Relationships among weight stigma, eating behaviors and stress in adolescents in Wuhan, China

Traces of social culture in the lived experiences of emotional eating among Iranian obese women

INTRODUCTION

Emotional eating is a situation with harmful consequences for the physical, mental and social health of humans. In this regard, the present study aimed to explain the role of social culture in the lived experiences of emotional eating in Iranian obese women.

METHODS

This was a qualitative study conducted using the phenomenological approach. Purposive heterogeneous sampling method was used to select 17 women with body mass index of 30 and above who had emotional eating experience. Data were collected through semi-structured and face-to-face interviews. A guideline designed by the research team, whose content validity was confirmed by the expert panel, was used to conduct the interviews. Data were analyzed based on Diekelmann 7-step approach, and trustworthiness was evaluated by Lincoln and Guba criteria.

RESULTS

The main topic of the findings was social culture and emotional eating, which was explained by three themes: "influence of social culture", "language culture of eating" and "the culture of eating together". Influence of social culture had three sub-themes: "a legal and popular entertainment", "hospitality culture: encouraging guests to overeat", and "coping with the social stigma of thinness and obesity". The language culture of eating had two sub-themes of "association of common infinitives" and "the symbol of swallowing anger ". Also, "culture of eating together" included 2 sub-topics with the titles "pleasant symbol of belonging and love" and "the symbol of family cohesion".

CONCLUSION

This study found that social culture through language, norms, and customs can initiate and/or reinforce emotional eating. The results of this study can be used in the design of interventions to improve emotional eating behavior in women by emphasizing the characteristics of Iranian social culture.

Stigma of Binge-Eating Disorder in Hong Kong Chinese Adults: Effects of Weight Status, Diagnostic Labeling, and Etiological Explanations

OBJECTIVE

Binge-eating disorder (BED) is a strongly stigmatized condition and is often complicated by weight stigma. Research on the intersection between BED and weight stigma is scarce especially in Chinese populations. The present study examined BED stigma in Chinese, whether BED stigma was independent from weight stigma, and whether diagnostic labeling and etiological explanations influenced the degree of BED stigma.

METHOD

Using a between-subject experimental vignette study, 642 participants (mean age = 29.74 years, SD = 11.34) were randomly assigned to read one of the 18 vignettes, describing a character with information on BED symptoms, weight status, diagnostic labeling, and etiological explanations, followed by measures of stigma and help-seeking intentions.

RESULTS

The character with BED symptoms was ascribed more negative personality characteristics, elicited more negative affective reactions, and triggered greater desired social distance compared to the character without BED symptoms. No evidence for weight stigma was found nor for its interaction with BED stigma. The Cantonese diagnostic label of BED, kwong sik zing, was associated with lower levels of volitional stigma and greater help-seeking intentions than the diagnostic label of eating disorders, jam sik sat tiu, and the absence of labeling. The effect of etiological explanations was only significant in the univariate test, indicating that providing either a psychosocial or a biogenetic etiological explanation lessened the negative evaluations of personality characteristics.

DISCUSSION

The present study provided first evidence for BED stigma in Chinese. BED stigma appeared to be attributable to the presence of disordered eating behavior rather than the BED diagnosis.

A systematic review of weight stigma and disordered eating cognitions and behaviors

Weight stigma is persistent across contexts and is associated with disordered eating cognitions and behaviors. This systematic review aimed to examine the existing literature that has explored the relationship between weight stigma and disordered eating cognitions and behaviors. We specifically examined three dimensions of weight stigma - experienced, anticipated, and internalized - and adopted an inclusive conceptualization of outcomes related to disordered eating (including constructs such as binge eating, body dissatisfaction, and other cognitions and behaviors such as dietary restraint, unhealthy weight control behaviors, and drive for thinness). We searched PubMed, Embase, CINAHL, Web of Science, Sociological Abstracts, and PsycINFO for English-language, peer-reviewed articles and dissertations with quantitative methodology published through October 2023. The search resulted in 242 articles meeting inclusion criteria. A narrative review found a consistent relationship between greater weight stigma and more disordered eating cognitions and behaviors. Methodological and theoretical limitations are discussed, as are critical avenues for future research and potential clinical implications stemming from this body of research. Given the widespread nature and impact of weight stigma on disordered eating, it is imperative that we intervene to address weight stigma at all levels, from the structural to the intrapersonal.

Eating-to-Cope Motives and Uncontrolled Eating as Mediators Between Negative Emotional States and Food Addiction Among Argentinean Young Adults

Negative emotional states (NES; i.e., depression, anxiety and stress) are likely contributors to the development of food addiction (FA). The association between NES and FA symptoms may be mediated by altered eating behaviors or by eating-to-cope motives. This study examined, in a sample of Argentinean young adults, the association between NES and FA symptoms via eating-to-cope motives and three patterns of eating behaviors. We also examined whether the model was invariant across college status. The transition from high school to college is usually associated with increased exposure to stress, which promotes the probability of engaging in altered eating behaviors. A sample of 499 Argentinean young adults (mean age = 24.9 ± 3.51 years) completed a survey that assessed FA symptoms, eating behaviors (i.e., uncontrolled, emotional, and restrained eating), eating-to-cope motives and NES. A path analysis tested the indirect association between NES and FA symptoms via uncontrolled, emotional or restrained eating, or by eating-to-cope. Stress and depression symptoms were indirectly associated with FA symptoms via uncontrolled eating and eating-to-cope motives. The model was invariant across college status. The findings suggest that NES are associated with FA symptoms by increasing uncontrolled eating and eating-to-cope motives. Young adults exhibiting greater depressive or stress symptoms, higher eating-to-cope, or higher uncontrolled eating may be at risk for FA. Future research should examine the significance of this pattern by tailoring interventions to these characteristics.

