Weight status or weight stigma? Obesity stereotypes—Not excess weight—Reduce working memory in school-aged children

How Does a 12-Week Physical Exercise Program Affect the Motor Proficiency and Cognitive Abilities of Overweight and Normal-Weight Preschool Children?

The objective of this research was to examine a 12-week exercise program and its impact on the motor proficiency and cognitive abilities of preschool children with overweight and normal weight. The study involved a total of 71 participants who were preschool children enrolled in a longitudinal study. Body mass index (BMI) was determined by measuring body height and weight, and the nutritional status of the children was assessed using the World Health Organization's (WHO) criteria. Motor proficiency encompasses both motor abilities and motor skills, and the assessment of motor abilities was conducted using subtests from the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2). These subtests measured fine motor integration, manual dexterity, balance, and bilateral coordination. The evaluation of motor skills involved the utilization of the Test of Gross Motor Development (TGMD-2), which examines both locomotor skills and manipulative skills. Cognitive abilities were assessed using the School Maturity Test (TZS). All participants, regardless of weight status, took part in a 12-week physical exercise program. According to the World Health Organization's criteria, 52 children (73.2%) were categorized as having a normal weight, while 19 children (26.8%) were classified as overweight. These findings indicate that every fourth child in the study was overweight. Using a statistical analysis called SPANOVA (2 × 2, group × time), differences were observed in three out of eleven variables. Specifically, there were significant differences in two motor skill variables: manipulative skills (p = 0.006) and total movement skills (p = 0.014). Additionally, there was a significant difference in one cognitive ability variable: visual memory (p = 0.010). No significant differences were found in the remaining variables. The findings of this study aimed to contribute to the understanding of the potential benefits of regular exercise on motor and cognitive development in preschool children, specifically examining the differences between overweight and normal-weight children. By investigating these effects, the study could provide valuable insights for educators, parents, and health professionals involved in promoting the overall well-being of preschool-aged children. Regular physical exercise has been found to have positive effects on motor and cognitive abilities in both overweight and normal-weight preschool children.

Body shaming and internalized weight bias as potential precursors of eating disorders in adolescents

Introduction

Body shaming (BS) is a growing phenomenon within the school context, especially among adolescents. Recently, it has been described as an unrepeated act in which a person expresses unsolicited, mostly negative comments about an individual's body. The targeted person perceives these comments as negative, offensive or body shame-inducing. Empirical evidence also suggests that body weight is the most common reason that youths are teased and bullied. Indeed, weight stigma, described as bias or discriminatory behaviors, attitudes, feelings, and thinking about individuals, because of their weight, can lead to weight-based discrimination and victimization. Preliminary evidence suggests that BS and weight stigma have negative effects on psychological health both in the short and long term. In the delicate stage of adolescence development and pubertal maturation, BS experiences can be highly prevalent and it can lead to adverse outcomes such as eating disorders (ED). However, prevalence data in the Italian context are still lacking.

Methods

The study aims to estimate weight-related BS perceived by different sources (i.e., peers and family members) and their associations with public and internalized weight bias, body mass index (BMI), body dissatisfaction, and ED symptoms. A sample of 919 high school students (Mage = 15.97, SD = 1.58; 57.1% boys) completed a battery of self-report questionnaires assessing these variables.

Results

One in four students reported experiences of weight-related BS by peers or family members. A total of 37% reported having at least one BS experience in a lifetime. Higher scores of ED symptoms, body dissatisfaction, and weight bias were reported by adolescents who experienced BS, especially females. Among overweight participants, results showed that internalized weight bias partially mediated the relationship between BS by family members and ED symptoms and fully mediated the relationship between BS by peers and ED symptoms, after controlling for age, sex and BMI.

Discussion

These findings, despite their cross-sectional nature, add an important contribution to the creation of quantitative empirical evidence on the phenomenon of BS. Its role in explaining eating disorders, both alone and with the mediation of internalized weight stigma has been first proved and needs to be confirmed by longitudinal results.

Obesity Bias and Stigma, Attitudes, and Beliefs Among Intern Doctors: a Cross-sectional Study from Türkiye

BACKGROUND

The purpose of this study was to determine intern physicians' attitudes and beliefs toward obesity and individuals with obesity and the frequency at which they encounter discriminatory language in their work environments.

