Mechanisms Explaining the Link Between Weight Discrimination and Poor Cardiovascular Health

解释体重歧视与心血管健康不良之间联系的机制

• 批准号: 10705356
• 负责人: Mary A Gerend
• 金额: $ 45.76万
• 依托单位: FLORIDA STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-23 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10705356
• 关键词: Address; Adverse effects; Affect; Affective; American; Behavioral; Body Weight; Body mass index; Characteristics; Cognitive; Compassion; Coupled; Data; Data Correlations; Discrimination; Eating; Education; Effect Modifiers (Epidemiology); Emotions; Employment; Ethnic Origin; Exposure to; Future; Gender; Goals; Health; Healthcare; High Prevalence; Hydrocortisone; Impairment; Individual; Inflammation; Informal Social Control; Intervention; Knowledge; Link; Literature; Methodology; Methods; Obesity; Outcome; Participant; Persons; Physiological; Pilot Projects; Procedures; Psychological Factors; Public Health; Published Comment; Race; Randomized; Research; Risk; Sampling; Sex Orientation; Social Class; Stereotyping; Stress; Testing; Weight; Weight Gain; Withdrawal; Work; adult obesity; bullying; cardiovascular disorder risk; cardiovascular health; effective intervention; experience; experimental study; improved; insight; mortality risk; novel; perceived discrimination; positive emotional state; psychologic; racial discrimination; recruit; resilience; response; sex; social; social health determinants; social stigma; therapy design; vigilance

Project Summary/Abstract Discrimination is a critical social determinant of health that underlies poor health outcomes. One common but understudied form of discrimination is weight discrimination. Weight discrimination is the behavioral manifestation of weight stigma—the social devaluation of people with excess body weight. Findings suggest that the stress produced by weight discrimination prompts weight gain, creating a vicious cycle between weight discrimination and obesity. Further, there is now well-documented evidence that experiencing weight discrimination is associated with increased risk for cardiovascular disease. Little is known, however, about mechanisms explaining the link between weight discrimination and poor cardiovascular health. Using a rigorous experimental approach, this project will identify mechanisms through which weight discrimination harms health. Findings will facilitate the long-term goal of this research: developing interventions to decrease the negative health consequences of weight discrimination. As a step toward this goal, this project proposes three experiments in which a diverse sample of adults with obesity will be randomly assigned to experience (vs. not experience) weight discrimination in a controlled experimental setting. Drawing on previous research and our pilot data, the interpersonal contexts chosen for these studies simulate situations in which people with obesity commonly experience weight discrimination in their daily lives (e.g., health care and employment settings). The following aims will be tested: (1) Identify early-stage cognitive, affective, behavioral, and physiological mechanisms activated by experimentally manipulated weight discrimination; (2) Identify psychological variables (e.g., internalized weight bias) that moderate effects of weight discrimination; and (3) Identify demographic characteristics (e.g., gender, race) that moderate effects of weight discrimination. Exposure to weight discrimination (vs. control) is hypothesized to result in elevated responses on early-stage mechanisms that culminate in poor cardiovascular health (e.g., impaired self-regulation, cognitive vigilance to signs of social disapproval, higher negative emotion, more social withdrawal and comfort eating, increased cortisol secretion and inflammation). This research will identify novel and highly modifiable targets for interventions designed to reduce the negative health effects of weight discrimination. In testing moderator variables, this work will identify individuals who display particular vulnerability vs. resilience to the harmful effects of discrimination. Information about moderators will thus help future intervention efforts target those individuals most likely to benefit from intervention. Given the high prevalence of obesity and the millions of Americans affected by weight discrimination, this research will address a crucial public health issue. At a broader level, this work will provide critical insight into mechanisms that underlie adverse health effects of other common forms of social stigma such as discrimination due to race, ethnicity, sexual orientation, or social class.

项目总结/摘要 歧视是健康的一个重要社会决定因素，是健康状况不佳的根源。一个共同的，但 歧视的另一种形式是体重歧视。体重歧视是一种 体重污名的表现-社会对超重者的贬低。发现表明 体重歧视产生的压力促使体重增加，在体重和体重之间形成恶性循环。 歧视和肥胖。此外，现在有充分的证据表明， 歧视与心血管疾病风险增加有关。然而，人们对 解释体重歧视和心血管健康状况不佳之间联系的机制。使用 严格的实验方法，该项目将确定通过体重歧视的机制， 危害健康。研究结果将有助于实现本研究的长期目标：制定干预措施， 体重歧视对健康的负面影响。作为实现这一目标的一步，该项目建议 三个实验中，一个不同的样本与肥胖的成年人将被随机分配到经验， (vs.没有经验）的重量歧视在一个受控的实验设置。借鉴以往的研究成果 和我们的试点数据，为这些研究选择的人际环境模拟的情况下， 肥胖者通常在他们的日常生活中经历体重歧视（例如，保健和就业 设置）。本研究将测试以下目标：（1）识别早期认知、情感、行为和 通过实验操作的体重辨别激活的生理机制;（2）识别 心理变量（例如，内化体重偏差）对体重歧视调节作用;（3） 确定人口统计特征（例如，性别，种族），这缓和了体重歧视的影响。 假设暴露于体重歧视（与对照组相比）会导致早期阶段的反应升高 最终导致心血管健康不良的机制（例如，自我调节受损，认知警觉， 社会不赞成的迹象，更高的负面情绪，更多的社会退缩和安慰性饮食，增加 皮质醇分泌和炎症）。这项研究将确定新的和高度可修改的目标， 旨在减少体重歧视对健康的负面影响的干预措施。在测试中调节剂 变量，这项工作将确定个人谁表现出特定的脆弱性与弹性的有害 歧视的影响。因此，关于主持人的信息将有助于今后的干预工作针对那些 最有可能从干预中受益的人。考虑到肥胖症的高流行率和数百万 这项研究将解决一个关键的公共健康问题。在 在更广泛的层面上，这项工作将提供关键的深入了解机制的基础上，不良健康影响的其他 常见的社会耻辱形式，如种族、民族、性取向或社会阶层的歧视。