Weight Control and Diabetes Research Center, The Miriam Hospital, Providence RI, United States; Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, United States.
Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia PA, United States.
Body Image. 2019 Sep;30:159-164. doi: 10.1016/j.bodyim.2019.07.005. Epub 2019 Jul 27.
Women are disproportionately impacted by pain compared to men, highlighting the need to better understand factors that contribute to this gender disparity. Previous findings suggest weight-related stigma may be associated with pain among women attempting to lose weight. The goal of this study is to determine if experienced and/or internalized weight bias mediate the relationship between body mass index (BMI) and pain-related impairment in a large, community-based sample of women across the weight spectrum (N = 309; M = 56.5, SD = 14.5; M = 28.5, SD = 7.1), and to evaluate whether this relationship differs for women with a pain condition. Analyses were performed using the Conditional-PROCESS Macro to examine the relationships between BMI, pain-related impairment, internalized and experienced weight-stigma, and the potentially moderating effect of pain-related conditions on these relationships. After adjusting for covariates, both experienced stigma and internalized weight stigma statistically mediated the BMI and pain-related impairment relationship; however, in the tests of moderated mediation, the indirect effect of internalized weight bias only held true for those without pain conditions. These findings offer a preliminary conceptual model and highlight the importance of pain research to include weight-related stigma.
与男性相比,女性受到疼痛的影响不成比例,这突出表明需要更好地了解导致这种性别差异的因素。先前的研究结果表明,与体重相关的污名可能与试图减肥的女性的疼痛有关。本研究的目的是确定在一个大型的、基于社区的、涵盖整个体重范围的女性样本中(N=309;M=56.5,SD=14.5;M=28.5,SD=7.1),经验和/或内化的体重偏见是否在 BMI 和与疼痛相关的损伤之间的关系中起中介作用,以及评估这种关系是否因有疼痛状况的女性而有所不同。使用条件过程宏(Conditional-PROCESS Macro)进行分析,以检验 BMI、与疼痛相关的损伤、内化和经验性体重污名之间的关系,以及疼痛相关状况对这些关系的潜在调节作用。在调整了协变量后,经验性污名和内化的体重偏见都在统计学上对 BMI 和与疼痛相关的损伤之间的关系起中介作用;然而,在有调节的中介检验中,内化的体重偏见的间接效应仅适用于没有疼痛状况的人群。这些发现提供了一个初步的概念模型,并强调了疼痛研究纳入与体重相关的污名的重要性。