School of Behavioural and Health Sciences, Australian Catholic University, 115 Victoria Parade, Fitzroy, VIC, 3065, Australia.
School of Psychology and Public Health, La Trobe University, Albury-Wodonga, 3690, Australia.
Obes Surg. 2022 Nov;32(11):3675-3686. doi: 10.1007/s11695-022-06245-z. Epub 2022 Sep 12.
Research suggests that internalised weight stigma may explain the relationship between perceived weight stigma and adverse psychological correlates (e.g. depression, disordered eating, body image disturbances). However, few studies have assessed this mechanism in individuals seeking bariatric surgery, even though depression and disordered eating are more common in this group than the general population.
We used data from a cross-sectional study with individuals seeking bariatric surgery (n = 217; 73.6% female) from Melbourne, Australia. Participants (M = 44.1 years, SD = 11.9; M = 43.1, SD = 7.9) completed a battery of self-report measures on weight stigma and biopsychosocial variables, prior to their procedures. Bias-corrected bootstrapped mediations were used to test the mediating role of internalised weight stigma. Significance thresholds were statistically corrected to reduce the risk of Type I error due to the large number of mediation tests conducted.
Controlling for BMI, internalised weight stigma mediated the relationship between perceived weight stigma and psychological quality of life, symptoms of depression and anxiety, stress, adverse coping behaviours, self-esteem, exercise avoidance, some disordered eating measures and body image subscales, but not physical quality of life or pain.
Although the findings are cross-sectional, they are mostly consistent with previous research in other cohorts and provide partial support for theoretical models of weight stigma. Interventions addressing internalised weight stigma may be a useful tool for clinicians to reduce the negative correlates associated with weight stigma.
研究表明,内化的体重歧视可能解释了感知到的体重歧视与负面心理相关因素(如抑郁、饮食失调、身体意象障碍)之间的关系。然而,尽管在这个群体中,抑郁和饮食失调比一般人群更为常见,但很少有研究评估这种机制在寻求减肥手术的个体中是否存在。
我们使用了来自澳大利亚墨尔本的减肥手术患者的横断面研究数据(n=217;73.6%为女性)。参与者(M=44.1 岁,SD=11.9;M=43.1,SD=7.9)在手术前完成了一系列关于体重歧视和生物心理变量的自我报告量表。使用偏差校正的自举中介分析来检验内化体重歧视的中介作用。由于进行了大量的中介测试,因此对显著性阈值进行了统计学校正,以降低由于类型 I 错误而导致的风险。
在控制 BMI 的情况下,内化的体重歧视中介了感知到的体重歧视与生活质量、抑郁和焦虑症状、压力、应对不良行为、自尊、运动回避、一些饮食失调测量和身体意象分量表之间的关系,但与身体质量或疼痛无关。
尽管这些发现是横断面的,但它们与其他队列中的先前研究大多一致,并为体重歧视的理论模型提供了部分支持。针对内化体重歧视的干预措施可能是临床医生减少与体重歧视相关的负面相关因素的有用工具。