Pearl Rebecca L, Wadden Thomas A, Chao Ariana M, Alamuddin Naji, Berkowitz Robert I, Walsh Olivia, Allison Kelly C, Tronieri Jena Shaw
Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, PA.
Behav Med. 2020 Apr-Jun;46(2):87-91. doi: 10.1080/08964289.2018.1556202. Epub 2019 Jan 18.
Obesity is a complex disease caused by a wide array of behavioral, biological, and environmental factors. However, obesity is often attributed to oversimplified and stigmatizing causal factors such as laziness, lack of willpower, and failure to take personal responsibility for one's health. Understanding of the causal factors that contribute to obesity may affect their weight management efforts. The current study explored associations between causal attributions for obesity and long-term weight loss, as well as examined potential changes in attributions with weight reduction. The 16-item Causal Attributions for Obesity scale (rated 1-7) was administered to 178 patients seeking behavioral/pharmacological weight-loss treatment. Causal attributions and weight were assessed at baseline, after 14 weeks of a low-calorie diet, and again at weeks 24 and 52 of a subsequent randomized trial (i.e., 66 weeks total). Logistic and linear regression examined effects of baseline causal attribution ratings on weight loss. Higher baseline ratings of personal responsibility attributions predicted 38% reduced odds of achieving ≥10% weight loss at week 52 ( = 0.02). Causal attribution ratings did not change over time or correlate continuously with weight change. Thus, attributing obesity to a failure of personal responsibility may impair long-term weight management efforts for individuals seeking ≥10% weight loss. Targeted techniques are needed to reduce patients' stigmatizing beliefs about the causes of obesity.
肥胖是一种由多种行为、生物和环境因素引起的复杂疾病。然而，肥胖往往被归因于一些过于简单化且带有污名化的因果因素，如懒惰、缺乏意志力以及未能对自身健康承担个人责任。对导致肥胖的因果因素的理解可能会影响他们的体重管理努力。当前的研究探讨了肥胖因果归因与长期体重减轻之间的关联，并研究了随着体重减轻归因可能发生的潜在变化。对178名寻求行为/药物减肥治疗的患者使用了16项肥胖因果归因量表（评分1 - 7）。在基线、低热量饮食14周后以及随后随机试验的第24周和第52周（即总共66周）评估因果归因和体重。逻辑回归和线性回归分析了基线因果归因评分对体重减轻的影响。个人责任归因的较高基线评分预测在第52周实现≥10%体重减轻的几率降低38%（ = 0.02）。因果归因评分并未随时间变化，也与体重变化没有持续相关性。因此，将肥胖归因于个人责任缺失可能会损害那些寻求体重减轻≥10%的个体的长期体重管理努力。需要有针对性的技巧来减少患者对肥胖原因的污名化观念。
