Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Eat Weight Disord. 2020 Dec;25(6):1583-1592. doi: 10.1007/s40519-019-00795-5. Epub 2019 Oct 31.
To examine whether weight-related self-stigma (aka weight bias internalization) and insomnia are potential predictors of psychological distress and quality of life (QoL) among Iranian adolescents with overweight (OW)/obesity (OB). To examine whether weight-related self-stigma and insomnia are potential mediators in the relationship between excess weight and health outcomes of distress and QoL.
All participants (n = 934; 444 males; mean age = 15.7 ± 1.2 years; zBMI = 2.8 ± 1.0) completed questionnaires on weight-related self-stigma and insomnia at baseline. Six months later, they completed questionnaires on psychological distress and QoL to assess health outcomes. Relationships among variables were tested using mediation analyses with bootstrapping method.
Weight-related self-stigma significantly mediated the effects of zBMI on psychological distress (effect = 0.22; bootstrapping SE = 0.09; 95% CI = 0.08, 0.45), psychosocial QoL (effect = - 0.64; bootstrapping SE = 0.19; 95% CI = - 1.10, - 0.32), and physical QoL (effect = - 1.35; bootstrapping SE = 0.54; 95% CI = - 2.43, - 0.26). Insomnia also significantly mediated the effects of zBMI on psychological distress (effect = 2.18; bootstrapping SE = 0.31; 95% CI = 1.61, 2.81), psychosocial QoL (effect = - 0.89; bootstrapping SE = 0.33; 95% CI = - 1.60, - 0.28), and physical QoL (effect = - 0.83; bootstrapping SE = 0.42; 95% CI = - 1.69, - 0.02). Full mediations were found in psychosocial QoL; partial mediations were found in psychological distress and physical QoL.
Weight-related self-stigma and insomnia were significant mediators in the effects of excess weight on health outcomes. Therefore, it is important to identify and treat weight-related self-stigma and insomnia for adolescents with OW/OB.
Level V, cross-sectional descriptive study.
研究伊朗超重/肥胖青少年的体重相关自我污名（又称体重偏见内化）和失眠是否是心理困扰和生活质量（QoL）的潜在预测因素。研究体重相关自我污名和失眠是否是超重与健康结果（困扰和 QoL）之间关系的潜在中介因素。
所有参与者（n=934；444 名男性；平均年龄=15.7±1.2 岁；zBMI=2.8±1.0）在基线时完成了与体重相关的自我污名和失眠的问卷。六个月后，他们完成了关于心理困扰和 QoL 的问卷，以评估健康结果。使用 bootstrap 方法的中介分析测试变量之间的关系。
体重相关自我污名显著中介了 zBMI 对心理困扰（效应=0.22；bootstrap SE=0.09；95%CI=0.08，0.45）、心理社会 QoL（效应=-0.64；bootstrap SE=0.19；95%CI=-1.10，-0.32）和身体 QoL（效应=-1.35；bootstrap SE=0.54；95%CI=-2.43，-0.26）的影响。失眠也显著中介了 zBMI 对心理困扰（效应=2.18；bootstrap SE=0.31；95%CI=1.61，2.81）、心理社会 QoL（效应=-0.89；bootstrap SE=0.33；95%CI=-1.60，-0.28）和身体 QoL（效应=-0.83；bootstrap SE=0.42；95%CI=-1.69，-0.02）的影响。中介作用完全体现在心理社会 QoL 中；部分中介作用体现在心理困扰和身体 QoL 中。
体重相关自我污名和失眠是超重对健康结果影响的重要中介因素。因此，对于超重/肥胖的青少年来说，识别和治疗体重相关的自我污名和失眠非常重要。
等级 V，横断面描述性研究。
