Weight perceptions in older adults: findings from the English Longitudinal Study of Ageing

Patient Perceptions of Weight Stigma Experiences in Healthcare: A Qualitative Analysis

BACKGROUND

Weight stigma is the social devaluation and denigration of individuals because of their excess body weight, resulting in poorer physical and mental health and healthcare avoidance. Attribution Theory and Goffman's theory of spoiled identity provided a general overarching framework for understanding weight stigma experiences.

OBJECTIVE

Our purpose was to explore weight stigma experiences from a broad range of perspectives emphasizing identities typically excluded in the weight stigma literature.

DESIGN

We conducted a qualitative descriptive study with data drawn from 73 substantive narrative comments from participants who responded to a larger survey.

RESULTS

Analysis developed five themes: Working on weight, Not being overweight, Lack of help and empathy, Exposure and embarrassment and Positive experiences. Individuals who would be clinically assessed as overweight, especially men, often did not identify with having a weight problem and found the framing of personal responsibility for weight empowering. Participants with larger body sizes more often attributed embarrassment and shame about weight to treatment in the clinical setting. Older participants were more likely to have positive experiences.

CONCLUSIONS

The findings suggest ongoing tension between the framing of weight as a personal responsibility as opposed to a multifactorial condition with many uncontrollable aspects. Gender, age and body size shaped respondent perspectives, with some young male respondents finding empowerment through perceived personal control of weight. The healthcare system perpetuates weight stigma through lack of adequate equipment and excessively weight-centric medical counselling. Recommending a healthy lifestyle to patients without support or personalized medical assessment may perpetuate weight stigma and associated detrimental health outcomes.

PATIENT OR PUBLIC CONTRIBUTION

Patients with obesity and overweight were integral to this study, providing comments for our qualitative analyses.

Incidence of a Multicomponent Physical Exercise Program on Body Composition in Overweight or Obese People Aged 60 Years or Older from Chile

This research aimed to explore the changes produced in body mass index (BMI), fat mass percentage (FMP), muscle mass percentage (MMP), and visceral fat percentage (VFP) in 60-year-old or over overweight or obese people after a multicomponent exercise program. This quasi-experimental study involved 70 overweight or obese older people between 60 and 86 years old (M = 73.15; SD = 5.94) who were randomly assigned to a control group (CG, n = 35) and an experimental group (EG, n = 35). At the beginning and at the end of the intervention program, anthropometric and body composition data were collected. The results showed an increase in BMI after the intervention in the CG (p = 0.010) and a decrease in the EG (p < 0.001). The results regarding the FMP indicate a significant decrease in the EG (p < 0.001) after the intervention, as occurs with the VFP (p = 0.003). The MMP increased in the EG (p < 0.001) after the intervention program. Regarding gender, statistically significant differences were found in the MMP after the intervention (p = 0.025), with higher percentages in men in the EG. VFP decreased in both men (p = 0.005) and women (p = 0.019) in the EG. From the results obtained, we can say that a 6-month multicomponent program produces a decrease in BMI, FMP, and VFP and an increase in MMP in its participants. This type of intervention seems to produce a greater increase in muscle mass in men than in women and a decrease in VFP in both genders.

Mediating role of weight concerns in the relationship between seasonality and eating behavior among community-dwelling older adults: A path analysis

BACKGROUND

Weight concerns are common among older adults, and it is unclear how they may impact the relationship between seasonality and eating behaviors, which can contribute to various health-related issues.

AIM

This study investigated the mediating role of weight concerns in the relationship between seasonality and eating behavior among community-dwelling older adults.

METHOD

A descriptive correlational analytical design was used on 200 randomly chosen participants who completed the Personal Inventory for Depression and Seasonal Affective Disorder Self-Assessment Version, the Adult Eating Behavior Questionnaire, and the Weight Concern Subscale. A path analysis was conducted to test the hypothesized model.

RESULTS

The study findings indicated that most older adults reported moderate-to-severe seasonal variations, moderate enjoyment of food, emotional overeating, emotional undereating, and food fussiness. Weight concern partially mediated the relationship between seasonality and eating behavior.

CONCLUSION

By understanding the complex interplay between these factors, weight concerns may play an essential role in mediating the effects of seasonal changes on eating behavior, while seasonal winter symptoms may directly impact eating behavior. These results have potential implications for nurses' efforts to develop interventions to promote healthy eating behaviors and manage weight concerns during seasonal variations, especially in the winter.

Non-linear relationship between body mass index and self-rated health in older Korean adults: body image and sex considerations

OBJECTIVES

The purpose of this study was to investigate the association between body mass index (BMI) and self-rated health (SRH) in older adults aged over 65 years while examining the influence of self-perceived body image (SBI) and sex.

