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The Effect of a Food Addiction Explanation Model for Weight Control and Obesity on Weight Stigma.
O'Brien, KS, Puhl, RM, Latner, JD, Lynott, D, Reid, JD, Vakhitova, Z, Hunter, JA, Scarf, D, Jeanes, R, Bouguettaya, A, et al
Nutrients. 2020;12(2)
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Research suggests that weight stigma is increasing and is associated with multiple negative health and psychological outcomes. Public health messaging presently emphasises weight gain as lack of personal control of diet and exercise, which contributes to the stigma and ignores the myriad of uncontrollable factors that also contribute to weight gain. One component of weight gain is food addiction, in which food is shown to be as rewarding to the brain as other addictive substances. It is currently unclear whether an explanation of the food addiction model (FAM) will affect weight stigma, and there is a need to understand the factors that contribute and reinforce weight stigmatisation. The aim of this study is to assess whether providing a FAM explanation for weight gain would impact expressions of weight stigma. Two experiments were done in which college students were randomly allocated to read a simulated article that focused on either food addiction or diet and exercise as contributing factors to obesity. The participants then completed a survey assessing their perception of obesity. This study found the FAM explanation resulted in a significantly lower weight stigma. Based on these results, the authors suggest current public health messaging that attributes obesity to lack of personal control needs to be changed as it exacerbates weight stigma.
Abstract
There is increasing scientific and public support for the notion that some foods may be addictive, and that poor weight control and obesity may, for some people, stem from having a food addiction. However, it remains unclear how a food addiction model (FAM) explanation for obesity and weight control will affect weight stigma. In two experiments (N = 530 and N = 690), we tested the effect of a food addiction explanation for obesity and weight control on weight stigma. In Experiment 1, participants who received a FAM explanation for weight control and obesity reported lower weight stigma scores (e.g., less dislike of 'fat people', and lower personal willpower blame) than those receiving an explanation emphasizing diet and exercise (F(4,525) = 7.675, p = 0.006; and F(4,525) = 5.393, p = 0.021, respectively). In Experiment 2, there was a significant group difference for the dislike of 'fat people' stigma measure (F(5,684) = 5.157, p = 0.006), but not for personal willpower weight stigma (F(5,684) = 0.217, p = 0.81). Participants receiving the diet and exercise explanation had greater dislike of 'fat people' than those in the FAM explanation and control group (p values < 0.05), with no difference between the FAM and control groups (p >0.05). The FAM explanation for weight control and obesity did not increase weight stigma and resulted in lower stigma than the diet and exercise explanation that attributes obesity to personal control. The results highlight the importance of health messaging about the causes of obesity and the need for communications that do not exacerbate weight stigma.
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A sympathetic nervous system evaluation of obesity stigma.
Oliver, MD, Datta, S, Baldwin, DR
PloS one. 2017;12(10):e0185703
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The negative health consequences of obesity are well known. Those classified as obese also suffer from discrimination which has further negative psychological and physiological effects on well-being. The aim of this study was to see if attitudes to obesity can be modified at the physiological and psychological level by priming. 70 people aged 18-53 were randomly assigned to 2 groups. One group was shown images of obesity in negative settings, the other in positive settings. All participants then viewed an actual obesity discrimination incident. Levels of the digestive enzyme salivary alpha amylase (sAA) and skin conductance (SC) were taken as measures of sympathetic nervous system (SNS) activity. Individuals in the negative priming group had significantly more SC arousal and exhibited the highest overall sAA response after viewing the incident when compared to the positively primed group. The authors conclude that clinicians addressing stigma issues should consider the use of positively primed images as a method for reducing the possible long-term physiological consequences of the negative attitudes surrounding obesity.
Abstract
The portrayal of obesity in the media is often one of negativity. Consequently, it may generate an increase in stigma. Obesity stigma, a form of social discrimination, is responsible for many of the negative psychological and physiological effects on individual wellness. These effects not only impact individual health, but also affect the economy, and ultimately, societal wellness. In an attempt to examine the influence of the media on obesity stigma, this study tested the hypothesis that positive priming would lead to a reduction in obesity stigma. To further our understanding of this relationship, we: 1) examined the role of priming on physiological measures (e.g. salivary alpha amylase and skin conductance) in 70 college students by introducing positive and negative media images of individuals with obesity, and 2) assessed psychological measures (e.g. perceived stress, need to belong, and self-esteem, and Body Mass Index). After the priming manipulation, participants read a vignette depicting the discrimination of an individual with obesity and answered subsequent questions assessing participants' attributional blame of obesity. Results of this study revealed that priming affects physiological responding to obesity stigmatization. In conclusion, these findings suggest that incorporating positive media images of individuals with obesity may be an effective tool for reducing stigma and the various physiological consequences associated with it, which in turn, can enhance societal health and wellness.
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Association between weight bias internalization and metabolic syndrome among treatment-seeking individuals with obesity.
