Weight stigma in men associated with harmful health consequences
July 30, 2019
Science Daily/UConn Rudd Center for Food Policy and Obesity
As many as 40% of men report experiencing weight stigma, but little is known about how this stigma affects their health. This study found that men experiencing weight stigma have more depressive symptoms, are more likely to binge eat, and have lower self-rated health.
Men's health may be compromised by weight stigma, finds the latest research from the Rudd Center for Food Policy and Obesity at the University of Connecticut.
Weight stigma is pervasive against people with obesity, and can contribute to both physical and emotional health problems for those targeted. As many as 40% of men report experiencing weight stigma, but when it comes to how this stigma affects their health, men have received less attention in research compared to women.
"It's often assumed that conversations about weight loss, poor body image, and dieting are more salient for women. Men are frequently overlooked, but that does not necessarily mean that men are less affected by weight stigma or less likely to internalize negative biases," says Mary Himmelstein, lead author of the study.
The research, published in the journal Obesity, involved two groups of men: 1,249 men from a diverse national survey panel, and 504 men from an online data collection service. Both groups of men completed identical surveys about their experiences of weight-based stigma, how much they internalized these experiences (e.g., blamed themselves), as well as their psychological wellbeing and health behaviors.
Key findings include:
· Both experienced and internalized weight stigma were associated with more depressive symptoms and more dieting behaviors.
· Men who experienced weight stigma had increased odds of engaging in binge eating.
· Men who internalized weight stigma had lower self-rated health.
These findings suggest the need for increased attention to men not only in research on links between weight stigma and health, but also among health professionals treating men for various health conditions, in which weight stigma may play a contributing role. In particular, it may be useful for health care providers to ask men about weight stigma to help identify those who may be vulnerable to depression or disordered eating behaviors, which are underdiagnosed in men.
"Our study shows that weight stigma is not a gendered issue. It can affect men's health in the same damaging ways in which we already know that it harms women's health, and neglecting these issues in men, either in research or clinical practice, may put them at a serious disadvantage in treatment," says Himmelstein. "Opportunities for supportive interventions should be available for men, women, and non-binary individuals alike to help them cope with weight stigma in less harmful ways."
https://www.sciencedaily.com/releases/2019/07/190730083717.htm
Should obesity be recognized as a disease?
July 17, 2019
Science Daily/BMJ
With obesity now affecting almost a third (29%) of the population in England, and expected to rise to 35% by 2030, should we now recognise it as a disease? Experts debate the issue in The BMJ today.
Obesity, in which excess body fat has accumulated to such an extent that health may be adversely affected, meets the dictionary definition of disease, argue Professor John Wilding at the University of Liverpool and Vicky Mooney, representing the European Coalition for People living with Obesity (ECPO).
They point out that more than 200 genes influence weight, and most of these are expressed in the brain or in adipose tissue. "Thus body weight, fat distribution, and risk of complications are strongly influenced by biology -- it is not an individual's fault if they develop obesity."
They argue that the recent rapid increase in obesity is not due to genetics but to an altered environment (food availability and cost, physical environment, and social factors).
Yet the widespread view is that obesity is self inflicted and that it is entirely the individual's responsibility to do something about it, while healthcare professionals seem ill informed on the complexity of obesity and what patients with obesity want.
Recognising obesity as a chronic disease with severe complications rather than a lifestyle choice "should help reduce the stigma and discrimination experienced by many people with obesity," they add.
They disagree that labelling a high proportion of the population as having a disease removes personal responsibility or may overwhelm health services, pointing out that other common diseases, such as high blood pressure and diabetes, require people to take action to manage their condition.
They suggest that most people with obesity will eventually develop complications, and those who do not could be considered as not having disease. "But unless we accept that obesity is a disease, we are not going to be able to curb the epidemic," they conclude.
But Dr Richard Pile, a GP with a special interest in cardiology and Clinical Lead for Prevention for Herts Valleys Clinical Commissioning Group, argues that adopting this approach "could actually result in worse outcomes for individuals and society."
He believes that the dictionary definition of disease "is so vague that we can classify almost anything as a disease" and says the question is not whether we can, but whether we should, and to what end.
