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Gerend MA, Wilkinson LJ, Sutin AR, Rosado JI, Ehrlich KB, Smith DW, Maner JK. Sociodemographic predictors of perceived weight discrimination. Int J Obes (Lond) 2024:10.1038/s41366-024-01535-1. [PMID: 38740855 DOI: 10.1038/s41366-024-01535-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 04/26/2024] [Accepted: 04/30/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Perceived weight discrimination is associated with increased risk for chronic diseases and reduced life expectancy. Nevertheless, little is known about perceived weight discrimination in racial, ethnic, and sexual minority groups or in individuals at the intersections of those groups. The goal of this study was to identify sociodemographic predictors of perceived weight discrimination. SUBJECTS/METHODS A diverse sample of adults (37% Black/African American, 36% Latino, 29% sexual minority) with a body mass index (BMI) ≥ 18.5 kg/m2 were recruited from a national US panel to complete an online survey (N = 2454). Perceived weight discrimination was assessed with the Stigmatizing Situations Survey-Brief (SSI-B). Using hierarchical linear regression analysis, SSI-B scores were predicted from the four sociodemographic characteristics of interest (gender, race, ethnicity, and sexual orientation) while controlling for BMI, age, education, and income (Step 1). At Step 2, all two-way interactions between the four sociodemographic characteristics were added to the model. RESULTS At Step 1, higher SSI-B scores were observed for Latino (vs. non-Latino) adults, sexual minority (vs. heterosexual) adults, younger (vs. older) adults, adults with higher (vs. lower) levels of education, and adults with higher (vs. lower) BMI. At Step 2, race interacted with gender, ethnicity, and sexual orientation to predict SSI-B scores such that relatively higher scores were observed for non-Black women, Black men, adults who identified as Black and Latino, and non-Black sexual minority adults. CONCLUSIONS Perceived weight discrimination varied across sociodemographic groups, with some subgroups reporting relatively high frequency. Black race appeared to be protective for some subgroups (e.g., Black women), but risk-enhancing for others (e.g., Black men, individuals who identified as Black and Latino). Additional research is needed to identify specific factors that cause certain sociodemographic groups -and indeed, certain individuals-to perceive higher levels of weight discrimination than others.
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Affiliation(s)
- Mary A Gerend
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL, USA.
| | | | - Angelina R Sutin
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL, USA
| | - Javier I Rosado
- College of Medicine, Florida State University, Immokalee Regional Campus, Immokalee, FL, USA
| | | | - David W Smith
- Cardiology, Southern Medical Group, Tallahassee, FL, USA
| | - Jon K Maner
- Department of Psychology, College of Arts and Sciences, Florida State University, Tallahassee, FL, USA
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Hughes AM, Flint SW, Clare K, Kousoulis AA, Rothwell ER, Bould H, Howe LD. Demographic, socioeconomic and life-course risk factors for internalized weight stigma in adulthood: evidence from an English birth cohort study. THE LANCET REGIONAL HEALTH. EUROPE 2024; 40:100895. [PMID: 38745988 PMCID: PMC11092882 DOI: 10.1016/j.lanepe.2024.100895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 03/15/2024] [Accepted: 03/19/2024] [Indexed: 05/16/2024]
Abstract
Background Obesity is highly stigmatized, with negative obesity-related stereotypes widespread across society. Internalized weight stigma (IWS) is linked to negative outcomes including poor mental health and disordered eating. Previous evidence examining population groups at higher risk of experiencing IWS comes from small, nonrepresentative samples. Here, we re-assess previously reported associations of IWS with demographic, socioeconomic, and wider social factors in a large general population birth cohort study for the first time. Methods In the Avon Longitudinal Study of Parents and Children (ALSPAC), we explored differences in IWS at age 31 years by sex, ethnicity, socioeconomic factors, sexual orientation, and family and wider social influences, using confounder-adjusted multivariable regression. Findings In models adjusted for potential confounders and BMI in childhood, adolescence, and adulthood (N = 4060), IWS was higher for females (standardized beta: 0.56, 95% CI: 0.50, 0.61), sexual minorities (0.17 S.D. higher, 95% CI: 0.09, 0.24), and less socioeconomically advantaged individuals (e.g., 0.16 S.D. higher (95% CI: 0.08, 0.24) for participants whose mothers had minimum or no qualifications, compared to a university degree). The social environment during adolescence and young adulthood was important: IWS was higher for people who at age 13 years felt pressure to lose weight from family (by 0.13 S.D., 95% CI: 0.03, 0.23), and the media (by 0.17, 95% CI: 0.10, 0.25), or had experienced bullying (e.g., 0.25 S.D., 95% CI: 0.17, 0.33 for bullying at age 23 years). Interpretation Internalized weight stigma differs substantially between demographic groups. Risk is elevated for females, sexual minorities, and socioeconomically disadvantaged adults, and this is not explained by differences in BMI. Pressure to lose weight from family and the media in adolescence may have long-lasting effects on IWS. Funding The ESRC, MRC, NIHR, and Wellcome Trust.
