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Browsing by Subject "weight stigma"

Now showing 1 - 3 of 3
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    Mapping the Beneficial and Adverse Consequences of Receiving Weight-Related Advice from a Healthcare Provider: Identifying Strategies to Optimize Well-Being
    (2023-05) Standen, Erin
    It is standard practice for healthcare providers to recommend weight loss to patients with obesity (U.S. Preventive Services Task Force). However, it is possible that people with higher weight perceive these interactions as stigmatizing even if providers are well-intentioned when delivering weight-related advice. To the extent that weight-related advice is perceived as stigmatizing, the advice itself may undermine patients' health via stress, reduced engagement in health behaviors, and healthcare avoidance. In a series of three studies, I examined the immediate consequences of receiving weight-related advice from a healthcare provider on weight-based identity threat and behavioral motivation. In Study 1, I used a doctor-patient interaction scenario study to document people's responses to weight-related advice (versus control advice) from a healthcare provider. Participants who received weight-related advice reported greater weight-based identity threat (ps < 0.001 across three measures) and greater motivation to change their eating behavior (p < 0.001). In Study 2, participants were randomly assigned to read scenarios in which the provider: (a) requested consent to discuss weight (or did not); (b) framed behavioral recommendations around overall health (or around weight loss). These strategies were designed to maximize the motivational benefit and minimize the weight-based identity threat caused by weight-related advice. However, there were no significant differences in these outcomes based on study condition (ps > 0.48). In Study 3, undergraduates with higher weight (BMI > 25 kg/m2) attended a “student wellness check-in,” during which a trained research assistant gave them “standard” weight-related advice, “optimized” weight-related advice (i.e., in which the research assistant requested consent and used a health frame), or no weight-related advice. Receiving weight-related advice led to significantly greater weight-based identity threat and behavioral motivation (ps < 0.02), but there were no differences in threat or motivation between the standard and optimized weight-related advice groups (ps > 0.17). Taken together, these studies indicate that well-intentioned weight-related advice from healthcare providers can be perceived as stigmatizing, even when motivating. Further investigation is needed to identify strategies that reduce patients' experience of weight-based identity threat, especially because weight stigma may undermine the motivational benefits of weight-related advice and harm people's health.
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    Self-Determination Theory as a Framework for an Early Model of Internalized Weight Bias
    (2022-08) Leget, Dakota L
    Devaluing oneself based on weight-based stereotypes is known as internalized weight bias (Durso & Latner, 2008) and is associated with adverse health outcomes, like depression, anxiety, and disordered eating behaviors (Pearl & Puhl, 2018). This study examined self-determination theory (SDT) constructs as mechanisms explaining differential vulnerability to internalizing weight stigma. Women ages 18-40 years (N = 480) completed a survey measuring enacted weight stigma, psychological need satisfaction, need frustration, autonomous weight regulation, controlled weight regulation, internalized weight bias, body dissatisfaction, psychological distress, and dysfunctional eating. An exploratory approach to structural equation modeling yielded a model with an acceptable, moderate fit for the data (χ2 = 2520.71, df = 720, p < .001, CMIN/DF = 3.50, RMSEA = .07, SRMR = .10, CFI = .87) and supported the impact of enacted weight stigma on psychological need levels. Enacted weight stigma related to greater need frustration, which then, related to more controlled reasons for engaging in weight-related behaviors. Controlled weight motivation was strongly related to internalized weight bias rather than body satisfaction. The findings supported that distress and dysfunctional eating behavior directly related to internalized weight bias, unlike body satisfaction. Future research should confirm the structural model as SDT constructs may be impactful as targets of prevention and treatment strategies to reduce internalized weight bias and its negative health correlates.
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    Weight stigma: Cross-sectional and longitudinal associations with disordered eating and weight-related health behaviors in an ethnically/racially and socioeconomically diverse sample of adolescents and young adults
    (2022-07) Hooper, Laura
    This dissertation used a health equity lens to examine whether experiencing weight teasing is associated with disordered eating behaviors (DEBs), health behaviors, and weight status in an ethnically/racially and socioeconomically diverse sample of youth. It also investigated whether positive family/parenting factors are protective for DEBs in youth who experience weight stigma. 1,534 Project EAT 2010-2018 participants were surveyed as adolescents (Mage=14.4 years) and eight years later. Participants were asked about weight-stigmatizing experiences (e.g., weight teasing). Outcomes included DEBs (e.g., unhealthy weight control behaviors, chronic dieting, binge eating), health behaviors (e.g., physical activity, sleep duration, nutrition habits), and weight status. Regression models were adjusted for sociodemographic characteristics and weight status. Interaction terms and stratified models assessed whether family/parenting factors buffered DEB risk in adolescents who experienced weight stigma. Experiencing weight teasing was significantly associated with higher prevalence of DEBs and high weight status, cross-sectionally during both adolescence and young adulthood, and longitudinally. Effects of weight teasing were similar across ethnic/racial and socioeconomic subgroups. Black Indigenous, and People of Color (BIPOC) and youth from low socioeconomic backgrounds had higher prevalence of weight teasing, DEBs, and high weight, when compared to their respective counterparts. There was evidence that positive family/parenting factors operate as effect modifiers in cross-sectional relationships between weight stigma and DEBs, although these factors were primarily protective for adolescents who did not experience weight stigma. Findings provide evidence that weight teasing is a risk factor for DEBs and high weight status, and that BIPOC youth and youth from low socioeconomic backgrounds are disproportionately affected by weight teasing, DEBs, and high weight status, suggesting weight-stigmatizing experiences may create barriers to health, especially for youth who are already underserved. Positive family/parenting factors did not entirely offset the effects of weight stigma on DEBs, which may reflect the strength of weight stigma as a risk factor for DEBs. Published guidelines provide recommendations for how to decrease weight stigma experienced by youth. Future research should build upon these guidelines and include qualitative, solutions-oriented methods aimed at understanding how families, healthcare providers, and policymakers can decrease weight stigma and its effects on diverse populations of youth.