Himmelstein Mary S, Puhl Rebecca M, Pearl Rebecca L, Pinto Angela M, Foster Gary D
Department of Psychological Sciences, Kent State University, PO Box 5190, Kent, OH, 44242-0001, USA.
Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT, USA.
Int J Behav Med. 2020 Oct;27(5):576-590. doi: 10.1007/s12529-020-09895-4.
Coping responses to weight stigma can adversely affect health. Using data from a large commercial weight management sample, this study examined how adults cope with weight stigma, relationships among experienced weight stigma, weight bias internalization, and coping, as well as coping strategies as mediators of the stigma-health relationship.
Participants were adults enrolled in WW (formerly Weight Watchers) who reported at least one lifetime experience of weight stigma (N = 11,924). Participants completed questionnaires about the type and frequency of stigma experiences, weight bias internalization, strategies used to cope with weight stigma, and health-related quality of life.
Active coping, planning, positive reframing, acceptance, emotional support, and exercise avoidance were the most common coping strategies employed in response to acute weight stigma experiences. Weight bias internalization was more strongly associated with coping strategies likely to exacerbate health (e.g., disordered eating, substance use, self-blame) than positive reframing, acceptance, and emotional support. More types of experienced weight stigma (e.g., teasing, unfair treatment) were associated with more frequent use of all coping strategies. Coping strategies did not mediate the stigma-health relationship, and several strategies were associated with poor mental health.
More types of experiences with weight stigma were associated with more attempts to cope generally, while weight bias internalization was associated with coping strategies which were in turn associated with poor mental health. Developing effective approaches for identifying individuals likely to internalize weight stigma and helping individuals adopt effective coping strategies in response to stigma are important avenues of future research.
应对体重歧视的反应可能会对健康产生不利影响。本研究利用来自一个大型商业体重管理样本的数据，考察了成年人如何应对体重歧视、经历的体重歧视、体重偏见内化和应对之间的关系，以及应对策略作为歧视与健康关系的中介作用。
参与者为参加慧俪轻体（原称“体重观察者”）的成年人，他们报告至少有过一次终身体重歧视经历（N = 11924）。参与者完成了关于歧视经历的类型和频率、体重偏见内化、用于应对体重歧视的策略以及与健康相关的生活质量的问卷调查。
积极应对、计划、积极重新评价、接受、情感支持和避免运动是应对急性体重歧视经历时最常用的应对策略。与积极重新评价、接受和情感支持相比，体重偏见内化与可能加剧健康问题的应对策略（如饮食失调、物质使用、自责）的关联更强。更多类型的经历过的体重歧视（如取笑、不公平待遇）与所有应对策略的更频繁使用相关。应对策略并未介导歧视与健康的关系，且有几种策略与心理健康不佳有关。
更多类型的体重歧视经历通常与更多的应对尝试相关，而体重偏见内化与应对策略相关，这些应对策略又与心理健康不佳相关。开发有效的方法来识别可能内化体重歧视的个体，并帮助个体采用有效的应对策略来应对歧视，是未来研究的重要方向。
