Investigating the relationship between internalized weight stigma and metabolic syndrome

项目摘要/摘要 体重较高(即肥胖)的人面临普遍而持久的耻辱。很多人 将负面的社会信息和关于体重的刻板印象内化，导致自我污蔑。 内在化体重污名与心理健康受损有关，但对其影响知之甚少。 身体健康。先前的初步数据表明，将体重污名内化到很高水平的肥胖成年人 学位可能比那些没有代谢综合征(METS)的人更容易患上代谢综合征。这可能是 由于持续自我贬低的长期压力，这些人将体重污名内化， 其结果是，炎症免疫反应的失调。确定内部化的贡献 体重对心血管疾病(CVD)风险和应激诱导的炎症的耻辱是进步的关键 了解耻辱对健康的影响并加强肥胖症的治疗。 目前的研究旨在确定内在化体重耻辱与代谢综合征的关系 除了身体质量指数(BMI)、抑郁症和人口统计特征的影响之外。这个 研究还将探索内在化体重耻辱是否与 炎症标志物C-反应蛋白(CRP)、白介素6(IL-6)和髓过氧化物酶(MPO)。这将是 110例绝经后肥胖妇女(体重指数≥为30 kg/m2)的横断面观察性研究 报告内在化体重污名的高水平或低水平，由体重偏差的截止点分数确定 内部化规模。符合条件的参与者将参加一次盲法评估访问，其中包括： 测量身高、体重、血压和腰围；空腹抽血评估 葡萄糖、甘油三酯、高密度脂蛋白胆固醇、C反应蛋白、IL-6和MPO；以及面谈评估 当前的药物、诊断和感染。参与者还将完成在线调查问卷， 评估抑郁和其他相关的心理社会措施。初步分析将确定 报告高内化污名和低内化污名的参与者达到标准的几率要大得多 对大都会来说。二次分析将探索内在化体重耻辱与CRP、IL-6、 和MPO。所有的分析都将控制BMI、抑郁和人口统计特征。 拟议的研究建立在K23奖项项目的基础上，该项目是一项随机对照试验，旨在测试 旨在降低内在性体重的心理干预对长期减肥的影响 耻辱与减肥治疗相结合，与单独减肥治疗相比。这项研究将延伸到 K23奖通过提供新的数据来关注心脏代谢健康，这些数据分离出 内在化体重污名与炎症和心血管疾病风险无关，与体重无关。数据将用于 告知未来的机械试验减少内化体重污名对压力标记物的影响， 炎症和心血管疾病风险。

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.