Endocrinology and Nutrition Department, Hospital Universitario Son Llàtzer. Health Research Institute of the Balearic Islands (IdISBa). Ctra Manacor km 4, Palma de Mallorca, Baleares, 07198, Spain; Clínica Rotger (Grupo Quirón). Via Roma, 3., Palma de Mallorca, Baleares, 07012, Spain.
Clínica Juaneda (Grupo Juaneda), Palma de Mallorca, Spain; Servicio de Endocrinología y Nutrición, Hospital Universitario Son Espases, Palma de Mallorca, Spain.
Physiol Behav. 2023 Apr 1;262:114088. doi: 10.1016/j.physbeh.2023.114088. Epub 2023 Jan 16.
Weight stigma (WS) and prejudice are one of the most prevalent ways of discrimination among adults, comparable with rates of racial discrimination. Exposure to WS among patients with obesity (PWO) may make the adoption of healthy dietary patterns and regular physical activity even more challenging and, therefore, the achievement of weight loss. Additionally, WS could also induce physiological responses such as increased levels of inflammatory markers, due to stress exposure.
Subjects attending two obesity clinics were evaluated at baseline and after a minimum follow-up of six months. The weight Bias Internalization Scale (WBIS) and the Stigmatizing Situations Inventory (SSI) were administered to evaluate WS. Also, anthropometric and inflammatory markers, including cortisol, ferritin and C-reactive protein (CRP), were recorded at baseline.
79 PWO (87.3%♀, 45.5 ± 1.3 years, 35.9 ± 6.3 kg/m) were included. At baseline, 72.2% started liraglutide as anti-obesity drug. Baseline body mass index (BMI) correlated positively with both WBIS (r = 0.23; p = 0.03) and SSI (r = 0.25; p = 0.02) scores. Mean percentual weight loss after a mean follow-up of six months was -7.28%. However, there was a negative, but not statistically significant, correlation between weight loss and both WBIS (r=-0.14; p = 0.2) and SSI (r=-0.19; p = 0.08). Regarding inflammatory markers, plasma cortisol levels at baseline correlated positively with WBIS (p = 0.005) and SSI (p = 0.02). CRP at baseline also presented a positive correlation with SSI (p = 0.03). No significant correlations were found for stigma tests and ferritin levels.
As weight increases among PWO, so does stigma. Despite we did not find a significant negative association between the presence of WS and weight loss outcomes, there was an increase in inflammatory markers among PWO who experienced higher levels of WS.
体重歧视（WS）和偏见是成年人中最普遍的歧视方式之一，可与种族歧视率相媲美。肥胖患者（PWO）接触 WS 可能使他们更难以采用健康的饮食模式和定期进行体育锻炼，从而更难以实现减肥。此外，WS 还可能由于暴露于压力而引起生理反应，例如炎症标志物水平升高。
在基线和至少 6 个月的随访后，评估参加两个肥胖诊所的受试者。进行体重偏见内化量表（WBIS）和污名化情境量表（SSI）评估 WS。此外，还记录了基线时的人体测量和炎症标志物，包括皮质醇、铁蛋白和 C 反应蛋白（CRP）。
共纳入 79 名 PWO（87.3%♀，45.5±1.3 岁，35.9±6.3kg/m）。基线时，72.2%开始使用利拉鲁肽作为抗肥胖药物。基线体重指数（BMI）与 WBIS（r=0.23；p=0.03）和 SSI（r=0.25；p=0.02）评分均呈正相关。在平均 6 个月的随访后，平均体重减轻率为-7.28%。然而，体重减轻与 WBIS（r=-0.14；p=0.2）和 SSI（r=-0.19；p=0.08）之间存在负相关，但无统计学意义。关于炎症标志物，基线时血浆皮质醇水平与 WBIS（p=0.005）和 SSI（p=0.02）呈正相关。CRP 与 SSI（p=0.03）也呈正相关。在污名测试和铁蛋白水平之间未发现显著相关性。
随着 PWO 体重的增加，WS 也随之增加。尽管我们没有发现 WS 与减肥结果之间存在显著的负相关，但在经历更高水平 WS 的 PWO 中，炎症标志物增加。
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