1
|
Magallares A, Recio P, Jáuregui-Lobera I, Benito de Valle P, Irles JA, Hymowitz G. Factor structure and measurement invariance of the Weight-Related Abuse Questionnaire (WRAQ). Eat Behav 2024; 52:101827. [PMID: 38007887 DOI: 10.1016/j.eatbeh.2023.101827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 09/26/2023] [Accepted: 11/16/2023] [Indexed: 11/28/2023]
Abstract
Weight-related abuse is defined as verbal or physical maltreatment specific to one's weight. The Weight-Related Abuse Questionnaire (WRAQ) is an instrument specifically designed to measure weight-related abuse. The main goal of this research was to study the factor structure and measurement invariance of the Spanish version of the WRAQ in a non-clinical and a clinical sample. The clinical sample included 150 participants with obesity (60 % women) from the Hospital de Valme (Sevilla, Spain). The non-clinical sample included 301 students (79 % women) from the Spanish Open University (UNED). Scales to measure weight self-stigma and fear of gaining weight were used to analyze the convergent validity of the WRAQ. A confirmatory factor analysis showed that a two-factor model (verbal and physical abuse) was an acceptable fit for the data in both the clinical and non-clinical samples. Multigroup Confirmatory Factor Analysis revealed scalar measurement invariance by sample and gender. Cronbach's alpha coefficients and composite reliability for both samples were found to be good, with values ranging from 0.83 to 0.96. Fear of gaining weight was correlated to verbal (r = 0.36, p < .01) and physical (r = 0.12, p < .05) abuse, and weight self-stigma was also related to physical (r = 0.21, p < .01) and verbal (r = 0.41, p < .01) abuse. These results suggest that the WRAQ can be used in clinical and non-clinical samples to assess verbal and physical abuse in both men and women.
Collapse
Affiliation(s)
- Alejandro Magallares
- School of Psychology, Social Psychology Department, Spanish Open University (UNED), Madrid, Spain
| | - Patricia Recio
- School of Psychology, Methodology Department, Spanish Open University (UNED), Madrid, Spain.
| | - Ignacio Jáuregui-Lobera
- School of Experimental Sciences, Nutrition and Bromatology, Universidad Pablo de Olavide, Sevilla, Spain
| | | | | | - Genna Hymowitz
- Bariatric and Weight Loss Psychology, Psychiatry and Behavioral Health, Stony Brook University, New York, United States
| |
Collapse
|
2
|
Bidopia T, Karvay YG, Stadterman Guarecuco JM, Jarcho JM, Burke NL. Race/Ethnicity as a Moderator of the Association Between Weight-Related Abuse and Disordered Eating. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01775-3. [PMID: 37668958 DOI: 10.1007/s40615-023-01775-3] [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: 04/14/2023] [Revised: 08/03/2023] [Accepted: 08/21/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVES Extant research supports a positive relationship between weight-related abuse (WRA) and disordered eating constructs. Individuals who face marginalization and who are more likely to live in larger bodies, such as Black and Hispanic individuals in the United States (U.S.), may be at a heightened risk of WRA. This study is aimed at understanding whether the relationship between WRA and disordered eating constructs varies by race/ethnicity. We hypothesized that individuals from marginalized backgrounds would have differential levels of dietary restraint, body dissatisfaction, and shape/weight overvaluation with increased experiences of WRA compared to non-Hispanic White individuals. METHODS Two thousand one hundred sixteen undergraduates were recruited from two U.S. universities for a survey-based study assessing psychosocial functioning. Participants completed a demographics questionnaire assessing race/ethnicity, the Weight-Related Abuse Questionnaire assessing WRA experiences, and the Eating Disorders Examination-Questionnaire assessing disordered eating constructs. RESULTS Results showed positive relationships between verbal (vWRA) and physical (pWRA) WRA and disordered eating behaviors and cognitions. Moreover, at higher levels of vWRA, Asian and multiracial individuals showed greater dietary restraint compared to White individuals. No other tested models were moderated by race/ethnicity. CONCLUSION WRA is positively associated with disordered eating behaviors and cognitions across racial/ethnic identities, and vWRA may be differentially related to increased dietary restraint in Asian and multiracial individuals compared to White individuals. Further research utilizing intersectional analyses (e.g., examining how this relationship varies according to the intersection of race/ethnicity, gender, and weight status) would help clarify this relationship.
