Schram Samantha J, Olson KayLoni L, Panza Emily, Lillis Jason
The Weight Control and Diabetes Research Center The Miriam Hospital Providence Rhode Island USA.
The Department of Psychiatry and Human Behavior Warren Alpert Medical School of Brown University Providence Rhode Island USA.
Obes Sci Pract. 2024 Oct 30;10(6):e70015. doi: 10.1002/osp4.70015. eCollection 2024 Dec.
Individuals with overweight or obesity often endure significant weight-based prejudice and discrimination in various settings. Experiencing weight-related stigma is linked to many adverse psychosocial outcomes. Weight self-stigma is when an individual internalizes and identifies with negative attributes ascribed to people with larger bodies and has self-devaluing thoughts because of their weight and is associated with poorer health outcomes.
This study explored how weight self-stigma may impact weight management efforts and outcomes for adults participating in an onlight weight-loss intervention.
508 adults (86.2% female, 84.6% White) with overweight or obesity participated in an asynchronous 12-week online weight-loss intervention with computer-generated feedback. Weight and weight self-stigma were measured at baseline and 3 months later.
Thirty-one point five percent of the sample reported high levels of stigma, which was associated with greater program dropout than those who did not report high stigma (32.5% vs. 21.6%). Program completers reporting high self-stigma showed better treatment engagement (77.0% vs. 69.7% lessons viewed) and weight loss ( = -6.31% vs. -5.08%); these differences were not observed when using intent-to-treat assumptions. When analyzed as a continuous variable, weight self-stigma showed no association with treatment engagement and outcome.
These findings highlight the complexity of understanding how self-stigma affects treatment engagement and outcome in behavioral weight loss and the need for more targeted research in this understudied area.
Results suggest that weight self-stigma plays a role in weight management during an online weight-loss intervention, affecting engagement and outcomes.
超重或肥胖个体在各种场合常常遭受严重的基于体重的偏见和歧视。经历与体重相关的耻辱感与许多不良的心理社会后果相关。体重自我耻辱感是指个体内化并认同赋予体型较大者的负面特质，并因其体重而产生自我贬低的想法，且与较差的健康结果相关。
本研究探讨了体重自我耻辱感如何影响参与在线减肥干预的成年人的体重管理努力及结果。
508名超重或肥胖成年人（86.2%为女性，84.6%为白人）参与了一项为期12周的异步在线减肥干预，并获得计算机生成的反馈。在基线和3个月后测量体重和体重自我耻辱感。
31.5%的样本报告有高度耻辱感，与未报告高度耻辱感的人相比，其项目退出率更高（32.5%对21.6%）。报告有高自我耻辱感的项目完成者表现出更好的治疗参与度（观看课程的比例为77.0%对69.7%）和体重减轻（分别为-6.31%对-5.08%）；在采用意向性分析假设时未观察到这些差异。当作为连续变量进行分析时，体重自我耻辱感与治疗参与度和结果无关联。
这些发现凸显了理解自我耻辱感如何影响行为减肥中的治疗参与度和结果的复杂性，以及在这个研究不足的领域进行更有针对性研究的必要性。
结果表明，体重自我耻辱感在在线减肥干预期间的体重管理中起作用，影响参与度和结果。
