Adult Eating and Weight Disorders Program, Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA.
Obesity (Silver Spring). 2012 May;20(5):1118-21. doi: 10.1038/oby.2012.12. Epub 2012 Jan 27.
Depressed mood in severely obese, bariatric surgery-seeking candidates is influenced by obesity stigma, yet the strategies for coping with this stigma are less well understood. This study hypothesized that coping strategies are significantly associated with depressed mood above and beyond demographic factors and frequency of weight-related stigma, with specific coping strategies differing between racial groups. Severely obese, bariatric surgery-seeking adults (N = 234; 91 African Americans) completed the Beck Depression Inventory (BDI) and Stigmatizing Situations Inventory (SSI). Two hierarchical linear regressions were conducted separately for African Americans and whites. For both racial groups, age, sex, BMI, years overweight, annual income, and education level did not account for a significant portion of the variance in BDI scores. The frequency of stigmatizing situations and coping strategies significantly explained 16.4% and 33.2%, respectively, of the variance for whites, and 25.9% and 25%, respectively, for African Americans (P < 0.001). Greater depressed mood in whites was associated with older age, lower education, fewer positive self-statements, and less self-love and more crying; while in African Americans greater depressed mood was associated only with ignoring the situation (P < 0.05). The study found that regardless of race, depressed mood in severely obese, bariatric surgery-seeking clients is related to the frequency of stigmatizing experiences and associated coping strategies. This suggests that efforts to reduce the deleterious effects of weight-related stigma need to focus both on reducing the frequency of stigmatization and on teaching effective coping strategies. These efforts also need to take into account the client's racial background.
严重肥胖、寻求减重手术的患者中抑郁情绪受肥胖污名影响，但应对这种污名的策略了解较少。本研究假设，应对策略与抑郁情绪显著相关，超出了人口统计学因素和与体重相关的污名频率，并且不同种族群体之间的应对策略存在差异。严重肥胖、寻求减重手术的成年人（N=234；91 名非裔美国人）完成贝克抑郁量表（BDI）和污名情境量表（SSI）。分别对非裔美国人和白人进行了两次分层线性回归。对于两个种族群体，年龄、性别、BMI、超重年数、年收入和教育水平都不能解释 BDI 分数方差的显著部分。污名情境的频率和应对策略分别显著解释了白人的 16.4%和 33.2%的方差，而非裔美国人的分别为 25.9%和 25%（P<0.001）。白人中抑郁情绪更严重与年龄更大、教育程度更低、积极的自我陈述更少、自我关爱和哭泣更多有关；而在非裔美国人中，抑郁情绪更严重仅与忽略这种情况有关（P<0.05）。研究发现，无论种族如何，严重肥胖、寻求减重手术的患者的抑郁情绪都与污名化经历的频率和相关应对策略有关。这表明，减少与体重相关的污名的有害影响的努力需要既关注减少污名化的频率，又关注教授有效的应对策略。这些努力还需要考虑到患者的种族背景。