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Affiliation(s)
- Amanda M. Hughes
- MRC Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Stuart W. Flint
- School of Psychology, University of Leeds, Leeds, UK
- Scaled Insights, Nexus, University of Leeds, Leeds, UK
| | - Ken Clare
- Leeds Beckett University, Leeds, UK
- Obesity UK, Halifax, UK
- European Coalition for People Living with Obesity, Dublin, Ireland
| | | | - Emily R. Rothwell
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Helen Bould
- MRC Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Gloucestershire Health and Care NHS Foundation Trust, Gloucestershire, UK
| | - Laura D. Howe
- MRC Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, UK
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Lucibello KM, Goldfield GS, Alberga AS, Leatherdale ST, Patte KA. Exploring the association between internalized weight bias and mental health among Canadian adolescents. Pediatr Obes 2024:e13118. [PMID: 38676448 DOI: 10.1111/ijpo.13118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 02/15/2024] [Accepted: 03/03/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Internalized weight bias (IWB) has been identified as a correlate of higher depressive and anxiety symptoms in adolescents with higher weights. However, there has been limited investigation into how IWB relates to positive mental health and whether these associations differ across genders. OBJECTIVES To examine the associations between IWB and mental health (depression, anxiety, flourishing) in adolescents with higher weights, and to test the potential moderating role of gender. METHODS Canadian adolescents with higher weights (N = 7538, 60% boys, 36% girls, 4% gender diverse, ages 12-19) from the COMPASS study completed a survey during the 2021-2022 school year. Data were analysed using generalized linear models. RESULTS Highest IWB and poorest mental health were noted within gender diverse adolescents, followed by girls then boys. Gender moderated the relationship between higher IWB and higher depression, higher anxiety and lower flourishing, with the strongest relationships noted among girls. CONCLUSION IWB interventions should be tailored to gender subgroups that may be particularly vulnerable to maladaptive mental health outcomes associated with IWB. System-level changes that mitigate perpetuation of weight bias and discrimination which lead to IWB are also essential, particularly for girls.
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Affiliation(s)
| | - Gary S Goldfield
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
| | - Angela S Alberga
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Scott T Leatherdale
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Karen A Patte
- Department of Health Sciences, Brock University, St. Catharines, ON, Canada
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DeFazio S, Mastrili N, Szoka N, Schneider KL, Cox S, Aylward L. Sexual orientation moderates the relationship between internalized weight bias and binge eating symptoms among adults pursuing bariatric surgery. Surg Obes Relat Dis 2024:S1550-7289(24)00126-6. [PMID: 38641526 DOI: 10.1016/j.soard.2024.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/16/2024] [Accepted: 03/09/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND Sexual minorities have higher rates of anxiety, depression, and binge eating compared to heterosexual peers. Internalized weight bias (IWB) is also higher for sexual minorities when compared to heterosexual peers. However, research has not examined whether the relationships between IWB and anxiety, depression, and binge eating differ among heterosexual and sexual minority adults pursuing bariatric surgery. OBJECTIVES To examine whether sexual orientation (heterosexual or sexual minority) moderated the relationships between IWB and anxiety, depression, and binge eating among adults pursuing bariatric surgery. SETTING University hospital, United States METHODS: Participants included 811 adults who presented for bariatric surgery, 45 (5.5%) of which identified as a sexual minority. Self-reported data were collected as part of a standard preoperative psychological evaluation for surgical clearance. Three separate moderation models were run to test hypotheses. RESULTS Sexual orientation did not moderate the association of IWB with anxiety or depression. The IWB by sexual orientation interaction was significant for binge eating (F 1856) = 4.84, P = .03, R2 = .27 such that the association between IWB and binge eating was significantly stronger for sexual minority patients (b = .54, 95% confidence interval {CI} [.36, .70]), compared to heterosexual patients (b = .33, 95% CI [.30, .38]). CONCLUSIONS Minority stress from identifying as a sexual minority may increase vulnerability to binge eating from IWB among bariatric candidates. Future research examining the directionality of the relationship between IWB and binge eating among sexual minorities is warranted.
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Affiliation(s)
- Sarah DeFazio
- School of Medicine, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Noelle Mastrili
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois
| | - Nova Szoka
- Department of Surgery, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Kristin L Schneider
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois
| | - Stephanie Cox
- Department of Behavioral Medicine and Psychiatry, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Laura Aylward
- Department of Behavioral Medicine and Psychiatry, West Virginia University School of Medicine, Morgantown, West Virginia.
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Levinson JA, Kinkel-Ram S, Myers B, Hunger JM. A systematic review of weight stigma and disordered eating cognitions and behaviors. Body Image 2024; 48:101678. [PMID: 38278088 DOI: 10.1016/j.bodyim.2023.101678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 12/23/2023] [Accepted: 12/27/2023] [Indexed: 01/28/2024]
Abstract
Weight stigma is persistent across contexts and is associated with disordered eating cognitions and behaviors. This systematic review aimed to examine the existing literature that has explored the relationship between weight stigma and disordered eating cognitions and behaviors. We specifically examined three dimensions of weight stigma - experienced, anticipated, and internalized - and adopted an inclusive conceptualization of outcomes related to disordered eating (including constructs such as binge eating, body dissatisfaction, and other cognitions and behaviors such as dietary restraint, unhealthy weight control behaviors, and drive for thinness). We searched PubMed, Embase, CINAHL, Web of Science, Sociological Abstracts, and PsycINFO for English-language, peer-reviewed articles and dissertations with quantitative methodology published through October 2023. The search resulted in 242 articles meeting inclusion criteria. A narrative review found a consistent relationship between greater weight stigma and more disordered eating cognitions and behaviors. Methodological and theoretical limitations are discussed, as are critical avenues for future research and potential clinical implications stemming from this body of research. Given the widespread nature and impact of weight stigma on disordered eating, it is imperative that we intervene to address weight stigma at all levels, from the structural to the intrapersonal.
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Affiliation(s)
- Jordan A Levinson
- Department of Psychology, University of California Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095, United States
| | - Shruti Kinkel-Ram
- Department of Psychology, Miami University, 90 N Patterson Avenue, Oxford, OH 45056, United States
| | - Bethany Myers
- University of California Los Angeles, Los Angeles, CA 90095, United States
| | - Jeffrey M Hunger
- Department of Psychology, Miami University, 90 N Patterson Avenue, Oxford, OH 45056, United States.
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