lifestyle behaviours was acceptable to parents, prompted parent-provider communication or improved parental weight perception accuracy. METHODS In this multi-site randomized controlled trial, exam rooms were randomized to display the posters (English and Spanish) or not. Children ages 3 to 8 years (N = 965) attending well visits were weighed and roomed per usual clinic protocol. After the visit, parents completed a questionnaire assessing demographics, child weight status perceptions and whether they discussed weight status with provider or were shown growth charts. We used separate logistic regression analyses to examine associations between intervention status and: asking provider about child weight, being shown growth charts, and accuracy of weight perception, adjusting for covariates and clustering by exam room. RESULTS Of the parents who saw the poster, 97% liked seeing it and reported greater understanding of weight status visualization (96%) and healthy lifestyle behaviours (94%). Parents who saw the poster were more likely to report being shown a growth chart (OR 1.87, 95% 1.06, 3.30) but were not more likely to ask about their child's weight status nor accurately report their child's weight status. CONCLUSIONS An educational exam room poster about healthy weight was well-received by parents and prompted providers to show the child's growth chart but did not prompt parent-initiated conversations about weight status nor improve parental weight perception accuracy.
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Affiliation(s)
- Callie L. Brown
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Janna B. Howard
- Department of Pediatrics, Duke University, Durham, North Carolina
- Duke Center for Childhood Obesity Research, Duke University, Durham, North Carolina
| | - Eliana M. Perrin
- Department of Pediatrics, Duke University, Durham, North Carolina
- Duke Center for Childhood Obesity Research, Duke University, Durham, North Carolina
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Sung PS, Cavataio M, Sauve J. Adaptive trunk sway velocities following repeated perturbations in subjects with and without low back pain. J Electromyogr Kinesiol 2020; 52:102423. [PMID: 32416446 DOI: 10.1016/j.jelekin.2020.102423] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 04/09/2020] [Accepted: 04/17/2020] [Indexed: 10/24/2022] Open
Abstract
Faster trunk motions could be a strategy to prevent loss of balance and fall injuries due to unexpected perturbations. However, it is unclear how trunk sway velocities can be compensated during stepping in subjects with low back pain (LBP). The purpose of this study was to investigate lower limb reaction, swing, and step times, as well as trunk sway velocities at heel strike and toe-off, following repeated step perturbations between subjects with and without LBP. There were 30 subjects with LBP and 42 control subjects who were exposed to treadmill-induced perturbations at a velocity of 0.12 m/sec for 0.62 m. The treadmill-induced steps caused subjects to walk forward for 4.90 sec after the perturbation. The groups demonstrated significant interactions on the lower limb reaction times and on the number of repeated perturbations (F = 4.83, p = 0.03) due to a decreased step time at the first perturbation (t = 2.52, p = 0.01) in the LBP group. For the trunk sway velocities, the repeated perturbations demonstrated a significant interaction between groups (F = 4.65, p = 0.03). This adaptive trunk strategy for gait stability increased step times with repeated perturbations in the LBP group. The group interactions on the trunk sway velocities also indicated a possible somatosensory integration for step time adjustments to avoid potential fall hazards. This adaptive response with repeated step perturbations could result in compensatory trunk sway for gait stability.
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Affiliation(s)
- Paul S Sung
- Department of Physical Therapy/Motion Analysis Center, Herbert H. and Grace A. Dow College of Health Professions, Central Michigan University, Health Professions Building, 1220 Mt. Pleasant, MI 48859, United States.
| | - Michael Cavataio
- Department of Physical Therapy/Motion Analysis Center, Herbert H. and Grace A. Dow College of Health Professions, Central Michigan University, Health Professions Building, 1220 Mt. Pleasant, MI 48859, United States
| | - Jake Sauve
- Department of Health Sciences, Central Michigan University, United States
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Pool AC, Coffman DL, Sarwer DB, LaRose JG, Hart CN. Associations between weight misperception, contextual factors, and weight loss behaviours in young adult men with overweight/obesity. Obes Sci Pract 2020; 6:39-46. [PMID: 32128241 PMCID: PMC7042023 DOI: 10.1002/osp4.382] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 10/14/2019] [Accepted: 10/16/2019] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Young men are less likely to engage in weight loss behaviours than their female counterparts. This may be because of an increased likelihood for young men, particularly young black men, with overweight/obesity to misperceive their weight status. This study examined racial differences in weight status perception accuracy and associations between this perception and weight loss behaviours among young men. Associations between weight loss behaviours and contextual factors were also explored. METHODS Data from 1417 young adult (YA) men with overweight/obesity from the 2007 to 2014 National Health and Nutrition Examination Survey (NHANES) were analysed. Associations between weight status perception accuracy, contextual factors, and weight loss attempts and behaviours were examined with logistic regression. RESULTS YA men with overweight/obesity were more likely to report weight loss attempts and behaviours if they perceived themselves as being overweight (OR = 3.10; 95% CI, 2.18-4.41; P < .01; OR = 3.20, 95% CI, 2.16-4.72, P < .01, respectively). Greater education and income were associated with a greater likelihood of reporting weight loss attempts and healthy weight loss behaviours. Greater reported depressive symptoms were associated with reported weight loss attempts but not healthy weight loss behaviours. There were no differences by race for reported weight loss attempts or behaviours. CONCLUSION Among YA men with overweight/obesity, perceiving oneself as overweight was associated with reporting weight loss attempts and healthy weight loss behaviours. Future research should consider how weight status perception accuracy affects weight loss attempts among YA men and what additional factors may account for racial differences.
