Department of Behavioural Science and Health, University College London, London, UK.
Department of Behavioural Science and Health, University College London, London, UK.
Psychoneuroendocrinology. 2018 Dec;98:67-73. doi: 10.1016/j.psyneuen.2018.08.018. Epub 2018 Aug 11.
Stigmatization of individuals with obesity is pervasive and may act as a psychological stressor. The present study examined whether perceived weight discrimination mediated the relationship between obesity and cortisol, an objective marker of chronic stress, in a population-based sample.
Data were from the English Longitudinal Study of Ageing (n = 1872). Height and weight were objectively measured in 2008/09. Experiences of weight-related discrimination were reported via questionnaire in 2010/11. Hair cortisol concentrations were determined from the scalp-nearest 2 cm hair segment in 2012/13. Mediation analyses tested the role of perceived weight discrimination in the associations between obesity and BMI and hair cortisol concentration, adjusting for age, sex, ethnicity, socio-economic status, smoking status, depression and hair-related factors.
Obesity, BMI and perceived weight discrimination were positively related to hair cortisol (all p < .01). Perceived weight discrimination significantly mediated associations between obesity and hair cortisol (β = 0.021, SE = 0.007, 95% CI 0.007-0.036) and BMI and hair cortisol (β = 0.001, SE = 0.0004, 95% CI 0.0004-0.002), accounting for 19% of the total effect of obesity and 23% of the total effect of BMI on hair cortisol.
Perceived weight discrimination is an important mediator of the association between obesity and cortisol. Interventions combating weight stigma and discrimination or promoting strategies for coping with stress could help to lessen the psychological and physiological burden of obesity.
肥胖个体普遍受到歧视，这可能成为一种心理应激源。本研究旨在人群样本中检验感知到的体重歧视是否在肥胖与皮质醇（一种慢性应激的客观标志物）之间的关系中起中介作用。
数据来自英国老龄化纵向研究（n=1872）。2008/09 年进行了身高和体重的客观测量。2010/11 年通过问卷调查报告了与体重相关的歧视经历。2012/13 年从头皮最近 2cm 的头发段测定了头发皮质醇浓度。中介分析检验了感知到的体重歧视在肥胖与 BMI 和头发皮质醇浓度之间的关联中的作用，调整了年龄、性别、种族、社会经济地位、吸烟状况、抑郁和头发相关因素。
肥胖、BMI 和感知到的体重歧视与头发皮质醇呈正相关（均 P<0.01）。感知到的体重歧视显著中介了肥胖与头发皮质醇（β=0.021，SE=0.007，95%置信区间 0.007-0.036）和 BMI 与头发皮质醇（β=0.001，SE=0.0004，95%置信区间 0.0004-0.002）之间的关联，解释了肥胖对头发皮质醇总效应的 19%和 BMI 对头发皮质醇总效应的 23%。
感知到的体重歧视是肥胖与皮质醇之间关联的一个重要中介因素。打击体重歧视和歧视的干预措施或促进应对压力的策略可能有助于减轻肥胖的心理和生理负担。
