Effects of weight stigma on BMI and inflammatory markers among people living with obesity

Weight-based discrimination and cortisol output: A systematic review

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.

Weight stigma and allostatic load in adults: protocol for a scoping review

INTRODUCTION

Weight-related stigma (WS) has been associated with adverse psychosocial and physical health effects. Despite the relationship between WS and allostatic load, there are no integrative reviews of this association. This scoping review aims to provide a comprehensive overview of the relationship between allostatic load biomarkers associated with WS by identifying gaps in this topic and proposing recommendations for future research.

METHODS AND ANALYSIS

This protocol was guided by the methodological framework of Arksey and O'Malley and the Joanna Briggs Institute (JBI). The research questions were based on the population-concept-context framework. Studies in adults diagnosed as overweight or obese, exposed to WS and assessing the association between WS and biomarkers of allostatic load will be included. A search will be conducted in Medline (Ovid), PsycINFO (Ovid), Scopus (Elsevier), Cochrane Library (Wiley) and Google Scholar. The search strategy will be conducted in three stages, based on the JBI recommendation with the MESH terms "Social Stigma," "Weight Prejudice," "Biomarkers," "Allostasis," "Adults" and related terms. Data extraction will be done with a template adapted from JBI. The search strategy and selection process results will be presented in a flow chart and summarised in the text. The main results will be presented in a descriptive synthesis.

ETHICS AND DISSEMINATION

Ethics review and approval are not required. The results will be disseminated through peer-reviewed publications, conferences, congresses or symposia.

Stigma-Generating Mechanisms in Families Enrolled in a Pediatric Weight Management Program: A Qualitative Study of Health Identities and Healthcare Authenticity

In recent years, there has been increased awareness of obesity as a condition that carries a high level of stigma, as well as growing recognition of its prevalence and harm. Despite the increasing body of research on this topic, there is a gap in the literature regarding mechanisms that generate or exacerbate perceptions of weight stigma, especially within families and pediatric healthcare settings. The present study aims to identify potential stigma-generating mechanisms by focusing on inter-relational dynamics within these contexts. We conducted in-depth, semi-structured interviews with 11 families and analyzed the data by applying sociological theories on health identities and authenticity. Our study found four themes that represent potential stigma-generating mechanisms by being explicitly related to familial health identities and healthcare authenticity: (1) negotiating and reconstruction familial self-understanding, (2) between guilt, shame and conflicts, (3) navigating weight perceptions, and (4) the necessity of positivity and relevance. Our study shows the complexities of weight stigma within family and pediatric healthcare settings, emphasizing the need for sensitive and tailored support, as well as the value of working authentically as crucial aspects in preventing and/or reducing stigma.