If labelling obesity as a disease was harmless then it wouldn't really matter, he writes. But labelling obesity as a disease "risks reducing autonomy, disempowering and robbing people of the intrinsic motivation that is such an important enabler of change."
There is an important difference psychologically between having a risk factor that you have some responsibility for and control over and having a disease that someone else is responsible for treating, he says.
What's more, making obesity a disease "may not benefit patients, but it will benefit healthcare providers and the pharmaceutical industry when health insurance and clinical guidelines promote treatment with drugs and surgery," he warns.
While self determination is key in enabling change, "we should acknowledge that the origins of obesity for most people are social, and so too is the solution," he adds. "If people meet, shop, cook, eat, and engage in activities together the end result will be improved wellbeing and reducing obesity will be a consequential beneficial side effect."
Classifying obesity as a disease is neither essential nor beneficial. It's much more complicated than that, he concludes.
https://www.sciencedaily.com/releases/2019/07/190717195401.htm
Early and ongoing experiences of weight stigma linked to self-directed weight shaming
New study identifies key characteristics of people who internalize weight bias
July 15, 2019
Science Daily/University of Pennsylvania School of Medicine
Weight bias is a common form of prejudice against people who are viewed as having excess weight. Some individuals who struggle with weight may internalize the stigma directed toward them, blaming and devaluing themselves because of their weight. While it's known that weight "self-stigma" is associated with poor mental and physical health, it isn't clear who is most prone to this internalization. In a new study published today in Obesity Science and Practice, researchers at Penn Medicine and the University of Connecticut Rudd Center for Food Policy and Obesity surveyed more than 18,000 adults enrolled in the commercial weight management program WW International (formerly Weight Watchers Inc.), and found that participants who internalized weight bias the most tended to be younger, female, have a higher body mass index (BMI), and have an earlier onset of their weight struggle. Participants who were black or had a romantic partner had lower levels of internalization.
"We don't yet know why some people who struggle with their weight internalize society's stigma and others do not," said the study's lead author Rebecca Pearl, PhD, an assistant professor of Psychology in Psychiatry in the Perelman School of Medicine at the University of Pennsylvania. "These findings represent a first step toward helping us identify, among people trying to manage their weight, who may be most likely to self-stigmatize. People who are trying to lose weight may be among the most vulnerable to weight self-stigma, but this issue is rarely discussed in treatment settings."
Research has found that, beyond the effects of BMI and depression, self-directed weight stigma is associated with increased risk for cardiovascular and metabolic disease. In this study -- the largest investigation of weight self-stigma in the world -- researchers surveyed adults to identify key characteristics and experiences of people who internalize weight bias.
Participants recalled when in their life they experienced weight stigma from other people, how frequent and how upsetting the experiences were, and who it was that called them names, rejected them, or denied them an opportunity simply because of their weight. Results showed that almost two-thirds of the participants reported experiencing weight stigma at least once in their life, and almost half reported experiencing these events when they were children or teens. The researchers examined the relationships between these experiences and levels of self-directed stigma.
Participants who reported experiencing weight stigma from others had higher levels of internalized weight bias than those who reported no experiences of weight stigma. Researchers say this was particularly true for participants who had weight-stigmatizing experiences early in life and continued to have these upsetting experiences as adults. People who experienced weight stigma from family members or friends, or from those in their workplace, community, or health care setting, also had greater evidence of weight self-stigma compared to participants who did not encounter weight stigma from those sources.
"Our findings can inform ways to support people who are experiencing or internalizing weight stigma, including opportunities to address weight stigma as part of weight management and healthy lifestyle programs," said the study's principal investigator Rebecca Puhl, PhD, a professor of Human Development and Family Sciences at the University of Connecticut.
The study sample, although the largest to date, represented only a small percentage of WW members, so the findings may not generalize to all members or to adults trying to lose weight in other ways. Some prior research has suggested that people who internalize weight bias may have worse long-term weight loss outcomes, but more research on this topic is needed.
In addition, Pearl's team is developing a psychological intervention for weight self-stigma that can be incorporated into weight management.
https://www.sciencedaily.com/releases/2019/07/190715075424.htm