"Better If They Laugh with Me than at Me": The Role of Humor in Coping with Obesity-Related Stigma in Women

A Scoping Review of Stigma Related to Prostate Cancer in Black Men

BACKGROUND

Prostate cancer (CaP) disproportionately affects 1-in-4 Black men and is a stigmatised disease within their communities. Yet, Black men are underrepresented in CaP research concerning stigma, which necessitates a scoping review to map available evidence on this topic to inform future research.

AIMS

To map published literature on stigma related to CaP in Black men to understand their experiences and/or perceptions and identify directions for future research.

METHODS

A scoping review was conducted using the five-step framework by Arksey and O'Malley. Studies published in English addressing stigma related to CaP from the perspectives of Black men and/or their families were included. We searched six databases including Medline, Embase, PsycInfo, CINAHL, Web of Science Core Collection and Google Scholar, from inception to April 2023. Citation searches were also conducted. Two independent reviewers conducted screening and data extraction. Data was synthesised using descriptive content analysis.

RESULTS

Thirty-four eligible studies conducted in the USA, UK, Trinidad and Tobago, South Africa, Cameroon and Canada from 1995 to 2023 were included. A total of 1867 Black men with/without a CaP diagnosis and 145 adult partners were included. Review findings showed a complex intersection of self-stigma, public stigma and structural stigma impacted Black men's perceptions of their masculinity. While men's experiences/perceptions of stigma varied depending on their illness status, there were commonalities in their masculinity concerns (underpinned by stigma), which influenced their attitude towards digital rectal examination, post-treatment side effects and social interactions on CaP. These have implications for public health messaging on CaP within Black communities, as well as patient-provider interactions with the men.

CONCLUSIONS

This novel review highlights the need to pay attention to how CaP is presented to Black men and their communities using avenues and languages that are culturally acceptable and empower them to negotiate self-stigma, public stigma and structural stigma related to CaP. Directions for further research were also identified.

Can equity in care be achieved for stigmatized patients? Discourses of ideological dilemmas in perioperative care

BACKGROUND

In the perioperative care of individuals with obesity, it is imperative to consider the presence of risk factors that may predispose them to complications. Providing optimal care in such cases proves to be a multifaceted challenge, significantly distinct from the care required for non-obese patients. However, patients with morbidities regarded as self-inflicted, such as obesity, described feelings of being judged and discriminated in healthcare. At the same time, healthcare personnel express difficulties in acting in an appropriate and non-insulting way. In this study, the aim was to analyse how registered nurse anaesthetists positioned themselves regarding obese patients in perioperative care.

METHODS

We used discursive psychology to analyse how registered nurse anaesthetists positioned themselves toward obese patients in perioperative care, while striving to provide equitable care. The empirical material was drawn from interviews with 15 registered nurse anaesthetists working in a hospital in northern Sweden.

RESULTS

Obese patients were described as "untypical", and more "resource-demanding" than for the "normal" patient in perioperative care. This created conflicting feelings, and generated frustration directed toward the patients when the care demanded extra work that had not been accounted for in the schedules created by the organization and managers.

CONCLUSIONS

Although the intention of these registered nurse anaesthetists was to offer all patients equitable care, the organization did not always provide the necessary resources. This contributed to the registered nurse anaesthetists either consciously or unconsciously blaming patients who deviated from the "norm".

Peer Teasing and Restrained Eating among Chinese College Students: The Chain Mediating Role of Negative Coping Styles and Negative Physical Self

This study aimed to determine whether negative coping styles and negative physical self sequentially mediate the relationship between peer teasing and restrained eating among Chinese university students. In total, 1127 participants (66.9% women, average age = 18.43 years; age range, 14-26 years) completed the Perception of Teasing Scale, Coping Style Questionnaire, Negative Physical Self Scale, and the Chinese version of the Restraint Scale. The mediational analysis showed that, after controlling for age, sex, and body mass index (BMI), peer teasing was related to restrained eating behaviors through (a) the mediating effect of negative coping styles, (b) the mediating effect of negative physical self, and (c) the chain-mediating effect of negative coping styles and negative physical self. This study showed for the first time that negative coping styles and negative physical self may chain mediate the association between peer teasing and restrained eating. It also provides suggestions for clinical practices as to strategies for controlling restrained eating.

