"Improving Understanding Of Weight Stigma With Causal Inference Methods And General Population Survey Data".

肥胖很常见，影响着欧洲16%的成年人和6%的儿童，但它也受到高度污名化。人们在医疗、教育和工作场所因体重而受到歧视，并造成严重后果。经历体重耻辱的人心理健康和生活质量更差。肥胖症患者避免寻求医疗保健，因为他们害怕与医疗专业人员进行负面的、污名化的互动。具有讽刺意味的是，体重耻辱感也可能导致肥胖，影响饮食模式和身体活动的障碍。当体重污名被“内化”时，人们开始相信与肥胖相关的负面刻板印象适用于自己-例如，认为自己懒惰，无能或比其他人更有价值。这种“内化”的体重耻辱不仅与肥胖者的饮食失调有关，也与正常体重和体重不足的人有关。这意味着体重耻辱感与整个体重范围内的心理健康有关。人们普遍担心，旨在减少肥胖的公共卫生举措可能会导致体重污名化，使其效果降低，并造成伤害。例如，给英国学龄儿童的父母发送“体重报告卡”并不能减少肥胖，但确实会使体重较重的孩子不吃早餐，在学校感到疲倦和不快乐。随着COVID-19大流行的爆发，国家封锁期间对体重控制的关注可能使情况变得更糟，导致转介到饮食失调服务的人数大幅增加。体重污名本身已被公认为一个公共卫生问题，但我们不知道如何减少体重污名或保护人们免受其影响。这是因为体重污名研究几乎完全基于小样本，不能代表整个人口。研究也集中在美国，所以我们对英国或欧洲的体重耻辱知之甚少。我们不知道一个人的种族或性别如何改变他们对体重的耻辱感，也不知道是什么让一些年轻人比其他人更容易“内化”体重耻辱感。最后，以前的研究确实使用了更大、更有代表性的样本，但由于所使用的方法，这些研究可能存在偏差。目标：该项目旨在通过欧洲大规模的一般人群调查，改变目前对日常体重耻辱的程度，谁受其影响最大，以及它是如何内在化的理解。目标1：探索歧视和骚扰的风险如何随着不同种族，性别和体型的组合而变化。目标2：调查工作场所中体重歧视的程度，如果这种情况随着时间的推移而发生变化，则使用方法来避免可能影响早期研究的偏见。潜在的应用和好处：目标1将有助于识别因多种原因而面临特别高的歧视和骚扰风险的成年人群体，并帮助我们更好地了解歧视在英国是如何发挥作用的。目标2将阐明解决工作场所体重污名化问题的必要性，例如通过员工培训计划-以及这种需要在未来是否会增加。目标3将有助于确定哪些年轻人群体最容易受到体重耻辱的负面心理影响，以及可以用来保护他们的因素。它将帮助我们更好地了解体重耻辱和心理健康之间的关系，包括饮食失调和抑郁症，以及对体重的态度如何通过家庭传递。研究结果可供组织和政策制定者使用，旨在减轻体重，种族和性别歧视的影响，减少工作场所的欺凌行为，并改善心理健康。

Context: Obesity is common, affecting 16% of adults and 6% of children in Europe, but it is also highly stigmatized. People are discriminated against because of their weight in medical, education, and workplace settings, with serious consequences. People who experience weight stigma have worse mental health and quality of life. People with obesity avoid seeking healthcare due to fear of negative, stigmatizing interactions with medical professionals. Ironically, weight stigma may also contribute to obesity, by affecting eating patterns and acting as barrier to physical activity. When weight stigma is 'internalized', people come to believe that negative obesity-related stereotypes apply to themselves - for example, thinking of themselves as lazy, incompetent, or less valuable than others. This 'internalized' weight stigma is linked to disordered eating not only for people with obesity, but also for normal-weight and underweight people. This means that weight stigma is relevant to mental health across the bodyweight range. There is widespread concern that public health initiatives aiming to reduce obesity may contribute to weight stigma, making them less effective, and causing harm. For example, sending 'weight report cards' to parents of UK schoolchildren does not reduce obesity, but does make heavier children skip breakfast and feel tired and unhappy at school. With the onset of the COVID-19 pandemic, the focus on weight control during national lockdowns may have made this situation worse, contributing to a huge increase in referrals to eating disorder services. Weight stigma is becoming recognised as a public health problem in its own right, but we do not know how to reduce weight stigma or protect people from its effects. This is because weight stigma research has been almost entirely based on small samples which are not representative of the whole population. Research has also focused on the United States, so we know very little about weight stigma in the UK or Europe. We do not know how a person's ethnicity or gender might change their experience of stigma around their weight, or what makes some young people more likely than others to 'internalize' weight stigma. Finally, previous research which did use larger, more representative samples may have been biased because of the methods used. Aims: This project aims to transform current understanding of the extent of everyday weight stigma, who is most affected by it, and how it becomes internalized, using large, general population European surveys.Objective 1: Explore how risk of discrimination and harassment varies with combinations of different ethnicities, genders, and body sizes.Objective 2: Investigate the extent of weight stigma in the workplace, and if this is changing with time, using methods to avoid bias which may have affected earlier research.Objective 3. Identify risk factors which make young people more likely to internalize weight stigma (apply negative obesity-related stereotypes to themselves).Potential applications and benefits: Objective 1 will help identify groups of adults at especially high risk of discrimination and harassment for multiple reasons and help us better understand how discrimination plays out in the UK. Objective 2 will clarify the need to tackle weight stigma in the workplace, for instance via employee training programmes - and if this need may increase in the future. Objective 3 will help identify which groups of young people are most at risk of negative psychological effects of weight stigma, and factors which could be used to protect them. It will help us better understand the relationships between weight stigma and mental health, including eating disorders and depression, and how attitudes about weight are passed down through families. Findings can be used by organizations and policymakers aiming to mitigate the effects of weight, ethnic, and gender discrimination, reduce bullying in the workplace, and improve mental health.