Pearl Rebecca L, Wadden Thomas A, Hopkins Christina M, Shaw Jena A, Hayes Matthew R, Bakizada Zayna M, Alfaris Nasreen, Chao Ariana M, Pinkasavage Emilie, Berkowitz Robert I, Alamuddin Naji
Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Department of Psychology, Duke University, Durham, North Carolina, USA.
Obesity (Silver Spring). 2017 Feb;25(2):317-322. doi: 10.1002/oby.21716.
Weight stigma is a chronic stressor that may increase cardiometabolic risk. Some individuals with obesity self-stigmatize (i.e., weight bias internalization, WBI). No study to date has examined whether WBI is associated with metabolic syndrome.
Blood pressure, waist circumference, and fasting glucose, triglycerides, and high-density lipoprotein cholesterol were measured at baseline in 178 adults with obesity enrolled in a weight-loss trial. Medication use for hypertension, dyslipidemia, and prediabetes was included in criteria for metabolic syndrome. One hundred fifty-nine participants (88.1% female, 67.3% black, mean BMI = 41.1 kg/m ) completed the Weight Bias Internalization Scale and Patient Health Questionnaire (PHQ-9, to assess depressive symptoms). Odds ratios and partial correlations were calculated adjusting for demographics, BMI, and PHQ-9 scores.
Fifty-one participants (32.1%) met criteria for metabolic syndrome. Odds of meeting criteria for metabolic syndrome were greater among participants with higher WBI, but not when controlling for all covariates (OR = 1.46, 95% CI = 1.00-2.13, P = 0.052). Higher WBI predicted greater odds of having high triglycerides (OR = 1.88, 95% CI = 1.14-3.09, P = 0.043). Analyzed categorically, high (vs. low) WBI predicted greater odds of metabolic syndrome and high triglycerides (Ps < 0.05).
Individuals with obesity who self-stigmatize may have heightened cardiometabolic risk. Biological and behavioral pathways linking WBI and metabolic syndrome require further exploration.
体重歧视是一种慢性应激源，可能会增加心血管代谢风险。一些肥胖个体存在自我歧视（即体重偏见内化，WBI）。迄今为止，尚无研究探讨WBI是否与代谢综合征相关。
在一项减肥试验中，对178名肥胖成年人进行了基线血压、腰围、空腹血糖、甘油三酯和高密度脂蛋白胆固醇测量。代谢综合征的标准包括高血压、血脂异常和糖尿病前期的药物使用情况。159名参与者（88.1%为女性，67.3%为黑人，平均BMI = 41.1 kg/m²）完成了体重偏见内化量表和患者健康问卷（PHQ - 9，用于评估抑郁症状）。计算了优势比和偏相关，并对人口统计学、BMI和PHQ - 9得分进行了调整。
51名参与者（32.1%）符合代谢综合征标准。WBI较高的参与者符合代谢综合征标准的几率更大，但在控制所有协变量后则不然（OR = 1.46，95%CI = 1.00 - 2.13，P = 0.052）。较高的WBI预示着甘油三酯升高的几率更大（OR = 1.88，95%CI = 1.14 - 3.09，P = 0.043）。分类分析显示，高（与低相比）WBI预示着代谢综合征和高甘油三酯的几率更大（P < 0.05）。
自我歧视的肥胖个体可能有更高的心血管代谢风险。连接WBI和代谢综合征的生物学和行为途径需要进一步探索。
