Responding to weight stigma: Helpful and unhelpful coping strategies

应对体重耻辱：有用和无用的应对策略

• 批准号: ES/S011129/1
• 负责人: Angela Meadows
• 金额: $ 13.3万
• 依托单位: UNIVERSITY OF EXETER
• 依托单位国家: 英国
• 项目类别: Fellowship
• 财政年份: 2018
• 资助国家: 英国
• 起止时间: 2018 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=ES%2FS011129%2F1
• 关键词: Responding; weight; stigma; Helpful; unhelpful

The prevalence of high-weight status is increasing globally, with approximately 60% of people in the UK considered "overweight" or "obese" by BMI standards, and similar rates in many other countries. Despite this, higher-weight individuals experience prejudice and discrimination in practically every domain of daily living, including education, employment, healthcare, and interpersonal relationships. We know from other oppressed groups that stigma is associated with poorer health and life outcomes, and in the last ten years, these effects have been demonstrated also in the case of weight stigma. A better understanding of how these processes occur and identification of potential targets for intervention to reduce resulting harms is of critical importance to public policy.Little is known about how the impact of weight stigma is transmitted, and even less on how the harms can be minimised. My PhD work focused predominantly on internalised weight stigma (IWS) - the phenomenon where higher-weight people devalue themselves because of their weight. IWS has been linked with a range of physical and psychological health problems, and unhelpful coping strategies such as disordered eating, avoidance of exercise, social isolation, and substance use. IWS is also an intermediary in many of the problems associated with experiencing stigma from others. However, we do not know why some people internalise societal stigma, others are largely unaffected, and some actively resist and challenge the stigma.During my PhD, I developed the first questionnaire to measure weight stigma resistance and demonstrated that resistance was associated with improved psychological wellbeing. I also drew on research from the mental health stigma literature and identified a number of key characteristics of internalisers and resisters. One important factor was whether the individual had a strong group identity - that is, whether they feel a sense of kinship and belonging with other higher-weight people. People with high group identity were less likely to internalise and more likely to resist. Another important factor was whether or not they felt that body weight was under individual control and simply a matter of willpower. Those who believed they could become slimmer tended not to resist stigma and were more likely to internalise it. But perhaps most interestingly, believing that stigma of higher-weight people was not justified helped to define resisters even if they didn't have high group identity and whether or not they felt their weight status was controllable. This means that it may be possible to develop health promotion interventions that take a social justice-based approach: that stigma is wrong whatever the circumstances and people deserve to be treated equally and with respect whatever their weight. Such an intervention may improve psychological wellbeing in higher-weight individuals regardless of their current beliefs and feelings about their weight.My goal is to pursue this avenue of research within academia. This fellowship would enhance my future applications for research funding and faculty positions in a number of ways. Two small studies would help me test the statistical properties of my stigma resistance measure, and would increase the likelihood that my resistance research will be published in a top journal where it would have a greater impact. Another study I would like to do would explore the relationship between both being stigmatised and observing other people being stigmatised on health, wellbeing, and use of unhealthy coping strategies in a large sample of medical students over the course of their training. I would also use the opportunity to build professional networks, disseminate my work more widely, enhance subject-specific knowledge, and acquire additional research, teaching, and other acadmic skills that would significantly strengthen my future career prospects and help me take the next steps toward an independent research career.

