Kalantzis Maria A, Maitland Daniel M, Yannon Miranda, Gaggiano Christina, He Jinbo, Barrita Aldo, Symmes Lorelai, O'Brien William H
Department of Psychology, Bowling Green State University, USA.
Department of Psychology and Counseling, University of Missouri Kansas City, USA.
Compr Psychoneuroendocrinol. 2025 Apr 3;22:100290. doi: 10.1016/j.cpnec.2025.100290. eCollection 2025 May.
Discrimination based on weight status (or weight-related discrimination/stigma) may be related to greater physical and mental health concerns via physiological and psychological phenotypes of stress. Cortisol output, a biomarker of stress, has been measured in relation to weight stigma and weight-related discrimination. This systematic review aims to synthesize existing research on the relationship between weight-related discrimination and cortisol output, evaluate methodological approaches for measuring these constructs, and identify research gaps regarding contextual factors influencing this relationship. A comprehensive search was conducted across multiple databases (PsycINFO, Scopus, ProQuest, and PubMed) from February 1 to July 1, 2024, resulting in 11 eligible studies that examined weight discrimination in relation to cortisol levels. Studies were assessed for quality using the NHLBI Study Quality Assessment Tool, and inter-rater reliability for coding was established at 90 %. The findings revealed a range of sample sizes (45-4341) and diverse participant characteristics, including variations in age, race, and body mass index (BMI). About half (N = 5) of the included studies reported a positive relation between weight stigma and cortisol output. The review also uncovered significant limitations in current methodologies, particularly concerning contextual factors and other marginalized identities, such as socioeconomic status and food insecurity, along with measuring other forms of discrimination in tandem with weight stigma, such as racial discrimination. These findings underscore the need for future research to adopt a more intersectional approach in examining the multifaceted nature of weight stigma and how it relates to a greater stress response in multiple marginalized identities, as well as including longitudinal modeling of weight stigma's impact on biomarkers for stress.
基于体重状况的歧视（或与体重相关的歧视/污名）可能通过压力的生理和心理表型，与更多的身心健康问题相关。皮质醇分泌量是一种压力生物标志物，已针对体重污名和与体重相关的歧视进行了测量。本系统综述旨在综合现有关于与体重相关的歧视和皮质醇分泌量之间关系的研究，评估测量这些构念的方法学途径，并确定影响这种关系的背景因素方面的研究空白。于2024年2月1日至7月1日在多个数据库（心理学文摘数据库、Scopus、ProQuest和医学期刊数据库）中进行了全面检索，得到11项符合条件的研究，这些研究考察了与皮质醇水平相关的体重歧视。使用美国国立心肺血液研究所研究质量评估工具对研究质量进行评估，编码的评分者间信度确定为90%。研究结果显示样本量范围为45至4341，参与者特征多样，包括年龄、种族和体重指数（BMI）的差异。纳入研究中约一半（N = 5）报告体重污名与皮质醇分泌量之间存在正相关关系。该综述还发现当前方法存在重大局限性，特别是在背景因素和其他边缘化身份方面，如社会经济地位和粮食不安全，以及同时测量与体重污名相关的其他形式的歧视，如种族歧视。这些发现强调，未来研究需要采用更具交叉性的方法，来审视体重污名的多面性及其与多种边缘化身份中更大压力反应的关系，以及纳入体重污名对压力生物标志物影响的纵向模型。