Collapse
Affiliation(s)
- Tatyana Bidopia
- Department of Psychology, Fordham University, Dealy Hall, 441 East Fordham Road, Bronx, NY, 10458, USA
| | - Yvette G Karvay
- Department of Psychology, Fordham University, Dealy Hall, 441 East Fordham Road, Bronx, NY, 10458, USA
| | | | - Johanna M Jarcho
- Department of Psychology, Temple University, Weiss Hall 866, 1701 N 13th St, Philadelphia, PA, 19122, USA
| | - Natasha L Burke
- Department of Psychology, Fordham University, Dealy Hall, 441 East Fordham Road, Bronx, NY, 10458, USA.
| |
Collapse
|
3
|
Weight stigma from media: Its associations with coping responses and health outcomes. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03179-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
4
|
Lin CY, Strong C, Latner JD, Lin YC, Tsai MC, Cheung P. Mediated effects of eating disturbances in the association of perceived weight stigma and emotional distress. Eat Weight Disord 2020; 25:509-518. [PMID: 30697663 DOI: 10.1007/s40519-019-00641-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 01/14/2019] [Indexed: 12/17/2022] Open
Abstract
PURPOSE This study aimed to examine the relationships between perceived weight stigma, eating disturbances, and emotional distress across individuals with different self-perceived weight status. METHODS University students from Hong Kong (n = 400) and Taiwan (n = 307) participated in this study and completed several questionnaires: Perceived Weight Stigma questionnaire; Three-factor Eating Questionnaire; Hospital Anxiety and Depression Scale. Each participant self-reported their height, weight, and self-perceived weight status. RESULTS After controlling for demographics, perceived weight stigma was associated with eating disturbances (β = 0.223, p < 0.001), depression (β = 0.143, p < 0.001), and anxiety (β = 0.193, p < 0.001); and eating disturbances was associated with depression (β = 0.147, p < 0.001) and anxiety (β = 0.300, p < 0.001) in the whole sample. Additionally, eating disturbances mediated the association between perceived weight stigma and emotional distress. Similar findings were shown in the subsamples who perceived themselves as higher weight or normal weight and in the male and female subsamples. However, in the subsamples who perceived themselves as lower weight, only the links between eating disturbances and emotional distress were significant. CONCLUSION Perceived weight stigma was associated with eating disturbances and emotional distress in young adults with both higher and normal weight. Eating disturbances were associated with emotional distress regardless of participants' weight status. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
Collapse
Affiliation(s)
- Chung-Ying Lin
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Hong Kong.
| | - Carol Strong
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Janet D Latner
- Department of Psychology, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Yi-Ching Lin
- Department of Early Childhood and Family Education, College of Education, National Taipei University of Education, Taipei, Taiwan
| | - Meng-Che Tsai
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Pauline Cheung
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Hong Kong
| |
Collapse
|
5
|
Wang Z, Wang B, Hu Y, Cheng L, Zhang S, Chen Y, Li R. Relationships among weight stigma, eating behaviors and stress in adolescents in Wuhan, China. Glob Health Res Policy 2020; 5:8. [PMID: 32161815 PMCID: PMC7060634 DOI: 10.1186/s41256-020-00138-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 02/24/2020] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of this study was to examine the relationships among weight stigma, eating behaviors, and stress, as well as to analyze the effect of stress in mediating the association between weight stigma and eating behaviors. Methods The study involved 1818 adolescents between 14 to 19 years of age and was conducted in Wuhan, China in 2019. Weight stigma, eating behaviors (cognitive restraint, uncontrolled eating, and emotional eating), and stress were assessed by self-report questionnaires. Hierarchical linear regression analyses were used to examine the predictors of cognitive restraint, uncontrolled eating, and emotional eating; the serial mediation models analyses were conducted to analyze the effect of stress in mediating the association between weight stigma and eating behaviors for the whole non-overweight (normal and underweight) and overweight or obese participants, respectively. Results Hierarchical linear regression analyses showed that experiences of weight stigma significantly predicted uncontrolled eating and emotional eating regardless of body mass index (BMI) (non-overweight adolescents: uncontrolled eating: β [SE] = 0.161 [0.017]; emotional eating: β [SE] = 0.199 [0.008], p < 0.05; overweight or obese adolescents: uncontrolled eating: β [SE] = 0.286 [0.030]; emotional eating: β [SE] = 0.267 [0.014], p < 0.05); experiences of weight stigma significantly predicted cognitive restraint among non-overweight adolescents (β [SE] = 0.204 [0.013], p < 0.05). Mediation analyses showed that stress mediated the associations between weight stigma and uncontrolled eating and emotional eating among non-overweight adolescents (uncontrolled eating: indirect effect coefficient = 0.0352, 95% CI = 0.0241, 0.0478; emotional eating: indirect effect coefficient = 0.0133, 95% CI = 0.0085, 0.0186). Conclusions These findings suggest that non-overweight individuals can still experience weight stigma and its associated negative consequences; the relationship between weight stigma and eating behaviors is modulated by weight status; stress mediated the associations between weight stigma and uncontrolled and emotional eating among non-overweight adolescents.