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Affiliation(s)
- Andrew C. Pool
- Center for Parent and Teen CommunicationCraig‐Dalsimer Division of Adolescent Medicine, Children's Hospital of PhiladelphiaPhiladelphiaPennsylvania
| | - Donna L. Coffman
- Department of Epidemiology and BiostatisticsTemple UniversityPhiladelphiaPennsylvania
| | - David B. Sarwer
- Center for Obesity Research and EducationTemple UniversityPhiladelphiaPennsylvania
- Department of Social and Behavioral SciencesTemple UniversityPhiladelphiaPennsylvania
| | - Jessica G. LaRose
- Department of Health Behavior and PolicyVirginia Commonwealth University School of MedicineRichmondVirginia
| | - Chantelle N. Hart
- Center for Obesity Research and EducationTemple UniversityPhiladelphiaPennsylvania
- Department of Social and Behavioral SciencesTemple UniversityPhiladelphiaPennsylvania
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Tanofsky-Kraff M, Schvey NA, Grilo CM. A developmental framework of binge-eating disorder based on pediatric loss of control eating. AMERICAN PSYCHOLOGIST 2020; 75:189-203. [PMID: 32052994 PMCID: PMC7027731 DOI: 10.1037/amp0000592] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Although binge-eating disorder may manifest in childhood, a significantly larger proportion of youth report episodes involving a loss of control while eating, the hallmark feature of binge eating that predicts excess weight gain and obesity. Adults with binge-eating disorder often report that symptoms emerged during childhood or adolescence, suggesting that a developmental perspective of binge eating may be warranted. Thus, loss of control eating may be a marker of prodromal binge-eating disorder among certain susceptible youth. The present article offers a broad developmental framework of binge-eating disorder and proposes areas of future research to determine which youths with loss of control eating are at risk for persistent and exacerbated behavior that may develop into binge-eating disorder and adult obesity. To this end, this article provides an overview of loss of control eating in childhood and adolescence, including its characterization, etiology, and clinical significance, with a particular focus on associations with metabolic risk, weight gain, and obesity. A conceptual model is proposed to further elucidate the mechanisms that may play a role in determining which youths with loss of control are at greatest risk for binge-eating disorder and obesity. Ways in which treatments for adult binge-eating disorder may inform approaches to reduce loss of control eating and prevent excess weight gain in youth are discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
| | - Natasha A Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
| | - Carlos M Grilo
- Department of Psychiatry, Yale University School of Medicine
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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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The Relationship between the Use of Social Networking Sites and Sexually Explicit Material, the Internalization of Appearance Ideals and Body Self-Surveillance: Results from a Longitudinal Study of Male Adolescents. J Youth Adolesc 2019; 49:383-398. [PMID: 31802316 DOI: 10.1007/s10964-019-01172-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 11/12/2019] [Indexed: 10/25/2022]
Abstract
Although there is now a substantial body of research suggesting a positive association between the exposure to sexualized content in the media and self-objectification/body surveillance, most of the studies have been cross-sectional, conducted in exclusively female samples, focused on the use of traditional media (e.g., printed magazines and TV), and have not assessed the role of the internalization of appearance ideals, which is potentially an important intervening variable in the relationship between media exposure and outcomes related to body concerns. Addressing the need for further assessments of self-objectification in more diverse samples, this study used five-wave longitudinal data to investigate the parallel changes in the use of social networking sites and sexually explicit material and the internalization of appearance ideals and body surveillance in Croatian adolescent men (Mage at baseline = 15.9, SD = 0.54; n= 743). Over a period of 22 months during the transition from middle to late adolescence, both the internalization of appearance ideals and body surveillance decreased. Furthermore, although the internalization of appearance ideals and body surveillance were associated both at baseline and over time, this study's results did not indicate a longitudinal relationship between respectively the use of online social networking sites and sexually explicit material and either the internalization of appearance ideals or body surveillance among adolescent males. Overall, this study's findings highlight the potential for a more specific assessment of the role of the use of social networking sites and sexually explicit material in self-objectification and body surveillance among young men. Future research may benefit from exploring the relationship between young men's modes of engagement with and motives for the use of social networking sites and body surveillance, as well as the possible association between the use of sexually explicit material and competency-based self-objectification, in particular sexual body functionality.
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