METHODS

Raw data were obtained from the Korea Community Health Survey, which included BMI measurements of Koreans aged over 65 years (n=59,628). Non-linear relationships between BMI and SRH were analyzed separately for each sex using restricted cubic splines while controlling for SBI and other confounding variables.

RESULTS

Men showed a reverse J-shaped association, while women showed a J-shaped association between BMI and poor SRH. However, including SBI in the model changed this association for men to an inverted U-shape showing a negative direction, with the highest risk of poor SRH observed in the underweight to overweight range. For women, a nearly linear positive relationship was observed. Regardless of BMI, those who perceived their weight as not "exactly the right weight" had a higher risk of poor SRH than those who perceived their weight as "exactly the right weight" in both men and women. Older men who thought they were much too fat or too thin had similar highest risks of poor SRH, whereas older women who thought they were too thin had the highest risk of poor SRH.

CONCLUSIONS

The findings of this study emphasize the importance of considering sex and body image perceptions when assessing the relationship between BMI and SRH in older adults, especially in men.

Perceived discrimination in middle-aged and older adults: Comparison between England and the United States

Objectives

This study examined differences in perceived discrimination across multiple characteristics in England and the United States (US), in middle- and older-aged adults.

Methods

Using data from the English Longitudinal Study of Aging (N = 8,671) and the US-based Health and Retirement Study (N = 7,927), we assessed cross-national differences in perceived discrimination attributed to disability, financial status, sex, race, sexual orientation, and weight. We also compared how perceived discrimination varied with socioeconomic position (SEP) based on wealth.

Results

Perceived discrimination due to financial status was more common in England (6.65%) than in the US (2.14%) adjusting for age, sex, and wealth [Odds Ratio (OR) = 1.09, 95% CI (1.07; 1.10)]. This affected people of low but not high SEP. Sexual orientation discrimination was more common in England [0.72 vs. 0.15%, OR = 4.61, 95% CI (2.48; 8.57)]. Sex-based perceived discrimination was more prevalent in the US (12.42%) than England (9.07%) adjusting for age and wealth [OR = 0.87, 95% CI (0.86; 0.89)]. Cross-national differences in sex discrimination did not vary with SEP. Racism was the most common type of perceived discrimination reported in both samples (England: 17.84%, US: 19.80%), with no significant cross-national differences after adjustment for sex.

Discussion

Perceived discrimination attributed to financial status and sexual orientation were more prevalent in England, while more women perceived sex discrimination in the US. This study suggests that country-specific and socioeconomic factors affect the prevalence of perceived discrimination. This may be relevant when targeting interventions aimed at reducing perceived discrimination.

The Perception of Overweight and Obesity among South African Adults: Implications for Intervention Strategies

Obesity is a public health problem, affecting more than half of the global population. Perceptions and beliefs play a significant role in preventing and managing overweight and obesity. Thus, the paper explores own perception of overweight and obesity on personal health among South African adults. This was a qualitative study in which the participants (n = 24) were interviewed in-depth on their perception of obesity and health. Thematic analysis was used in data assessment. The results revealed four main themes: perceived causes of obesity, self-perception of being obese, perception of obesity, health, and cultural beliefs. Environmental and personal factors were perceived as the leading cause of overweight and obesity. The findings further showed that body weight preference was personal and differed from individual to individual. The study provided insight into perceptions of obesity from individuals' perspectives. The misperceptions of overweight and obesity are helpful in the design of impactful intervention programmes that can be used to prevent and manage obesity in South Africa.

Views of Own Body Weight and the Perceived Risks of Developing Obesity and NCDs in South African Adults

Obesity has become a serious public health problem worldwide and is linked to an increased risk of non-communicable diseases (NCDs). Poor self-perception of body weight is postulated to play a negative role in curbing increased rates of obesity. This study investigated the views of own body weight and perceived risk of developing NCDs in South African adults. This was a community-based quantitative study. Descriptive statistics were used, and logistic regression analysis was conducted on the data. A total of 1050 respondents took part in the study. Of the 161 respondents who perceived themselves to be normal weight, 98.8% (n = 159) misperceived their body weight. The majority of respondents (>90%) who were overweight according to the calculated BMI perceived no risk of developing obesity-related diseases. Most of the respondents, 46% (n = 253), believed that body weight was influenced by heredity. The method used for weight loss by 57% (n = 173) of the respondents was exercising at home. There was a statistically significant association between Body Mass Index (BMI), employment status, risk of developing diabetes, and body weight misperception (p < 0.05). Misperception of body weight was common among the study respondents and may influence weight control intervention strategies. Health promotion targeting personal behaviour, such as body weight self-perception, is crucial in supporting targeted strategies to address obesity in South Africa.