高体重状态的流行率在全球范围内不断增加，英国约有60%的人被认为是“超重”或“肥胖”的BMI标准，在许多其他国家也有类似的比例。尽管如此，体重较高的人在日常生活的几乎每个领域都受到偏见和歧视，包括教育，就业，医疗保健和人际关系。我们从其他受压迫群体那里了解到，耻辱感与更差的健康和生活结果有关，在过去的十年里，这些影响也在体重耻辱的情况下得到了证明。更好地了解这些过程是如何发生的，并确定潜在的干预目标，以减少由此产生的危害，这对公共政策至关重要。人们对体重耻辱的影响是如何传播的知之甚少，更不知道如何将危害降到最低。我的博士工作主要集中在内化的体重耻辱（IWS）-体重较高的人因为体重而贬低自己的现象。IWS与一系列身体和心理健康问题以及无益的应对策略有关，如饮食失调，避免锻炼，社会孤立和物质使用。IWS也是许多与遭受他人羞辱有关的问题的中介。然而，我们不知道为什么有些人内化社会耻辱，其他人基本上不受影响，有些人积极抵制和挑战耻辱。在我的博士学位期间，我开发了第一份问卷来衡量体重耻辱抵抗力，并证明抵抗力与改善心理健康有关。我还借鉴了心理健康污名文献的研究，并确定了内化者和抵制者的一些关键特征。一个重要的因素是个体是否有强烈的群体认同感--也就是说，他们是否对其他体重较高的人有亲属关系和归属感。具有高群体认同感的人不太可能内化，更可能抵制。另一个重要的因素是他们是否认为体重是在个人控制之下的，仅仅是意志力的问题。那些相信自己可以变得更苗条的人倾向于不抵制耻辱感，并且更有可能将其内化。但也许最有趣的是，相信高体重者的耻辱感是不合理的有助于定义抵制者，即使他们没有高群体认同感，也不管他们是否认为自己的体重状况是可控的。这意味着有可能制定采取基于社会正义的办法的健康促进干预措施：无论在何种情况下，污名化都是错误的，人们无论体重如何都应该得到平等对待和尊重。这种干预可能会改善高体重个体的心理健康，而不管他们目前对自己体重的信念和感受如何。这个奖学金将提高我未来的研究资金和教师职位的申请在许多方面。两个小的研究将帮助我测试我的污名抵抗措施的统计特性，并将增加我的抵抗研究将在顶级期刊上发表的可能性，在那里它将产生更大的影响。我想做的另一项研究将探讨被污名化和观察其他人被污名化的健康，福祉和使用不健康的应对策略之间的关系，在大样本的医学生在他们的培训过程中。我还将利用这个机会建立专业网络，更广泛地传播我的工作，提高特定学科的知识，并获得额外的研究，教学和其他学术技能，这将大大加强我未来的职业前景，并帮助我采取下一步走向独立的研究生涯。

项目成果

Fat acceptance 101: Midwestern American women's perspective on cultural body acceptance

• DOI: 10.1080/14461242.2019.1604150
• 发表时间: 2019-04-13
• 期刊: HEALTH SOCIOLOGY REVIEW
• 影响因子: 3.6
• 作者: Bombak, Andrea E.;Meadows, Angela;Billette, Jacqueline
• 通讯作者: Billette, Jacqueline

Weight stigma and physical health: an unconsidered 'obesity' cost : Letter to the Editor: Response to Singh et al. (2018). Is there more to the equation? Weight bias and the costs of obesity. Canadian Journal of Public Health. https://doi.org/10.17269/s41997-018-0146-2. Online first: 26 October 2018.

体重耻辱和身体健康：未考虑的“肥胖”成本：致编辑的信：对辛格等人的回应

• DOI: 10.17269/s41997-019-00223-2
• 发表时间: 2019
• 期刊: Canadian journal of public health = Revue canadienne de sante publique
• 作者: Meadows A

The Multifaceted Nature of Weight-Related Self-Stigma: Validation of the Two-Factor Weight Bias Internalization Scale (WBIS-2F)

• DOI: 10.3389/fpsyg.2019.00808
• 发表时间: 2019-04-16
• 期刊: FRONTIERS IN PSYCHOLOGY
• 影响因子: 3.8
• 作者: Meadows, Angela;Higgs, Suzanne
• 通讯作者: Higgs, Suzanne

Internalized weight stigma and the progression of food addiction over time

• DOI: 10.1016/j.bodyim.2020.05.002
• 发表时间: 2020-09-01
• 期刊: BODY IMAGE
• 影响因子: 5.2
• 作者: Meadows, Angela;Higgs, Suzanne
• 通讯作者: Higgs, Suzanne

A bifactor analysis of the Weight Bias Internalization Scale: What are we really measuring?

• DOI: 10.1016/j.bodyim.2020.02.013
• 发表时间: 2020-06-01
• 期刊: BODY IMAGE
• 影响因子: 5.2
• 作者: Meadows, Angela;Higgs, Suzanne
• 通讯作者: Higgs, Suzanne