Psychological, Physiological, and Behavioral Effects of Weight Stigma

描述（由申请人提供）：肥胖是一种“全球流行病”，影响着所有年龄和社会经济水平的人。超重或肥胖会使人面临严重健康问题的风险。这也使她们在各个领域受到深刻的污名化和歧视。经历种族和民族歧视与较差的身心健康有关，包括心血管疾病、高血压、血压反应性和抑郁症。然而，经历体重歧视对健康的影响在很大程度上被忽视了。拟议的研究探讨了经历或预期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，并引发一系列负面情绪、认知和生物反应，从而损害精神和身体健康。我们还提出，经历或预期WS会激活那些超重或认为自己超重的人体重增加的过程，从而损害健康。其中包括增加与压力有关的饮食，降低调节饮食和锻炼的自我控制能力。我们认为，WS也增加了通过减肥来避免耻辱的动机和意图，同时通过上述过程降低了这样做的能力。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回避行为，例如避免锻炼，或从事不健康的行为来减肥。我们建议进行4个实验来验证这些假设。我们的目标是证明，对于超重的个人来说，引发对WS关注的社会环境，包括接触有关肥胖流行的公共卫生信息：1)压力大，表现为血压升高、皮质醇反应、情绪和激活的刻板印象；2)自我调节能力下降，表现为在需要自我控制的认知任务中表现较差，以及超重的人抵抗高脂肪食物的能力下降；3)增加了通过减肥来避免耻辱的动机和意图，同时降低了个人的减肥能力。从而导致不健康的饮食习惯和避免锻炼。我们还建议测试上述效应的三个潜在调节因子以及这些效应的几个中介因子。此外，我们将研究进食对WS的下游影响。总的来说，这些实验将更好地理解体重耻辱感的心理、生理和行为影响，包括心血管疾病、抑郁和体重增加的风险增加，以及如何减轻这些影响。研究结果具有巨大的潜力，可以阐明可能导致和潜在地减少肥胖的心理过程，并将对设计减少肥胖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.