超重和肥胖成年人中感知到的体重歧视与慢性疾病
Perceived weight discrimination and chronic medical conditions in adults with overweight and obesity.
作者信息
Udo Tomoko, Purcell Katherine, Grilo Carlos M
机构信息
Department of Health Policy, Management, and Behavior, School of Public Health, University at Albany, State University of New York, Rensselaer, NY, USA.
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
出版信息
Int J Clin Pract. 2016 Dec;70(12):1003-1011. doi: 10.1111/ijcp.12902.
AIM
This study investigated whether perceived weight discrimination is associated with increased risk for major chronic medical conditions and whether the associations persist after adjusting for other stressful life events in addition to BMI, physical activity and sociodemographic variables.
METHODS
The study included 21 357 overweight/obese adults (52.9% women) from the 2001 to 2002 and 2004 to 2005 National Survey of Alcohol and Related Conditions.
RESULTS
Perceived weight discrimination was significantly associated with risk for arteriosclerosis, diabetes, high cholesterol, myocardial infarction, minor heart conditions and stomach ulcers. Perceived weight discrimination was associated with reporting more stressful life events. After adjusting additionally for stressful life events in the final multiple logistic regression, associations with arteriosclerosis, diabetes and minor cardiac conditions remained significant. Gender-stratified analyses revealed that perceived weight discrimination was associated with different medical conditions in women than men, and many associations became non-significant when adjusting for stressful life events, particularly for women.
CONCLUSIONS
Among overweight/obese adults, perceived weight discrimination is associated with significantly increased risk for obesity-related chronic medical conditions even after adjusting for BMI, physical activity and sociodemographic variables. Accounting for other acute stressful life events may also be important in understanding the health effects of perceived weight discrimination. Such added health risk of overweight/obesity posed by perceived weight discrimination warrants public health and policy interventions against weight discrimination to reduce the socioeconomic burden of obesity.
目的
本研究调查了感知到的体重歧视是否与主要慢性疾病风险增加相关，以及在对体重指数（BMI）、身体活动和社会人口统计学变量之外的其他压力性生活事件进行调整后，这种关联是否仍然存在。
方法
该研究纳入了2001至2002年以及2004至2005年全国酒精及相关状况调查中的21357名超重/肥胖成年人（52.9%为女性）。
结果
感知到的体重歧视与动脉硬化、糖尿病、高胆固醇、心肌梗死、轻度心脏病和胃溃疡的风险显著相关。感知到的体重歧视与报告更多压力性生活事件有关。在最终的多元逻辑回归中进一步对压力性生活事件进行调整后，与动脉硬化、糖尿病和轻度心脏病的关联仍然显著。按性别分层分析显示，感知到的体重歧视在女性和男性中与不同的疾病相关，并且在对压力性生活事件进行调整后，许多关联变得不显著，尤其是对女性而言。
结论
在超重/肥胖成年人中，即使对BMI、身体活动和社会人口统计学变量进行调整后，感知到的体重歧视仍与肥胖相关慢性疾病风险显著增加有关。考虑其他急性压力性生活事件对于理解感知到的体重歧视对健康的影响可能也很重要。这种由感知到的体重歧视带来的超重/肥胖额外健康风险，需要公共卫生和政策干预来反对体重歧视，以减轻肥胖的社会经济负担。
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