Weight bias internalization and beliefs about the causes of obesity among the Canadian public

Does dissection influence weight bias among doctor of physical therapy students?

Anatomy with human dissection may help to develop respect for the human body and professionalism; however, dissection may worsen students' attitudes about body weight and adiposity. The purpose of this study was to measure weight bias among Doctor of Physical Therapy (DPT) students enrolled in gross anatomy and determine if, and how the experience of dissection impacts weight bias. Ninety-seven DPT students (70 University of Colorado [CU], 27 Moravian University [MU]) were invited to complete a survey during the first and final weeks of their anatomy course. The survey included demographic items, two measures of weight bias-the Modified Weight Bias Internalized Scale (M-WBIS) and the Attitudes Towards Obese Persons (ATOP) Scale-and open-ended questions for the students who participated in dissection (CU students) that explored attitudes about body weight and adiposity. At baseline, there were no significant differences (p > 0.202) in ATOP, M-WBIS, or BMI between the two universities. The mean scores on both the ATOP and M-WBIS indicated a moderate degree of both internalized and externalized weight bias. There were no significant changes in ATOP (p = 0.566) or M-WBIS scores (p = 0.428). BMI had a low correlation with initial M-WBIS scores (⍴ = 0.294, p = 0.038) and a high correlation with change scores in CU students (⍴ = 0.530, p = 0.011). Future studies should utilize the same measures of weight bias in other healthcare trainees to facilitate comparison and incorporate larger populations of DPT students.

Factors Associated with the Health-Related Self-Care Capacity of Overweight and Obese People

This study aimed to investigate the relationship between beliefs about obese people and health-related self-care among overweight and obese people, considering sociodemographic aspects. This study adopted a cross-sectional design. The sample consisted of 207 participants selected through a simple random sampling method. The "Beliefs About Obese Persons Scale" (BAOP) and the "Self-Care Agency Rating Scale-Revised" (ASA-R) questionnaires were applied to data collection. The results showed that 82.6% believed that obesity is a condition the individual cannot control, and 74.4% expressed inadequate self-care regarding their health. A multivariate analysis found that belonging to the adult age group increases the probability of presenting adequate health-related self-care by 4.7 times (95% CI = 1.892-11.790) compared to older adults. The belief that obesity is an uncontrollable condition increases the probability of inadequate self-care by 6.3 times (95% CI = 2.360-16.924), in contrast to the perception that it is a controllable condition. Moreover, overweight people are 0.139 times (95% CI = 0.044-0.443) less likely to have adequate self-care compared to people with obesity. In conclusion, being an adult and having the belief that obesity is a condition that can be controlled is associated with adequate health-related self-care, while being overweight is associated with inadequate health care.

Presentation of a weight bias internalization tool for use in pregnancy and a call for future research: A commentary

Background

Emerging evidence has shown that weight stigma is a concern during pregnancy, with several studies documenting common sources including healthcare, the media and interpersonal networks. Experiencing weight stigma may lead to weight bias internalization (WBI), whereby individuals accept and self-direct negative weight-related stereotypes, and limited research has assessed this in the context of pregnancy. Pregnancy is unique in terms of weight changes as many individuals will experience gestational weight gain (GWG). Accordingly, a WBI tool that accounts for GWG may be a more population-specific resource to use.

Methods

This commentary presents a pregnancy-specific WBI tool that accounts for GWG. The validated Adult WBI scale was modified to include 'pregnancy weight gain'. This commentary also presents a brief summary of research that has assessed WBI in pregnancy and recommendations for future work.

Results

Recommended future work includes validation of the pregnancy-specific WBI tool and prospective examinations of weight stigma and WBI in pregnancy and implications on maternal and newborn outcomes.

Conclusion

Ultimately this research may inform development of interventions and resources to mitigate weight stigma and WBI in pregnancy and overall may contribute to improving prenatal outcomes and experiences.

The 26RFa (QRFP)/GPR103 Neuropeptidergic System: A Key Regulator of Energy and Glucose Metabolism

BACKGROUND

Obesity and type 2 diabetes are strongly associated pathologies, currently considered as a worldwide epidemic problem. Understanding the mechanisms that drive the development of these diseases would enable to develop new therapeutic strategies for their prevention and treatment. Particularly, the role of the brain in energy and glucose homeostasis has been studied for 2 decades. In specific, the hypothalamus contains well-identified neural networks that regulate appetite and potentially also glucose homeostasis. A new concept has thus emerged, suggesting that obesity and diabetes could be due to a dysfunction of the same, still poorly understood, neural networks.

SUMMARY

The neuropeptide 26RFa (also termed QRFP) belongs to the family of RFamide regulatory peptides and has been identified as the endogenous ligand of the human G protein-coupled receptor GPR103 (QRFPR). The primary structure of 26RFa is strongly conserved during vertebrate evolution, suggesting its crucial roles in the control of vital functions. Indeed, the 26RFa/GPR103 peptidergic system is reported to be involved in the control of various neuroendocrine functions, notably the control of energy metabolism in which it plays an important role, both centrally and peripherally, since 26RFa regulates feeding behavior, thermogenesis and lipogenesis. Moreover, 26RFa is reported to control glucose homeostasis both peripherally, where it acts as an incretin, and centrally, where the 26RFa/GPR103 system relays insulin signaling in the brain to control glucose metabolism.

KEY MESSAGES

This review gives a comprehensive overview of the role of the 26RFa/GPR103 system as a key player in the control of energy and glucose metabolism. In a pathophysiological context, this neuropeptidergic system represents a prime therapeutic target whose mechanisms are highly relevant to decipher.

Patient perceptions about obesity management in the context of concomitant care for other chronic diseases

Background

Approximately 15% of Canadian adults live with two or more chronic diseases, many of which are obesity related. The degree to which Canadian obesity treatment guidelines are integrated into chronic disease management is unknown.

Methods

We conducted a 12-min online survey among a non-probability sample of 2506 adult Canadians who met at least one of the following criteria: 1) BMI ≥30 kg/m2; 2) medical diagnosis of obesity; 3) undergone medically supervised treatment for obesity; or 4) a belief that excess/abnormal adipose tissue impairs their health. Participants must have been diagnosed with at least one of 12 prevalent obesity-related chronic diseases. Data analysis consisted of descriptive statistics.

Results

One in four (26.4%) reported a diagnosis of obesity, but only 9.2% said they had received medically supervised obesity treatment. The majority (55%) agreed obesity makes managing their other chronic diseases challenging; 39% agreed their chronic disease(s) have progressed or gotten worse because of their obesity. While over half (54%) reported being aware that obesity is classified as a chronic disease, 78% responded obesity was their responsibility to manage on their own. Only 33% of respondents responded they have had success with obesity treatment.

Interpretation

While awareness of obesity as a chronic disease is increasing, obesity care within the context of a wider chronic disease management model is suboptimal. More work remains to be done to make Canadian obesity guidelines standard for obesity care.