METHODS

This cross-sectional study was performed with intern physicians at the Ondokuz Mayıs University Medical Faculty in Samsun, Türkiye. A questionnaire was employed for data collection (Appendix). Two hundred eighteen (82.2%) interns took part in the study. The questionnaire consisted of 53 questions in five sections, and included the attitudes toward obese persons (ATOP) and beliefs about obese persons (BAOP) scales.

RESULTS

The interns most frequently cited genetic factors (98.1%) and endocrine disorder-metabolic disorders (98.1%) as non-behavioral causes of obesity, and overeating (96.2%) and physical immobility (96.2%) as behavioral causes. Lifestyle changes and exercise were most frequently recommended for treatment. The interns' attitudes toward individuals with obesity were very slightly negative, but close to neutral. Analysis showed that 46.8% of the interns reported hearing members of academic staff, intern physicians, or health workers make negative or derogatory comments or jokes about obese patients during their education, while 22.0% reported witnessing an obese patient being subjected to discriminatory treatment in the hospital environment.

CONCLUSION

Medical faculties must develop curricula aimed at comprehensively addressing obesity-related bias. Such a curriculum should allow students to reflect on their biases, be aimed at reducing the effect of those biases on patient communication, and involve strategies directed toward eliminating those effects from physicians' treatment decisions.

Weight stigma and bias: A guide for pediatric clinicians

Introduction

Many children and adolescents with obesity experience weight stigma and bias, which can have detrimental mental health, medical, and social consequences. Weight stigma in the healthcare setting threatens the therapeutic relationship between health care providers and their pediatric patients and families.

Methods

Data supporting this guidance were derived from cited references.

Results

Based upon referenced citations, this review offers 7 best practices for pediatric providers to work to reduce weight stigma including: assess for personal weight bias, improve communication, provide a welcoming clinic environment, seek out additional training and informative experiences, evaluate the messaging and culture of the organization, screen for trauma and bullying, and enlist the help of board-certified obesity medicine specialists.

Conclusions

Providers have an important role in mitigating the harmful effects of weight stigma. It is our hope these recommendations, as well as the other resources provided, will help providers to begin to address their own individual weight biases, as well as the institutional weight biases where we care for patients.

Toward a New Approach to Investigate the Role of Working Memory in Stereotype Threat Effects

Stereotype threat arises when the activation of negative stereotypes about a group impairs performance of stigmatized individuals on stereotype relevant tasks. There is ample evidence that stereotype threat leads to performance detriments by consuming executive resources. Several studies indeed showed that working memory (WM) mediates stereotype threat effects among young adults. More recently, researchers have sought to understand whether the same mechanisms underlie age-based stereotype threat, but findings are mixed regarding the role of WM and some authors rather favor a motivational explanation based on regulatory fit. The present review critically appraises the empirical support for distinct forms of stereotype threat effects mediated by distinct mechanisms. We propose a novel approach based on one of the most recent WM models, the time-based resource sharing model, to evaluate the impact of stereotype threat on attentional resources in WM among both young and older adults.

Weight stigma in children and adolescents: Recommendations for practice and policy

ABSTRACT

Weight stigma is the devaluation of a person because of excess body weight. Individuals who experience stigmatization are at increased risk for adverse physical and psychological health outcomes. This article provides an overview of weight stigma and the implications for nursing practice and policy.

Baseline associations between biomarkers, cognitive function, and self-regulation indices in the Cognitive and Self-regulatory Mechanisms of Obesity Study

OBJECTIVE

Understanding how biological, cognitive, and self-regulatory factors are related to obesity, and weight regulation is clearly needed to optimize obesity prevention and treatment. The objective of this investigation was to understand how baseline biological, cognitive, and self-regulatory factors are related to adiposity at the initiation of a behavioral weight loss intervention among treatment-seeking adults with overweight/obesity.

METHODS

Participants (N = 107) in the Cognitive and Self-regulatory Mechanisms of Obesity Study (Identifier-NCT02786238) completed a baseline assessment with anthropometric, cardiometabolic, inflammatory, cognitive function, and self-regulation measures as part of a larger on-going trial. Data were analyzed with linear regression.

