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

背景：肥胖很常见，影响着欧洲16%的成年人和6%的儿童，但它也被高度污名化。人们在医疗、教育和工作场所因体重而受到歧视，造成严重后果。经历过体重耻辱的人的心理健康和生活质量都更差。肥胖的人避免寻求医疗保健，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，体重耻辱也可能通过影响饮食模式和成为体育活动的障碍而导致肥胖。当体重耻辱被“内化”时，人们开始相信与肥胖相关的负面刻板印象也适用于自己——例如，认为自己懒惰、无能或不如别人有价值。这种“内化”的体重耻辱感不仅与肥胖者的饮食失调有关，也与正常体重和体重过轻的人的饮食失调有关。这意味着体重耻辱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肥胖的耻辱，使其效果降低，并造成伤害。例如，向英国学生的父母发送“体重报告卡”并不能减少肥胖，反而会让体重较重的孩子不吃早餐，在学校感到疲倦和不开心。随着COVID-19大流行的爆发，在国家封锁期间对体重控制的关注可能使这种情况变得更糟，导致转诊到饮食失调服务的人数大幅增加。体重耻辱感本身已被视为一个公共卫生问题，但我们不知道如何减轻体重耻辱感或保护人们免受其影响。这是因为体重病耻感研究几乎完全基于小样本，不能代表整个人群。研究也集中在美国，所以我们对英国或欧洲的体重歧视知之甚少。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，之前的研究确实使用了更大、更有代表性的样本，但由于使用的方法，这些研究可能存在偏差。目的：该项目旨在改变目前对日常体重耻辱程度的理解，谁受其影响最大，以及它是如何内化的，使用大型，一般人群的欧洲调查。目标1：探讨不同种族、性别和体型的组合对歧视和骚扰风险的影响。目标2：调查工作场所体重歧视的程度，如果这种情况随着时间的推移而改变，使用方法避免可能影响早期研究的偏见。目标3。确定使年轻人更容易内化体重耻辱感的风险因素（对自己施加与肥胖相关的负面刻板印象）。潜在的应用和好处：目标1将有助于确定由于多种原因而受到歧视和骚扰风险特别高的成年人群体，并帮助我们更好地理解英国的歧视是如何发生的。目标2将澄清需要通过员工培训计划等方式解决工作场所对体重的歧视问题，以及未来这种需求是否会增加。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感的负面心理影响，以及可以用来保护他们的因素。它将帮助我们更好地理解体重耻辱与心理健康之间的关系，包括饮食失调和抑郁症，以及对体重的态度是如何通过家庭传递的。研究结果可用于旨在减轻体重、种族和性别歧视影响的组织和政策制定者，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.