体重歧视与健康行为：来自“美国人饮食研究”的证据。
Weight stigma and health behaviors: evidence from the Eating in America Study.
机构信息
Department of Psychology, University of California, Los Angeles, CA, USA.
Department of Psychology, Miami University, Oxford, OH, USA.
出版信息
Int J Obes (Lond). 2021 Jul;45(7):1499-1509. doi: 10.1038/s41366-021-00814-5. Epub 2021 May 1.
BACKGROUND
Weight stigma is pervasive across the U.S. and is associated with poor health outcomes including all-cause mortality. One potential reason that weight stigma may be detrimental to health is that it begets poorer health behaviors. Therefore, the present study tested for associations between weight stigma and four health behaviors (i.e., eating behavior, alcohol use, sleep disturbance, and physical activity), while controlling for BMI and other potential confounds.
SUBJECTS/METHODS: Participants (N = 2022) in the U.S. were recruited for the Eating in America Study using a Qualtrics panel between December 2019 and January 2020 and were census-matched according to national quotas for age, gender, income, race/ethnicity, and census region. Participants completed questionnaires about weight stigma, health behaviors, demographics, and anthropometric measurements. The current study employed a two-stage investigation: exploratory analyses were first performed on a random sample of the dataset (n = 438), then the remaining unexamined data were used to conduct confirmatory analyses that were preregistered on the Open Science Framework.
RESULTS
Controlling for BMI, weight stigma was significantly associated with greater disordered eating (b = 0.34, 95% CI [0.31, 0.38], p < 0.001), comfort eating (b = 0.32, 95% CI [0.25, 0.39], p < 0.001), sleep disturbance (b = 0.27, 95% CI [0.20, 0.33], p < 0.001), and alcohol use (b = 0.30, 95% CI [0.11, 0.49], p = 0.002), but not lower physical activity (b = -0.04, 95% CI [-0.13, 0.05], p = 0.402) for individuals across the weight spectrum. BMI and perceived weight status significantly moderated the effects of weight stigma on disordered eating and alcohol use. No gender differences were found. These confirmatory analyses partially replicated the exploratory stage 1 findings.
CONCLUSIONS
This study provides preliminary evidence that weight stigma is linked to several poor health behaviors, which may impact physical health.
背景
体重歧视在美国普遍存在，并与包括全因死亡率在内的不良健康结果有关。体重歧视可能对健康有害的一个潜在原因是，它会导致更差的健康行为。因此，本研究测试了体重歧视与四种健康行为（即饮食行为、饮酒、睡眠障碍和身体活动）之间的关联，同时控制了 BMI 和其他潜在的混杂因素。
受试者/方法：2019 年 12 月至 2020 年 1 月期间，通过 Qualtrics 小组，使用美国的“饮食在美国研究”（Eating in America Study）招募了受试者，并根据年龄、性别、收入、种族/民族和人口普查区域等全国配额进行人口普查匹配。参与者完成了关于体重歧视、健康行为、人口统计学和人体测量学测量的问卷。本研究采用了两阶段调查：首先对数据集的随机样本（n=438）进行了探索性分析，然后使用剩余未检查的数据进行了预先在开放科学框架上注册的验证性分析。
结果
控制 BMI 后，体重歧视与饮食障碍（b=0.34，95%CI[0.31，0.38]，p<0.001）、安慰性进食（b=0.32，95%CI[0.25，0.39]，p<0.001）、睡眠障碍（b=0.27，95%CI[0.20，0.33]，p<0.001）和饮酒（b=0.30，95%CI[0.11，0.49]，p=0.002）显著相关，但与体力活动（b=-0.04，95%CI[-0.13，0.05]，p=0.402）无关，适用于体重范围内的个体。BMI 和感知体重状况显著调节了体重歧视对饮食障碍和饮酒的影响。未发现性别差异。这些验证性分析部分复制了探索性阶段 1 的发现。
结论
本研究初步证明了体重歧视与几种不良健康行为有关，这可能会影响身体健康。
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