RESULTS

At baseline, body mass index, body fat percentage, and waist circumference (WC) were positively associated with fasting insulin and insulin resistance. Higher WC was related to higher fasting glucose and hemoglobin A1c (HbA1c). Higher glucose and insulin resistance levels were related to lower list sorting working memory. Higher glucose and HbA1c levels were negatively associated with reading scores. Cognitive function and self-regulation indices were unrelated.

CONCLUSIONS

In adults with overweight/obesity entering a weight loss treatment study: (1) elevated WC and associated glycemic impairment were negatively associated with cognition, (2) poorer executive function and reading abilities were associated with poorer glycemic control, and (3) objectively measured cognitive functions were unrelated to self-reported/behavioral measures of self-regulation. Such findings increase understanding of the relationships between adiposity, biomarkers, cognition, and self-regulation at treatment initiation and may ultimately inform barriers to successful obesity treatment response.

Complexity and Stigma of Pediatric Obesity

Weight stigma is rooted in a fundamental misunderstanding of the origins of obesity, wherein the interplay of behavioral, environmental, genetic, and metabolic factors is deemphasized. Instead, the widespread societal and cultural presence of weight stigma fosters misconceptions of obesity being solely a result of unhealthy personal choices. Weight stigma is pervasive in childhood and adolescence and can affect individuals throughout their life. Although the prevalence of pediatric obesity remains high throughout the world, it becomes increasingly important to understand how weight stigma affects weight and health outcomes in children and adolescents with overweight or obesity, including in those with rare genetic diseases of obesity. We identified and reviewed recent literature (primarily published since 2000) on weight stigma in the pediatric setting. Articles were identified with search terms including pediatric obesity, weight bias, weight stigma, weight-based teasing and bullying, and weight bias in health care. In this narrative review, we discuss the stigma of pediatric obesity as it relates to the complex etiology of obesity as well as describe best practices for avoiding bias and perpetuating stigma in the health care setting.

Weight Stigma in Youth: Prevalence, Consequences, and Considerations for Clinical Practice

PURPOSE OF REVIEW

This review summarizes recent evidence on weight stigma experienced by youth with overweight or obesity. We examine the prevalence and sources of weight-based victimization targeting youth, consequences of these stigmatizing experiences for their psychological and physical health, and considerations for addressing weight stigma in clinical practice and pediatric care.

RECENT FINDINGS

Weight stigma is highly prevalent among youth with high body weight, who are targets of weight-based victimization from peers, parents, and teachers. These experiences place youth at risk for psychological distress (primarily depressive symptoms, low self-esteem, and suicidal ideation), worse social and academic outcomes, and adverse physical health consequences including maladaptive eating behaviors, lower physical activity, substance use, and weight gain. Healthcare professionals and clinicians have important roles to play in efforts to help reduce weight stigma and support youth with obesity. Fundamental to these efforts is the use of supportive, compassionate, and non-stigmatizing communication with youth and their families.

Food Addiction and Psychosocial Adversity: Biological Embedding, Contextual Factors, and Public Health Implications

The role of stress, trauma, and adversity particularly early in life has been identified as a contributing factor in both drug and food addictions. While links between traumatic stress and substance use disorders are well documented, the pathways to food addiction and obesity are less established. This review focuses on psychosocial and neurobiological factors that may increase risk for addiction-like behaviors and ultimately increase BMI over the lifespan. Early childhood and adolescent adversity can induce long-lasting alterations in the glucocorticoid and dopamine systems that lead to increased addiction vulnerability later in life. Allostatic load, the hypothalamic-pituitary-adrenal axis, and emerging data on epigenetics in the context of biological embedding are highlighted. A conceptual model for food addiction is proposed, which integrates data on the biological embedding of adversity as well as upstream psychological, social, and environmental factors. Dietary restraint as a feature of disordered eating is discussed as an important contextual factor related to food addiction. Discussion of various public health and policy considerations are based on the concept that improved knowledge of biopsychosocial mechanisms contributing to food addiction may decrease stigma associated with obesity and disordered eating behavior.