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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:jsae042. [PMID: 38853703 DOI: 10.1093/jpepsy/jsae042] [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: 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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Gale A, Nepomnyaschy L. School Connectedness and Mental Health Among Black Adolescents. J Youth Adolesc 2024; 53:1066-1077. [PMID: 37938482 DOI: 10.1007/s10964-023-01898-0] [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: 07/21/2023] [Accepted: 10/24/2023] [Indexed: 11/09/2023]
Abstract
Black students' school experiences are important for their mental health. The current study explored the link between school connectedness in middle childhood and depressive symptoms and aggressive behaviors among Black adolescents. Participants were Black youth (Mage = 9.36 years, SD = 0.38 at time 1), (Mage = 15.59 years, SD = 0.60 at time 2), and 50.2% female. The findings demonstrated a significant association between school connectedness assessed at age nine and reduced depressive symptoms and aggressive behaviors reported at age fifteen. Notably, gender moderated the relationship between school connectedness and depressive symptoms, with a stronger association found for girls. These results offer valuable insights into how early perceptions of school connectedness impact the mental health of Black adolescents as they grow older. These findings also indicate that girls might be more attuned to the social and emotional aspects of their schools. These findings validate the significance of a sense of connection to school with mental health outcomes among Black adolescents and indicate the possibility of school connectedness interventions to enhance their overall well-being.
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Affiliation(s)
- Adrian Gale
- Rutgers University School of Social Work, New Brunswick, NJ, USA.
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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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Cardel MI, Newsome FA, Pearl RL, Ross KM, Dillard JR, Miller DR, Hayes JF, Wilfley D, Keel PK, Dhurandhar EJ, Balantekin KN. Patient-Centered Care for Obesity: How Health Care Providers Can Treat Obesity While Actively Addressing Weight Stigma and Eating Disorder Risk. J Acad Nutr Diet 2022; 122:1089-1098. [PMID: 35033698 PMCID: PMC10056599 DOI: 10.1016/j.jand.2022.01.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 11/10/2021] [Accepted: 01/11/2022] [Indexed: 02/01/2023]
Affiliation(s)
- Michelle I Cardel
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL; WW International, Inc., New York, NY.
| | - Faith A Newsome
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL
| | - Rebecca L Pearl
- Department of Clinical and Health Psychology, University of Florida College of Public Health and Health Professions, Gainesville, FL
| | - Kathryn M Ross
- Department of Clinical and Health Psychology, University of Florida College of Public Health and Health Professions, Gainesville, FL
| | - Julia R Dillard
- University of Toledo, College of Medicine and Life Sciences, Toledo, OH
| | - Darci R Miller
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL
| | - Jacqueline F Hayes
- Weight Control and Diabetes Research Center at the Miriam Hospital and Department of Psychiatry and Human Behavior, Brown University, Providence, RI
| | - Denise Wilfley
- Washington University in St Louis, College of Medicine, St Louis, MO
| | - Pamela K Keel
- Department of Psychology, Florida State University, Tallahassee, FL
| | | | - Katherine N Balantekin
- Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY
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Fung XCC, Siu AMH, Potenza MN, O'Brien KS, Latner JD, Chen CY, Chen IH, Lin CY. Problematic Use of Internet-Related Activities and Perceived Weight Stigma in Schoolchildren: A Longitudinal Study Across Different Epidemic Periods of COVID-19 in China. Front Psychiatry 2021; 12:675839. [PMID: 34108898 PMCID: PMC8183469 DOI: 10.3389/fpsyt.2021.675839] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 04/19/2021] [Indexed: 12/24/2022] Open
Abstract
Background: Social distancing and school suspension due to the coronavirus pandemic (COVID-19) may have a negative impact on children's behavior and well-being. Problematic smartphone use (PSU), problematic social media use (PSMU) and perceived weight stigma (PWS) are particularly important issues for children, yet we have a poor understanding of how these may have been affected by lockdowns and physical isolation resulting from COVID-19. This research aimed to understand how these psychosocial and behavioral variables may be associated with psychological distress, and how these associations may have changed during the COVID-19 pandemic. Methods: A total of 489 children completed a three-wave longitudinal study from January 2020 to June 2020. The first wave was conducted before the COVID-19 outbreak. The second wave was conducted during the outbreak. The third wave was conducted during post-COVID-19 lockdown. Questionnaires measured psychological distress, PSU, PSMU, and PWS. Results: PSU, PSMU, PWS and psychological distress were all significantly associated with each other. PSU was significantly higher during outbreak. PWS was significantly higher before outbreak. We found an increased association between PSMU and PWS across three waves in all three models. The association between PSU and depression/anxiety decreased across three waves; however, association between PSMU and depression/anxiety increased across three waves. Conclusions: COVID-19 initiated school suspension and associated lockdowns appear to have exacerbated PSU and depression among children. However, PWS was reduced during this period. Children should use smartphones and social media safely and cautiously, and be aware of the potential exposure to weight stigmatization.
