Huang Po-Ching, Latner Janet D, Bevan Nadia, Griffiths Mark D, Chen Jung-Sheng, Huang Chi Hsien, O'Brien Kerry S, Lin Chung-Ying
School of Physical Therapy, Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Rd, Taoyuan, 333323, Taiwan.
Department of Psychology, University of Hawaii at Manoa, 2500 Campus Road, Honolulu, HI, 96822, USA.
J Eat Disord. 2024 Sep 30;12(1):150. doi: 10.1186/s40337-024-01112-x.
Perceived weight stigma (PWS) and internalized weight stigma (IWS) are both associated with psychological distress and food addiction (FA). Using the previously proposed 'cyclic obesity/weight-based stigma' (COBWEBS) model, the present study extended the framework to investigate the mediating effects of IWS and psychological distress in the association between PWS and FA among young adults. Given that individuals who are overweight/have obesity have different vulnerabilities, this population was separately analyzed alongside the total study population.
An online survey comprising the Perceived Weight Stigma Scale, Weight Bias Internalization Scale (WBIS), Depression, Anxiety and Stress Scale-21 (DASS-21), and modified Yale Food Addiction Scale Version 2 was completed by 601 participants (59.6% females; mean age 29.3 years [SD = 6.07]). A total of 219 participants were categorized as being overweight/having obesity.
A direct correlation was found between PWS and FA (standardized coefficient [β] = 0.28, p < 0.001) among both populations, and was mediated by IWS and psychological distress (β [95% CI] = 0.03 [0.01, 0.05] for WBIS score and 0.10 [0.06, 0.14] for DASS-21 score) among the total participants, but only mediated by psychological distress among participants who were overweight/had obesity (β [95% CI] = 0.14 [0.06, 0.24]).
The results demonstrated novel perspectives by showing the direct association between PWS and FA and the mediating roles of IWS and psychological distress. Treatment strategies such as psychological acceptance and psychoeducation could be used to reduce weight stigma, which could have positive downstream benefits of ameliorating FA. Future research may seek to study strategies for reducing weight stigma and psychological distress, to investigate their efficacy in improving disordered eating.
感知到的体重污名（PWS）和内化的体重污名（IWS）均与心理困扰和食物成瘾（FA）相关。本研究使用先前提出的“循环性肥胖/基于体重的污名”（COBWEBS）模型，扩展了该框架，以研究IWS和心理困扰在年轻成年人中PWS与FA之间关联中的中介作用。鉴于超重/肥胖个体具有不同的易感性，该人群与总研究人群分开进行了分析。
601名参与者（59.6%为女性；平均年龄29.3岁[标准差=6.07]）完成了一项在线调查，该调查包括感知体重污名量表、体重偏见内化量表（WBIS）、抑郁、焦虑和压力量表-21（DASS-21）以及修订后的耶鲁食物成瘾量表第2版。共有219名参与者被归类为超重/肥胖。
在这两个人群中，均发现PWS与FA之间存在直接相关性（标准化系数[β]=0.28，p<0.001），在总参与者中，这种相关性由IWS和心理困扰介导（WBIS得分的β[95%置信区间]=0.03[0.01，0.05]，DASS-21得分的β[95%置信区间]=0.10[0.06，0.14]），但在超重/肥胖参与者中仅由心理困扰介导（β[95%置信区间]=0.14[0.06，0.24]）。
研究结果通过显示PWS与FA之间的直接关联以及IWS和心理困扰的中介作用，展示了新的观点。心理接纳和心理教育等治疗策略可用于减轻体重污名，这可能会对改善FA产生积极的下游益处。未来的研究可以寻求研究减轻体重污名和心理困扰的策略，以调查它们在改善饮食失调方面的效果。