Collapse
Affiliation(s)
- Zhanxia Wang
- 1Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan, 430071 China
| | - Bowen Wang
- 1Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan, 430071 China
| | - Yiluan Hu
- 1Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan, 430071 China
| | - Lei Cheng
- 1Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan, 430071 China
| | - Siqi Zhang
- 1Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan, 430071 China
| | - Yanan Chen
- 1Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan, 430071 China
| | - Rui Li
- 1Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan, 430071 China.,2Global Health Institute, School of Health Sciences, Wuhan University, Wuhan, 430071 China
| |
Collapse
|
6
|
King WC, Hinerman A, Kalarchian MA, Devlin MJ, Marcus MD, Mitchell JE. The impact of childhood trauma on change in depressive symptoms, eating pathology, and weight after Roux-en-Y gastric bypass. Surg Obes Relat Dis 2019; 15:1080-1088. [PMID: 31153892 DOI: 10.1016/j.soard.2019.04.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/25/2019] [Accepted: 04/03/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND History of childhood trauma is associated with increased risk of mental disorders, eating pathology, and obesity. OBJECTIVE To examine associations between childhood trauma and changes in depressive symptoms, eating pathology, and weight after Roux-en-Y Gastric Bypass (RYGB). SETTING Three U.S. academic medical centers. METHOD Adults undergoing bariatric surgery (2007-2011) were enrolled in a cohort study. Participants (96 of 114; 86%) completed the Beck Depression Inventory-1 (BDI-1) to assess depressive symptomology, the interviewer-administered Eating Disorder Examination (EDE) to assess subthreshold eating pathology, weight assessment before and 6 months and annually after RYGB for ≥7 years, and the Childhood Trauma Questionnaire (CTQ) once post-RYGB. RESULTS Presurgery, median age was 46 years, and median body mass index was 47 kg/m2; 79% were female. Data completeness across 7-year follow-up was 78% to 90%, 66% to 91%, and 93% to 100% for the BDI-1, EDE, and weight, respectively. Using mixed models, presence/severity of childhood emotional abuse, emotional neglect, and physical neglect, but not sexual abuse or physical abuse, were significantly associated (P < .05) with change (i.e., less improvement/worsening) in the BDI-1 and EDE global scores, as were higher total CTQ score and more types of moderate-intensity trauma. All CTQ measures were associated (P < .05) with less improvement or worsening in the EDE eating concern and shape concern scores. CTQ measures were not significantly related to weight loss or regain. CONCLUSIONS Although childhood trauma did not affect weight outcomes after RYGB, those who experienced childhood trauma had less improvement in depressive symptomology and eating pathology and therefore might benefit from clinical intervention.
