HIV Status, Obesity, and Risk for Weight Stigma: Comparing Weight Stigma Experiences and Internalization Among Adults with Obesity with and Without HIV

Analyzivng Demand for Customized Obesity Prevention and Management Across Adult Age Groups Using Focus Group Interview

With the increasing obesity rates, many studies on obesity prevention and management have been implemented. However, few studies focused on obesity in adulthood and different perceptions of obesity between life cycles. Thus, this study aimed to investigate the demand for customized obesity prevention and management (OPM) strategies across adult age groups. Focus group interviews were conducted to gather insights from three age groups: young adults (20-34 years), middle-aged adults (35-49 years), and seniors (50-64 years). A total of 17 participants took part in the study, with 5 participants in Group 1, 6 participants in Group 2, and 6 participants in Group 3. Thematic analysis and the use of NetMiner version 4.4.3 facilitated data categorization and scrutiny. The study employed qualitative methods to explore perceptions of obesity and preferences for personalized OPM strategies among participants. Diverse perspectives on obesity as a health threat were found among the age groups. While all stressed the importance of personalized OPM, preferences for strategies varied. Diet and exercise combination emerged as a common preference. This study highlighted the need for customized OPM approaches aligned with age-specific preferences.

Daily weight stigma experiences, and disordered and intuitive eating behaviors among young adults with body dissatisfaction

OBJECTIVE

The present study aimed to extend naturalistic weight stigma research by examining the following aims among young adults with body dissatisfaction and varied body mass indices (BMIs): (1) characterize the frequency of individuals' daily weight stigma experiences, and contextual variations, over a 14-day period; (2) examine whether BMI moderated daily associations between weight stigma experiences relative to eating disorder symptoms and intuitive eating behaviors.

METHOD

Women (n = 174) and men (n = 24) completed a 14-day daily diary protocol. Concurrent and time-lagged multilevel models examined associations between daily weight stigma, and eating disorder and intuitive eating behaviors among women only due to the small subsample of men.

RESULTS

Over the 14-day assessment, 43.94% (n = 87) of participants experienced weight stigma. Weight stigma rates varied based on how, where, and by whom weight stigma was expressed, and via BMI. Further, among women, multiple concurrent within-person associations were identified between women's daily weight stigma experiences and daily eating disorder symptoms (skipping meals, binge eating, and body dissatisfaction). Time-lagged associations also showed that women's weight stigma experiences on a given day were associated with a greater likelihood that they would limit the amount of food they consumed the next day. These associations did not differ via women's BMIs.

DISCUSSION

Collectively, these findings provide important information on how weight stigma experiences unfold in daily life among individuals with body dissatisfaction and varied BMIs, and the proximal and more enduring impact of women's daily weight stigma experiences on their use of multiple adverse eating behaviors that can promote poor health.

PUBLIC SIGNIFICANCE

The present findings provide important information on how, where, and by whom weight stigma experiences unfold in daily life among young adults with body dissatisfaction and varied body weights, as well as the proximal and more enduring impact of women's daily weight stigma experiences on their use of a variety of adverse eating behaviors that can promote poor health.

"It's only fatness, it doesn't kill": a qualitative study on perceptions of weight gain from use of dolutegravir-based regimens in women living with HIV in Uganda

Background

Dolutegravir (DTG)-based regimens have been recommended by the WHO as the preferred first-line and second-line HIV treatment in all populations. Evidence suggests an association with weight gain, particularly among black women. Our study investigated perceptions of weight gain from DTG-based regimen use on body image and adherence of antiretroviral therapy in women living with HIV (WLHIV) in Uganda.

Methods

Between April and June 2021, we conducted semi-structured interviews involving 25 WLHIV (adolescents, women of reproductive potential and post-menopausal women) and 19 healthcare professionals (clinicians, nurses, ART managers and counsellors) purposively selected from HIV clinics in Kampala. The interviews explored perceptions of body weight and image; experiences and management of weight related side effects associated with DTG; and knowledge and communication of DTG-related risks. Data was analysed thematically in NVivo 12 software.

Results

Our findings indicate WLHIV in Uganda commonly disliked thin body size and aspired to gain moderate to high level body weight to improve their body image, social standing and hide their sero-positive status. Both WLHIV and healthcare professionals widely associated weight gain with DTG use, although it was rarely perceived as an adverse event and was unlikely to be reported or to alter medication adherence. Clinical management and pharmacovigilance of DTG-related weight gain were hampered by the limited knowledge of WLHIV of the health risks of being over-weight and obesity; lack of diagnostic equipment and resources; and limited clinical guidance for managing weight gain and associated cardiovascular and metabolic comorbidities.

Conclusions

The study highlights the significance of large body-size in promoting psychosocial wellbeing in WLHIV in Uganda. Although weight gain is recognized as a side effect of DTG, it may be welcomed by some WLHIV. Healthcare professionals should actively talk about and monitor for weight gain and occurrence of associated comorbidities to facilitate timely interventions. Improved supply of diagnostic equipment and support with sufficient guidance for managing weight gain for healthcare professionals in Uganda are recommended.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12905-022-01814-x.