Psychological, Physiological, and Behavioral Effects of Weight Stigma

描述(申请人提供)：肥胖是一种“全球流行病”，影响各个年龄段和社会经济水平的人。超重或肥胖会使人们面临严重健康问题的风险。它还使他们在广泛的各个领域遭受严重的污名和歧视。经历种族和民族歧视与较差的心理和身体健康有关，包括心血管疾病、高血压、血压反应性和抑郁症。然而，经历基于体重的污名化(WS)对健康的影响在很大程度上被忽视了。这项拟议的研究解决了经历或预期WS对超重男性和女性的心理、行为和生物学影响。我们认为，WS是有压力的，会引发一系列负面情绪、认知和生物反应，从而损害心理和身体健康。我们还提出，经历或预期WS会通过激活那些超重或认为自己超重的人的体重增加过程来损害健康。这些措施包括增加与压力相关的饮食，减少调节饮食和锻炼所必需的自我控制能力。我们认为，WS还通过减肥增加了避免耻辱的动机和意图，同时通过上述过程降低了做到这一点的能力。这进一步加剧了威胁，并可能导致超重者从事对健康有负面影响的耻辱避免行为，如避免锻炼，或为减肥而从事不健康的行为。我们建议进行4个实验来验证这些假设。我们的目的是证明对于超重的人来说，引发对WS的担忧的社会环境，包括接触到关于肥胖流行的公共健康消息：1)压力大，以血压增加、皮质醇反应性、情绪和激活的刻板印象为指标，2)自我调节能力下降，指标是需要自我控制的认知任务表现较差，以及超重者抵抗食用肥胖性食物的能力下降，以及3)通过尝试减肥来增加动力和意图避免污名，同时降低个人这样做的能力，从而导致不健康的饮食行为和避免运动。我们还建议测试上述影响的三个潜在调节因素以及这些影响的几个调节因素。此外，我们还将研究进食对WS的下游影响。总而言之，这些实验将更好地了解体重污名对心理、生理和行为的影响，包括增加心血管疾病、抑郁和体重增加的风险，以及如何减轻这些影响。这些发现具有巨大的潜力，可以阐明可能导致并可能减少肥胖的心理过程，并将对设计减少肥胖症流行的公共运动产生影响。

DESCRIPTION (provided by applicant): Obesity is a "global epidemic," affecting people of all ages and socioeconomic levels. Being overweight or obese puts people at risk for serious health problems. It also exposes them to profound stigmatization and discrimination across a wide variety of domains. Experiencing racial and ethnic discrimination has been linked to poorer mental and physical health, including cardiovascular disease, hypertension, blood pressure reactivity, and depression. The effects of experiencing weight-based stigmatization (WS) on health, however, have been largely ignored. The proposed research addresses the psychological, behavioral, and biological effects on overweight men and women of experiencing or anticipating WS. We propose that WS is stressful and triggers a cascade of negative emotions, cognitions and biological responses that can damage mental and physical health. We also propose that experiencing or anticipating WS impairs health by activating processes that contribute to weight gain among those who are or perceive themselves to be overweight. These include increasing stress-related eating and reducing self-control capacity essential for regulating diet and exercise. We propose that WS also increases motivation and intentions to avoid stigma by losing weight while simultaneously decreasing the capacity to do so via the processes described above. This further exacerbates threat and can lead the overweight to engage in stigma-avoidance behaviors with negative health implications, such as avoiding exercise, or engaging in unhealthy behaviors to lose weight. We propose to conduct 4 experiments to test these hypotheses. Our aims are to demonstrate that for individuals who are overweight, social contexts that activate concerns about WS, including exposure to public health messages about the obesity epidemic: 1) are stressful, as indexed by increased blood pressure, cortisol reactivity, emotions, and activated stereotypes, 2) decrease self-regulatory capacity, as indexed by poorer performance on cognitive tasks requiring self-control and by reduced capacity of people who are overweight to resist consuming fattening food, and 3) increase motivation and intention to avoid stigma by attempting to lose weight, while decreasing individuals' capacity to do so, thus contributing to unhealthy eating behaviors and avoidance of exercise. We also propose to test three potential moderators of the above effects as well as several mediators of these effects. In addition, we will examine the downstream consequences of eating in response to WS. Collectively, these experiments will provide a better understanding of the psychological, physiological, and behavioral effects of weight stigma, including increased risk for cardiovascular disease, depression, and weight gain, and how these effects may be mitigated. Findings hold enormous potential to illuminate psychological processes that may contribute to, and potentially reduce, obesity and will have implications for the design of public campaigns to reduce the obesity epidemic.