Weight bias internalization, core self-evaluation, and health in overweight and obese persons
Weight bias internalization, core self-evaluation, and health in overweight and obese persons
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DOI：
10.1002/oby.20561
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发表时间：
2014-01-01
期刊：
影响因子：
6.9
通讯作者：
Zenger, Markus
中科院分区：
文献类型：
--
作者：
Hilbert, Anja;Braehler, Elmar;Zenger, Markus
客观体重偏差与超重和肥胖个体的精神病理学密切相关。然而，自我耻辱过程模型中概念化的自我评价过程以及对其他健康相关结果的影响仍有待澄清。设计和方法 在 N = 1158 名超重和肥胖个体的代表性一般人群样本中，使用结构方程模型检查了核心自我评价作为体重偏差内化与心理和全球健康结果之间以及体重偏差内化与医疗保健利用之间中介的影响。结果在超重和肥胖个体中，体重偏差内化程度越高，核心自我评价就会越低，而核心自我评价反过来又会导致抑郁和焦虑程度增加、整体健康状况下降以及医疗保健利用率提高。这些中介关联在子样本分析中和控制社会人口统计学变量后基本稳定。结论 结果表明，具有内在体重偏差的超重和肥胖个体存在健康受损的风险，特别是如果他们的核心自我评价较低，这使他们成为减少自我耻辱干预措施的目标群体。体重偏差内化并不代表医疗保健利用的障碍，但预测更大的医疗保健利用与更大的健康损害相关。
Objective Weight bias has strong associations with psychopathology in overweight and obese individuals. However, self-evaluative processes, as conceptualized in the process model of self-stigma, and implications for other health-related outcomes, remain to be clarified. Design and Methods In a representative general population sample of N = 1158 overweight and obese individuals, the impact of core self-evaluation as a mediator between weight bias internalization and mental and global health outcomes as well as between weight bias internalization and health care utilization, was examined using structural equation modeling. Results In overweight and obese individuals, greater weight bias internalization predicted lower core self-evaluation, which in turn predicted greater depression and anxiety, lower global health, and greater health care utilization. These mediational associations were largely stable in subsample analyses and after controlling for sociodemographic variables. Conclusions The results show that overweight and obese individuals with internalized weight bias are at risk for impaired health, especially if they experience low core self-evaluation, making them a group with which to target for interventions to reduce self-stigma. Weight bias internalization did not represent a barrier to health care utilization, but predicted greater health care utilization in association with greater health impairments.