Weight Stigma Mediates the Association Between BMI and Self-Reported Health
Weight Stigma Mediates the Association Between BMI and Self-Reported Health
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DOI：
10.1037/hea0000106
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发表时间：
2015-02-01
影响因子：
4.2
通讯作者：
Major, Brenda
中科院分区：
文献类型：
--
作者：
Hunger, Jeffrey M.;Major, Brenda
目的：体重耻辱在美国普遍存在。我们测试了这样一个假设：耻辱可能是肥胖对自我报告的健康产生负面影响的一种机制。两项研究探讨了基于体重的歧视和对体重耻辱的担忧是否介导了 BMI 与自我报告的心理健康（研究 1）和身体健康（研究 2）之间的关联。方法：在两项在线研究中，成年社区成员完成了与耻辱相关的中介因素（感知的体重歧视、体重耻辱问题）的测量，并提供了他们的身高和体重。在研究 1（N = 171）中，参与者还完成了心理健康（抑郁、自尊、生活质量）的测量，而研究 2（N = 194）的参与者也完成了自我报告的身体健康的测量。使用过程建模来同时测试通过感知歧视和耻辱问题的调解以及通过这两个变量的串行调解。结果：在这两项研究中，我们假设并发现了对系列中介的支持，即体重指数通过影响感知歧视和对耻辱的担忧，与较差的自我报告健康状况间接相关。此外，对耻辱感的担忧介导了体重指数和健康之间的关联，与感知到的歧视无关。结论：体重耻辱是 BMI 与自我报告健康之间关联的重要中介因素。此外，结果表明，对未来面临耻辱的担忧会调节过去感知的歧视经历与心理和身体健康之间的联系。
Objective: Weight stigma is pervasive in the United States. We tested the hypothesis that stigma may be a mechanism through which obesity negatively affects self-reported health. Two studies examined whether perceived weight-based discrimination and concerns over weight stigma mediated the association between BMI and self-reported psychological health (Study 1) and physical health (Study 2). Method: In 2 online studies, adult community members completed measures of stigma-relevant mediators (perceived weight discrimination, weight stigma concerns) and provided their height and weight. In Study 1 (N = 171) participants also completed measures of psychological health (depression, self-esteem, quality of life), whereas participants in Study 2 (N = 194) also completed a measure of self-reported physical health. Process modeling was used to simultaneously test for mediation through perceived discrimination and stigma concerns independently as well as for serial mediation through both variables. Results: Across both studies, we hypothesized and found support for serial mediation such that BMI was indirectly related to poorer self-reported health through its effect on perceived discrimination and concerns about stigma. Additionally, concerns about stigma mediated the association between BMI and health independent of perceived discrimination. Conclusions: Weight stigma is an important mediator of the association between BMI and self-reported health. Furthermore, results indicate that concerns about facing stigma in the future mediate the link between perceived past experiences of discrimination and psychological and physical health.