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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.
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Patients' and professionals' experiences and perspectives of obesity in health-care settings: a synthesis of current research.
Mold, F, Forbes, A
Health expectations : an international journal of public participation in health care and health policy. 2013;16(2):119-42
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Obesity is a complex condition, and likely to be the result of a range of biological, psychological, and social factors, making it one of the most difficult and challenging health problems to manage. Obesity is often stigmatised, with obese people being subject to discrimination that could affect their access to therapies or the success of such therapies. This review looked at current research examining the experiences of both obese people and health‐care professionals. The authors reviewed a total of 30 studies. From the studies that explored patient experiences and perspectives, four themes emerged: i) ambivalence of health professionals towards patients’ needs leading to a sense of personal ambivalence for obese individuals in accessing and using services; ii) experience of weight-based stigma leading to feelings of powerlessness and humiliation; iii) negative experiences with health-care professionals leading to a reluctance to access services and/or engage in positive health behaviours; and iv) experiences of stigmatisation leading to poorer psychological health and negative behaviours. The studies that explored health professionals’ experiences and perspectives found differences in how professionals view obese patients that included ambivalence, and negative attitudes and beliefs towards overweight people. One study found that overweight and obese women were less likely to undergo routine cancer screening procedures such as cervical screening and mammograms. The studies presented in this review show that obesity has a strong social effect, not only on how obese individuals view themselves, but also on how they access and interact with health‐care providers. This can impact negatively on psycho‐emotional functioning, on the uptake of health care and on the experience of care of obese people. Given the rising levels of obesity, further work is essential to improve the health‐care provision for this population.
Abstract
BACKGROUND Obesity-related stigma likely influences how obese people interact with health-care professionals and access health care. AIM: To undertake a synthesis of studies examining the views and experiences of both obese people in relation to their health-care provision and health-care professionals in providing care to obese patients. SEARCH STRATEGY A systematic search of key electronic databases relating to professional or patient experiences of, or perspectives on, obesity was performed in 2008 and updated in 2010. Reference lists of article bibliographies were searched, along with hand searches of relevant journals. INCLUSION CRITERIA Studies were screened against explicit inclusion criteria and published between 1990 and 2010. Findings were examined and organized thematically. DATA EXTRACTION Data were extracted focusing on obesity, stigma and access to health-care services. All included studies were subject to critical appraisal to assess the quality of the research. FINDINGS Thirty studies were identified. All the studies reported obesity impacting on health-care interactions. Key themes identified were experiences of stigma and feelings of powerlessness, treatment avoidance, psycho-emotional functioning, professional attitudes, confidence and training, variations in health contact time and finally, differences in treatment options and preventative measures. CONCLUSION Obesity is a stigmatized condition that impacts negatively on the relationship between patients and health-care providers. Given the increasing prevalence of obesity and the range of therapeutic options available, further work is necessary to understand how the presence of obesity affects health-care interactions and decision making.
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The stigma of obesity in the general public and its implications for public health - a systematic review.
Sikorski, C, Luppa, M, Kaiser, M, Glaesmer, H, Schomerus, G, König, HH, Riedel-Heller, SG
BMC public health. 2011;11:661
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Obesity rates are still rising and, in addition to co-morbid diseases, perceived discrimination and stigmatisation leads to worse outcomes in obese individuals. The aim of this systematic review, including seven studies, was to investigate how the lay public perceive people with obesity or overweight (stigmatizing attitudes); (b) what they attribute obesity to (causal attribution) and (c) what types of interventions they support. Higher rates of stigmatising attitudes were associated with attributing obesity more to behaviour and less to heredity, lower levels of education and older age of the respondents, and not seeing obesity as an illness. Causal attributions varied slightly from study to study but most found that lack of activity behaviour, overeating and lack of willpower were the most prevalent causal attributions, with more than two thirds of respondents associating these factors to obesity, whilst only about a third agreed to heredity being an important factor. Environmental factors, in particular a bad food environment, was seen as a possible factor in obesity by about half of the respondents. In terms of prevention efforts, support was highest for childhood prevention and information campaigns, followed by banning junk foods in schools and banning junk food advertising, whilst taxation of unhealthy foods received the least support.
