Investigating the relationship between internalized weight stigma and metabolic syndrome

项目总结/摘要 体重较高的人（即，肥胖症）面临普遍和持久的耻辱。许多个人 内化关于体重的负面社会信息和陈规定型观念，导致自我导向的污名化。 内化的体重耻辱感与心理健康受损有关，但对其对健康的影响知之甚少。 身体健康先前的初步数据表明，肥胖的成年人谁内化的体重耻辱，以高 程度可能有更大的脆弱性，代谢综合征（MetS）比那些谁没有。这可能是 由于长期的压力，不断自我贬低的个人谁内化体重耻辱， 其结果是炎症免疫反应失调。确定内部化的贡献 体重耻辱心血管疾病（CVD）的风险和压力引起的炎症是至关重要的， 了解耻辱对健康的影响，并加强对肥胖症的治疗。 本研究旨在探讨内化体重污名与代谢综合征之间的关系 超过了体重指数（BMI）、抑郁症和人口统计学特征的影响。的 研究还将探讨内化的体重耻辱感是否与高水平的 炎症标志物C-反应蛋白（CRP）、白细胞介素-6（IL-6）和髓过氧化物酶（MPO）。这将是 一项对110名绝经后肥胖女性（BMI ≥ 30 kg/m2）进行的横断面观察性研究， 报告高或低水平的内化体重耻辱，由体重偏差的截止分数决定 内化量表。合格受试者将参加单盲评估访视，其中包括： 测量身高、体重、血压和腰围;空腹抽血评估 血糖、甘油三酯、高密度脂蛋白胆固醇、CRP、IL-6和MPO;并通过访谈进行评估 目前的药物诊断和感染参与者还将完成在线问卷， 评估抑郁症和其他相关的心理社会措施。初步分析将确定是否 报告高与低内化耻辱感的参与者达到标准的几率明显更大 对于Mets。二次分析将探讨内化的体重污名与CRP、IL-6、 和MPO。所有分析将控制BMI、抑郁和人口统计学特征。 这项拟议的研究建立在K23奖项目的基础上，该项目是一项随机对照试验， 旨在降低内化体重的心理干预对长期减肥的影响 耻辱，结合减肥治疗，与单独减肥治疗相比。这项研究将扩大 K23奖重点关注心脏代谢健康，通过提供新的数据， 内化体重耻辱炎症和CVD风险，独立于体重。数据将用于 为将来的机制试验提供信息，以了解减少内化的体重耻辱感对压力标志物的影响， 炎症和CVD风险。

PROJECT SUMMARY/ABSTRACT Persons with a higher body weight (i.e., obesity) face pervasive and persistent stigma. Many individuals internalize negative societal messages and stereotypes about weight, leading to self-directed stigmatization. Internalized weight stigma is associated with impaired mental health, but little is known about its effects on physical health. Prior preliminary data suggest that adults with obesity who internalize weight stigma to a high degree may have greater vulnerability to the metabolic syndrome (MetS) than those who do not. This may be due to the chronic stress of constant self-disparagement among individuals who internalize weight stigma and, as a result, dysregulation of the inflammatory-immune response. Identifying the contribution of internalized weight stigma to cardiovascular disease (CVD) risk and stress-induced inflammation is critical to advancing knowledge of the health effects of stigma and to enhancing the treatment of obesity. The current study aims to determine the relationship between internalized weight stigma and MetS above and beyond the effects of body mass index (BMI), depression, and demographic characteristics. The study will also explore whether internalized weight stigma is associated with heightened levels of the inflammatory markers C-reactive protein (CRP), interleukin-6 (IL-6), and myeloperoxidase (MPO). This will be a cross-sectional, observational study of 110 postmenopausal women with obesity (BMI ≥ 30 kg/m2) who report either high or low levels of internalized weight stigma, as determined by cutoff scores on the Weight Bias Internalization Scale. Eligible participants will attend a single blinded assessment visit, which will include: measurement of height, weight, blood pressure, and waist circumference; fasting blood draw to assess glucose, triglycerides, high-density lipoprotein cholesterol, CRP, IL-6, and MPO; and assessment by interview of current medications, diagnoses, and infections. Participants will also complete online questionnaires that assess depression and other relevant psychosocial measures. The primary analysis will determine whether participants who report high versus low internalized stigma have significantly greater odds of meeting criteria for MetS. Secondary analyses will explore the relationship between internalized weight stigma and CRP, IL-6, and MPO, respectively. All analyses will control for BMI, depression, and demographic characteristics. The proposed study builds on the K23 award project, which is a randomized controlled trial that tests the effects on long-term weight loss of a psychological intervention designed to reduce internalized weight stigma, combined with weight loss treatment, compared to weight loss treatment alone. This study will extend the K23 award focus on cardiometabolic health by providing novel data that isolate the contribution of internalized weight stigma to inflammation and CVD risk, independent of body weight. Data will be used to inform a future mechanistic trial of the effects of reducing internalized weight stigma on markers of stress, inflammation, and CVD risk.