Pearl, RL, Wadden, TA, Hopkins, CM, Shaw, JA, Hayes, MR, Bakizada, ZM, Alfaris, N, Chao, AM, Pinkasavage, E, Berkowitz, RI, et al
Obesity (Silver Spring, Md.). 2017;25(2):317-322
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Weight stigma is a psychosocial consequence in which individuals with obesity experience public discrimination and devaluation. Some individuals apply these negative stereotypes to themselves, which creates a self-directed stigma referred to as weight bias internalization (WBI). While studies have found perceived weight discrimination to be associated with an increased risk of mortality, no study has investigated the relationship between WBI and obesity on the risk of developing metabolic syndrome (MetS). The aim of this study is to examine the relationship between WBI and MetS. The authors hypothesised that among obese individuals, higher levels of WBI would be associated with increased odds of having MetS. Among the 178 obese adults recruited, 159 completed the study. Tests included anthropometric measurements, blood analysis, the Weight Bias Internalization Scale (WBIS) and the Patient Health Questionnaire. This study found that individuals who self-stigmatise may have a heightened risk of dyslipidemia, one component of MetS. Based on these results, the authors conclude that weight stigma is a chronic stressor and may contribute to poor health. Future studies are needed to identify specific pathways in which WBI exacerbates cardiometaoblic risk factors.
Abstract
OBJECTIVE Weight stigma is a chronic stressor that may increase cardiometabolic risk. Some individuals with obesity self-stigmatize (i.e., weight bias internalization, WBI). No study to date has examined whether WBI is associated with metabolic syndrome. METHODS Blood pressure, waist circumference, and fasting glucose, triglycerides, and high-density lipoprotein cholesterol were measured at baseline in 178 adults with obesity enrolled in a weight-loss trial. Medication use for hypertension, dyslipidemia, and prediabetes was included in criteria for metabolic syndrome. One hundred fifty-nine participants (88.1% female, 67.3% black, mean BMI = 41.1 kg/m2 ) completed the Weight Bias Internalization Scale and Patient Health Questionnaire (PHQ-9, to assess depressive symptoms). Odds ratios and partial correlations were calculated adjusting for demographics, BMI, and PHQ-9 scores. RESULTS Fifty-one participants (32.1%) met criteria for metabolic syndrome. Odds of meeting criteria for metabolic syndrome were greater among participants with higher WBI, but not when controlling for all covariates (OR = 1.46, 95% CI = 1.00-2.13, P = 0.052). Higher WBI predicted greater odds of having high triglycerides (OR = 1.88, 95% CI = 1.14-3.09, P = 0.043). Analyzed categorically, high (vs. low) WBI predicted greater odds of metabolic syndrome and high triglycerides (Ps < 0.05). CONCLUSIONS Individuals with obesity who self-stigmatize may have heightened cardiometabolic risk. Biological and behavioral pathways linking WBI and metabolic syndrome require further exploration.
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Locus of control and obesity.
Neymotin, F, Nemzer, LR
Frontiers in endocrinology. 2014;5:159
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Obesity is a multifactorial disease, which makes it a complicated issue to address. In particular psychology and a concept know as locus of control plays a huge role. Locus of control refers to an individual’s ability to acknowledge that their environment and choices are under their control. However, whether this is a cause of obesity or mutually occurring is unclear. This review of 49 papers aimed to determine the relationship between obesity and locus of control. The authors discussed that the majority of literature agrees on a correlation between locus of control and obesity, however it is not straight forward as there is no set definition for locus of control. Whether locus of control causes obesity or obesity causes locus of control was also difficult to determine, but it was stated that locus of control is difficult to change. The mechanisms behind causation were discussed and stress hormones and hormones which make you feel full or hungry were implicated. It was concluded that there is a correlation between locus of control and obesity, however which one is causal, still needs more research. This paper could be used by healthcare practitioners to understand the important role that psychology plays in the development of obesity.
Abstract
In the developed world, the hazards associated with obesity have largely outstripped the risk of starvation. Obesity remains a difficult public health issue to address, due in large part to the many disciplines involved. A full understanding requires knowledge in the fields of genetics, endocrinology, psychology, sociology, economics, and public policy - among others. In this short review, which serves as an introduction to the Frontiers in Endocrinology research topic, we address one cross-disciplinary relationship: the interaction between the hunger/satiation neural circuitry, an individual's perceived locus of control, and the risk for obesity. Mammals have evolved a complex system for modulating energy intake. Overlaid on this, in humans, there exists a wide variation in "perceived locus of control" - that is, the extent to which an individual believes to be in charge of the events that affect them. Whether one has primarily an internal or external locus of control itself affects, and is affected by, external and physiological factors and has been correlated with the risk for obesity. Thus, the path from hunger and satiation to an individual's actual behavior may often be moderated by psychological factors, included among which is locus of control.