Does obesity rule out happiness? Preschool children's perceptions of beauty-related happiness

BACKGROUND

Obesity is considered to be one of the most important factors reducing the sense of happiness and satisfaction with life, especially among women. This belief already exists in middle childhood, as the preschool period is a crucial point in the development of attitudes towards beauty. Preschoolers can identify physically attractive individuals, and they might already form attributions regarding the looks of adults (especially women), which in turn may constitute a foundation for their future concept of beauty-related happiness. Children's attitudes towards the body are also strongly influenced by the content of gender stereotypes that prescribe and proscribe what women and men should look like. In our study, we aimed to analyse the relationship between associations of obesity and happiness made by preschool girls and boys (5-year-olds).

METHODS

A total of 680 families with five-year-old children (329 girls, 351 boys; Mage = 5.7 years) and both parents took part in the study. Children's associations of different types of body sizes with perceptions of happiness were measured with the Beauty & Health pictorial scale.

RESULTS

Our results indicate that obese bodies were seen as unattractive, independent of gender (p < .001). Children associated looks with happiness-the body type identified as the most physically attractive was also seen as a happiest person. Lowest happiness scores were also ascribed to obese body types, but girls assessed men with a normal body type as happier than boys (t = 2.87, p = .004).

CONCLUSIONS

Female bodies are already perceived along gender stereotypical lines at the age of 5, and are also related to potential predictions concerning women's happiness. Children assessed female individuals with slim bodies, as well as those with normal weight, as happier than obese females.

The Relationship between Obligatory Exercise and Eating Attitudes, and the Mediating Role of Sociocultural Attitudes towards Appearance during the COVID-19 Pandemic

A strong sociocultural context could affect an individual's aesthetic standards. In order to achieve a socially recognized ideal appearance, obligatory exercisers might increase dieting behavior when exercise actions are disturbed, thereby placing the individual at risk of eating disorders. The current study mainly examined the relationship between obligatory exercise and eating attitudes during the COVID-19 pandemic, and considered the mediating role of externalized sociocultural attitudes towards appearance between the two. A total of 342 participants (175 females, 167 males) from various regions of China were invited to fill out the questionnaires including the Obligatory Exercise Questionnaire, the Sociocultural Attitudes Toward Appearance Questionnaire-3, and the Eating Attitudes Test. In total, 51.5% of the participants presented symptoms of an obligatory exercise behavior. Among them, males, young adults, and the participants with lower BMI had higher OEQ scores, whereas females and young adults had higher EAT-26 scores. Meanwhile, 9.4% of the participants might have had an eating disorder. The OEQ score was positively correlated with the EAT-26 total score as well as SATAQ-3 'Pressures' and 'Information' subscales. In addition, the EAT-26 total score was positively correlated with the SATAQ-3 'Pressures' and 'Information' subscales. Externalized sociocultural attitudes towards appearance served as a mediator between obligatory exercise behavior and eating attitudes, and the mediation effect accounted for 56.82% of the total effect. Obligatory exercise behavior may have an indirect effect on eating attitudes through sociocultural attitudes towards appearance. Given the sociocultural information and pressures, in order to maintain or pursue an ideal appearance, many people tend to keep a pathological diet. Thus, forming a positive and healthy social aesthetic orientation is beneficial in helping obligatory exercisers to develop reasonable eating habits.

Attitudes Towards Appearance and Body-Related Stigma Among Young Women With Obesity and Psoriasis

The goal of this study was to investigate the role of the subjective assessment of one's body image in the relationship between objective indices of appearance and perceived stigma in young women affected by obesity and psoriasis. These are chronic diseases that decrease one's physical attractiveness and are associated with stigmas related to body defects. A total of 188 women in early adulthood took part in the study (M = 25.58; SD = 2.90), including obese women (n = 54), women suffering from psoriasis (n = 57), and a control group (n = 77). The participants completed the Multidimensional Body-Self Relations Questionnaire, Perceived Stigmatisation Questionnaire, and a socio-demographic questionnaire. Anthropometric data were gathered using a body composition analyzer. Objective parameters of body shape were calculated (WHR and ICO). Subjective assessment of one's body and attitudes towards one's body were found to influence perceived stigma, independently of the condition causing the stigma and of the objective appearance of the participant. This study did not support the existence of a relationship between parameters regarding body shape and sense of stigma, even when subjective body assessment acted as a moderator. At the same time, body mass was a strong predictor of levels of perceived stigma. Women affected with obesity perceived a higher level of stigma than the other groups. The severity of psoriasis did not impact the perceived stigma. Moreover, women with psoriasis assessed their health-as a part of the assessment of their bodies-the highest, which may explain the lower perceived stigma in this group.