Obesity stigma and health behavior: An experimental approach

项目总结 超过70%的美国成年人被归类为超重或肥胖，体重污名被定义为负面 针对体重较重的人的态度、偏见和歧视非常普遍。我们的长期目标是 了解并最终减轻体重污名对肥胖风险的负面行为影响 和心血管疾病。为了实现这一目标，我们首先必须从根本上认识 体重污名的因果过程以及它如何在人们的生活中促进肥胖。因此，重点是 这项基本的人体实验研究(BESH)的目的是使用实验操作作为探针 对体重歧视的肥胖本质有一个基本的因果理解。许多可用的 将体重污名与不良健康结果联系起来的证据是观察性的，排除了以下结论 因果关系。现有的少数几项可以推断因果关系的实验研究只能评估 人工实验室设置。此外，到目前为止，这些文献的重点是记录体重的负面影响 耻辱，而不考虑可能提供保护的复原力因素。因此，我们的整体 目标是(1)检验体重耻辱导致健康行为减少的中心假设 使用生态瞬时评估(EMA)和活动记录法进行日常生活，以及(2)确定复原力因素 在未来的工作中，这可能会成为体重污名干预的目标。中心假设是基于现有的 文献和我们的8项初步研究，其中包括一项对2,000名参与者的研究-与美国人口普查匹配。 显示体重增加、耻辱与暴饮暴食和睡眠相关的人口统计学 骚乱。我们对健康行为的关注很重要，因为行为占可预防行为的40% 它可以降低死亡率，对肥胖和心血管疾病有很强的保护作用。此外，有证据表明， 新冠肺炎大流行正在对饮食、锻炼和睡眠造成不利影响。使用真正的实验设计， 因此，我们将追求以下目标，利用我们在处理体重污名方面的丰富经验 实验室实验和我们在生态瞬时评估和行动图方面的专业知识 学习。目标1：测试体重歧视对日常生活中饮食、体力活动和睡眠的因果影响 会随机将参与者分配到体重污名与对照操作之间，并测量健康变化 日常生活中的行为(EMA食物日记记录的3天饮食，客观测量的身体状况 通过24小时活动记录捕获的活动和睡眠，通过夜间活动记录客观地捕获，以及主观地捕获 自我报告的睡眠指标)。目标2：找出抵御因果影响的复原力因素 体重污名-我们将测试来自两个理论来源(身份/归属感和 压力/应对)。这项研究将提供对体重污名的基本理解，以潜在地识别 未来的干预目标是减轻数亿人的不良健康后果 美国人面临体重污名、肥胖和心血管疾病的风险。

PROJECT SUMMARY Over 70% of U.S. adults are classifiable as overweight or obese, and weight stigma, defined as the negative attitudes, prejudice, and discrimination directed at heavier individuals, is highly prevalent. Our long-term goal is to understand and ultimately mitigate the negative behavioral effects of weight stigma that pose risk for obesity and cardiovascular disease. In order to achieve this goal, we must first gain a fundamental understanding of the causal processes of weight stigma and how it functions in people’s lives to promote obesity. Therefore, the focus of this basic experimental study in humans (BESH) is to use an experimental manipulation as a probe in order to gain a fundamental causal understanding of the obesogenic nature of weight stigma. Much of the available evidence tying weight stigma to poor health outcomes is observational, precluding conclusions regarding causality. The few existing experimental studies that can infer causality only assess immediate outcomes in artificial lab settings. Moreover, the literature has thus far focused on documenting the negative effects of weight stigma, without attending to resilience factors that could confer protection against them. Therefore, our overall objectives are to (1) test the central hypothesis that weight stigma causes decrements in health behaviors in everyday life using ecological momentary assessment (EMA) and actigraphy, and (2) identify resilience factors that could, in future work, be targeted in weight stigma interventions. The central hypothesis is based on existing literature and our 8 preliminary studies, which include a study of 2,000 participants census-matched to U.S. population demographics demonstrating associations between greater weight stigma and binge eating and sleep disturbance. Our focus on health behaviors is important because behaviors account for 40% of preventable deaths and are strongly protective against obesity and cardiovascular disease. Moreover, there is evidence that the COVID-19 pandemic is detrimentally impacting diet, exercise, and sleep. Using a true experimental design, we will therefore pursue the following aims that capitalize on our deep experience manipulating weight stigma in laboratory experiments and our demonstrated expertise in ecological momentary assessment and actigraphy studies. AIM 1: Test the causal effects of weight stigma on diet, physical activity, and sleep in everyday life—we will randomly assign participants to a weight stigma vs. control manipulation and measure changes health behaviors in their everyday lives (3-day diet as captured by EMA food diaries, objectively measured physical activity captured by 24-hour actigraphy, and sleep, captured objectively by overnight actigraphy and subjectively self-reported sleep measures). AIM 2: Identify resilience factors that confer protection against the causal effects of weight stigma—we will test moderators drawn from two sources of theory (identity/belongingness and stress/coping). This research will provide a fundamental understanding of weight stigma to potentially identify a future intervention target to ameliorate unfavorable health consequences for the hundreds of millions of Americans at risk for weight stigma, obesity, and cardiovascular disease.