Collapse
Affiliation(s)
- Wendy C King
- Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
| | - Amanda Hinerman
- Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | | | - Michael J Devlin
- Columbia University Vagelos College of Physicians and Surgeons/New York State Psychiatric Institute, New York, New York
| | - Marsha D Marcus
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | | |
Collapse
|
7
|
Sattler KM, Deane FP, Tapsell L, Kelly PJ. Gender differences in the relationship of weight-based stigmatisation with motivation to exercise and physical activity in overweight individuals. Health Psychol Open 2018; 5:2055102918759691. [PMID: 29552349 PMCID: PMC5846936 DOI: 10.1177/2055102918759691] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Weight stigma is related to lower levels of motivation to exercise in overweight and obesity. This study explored the nature of the relationship between stigma, motivation to exercise and physical activity while accounting for gender differences. Participants were 439 adults with overweight and obesity (mean body mass index = 32.18 kg/m2, standard deviation = 4.09 kg/m2). Females reported significantly more frequent stigma experiences than males. Mediation models found a conditional direct effect of weight stigma for males, with higher frequency of stigma experiences related to higher levels of walking and vigorous physical activity. A conditional indirect effect was found for females for walking, moderate and vigorous levels of physical activity, with higher weight stigma related to lower autonomous motivation, and lower levels of physical activity. Findings suggest that males and females are affected differently by weight-stigma experiences.
Collapse
|
8
|
Zuba A, Warschburger P. The role of weight teasing and weight bias internalization in psychological functioning: a prospective study among school-aged children. Eur Child Adolesc Psychiatry 2017; 26:1245-1255. [PMID: 28361259 DOI: 10.1007/s00787-017-0982-2] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 03/22/2017] [Indexed: 11/25/2022]
Abstract
Weight-related teasing is a widespread phenomenon in childhood, and might foster the internalization of weight bias. The goal of this study was to examine the role of weight teasing and weight bias internalization as mediators between weight status and negative psychological sequelae, such as restrained eating and emotional and conduct problems in childhood. Participants included 546 female (52%) and 501 (48%) male children aged 7-11 and their parents, who completed surveys assessing weight teasing, weight bias internalization, restrained eating behaviors, and emotional and conduct problems at two points of measurement, approximately 2 years apart. To examine the hypothesized mediation, a prospective design using structural equation modeling was applied. As expected, the experience of weight teasing and the internalization of weight bias were mediators in the relationship between weight status and psychosocial problems. This pattern was observed independently of gender or weight status. Our findings suggest that the experience of weight teasing and internalization of weight bias is more important than weight status in explaining psychological functioning among children and indicate a need for appropriate prevention and intervention approaches.
Collapse
Affiliation(s)
- Anna Zuba
- Department of Psychology, University of Potsdam, Karl-Liebknecht-Str. 24/25, 14476, Potsdam, Germany
| | - Petra Warschburger
- Department of Psychology, University of Potsdam, Karl-Liebknecht-Str. 24/25, 14476, Potsdam, Germany.
| |
Collapse
|
9
|
The relationship between weight stigma and eating behavior is explained by weight bias internalization and psychological distress. Appetite 2016; 102:70-6. [DOI: 10.1016/j.appet.2016.02.032] [Citation(s) in RCA: 144] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 02/14/2016] [Accepted: 02/16/2016] [Indexed: 11/20/2022]
|
10
|
Nolan LJ, Eshleman A. Paved with good intentions: Paradoxical eating responses to weight stigma. Appetite 2016; 102:15-24. [DOI: 10.1016/j.appet.2016.01.027] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 12/13/2015] [Accepted: 01/19/2016] [Indexed: 11/28/2022]
|
11
|
Weight stigma and eating behavior: A review of the literature. Appetite 2016; 102:3-14. [PMID: 26829371 DOI: 10.1016/j.appet.2016.01.034] [Citation(s) in RCA: 165] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 12/19/2015] [Accepted: 01/28/2016] [Indexed: 01/17/2023]
Abstract
Weight stigma is a pervasive social problem, and this paper reviews the evidence linking weight stigma to eating behavior. Correlational studies consistently find that experiences with weight stigma are associated with unhealthy eating behaviors and eating pathology (such as binge eating, skipping meals), although results vary somewhat depending on the sample being studied and the specific stigma/eating constructs being assessed. Experimental studies consistently find that manipulations such as priming overweight stereotypes, exposure to stigmatizing content, and social exclusion all lead to increased food intake, but whether or not those manipulations capture the impact of weight stigma experiences per se is less clear. Finally, studies of stigma experiences in daily life show that more frequent stigma experiences are associated with decreased motivation to diet and with less healthy eating behaviors. Overall, this research highlights the potential for weight stigma to negatively impact individuals' eating behavior, which in turn could have consequences for their overall health and well-being.
Collapse
|