Abstract
BACKGROUND Up to this date, prevalence rates of obesity are still rising. Aside from co-morbid diseases, perceived discrimination and stigmatization leads to worsen outcomes in obese individuals. Higher stigmatizing attitudes towards obese individuals may also result in less support of preventive and interventive measures. In light of the immense burden of obesity on health care systems and also on the individuals' quality of life, accepted and subsidized preventive measures are needed. Policy support might be determined by views of the lay public on causes of obesity and resulting weight stigma. This study seeks to answer how representative samples of the lay public perceive people with obesity or overweight status (stigmatizing attitudes); what these samples attribute obesity to (causal attribution) and what types of interventions are supported by the lay public and which factors determine that support (prevention support). METHODS A systematic literature search was conducted. All studies of representative samples reporting results on (a) stigmatizing attitudes towards overweight and obese individuals, (b) causal beliefs and (c) prevention support were included. RESULTS Only 7 articles were found. One study reported prevalence rates of stigmatizing attitudes. About a quarter of the population in Germany displayed definite stigmatizing attitudes. Other studies reported causal attributions. While external influences on weight are considered as well, it seems that internal factors are rated to be of higher importance. Across the studies found, regulative prevention is supported by about half of the population, while childhood prevention has highest approval rates. Results on sociodemographic determinants differ substantially. CONCLUSIONS Further research on public attitudes toward and perception of overweight and obesity is urgently needed to depict the prevailing degree of stigmatization. Introducing a multidimensional concept of the etiology of obesity to the lay public might be a starting point in stigma reduction.
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The views of young children in the UK about obesity, body size, shape and weight: a systematic review.
Rees, R, Oliver, K, Woodman, J, Thomas, J
BMC public health. 2011;11:188
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Obesity in children is an increasing problem in Westernised societies; obese children are more at risk of poorer health in the short and long term. The aim of the study was to explore the views of children about the meanings of obesity and body size, shape or weight and their own experience of these issues. This systemic review looked at 28 studies done in UK, conducted after 1997 in children aged 4-11. The review’s findings suggest that for children, the health consequences of obesity seemed to be mostly irrelevant. Impact on their social lives was far more important. Also, despite often having healthy body sizes, children continue to dislike their own bodies. This review highlights the need to consider the social aspect of childhood obesity and that children’s perspectives should be used in the policy making process. The authors conclude that the studies did not fully represent children’s diversity and therefore higher quality research is needed to enable relevant interventions to be put into place.
Abstract
BACKGROUND There are high levels of concern about childhood obesity, with obese children being at higher risk of poorer health both in the short and longer terms. Children's attitudes to, and beliefs about, their bodies have also raised concern. Children themselves have a stake in this debate; their perspectives on this issue can inform the ways in which interventions aim to work.This systematic review of qualitative and quantitative research aimed to explore the views of UK children about the meanings of obesity and body size, shape or weight and their own experiences of these issues. METHODS We conducted sensitive searches of electronic databases and specialist websites, and contacted experts. We included studies published from the start of 1997 which reported the perspectives of UK children aged 4-11 about obesity or body size, shape or weight, and which described key aspects of their methods. Included studies were coded and quality-assessed by two reviewers independently.Findings were synthesised in two analyses: i) an interpretive synthesis of findings from open-ended questions; and ii) an aggregative synthesis of findings from closed questions. We juxtaposed the findings from the two syntheses. The effect of excluding the lowest quality studies was explored. We also consulted young people to explore the credibility of a subset of findings. RESULTS We included 28 studies. Instead of a focus on health, children emphasised the social impact of body size, describing experiences and awareness of abuse and isolation for children with a greater weight. Body size was seen as under the individual's control and children attributed negative characteristics to overweight people. Children actively assessed their own size; many wished their bodies were different and some were anxious about their shape.Reviewers judged that children's engagement and participation in discussion had only rarely been supported in the included studies, and few study findings had depth or breadth. CONCLUSIONS Initiatives need to consider the social aspects of obesity, in particular unhelpful beliefs, attitudes and discriminatory behaviours around body size. Researchers and policy-makers should involve children actively and seek their views on appropriate forms of support around this issue.