Integrated Research and Treatment Center Adiposity Diseases, University of Leipzig, Leipzig, Germany; Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.
Obesity (Silver Spring). 2014 Jan;22(1):79-85. doi: 10.1002/oby.20561. Epub 2013 Sep 10.
Weight bias has strong associations with psychopathology in overweight and obese individuals. However, self-evaluative processes, as conceptualized in the process model of self-stigma, and implications for other health-related outcomes, remain to be clarified.
In a representative general population sample of N = 1158 overweight and obese individuals, the impact of core self-evaluation as a mediator between weight bias internalization and mental and global health outcomes as well as between weight bias internalization and health care utilization, was examined using structural equation modeling.
In overweight and obese individuals, greater weight bias internalization predicted lower core self-evaluation, which in turn predicted greater depression and anxiety, lower global health, and greater health care utilization. These mediational associations were largely stable in subsample analyses and after controlling for sociodemographic variables.
The results show that overweight and obese individuals with internalized weight bias are at risk for impaired health, especially if they experience low core self-evaluation, making them a group with which to target for interventions to reduce self-stigma. Weight bias internalization did not represent a barrier to health care utilization, but predicted greater health care utilization in association with greater health impairments.
体重偏见与超重和肥胖个体的精神病理学密切相关。然而，自我评估过程，如自我污名化过程模型中所概念化的，以及对其他与健康相关的结果的影响，仍有待阐明。
在一个代表性的超重和肥胖人群的一般人群样本中（N=1158 人），使用结构方程模型检验了核心自我评价作为体重偏见内化与心理健康和整体健康结果之间以及体重偏见内化与医疗保健利用之间的中介变量的影响。
在超重和肥胖个体中，更大的体重偏见内化预测了更低的核心自我评价，而核心自我评价又预测了更大的抑郁和焦虑、更低的整体健康以及更多的医疗保健利用。这些中介关联在亚组分析和控制社会人口统计学变量后基本保持稳定。
研究结果表明，内化体重偏见的超重和肥胖个体面临健康受损的风险，尤其是如果他们经历低核心自我评价，这使他们成为需要干预以减少自我污名化的群体。体重偏见内化本身并不是获得医疗保健的障碍，但与更大的健康损害相关，预测了更多的医疗保健利用。
