体重歧视与体重相关健康：体重管理成人中自我报告测量指标的关联。
Weight Stigma and Weight-Related Health: Associations of Self-Report Measures Among Adults in Weight Management.
机构信息
Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA.
出版信息
Ann Behav Med. 2020 Nov 1;54(11):904-914. doi: 10.1093/abm/kaaa026.
BACKGROUND
Weight stigma impairs health. Few studies have disentangled the associations of experienced versus internalized stigma with weight-related outcomes.
PURPOSE
To examine weight and health variables associated with weight stigma experiences and internalization in the largest-to-date sample of adults in weight management.
METHODS
WW (formerly Weight Watchers) members (N = 18,769, 94.6% female, 91.1% white) completed an online survey from 2017 to 2018. Participants reported whether they had experienced weight stigma and, if so, the onset, past-year frequency and distress, and interpersonal sources of stigma. Participants completed the Modified Weight Bias Internalization Scale (WBIS-M) and self-reported: past-year weight and lifetime weight cycles; current self-monitoring behaviors; eating self-efficacy; physical activity; perceived stress; eating to cope; body image; and mental and physical health-related quality-of-life (HRQOL). Participants reported their demographic characteristics, including height and weight to compute body mass index.
RESULTS
In logistic and linear regression analyses (controlling for participant characteristics), WBIS-M scores were negatively associated with weight loss, self-monitoring, eating self-efficacy, body image, and mental HRQOL and positively associated with weight gain, weight cycling, perceived stress, and eating to cope (p < .001). Experiencing weight stigma was associated with greater weight loss and less weight gain, although associations with other variables had small effect sizes (absolute β values < 0.10). WBIS-M scores remained significantly associated with all variables when including stigma onset, frequency/distress, and sources.
CONCLUSIONS
Internalized, but not experienced, weight stigma was consistently associated with adverse weight and health factors. Developing and testing interventions targeting internalized stigma in the context of weight management should be a research priority.
背景
体重歧视会损害健康。很少有研究能够厘清经历过的和内化的歧视与体重相关结果之间的关联。
目的
在最大的体重管理成年人样本中，研究与体重歧视经历和内化相关的体重和健康变量。
方法
WW（前身为 Weight Watchers）会员（N=18769 名，94.6%为女性，91.1%为白人）于 2017 年至 2018 年期间在线完成了一项调查。参与者报告了他们是否经历过体重歧视，如果有，那么歧视的开始时间、过去一年的频率和困扰程度以及人际来源。参与者完成了《体重偏见内化量表》（WBIS-M）的修订版，并报告了：过去一年的体重和终生体重循环；当前的自我监测行为；饮食自信；身体活动；感知压力；饮食应对；身体形象；以及精神和身体健康相关生活质量（HRQOL）。参与者报告了他们的人口统计学特征，包括身高和体重，以计算体重指数。
结果
在逻辑回归和线性回归分析中（控制参与者特征），WBIS-M 评分与体重减轻、自我监测、饮食自信、身体形象和心理健康 HRQOL 呈负相关，与体重增加、体重循环、感知压力和饮食应对呈正相关（p<.001）。经历体重歧视与体重减轻更多、体重增加更少有关，尽管与其他变量的关联效应较小（绝对β值<0.10）。当纳入歧视开始、频率/困扰和来源时，WBIS-M 评分仍与所有变量显著相关。
结论
内化的但不是经历过的体重歧视与不良的体重和健康因素始终相关。在体重管理背景下，针对内化的歧视制定和测试干预措施应成为研究重点。
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