The mediation effect of perceived weight stigma in association between weight status and eating disturbances among university students: is there any gender difference?

BACKGROUND

The study aimed to examine the association between perceived weight stigma (PWS), weight status, and eating disturbances. We hypothesized that PWS would partially mediate the association between weight status and eating disturbances among university students.

METHODS

The study involved 705 undergraduate students (379 females and 326 males) recruited from Hong Kong and Taiwan Universities (399 Hong Kong; 306 Taiwan participants). Our sample was from one Hong Kong university (located in Kowloon) and five Taiwan universities (three located in Southern Taiwan, one located in Central Taiwan, and one located in North Taiwan). Participants' mean age was 20.27 years (SD = 1.79). All participants completed a demographic information sheet, the Three-Factor Eating Questionnaire-18 (TFEQ-R18), and the PWS questionnaire. PROCESS macro models were used to analyze potential mediations.

RESULTS

We found a significantly higher PWS scores in a high weight group for females and males. There was a significant difference between weight status and eating disturbances. Moreover, PWS partially mediated the association between weight status and eating disturbances for both genders.

CONCLUSIONS

PWS is associated with weight status and eating disturbances, making it an important target for health improvement among young adults. Further studies are needed to corroborate such associations in participants from other societies and cultures.

Treatment Outcomes and Trajectories of Change in Patients Attributing Their Eating Disorder Onset to Anti-obesity Messaging

OBJECTIVE

Given the increased prevalence of eating disorders (EDs) among individuals higher on the weight spectrum, we aimed to 1) report the prevalence of ED patients in higher levels of care (residential, partial hospitalization, and intensive outpatient) attributing the onset of their ED to anti-obesity messaging, 2) report the most commonly recollected sources of those messages, and 3) determine if those attributing the onset of their ED to anti-obesity messaging a) enter, b) exit, and c) respond to treatment differently from peers who did not.

METHODS

This retrospective cohort study used data from 2901 patients receiving ED treatment in higher levels of care at a US-based center between 2015 and 2018. Multilevel models examined differences in ED symptoms and trajectories of change over time. NVivo was used to analyze the patients' comments about sources of messages.

RESULTS

Eighteen percent attributed their ED onset to anti-obesity messaging, 45% did not, and 37% were unsure. Of those providing comments, the most common sources included the following: educational curriculum/school context (45.9%), media/Internet (24.7%), health care (10.4%), family (9%), and peer bullying (3.7%). At admission, patients attributing their ED onset to anti-obesity messaging had more severe ED symptoms than those who did not (γ = 0.463, standard error [SE] = 0.086, p < .001) and those who were unsure (γ = 0.288, SE = 0.089, p < .001); no differences were evident at discharge (p > .483). During phase 2 of treatment, patients attributing their ED onset to anti-obesity messaging improved faster than those who did not (γ = 0.003, SE = 0.001, p = .008) and those who were unsure (γ = 0.003, SE = 0.001, p = .014).

CONCLUSIONS

Anti-obesity messaging may put vulnerable individuals at risk for EDs. We recommend increasing weight bias training for school personnel and health care professionals. To reduce health disparities, we also suggest the promotion of weight-neutral health-enhancing self-care practices in media and public health campaigns, legislative policies, and health care overall.

Frequency and Correlates of Weight-Based Discrimination among Adolescents in China

BACKGROUND

Unfair treatment on the basis of body weight is common in the West and associated with lower well-being, starting at least as early as adolescence. We examine whether the frequency and predictors and correlates of weight discrimination seen in the West extend to adolescents in China.

METHODS

Participants (N = 1539) were adolescents in China who took part in a longitudinal study of mental health and academic burnout in high school. At Wave 1, participants reported on their personality and well-being and completed a school health check that included measured height and weight. At Wave 2 approximately 6 months later, participants reported on experiences with unfair treatment and completed the same measures of well-being.

RESULTS

Of 10 attributions for unfair treatment, weight was most common at 18%. Female gender and body mass index were associated with greater risk of reporting weight discrimination. Emotional stability, conscientiousness, and state happiness measured at Wave 1 were associated with lower risk of weight discrimination at Wave 2. Concurrently, weight discrimination was associated with lower happiness, less life satisfaction, and more distress.

CONCLUSIONS

Adolescents in China report weight discrimination, and the patterns of association between weight discrimination and psychological function are similar to what is seen in the West.