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Affiliation(s)
- Xavier C C Fung
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Andrew M H Siu
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Marc N Potenza
- Departments of Psychiatry and Neuroscience and the Child Study Center, School of Medicine, Yale University, New Haven, CT, United States.,Connecticut Council on Problem Gambling, Wethersfield, CT, United States
| | - Kerry S O'Brien
- School of Social Sciences, Faculty of Arts, Monash University, Melbourne, VIC, Australia
| | - Janet D Latner
- Department of Psychology, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Chao-Ying Chen
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - I-Hua Chen
- International College, Krirk University, Bangkok, Thailand.,School of Education Science, Minnan Normal University, Zhangzhou, China
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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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: 108] [Impact Index Per Article: 27.0] [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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Kunyu D, Juang LP, Schachner MK, Schwarzenthal M. Discrimination Among Youth of Immigrant Descent in Germany. ZEITSCHRIFT FUR ENTWICKLUNGSPSYCHOLOGIE UND PADAGOGISCHE PSYCHOLOGIE 2020. [DOI: 10.1026/0049-8637/a000231] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Abstract. Ethnic discrimination has a negative impact on the socioemotional, behavioral, relational, and academic adjustment of adolescents, while belonging with classmates, teachers, heritage, and national group may promote positive socioemotional and academic adjustment. We investigate (1) whether greater discrimination by peers and a lower sense of belonging with classmates, teachers, heritage group, and national group are associated with lower socioemotional and academic adjustment of adolescents of immigrant descent in Germany; and (2) whether a sense of belonging with these different sources acts as a protective factor lowering the negative effects of discrimination on adjustment. Our sample included 439 7th-grade adolescents (51 % female, Mage = 12.4 years) of immigrant descent from 15 Berlin secondary schools. Results showed that higher discrimination was related to greater physiological stress, depressive symptoms, and disruptive school behavior. Higher heritage (but not national) identity, a higher sense of belonging with classmates and with teachers were associated with better socioemotional and academic adjustment. An examination of interaction effects between discrimination and forms of belonging on adjustment revealed that, while the association between discrimination and poorer adjustment weakened for those with higher heritage identity, the association between discrimination and physiological stress increased for those with higher teacher relatedness. We conclude that heritage identity (but not national identity or sense of belonging with classmates) can indeed be a protective factor against the negative effects of discrimination for adolescents of immigrant descent in Germany. Even though belonging with teachers may exacerbate discrimination effects, further investigation with longitudinal data is needed. The findings underline the important role of heritage ties among adolescents of immigrant descent as a source of adjustment, especially in light of discrimination experiences.
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Affiliation(s)
- David Kunyu
- Inclusive Education, University of Potsdam, Germany
| | | | - Maja K. Schachner
- Educational Psychology, Martin Luther University of Halle-Wittenberg, Germany
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Teacher Relationships and Adolescents Experiencing Identity-Based Victimization: What Matters for Whom Among Stigmatized Adolescents. SCHOOL MENTAL HEALTH 2019. [DOI: 10.1007/s12310-019-09327-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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