de Macêdo Patricia Fortes Cavalcanti, Nepomuceno Carina Marcia Magalhães, Dos Santos Nedja Silva, Queiroz Valterlinda Alves de Oliveira, Pereira Emile Miranda, Leal Lucineide da Conceição, Santos Lígia Amparo da Silva, Nascimento Leonardo Fernandes, Martins Poliana Cardoso, de Santana Mônica Leila Portela
School of Nutrition, Federal University of Bahia, Salvador, Brazil.
Metropolitan Union for the Development of Education and Culture (UNIME), Psychology Course, Salvador, Bahia, Brazil.
J Eat Disord. 2022 Mar 26;10(1):44. doi: 10.1186/s40337-022-00563-4.
Weight stigma is a phenomenon associated with adverse behavioural and psychological consequences. Although experts suggest that its increase during the COVID-19 pandemic may be associated with worse health outcomes for people with obesity, a thorough analysis of the main findings and gaps is still needed when relating to this subject.
We aim to answer three questions: (1) How does weight stigma manifest in the COVID-19 pandemic? (2) How can weight stigma affect people with overweight or obesity in times of COVID-19? (3) What are the perceptions and experiences of weight stigma during the pandemic in individuals who experience overweight or obesity?
We conducted a scoping review of studies addressing weight stigma and the COVID-19 pandemic in electronic databases (Medline/PubMed, CINAHL, Embase, PsycInfo, BVS/Lilacs, Scopus, Web of Science, Google Scholar, and OpenGrey) published until 10th August 2021. All relevant studies were reviewed in full by two researchers. In addition, a narrative synthesis of the data was performed.
The results included 35 studies out of 8,090 records and identified 13 original research publications, 14 text and opinion papers, and 6 narrative reviews. The results revealed the presence of weight stigma in the media, healthcare settings, interpersonal relationships, and public campaigns during the COVID-19 pandemic. The evidence of increasing weight stigma in the COVID-19 outbreak is limited, though. Many weight discrimination consequences were described during this time, such as impairment in accessing healthcare, worst COVID-19 outcomes, and maladaptive eating. However, only maladaptive behaviours and decline in mental health outcomes were demonstrated empirically in all age groups. This effect occurred regardless of body mass index, but people with high body weight were more likely to experience weight stigma. For some people with obesity, weight stigma in the pandemic has made activities of daily routine difficult.
The results suggest that weight stigma in the COVID-19 pandemic occurs in several settings; moreover, although weight discrimination impacts mental health, whether before or during the pandemic, this influence between the pandemic and pre-pandemic scenario is still unclear. Therefore, more research is required in this field while the pandemic lasts, especially with people with obesity. Overall, people with overweight or obesity are more vulnerable to weight stigma than individuals without overweight. In addition, weight stigma refers to discrimination or prejudice based on a person's weight and relates to several consequences, for instance, poor healthcare treatment and mental health problems. In the COVID-19 outbreak, these weight stigma effects tend to become even more critical because they may be associated with unfavourable COVID-19 outcomes and eating disorder risks. Thus, it is crucial to investigate how weight stigma occurs during the pandemic and its impact on health, mainly for the most affected people. We investigated 35 studies published between 2019 and 2021 to map and explore how weight stigma was manifested and the related consequences for people with overweight or obesity in the COVID-19 pandemic. Only about a third of them were quantitative or qualitative, limiting the evidence of weight stigma in the COVID-19 context. The available evidence suggests that weight stigma manifests in several settings such as media, healthcare, public campaigns, and is more common in people with excess weight. However, weight discrimination experiences before or during the pandemic were associated with adverse psychological and behavioural consequences across all age groups, regardless of body weight. For some people with obesity, for instance, weight stigma made it difficult to accomplish their activities of daily routine. Nevertheless, it remains unclear whether weight stigma has increased in the pandemic, thus, more studies are required, especially about people with overweight or obesity.
体重歧视是一种与不良行为和心理后果相关的现象。尽管专家认为在新冠疫情期间体重歧视的增加可能与肥胖人群更差的健康结果有关，但在涉及这一主题时，仍需要对主要研究结果和差距进行全面分析。
我们旨在回答三个问题：（1）体重歧视在新冠疫情中如何表现？（2）在新冠疫情期间，体重歧视如何影响超重或肥胖人群？（3）在疫情期间，超重或肥胖个体对体重歧视的认知和经历是怎样的？
我们对截至2021年8月10日在电子数据库（Medline/PubMed、CINAHL、Embase、PsycInfo、BVS/Lilacs、Scopus、Web of Science、Google Scholar和OpenGrey）中发表的关于体重歧视和新冠疫情的研究进行了范围综述。两名研究人员对所有相关研究进行了全面审查。此外，还对数据进行了叙述性综合分析。
在8090条记录中，结果纳入了35项研究，确定了13篇原创研究论文、14篇文本和观点论文以及6篇叙述性综述。结果显示，在新冠疫情期间，媒体、医疗机构、人际关系和公共宣传活动中都存在体重歧视。不过，关于新冠疫情爆发期间体重歧视增加的证据有限。在此期间描述了许多体重歧视的后果，如获得医疗保健的障碍、更差的新冠疫情结果以及适应不良的饮食。然而，只有适应不良行为和心理健康结果下降在所有年龄组中得到了实证证明。这种影响与体重指数无关，但体重高的人更容易经历体重歧视。对于一些肥胖者来说，疫情期间的体重歧视使日常活动变得困难。
结果表明，新冠疫情中的体重歧视发生在多种环境中；此外，尽管体重歧视会影响心理健康，无论是在疫情之前还是期间，但疫情与疫情前情况之间的这种影响仍不清楚。因此，在疫情持续期间，这一领域需要更多研究，尤其是针对肥胖人群。总体而言，超重或肥胖者比非超重者更容易受到体重歧视。此外，体重歧视是指基于一个人的体重的歧视或偏见，与多种后果相关，例如医疗待遇差和心理健康问题。在新冠疫情爆发期间，这些体重歧视的影响往往变得更加严重，因为它们可能与不利的新冠疫情结果和饮食失调风险相关。因此，调查疫情期间体重歧视如何发生及其对健康的影响至关重要，主要针对受影响最严重的人群。我们调查了2项2019年至2021年发表的研究，以梳理和探索体重歧视在新冠疫情中是如何表现的，以及对超重或肥胖人群的相关后果。其中只有约三分之一是定量或定性的，限制了新冠疫情背景下体重歧视的证据。现有证据表明，体重歧视在媒体、医疗保健、公共宣传等多种环境中表现出来，在超重人群中更为常见。然而，疫情之前或期间的体重歧视经历与所有年龄组的不良心理和行为后果相关，与体重无关。例如，对于一些肥胖者来说，体重歧视使他们难以完成日常活动。然而，体重歧视在疫情期间是否增加仍不清楚，因此需要更多研究，尤其是关于超重或肥胖人群的研究。
