Sikorski Claudia, Luppa Melanie, Luck Tobias, Riedel-Heller Steffi G
Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Germany; Leipzig University Medical Center, IFB Adiposity Diseases, Leipzig, Germany; Mailman School of Public Health, Department of Epidemiology, Columbia University, New York City, New York, USA.
Obesity (Silver Spring). 2015 Feb;23(2):266-76. doi: 10.1002/oby.20952. Epub 2014 Dec 31.
Research consistently shows a negative view of individuals with obesity in the general public and in various other settings. Stigma and discrimination can be considered chronic stressors, as these factors have a profound impact on the psychological well-being of the affected individuals. This article proposes a framework that entails a mediation of the adverse effects of discrimination and stigmatization on mental well-being through elevated psychological risk factors that are not unique to weight but that could affect overweight and normal-weight individuals alike.
A systematic review was conducted to assess the prevalence of psychological risk factors, such as self-esteem and coping, in individuals with obesity.
Forty-six articles were assessed and included for detailed analysis. The number of studies on these topics is limited to certain dimensions of psychological processes. The best evaluated association of obesity and psychosocial aspects is seen for self-esteem. Most studies establish a negative association of weight and self-esteem in children and adults. All studies with mediation analysis find a positive mediation through psychological risk factors on mental health outcomes.
This review shows that elevated psychological risk factors are existent in individuals with obesity and that they may be a mediator between weight discrimination and pathopsychological outcomes.
研究一致表明，普通公众以及其他各种环境中的人们对肥胖个体持负面看法。耻辱感和歧视可被视为慢性应激源，因为这些因素会对受影响个体的心理健康产生深远影响。本文提出了一个框架，该框架通过并非体重所特有的、但可能对超重和正常体重个体均有影响的心理风险因素的升高，对歧视和污名化对心理健康的不利影响进行调解。
进行了一项系统综述，以评估肥胖个体中心理风险因素（如自尊和应对方式）的患病率。
评估了46篇文章并纳入详细分析。关于这些主题的研究数量仅限于心理过程的某些维度。肥胖与心理社会方面评估最好的关联体现在自尊方面。大多数研究表明儿童和成人的体重与自尊呈负相关。所有进行中介分析的研究均发现心理风险因素对心理健康结果有正向中介作用。
本综述表明，肥胖个体存在心理风险因素升高的情况，且这些因素可能是体重歧视与精神心理结果之间的中介因素。
