家庭和育儿因素能否减轻体重污名对年轻人饮食失调的影响？一项基于人群的纵向研究。
Can Family and Parenting Factors Modify the Impact of Weight Stigma on Disordered Eating in Young People? A Population-Based Longitudinal Study.
机构信息
Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota.
Department of Human Development and Family Sciences, University of Connecticut, Storrs, Connecticut.
出版信息
J Adolesc Health. 2023 Jul;73(1):44-52. doi: 10.1016/j.jadohealth.2023.01.024. Epub 2023 Mar 11.
PURPOSE
Weight stigma is a prevalent problem in adolescents and a risk factor for disordered eating behaviors (DEBs). This study examined whether positive family/parenting factors were protective for DEBs among an ethnically/racially and socioeconomically diverse sample of adolescents with and without weight stigmatizing experiences.
METHODS
In Project Eating and Activity over Time (EAT) 2010-2018, 1,568 adolescents (mean age = 14.4 ± 2.0 years) were surveyed and followed into young adulthood (mean age = 22.2 ± 2.0 years). Modified Poisson regression models examined the relationships between three weight-stigmatizing experiences and four DEBs (e.g., overeating and binge eating) in models adjusted for sociodemographic characteristics and weight status. Interaction terms and stratified models examined whether family/parenting factors were protective for DEBs based on weight stigma status.
RESULTS
Higher family functioning and support for psychological autonomy were cross sectionally protective for DEBs. However, this pattern was primarily observed in adolescents who did not experience weight stigma. For example, among adolescents who did not experience peer weight teasing, high support for psychological autonomy was associated with lower prevalence of overeating (high support: 7.0%, low support: 12.5%, p = .003). Whereas, in participants who experienced family weight teasing, the difference in prevalence of overeating based on support for psychological autonomy was not statistically significant (high support: 17.9%, low support: 22.4%, p = .260).
DISCUSSION
General positive family and parenting factors did not entirely offset the effects of weight-stigmatizing experiences on DEBs, which may reflect the strength of weight stigma as a risk factor for DEBs. Future research is needed to identify effective strategies family members can use to support youth who experience weight stigma.
目的
体重歧视在青少年中是一个普遍存在的问题，也是饮食障碍行为（DEBs）的一个风险因素。本研究旨在探讨在一个具有种族、社会经济多样性的青少年样本中，积极的家庭/养育因素是否对有和没有体重歧视经历的青少年的 DEBs 具有保护作用。
方法
在 2010-2018 年的 Eating and Activity over Time（EAT）项目中，对 1568 名青少年（平均年龄 14.4 ± 2.0 岁）进行了调查，并随访至成年早期（平均年龄 22.2 ± 2.0 岁）。修正泊松回归模型考察了三种体重歧视经历与四种 DEBs（如暴饮暴食和暴食）之间的关系，这些模型调整了社会人口统计学特征和体重状况。交互项和分层模型检验了家庭/养育因素是否根据体重歧视状况对 DEBs 具有保护作用。
结果
较高的家庭功能和对心理自主性的支持在横断面与 DEBs 呈保护关系。然而，这种模式主要出现在没有经历体重歧视的青少年中。例如，在没有经历同伴体重嘲笑的青少年中，对心理自主性的高支持与较低的暴饮暴食发生率相关（高支持：7.0%，低支持：12.5%，p =.003）。然而，在经历过家庭体重嘲笑的参与者中，基于心理自主性支持的暴饮暴食发生率差异在统计学上无显著性（高支持：17.9%，低支持：22.4%，p =.260）。
讨论
一般积极的家庭和养育因素并没有完全消除体重歧视经历对 DEBs 的影响，这可能反映了体重歧视作为 DEBs 的一个风险因素的强度。未来的研究需要确定家庭成员可以用来支持经历体重歧视的青少年的有效策略。
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