Mensinger Janell L, Calogero Rachel M, Tylka Tracy L
Reading Health System, Sixth Avenue and Spruce Street, West Reading, PA 19611, USA; Drexel University, College of Nursing and Health Professions 1601 Cherry Street, 3 Parkway Building, 9th Floor, MS 9503, Philadelphia, PA 19102, USA.
University of Kent School of Psychology, Keynes College Canterbury CT2 7NZ, UK.
Appetite. 2016 Jul 1;102:32-43. doi: 10.1016/j.appet.2016.01.033. Epub 2016 Jan 29.
Weight stigma is a significant socio-structural barrier to reducing health disparities and improving quality of life for higher weight individuals. The aim of this study was to examine the impact of internalized weight stigma on eating behaviors after participating in a randomized controlled trial comparing the health benefits of a weight-neutral program to a conventional weight-management program for 80 community women with high body mass index (BMI > 30, age range: 30-45). Programs involved 6 months of facilitator-guided weekly group meetings using structured manuals. Assessments occurred at baseline, post-intervention (6 months), and 24-months post-randomization. Eating behavior outcome measurements included the Eating Disorder Examination-Questionnaire and the Intuitive Eating Scale. Intention-to-treat linear mixed models were used to test for higher-order interactions between internalized weight stigma, group, and time. Findings revealed significant 3-way and 2-way interactions between internalized weight stigma, group, and time for disordered and adaptive eating behaviors, respectively. Only weight-neutral program participants with low internalized weight stigma improved global disordered eating scores. Participants from both programs with low internalized weight stigma improved adaptive eating at 6 months, but only weight-neutral program participants maintained changes at follow-up. Participants with high internalized weight stigma demonstrated no changes in disordered and adaptive eating, regardless of program. In order to enhance the overall benefit from weight-neutral approaches, these findings underscore the need to incorporate more innovative and direct methods to reduce internalized weight stigma for women with high BMI.
体重歧视是减少健康差距和改善高体重个体生活质量的一个重大社会结构障碍。本研究的目的是在一项随机对照试验中，比较体重中性计划与传统体重管理计划对80名社区高体重指数女性（BMI>30，年龄范围：30 - 45岁）的健康益处，探讨内化体重歧视对饮食行为的影响。这些计划包括使用结构化手册，在6个月内由主持人指导每周进行小组会议。评估在基线、干预后（6个月）和随机分组后24个月进行。饮食行为结果测量包括饮食失调检查问卷和直觉饮食量表。采用意向性治疗线性混合模型来检验内化体重歧视、组别和时间之间的高阶交互作用。研究结果分别揭示了内化体重歧视、组别和时间在紊乱和适应性饮食行为方面存在显著的三向和双向交互作用。只有内化体重歧视程度低的体重中性计划参与者的整体紊乱饮食得分有所改善。两个计划中内化体重歧视程度低的参与者在6个月时适应性饮食都有所改善，但只有体重中性计划参与者在随访时保持了这些变化。无论参加哪个计划，内化体重歧视程度高的参与者在紊乱和适应性饮食方面都没有变化。为了增强体重中性方法的整体益处，这些研究结果强调需要采用更具创新性和直接的方法来减少高BMI女性的内化体重歧视。
