Division of Epidemiology and Community Health, University of Minnesota, Suite 300, 1300 S, 2nd St., Minneapolis, MN, 55454-1015, USA.
Department of Food Science and Nutrition, University of Minnesota, 225 Food Science and Nutrition, 1334 Eckles Ave, St. Paul, MN, 55108, USA.
Int J Behav Nutr Phys Act. 2022 Jun 23;19(1):71. doi: 10.1186/s12966-022-01307-y.
Weight stigma is prevalent among young people and harmful to health. The current study used a health equity lens to examine cross-sectional and longitudinal associations between experiencing weight teasing (a form of weight stigma) with a range of weight-related health behaviors and weight status in an ethnically/racially and socioeconomically diverse sample of young people. We also assessed whether ethnicity/race and adolescent socioeconomic status (SES) operated as effect modifiers in these relationships.
Adolescents (n = 1568) were enrolled in EAT 2010-2018 (Eating and Activity over Time) and followed into young adulthood. Weight teasing; screen time; moderate-to-vigorous physical activity (MVPA); sleep duration; breakfast frequency; fruit, vegetable, sugar-sweetened beverage (SSB), and fast-food intake; and body mass index (BMI) were assessed at baseline (mean age = 14.4 years) and eight-year follow-up (mean age = 22.2 years). Multivariate linear regression estimated marginal means and 95% confidence intervals. All analyses adjusted for BMI and sociodemographic characteristics.
Weight teasing was cross-sectionally associated with longer screen time, shorter sleep duration, and higher BMI during adolescence; and cross-sectionally associated with shorter sleep duration, lower breakfast frequency, higher fast-food intake, higher SSB intake, and higher BMI during young adulthood. In the longitudinal analyses, weight teasing was not associated with health behaviors but did predict higher BMI (teased: 28.2 kg/m, not teased: 26.4 kg/m, p < 0.001). White and higher adolescent SES subgroups had higher MVPA, more frequent breakfast intake, lower fast-food intake, and lower BMI than their respective counterparts. The relationships between weight teasing and health behaviors and weight status were largely consistent across ethnic/racial and adolescent SES subgroups.
Findings add to growing evidence that weight-based mistreatment poses a threat to weight-related health and that young people across ethnic/racial and SES subgroups are vulnerable to the negative effects of weight teasing. Limitations include attrition at follow-up and the self-reported nature of many measures. Results suggest a need for increased attention to existing recommendations to reduce weight stigma in young people from diverse ethnic/racial and socioeconomic backgrounds including training for healthcare providers to better equip them to address the harms of weight teasing and foster more compassionate care to promote health-supporting behaviors in young people.
体重歧视在年轻人中很普遍，对健康有害。本研究从健康公平的角度出发，在一个种族/民族和社会经济多样化的年轻人样本中，考察了经历体重嘲笑（体重歧视的一种形式）与一系列与体重相关的健康行为和体重状况之间的横断面和纵向关联。我们还评估了种族/民族和青少年社会经济地位（SES）是否在这些关系中充当了调节因素。
青少年（n=1568）参加了 EAT 2010-2018 年（饮食和活动随时间变化）研究，并在进入成年早期后进行了随访。在基线（平均年龄 14.4 岁）和 8 年随访（平均年龄 22.2 岁）时评估了体重嘲笑、屏幕时间、中等到剧烈体力活动（MVPA）、睡眠时间、早餐频率、水果、蔬菜、含糖饮料（SSB）和快餐摄入量以及体重指数（BMI）。多变量线性回归估计了边际均值和 95%置信区间。所有分析均调整了 BMI 和社会人口特征。
体重嘲笑与青少年时期的屏幕时间延长、睡眠时间缩短和 BMI 升高有关；与成年早期的睡眠时间缩短、早餐频率降低、快餐摄入增加、SSB 摄入增加和 BMI 升高有关。在纵向分析中，体重嘲笑与健康行为无关，但预测 BMI 较高（被嘲笑：28.2kg/m，未被嘲笑：26.4kg/m，p<0.001）。白人和较高的青少年 SES 亚组的 MVPA 更高、早餐摄入更频繁、快餐摄入更少、BMI 更低，与各自的亚组相比。体重嘲笑与健康行为和体重状况之间的关系在种族/民族和青少年 SES 亚组中基本一致。
研究结果进一步证明，基于体重的虐待对与体重相关的健康构成威胁，并且来自不同种族/民族和社会经济背景的年轻人都容易受到体重嘲笑的负面影响。研究的局限性包括随访时的流失和许多测量方法的自我报告性质。结果表明，需要更加关注减少来自不同种族/民族和社会经济背景的年轻人的体重歧视的现有建议，包括培训医疗保健提供者，以更好地使他们能够解决体重嘲笑的危害，并培养更富有同情心的护理，以促进年轻人的健康支持行为。
