Star Anita, Hay Phillipa, Quirk Frances, Mond Jonathan
Private Practice, Albury, 2640 New South Wales Australia ; School of Medicine and Dentistry, James Cook University, Townsville, Queensland 4811 Australia.
School of Medicine and Dentistry, James Cook University, Townsville, Queensland 4811 Australia ; School of Medicine, University of Western Sydney, Locked bag 1797, Penrith, New South Wales 2751 Australia.
BMC Obes. 2015 Feb 7;2:4. doi: 10.1186/s40608-014-0032-2. eCollection 2015.
Obesity stigma has been shown to increase binge eating, whilst positive regard for eating disorders (EDs) may increase dietary restriction which can also lead to binge eating and weight gain. In the context of increasing prevalence of both obesity and EDs exploring community attitudes towards these illnesses may uncover new variables worthy of consideration in population health campaigns. The aim of the study was to explore community perceived stigma and conversely favourable regard toward eating disorder (ED) sufferers of varying weight status, and understand how the attitudes of obese individuals may differ from those of non-obese individuals. Data for this purpose were derived from interviews with individuals participating in a general population health survey. Vignettes of an underweight female with Anorexia Nervosa (AN), a normal weight male with an atypical eating disorder (NWED) and an obese female with Binge Eating Disorder (BED) were presented to three randomly selected sub-samples of n = 983, 1033 and 1030 respectively. Questions followed that assessed participants' attitudes towards and beliefs about the person described in the vignette and their eating behaviours.
Sixty-six per cent of participants who responded to the obese BED vignette believed that there would be discrimination against the person described (primarily because of her weight). Corresponding figures were for the AN and NWED vignettes were 48% and 35%, respectively. A positive regard for weight-loss or body-image-enhancing ED behaviours was reported 'occasionally' or more often by 8.8% of respondents to the AN vignette and by 27.5% of respondents to the NWED vignette. Positive regard for ED behaviours was significantly more likely in obese participants (AN: 15%; NWED: 43%).
The findings support integrated ED and obesity prevention programs that address weight stigma and the social desirability of ED behaviours in vulnerable individuals.
肥胖污名已被证明会增加暴饮暴食，而对饮食失调（ED）的积极关注可能会增加饮食限制，这也可能导致暴饮暴食和体重增加。在肥胖和饮食失调患病率不断上升的背景下，探索社区对这些疾病的态度可能会发现一些在人群健康运动中值得考虑的新变量。本研究的目的是探讨社区对不同体重状况的饮食失调（ED）患者的污名化认知以及相反的好感度，并了解肥胖个体的态度与非肥胖个体的态度有何不同。为此目的的数据来自对参与一项普通人群健康调查的个体的访谈。分别向三个随机抽取的子样本（n = 983、1033和1030）展示了神经性厌食症（AN）的体重过轻女性、非典型饮食失调（NWED）的正常体重男性和暴饮暴食症（BED）的肥胖女性的描述。随后提出的问题评估了参与者对描述中的人物及其饮食行为的态度和信念。
对肥胖的暴饮暴食症描述做出回应的参与者中，66%的人认为所描述的人会受到歧视（主要是因为她的体重）。神经性厌食症和非典型饮食失调描述的相应比例分别为48%和35%。神经性厌食症描述的受访者中有8.8%、非典型饮食失调描述的受访者中有27.5%报告“偶尔”或更频繁地对减肥或改善身体形象的饮食失调行为持积极态度。肥胖参与者对饮食失调行为持积极态度的可能性显著更高（神经性厌食症：15%；非典型饮食失调：43%）。
研究结果支持综合的饮食失调和肥胖预防项目，该项目应解决体重污名以及弱势群体中饮食失调行为的社会期望问题。
