Objective: To test the effects of a cognitive-behavioral intervention for weight bias internalization (WBI; i.e., self-stigma) combined with behavioral weight loss (BWL). Method: Adults with obesity and elevated WBI were randomly assigned to BWL alone or combined with the Weight Bias Internalization and Stigma Program (BWL ϩ BIAS). Participants attended weekly group meetings for 12 weeks, followed by 2 biweekly and 2 monthly meetings (26 weeks total). Changes at Week 12 on the Weight Bias Internalization Scale (WBIS) and Weight Self-Stigma Questionnaire (WSSQ) were the principal outcomes, with changes at Week 26 assessed as secondary outcomes. Other outcomes included changes in mood, body image, eating behaviors, self-monitoring, and weight. Results: Seventy-two participants were randomized (84.7% female, 66.7% Black, mean age ϭ 47.1 Ϯ 11.5 years) Linear mixed models showed no significant differences between the BWL ϩ BIAS and BWL groups in WBIS changes at Week 12 (Ϫ1.3 Ϯ 0.2 vs. Ϫ1.0 Ϯ 0.2) or week 26 (Ϫ1.5 Ϯ 0.2 vs. Ϫ1.3 Ϯ 0.2). BWL ϩ BIAS participants had greater reductions in WSSQ total scores at Week 12 (p ϭ .03), with greater changes on the self-devaluation subscale at Weeks 12 and 26 (p Յ .03). BWL ϩ BIAS participants reported significantly greater benefits on measures of eating and self-monitoring. Percent weight loss at Week 26 did not differ significantly between groups (BWL ϩ BIAS ϭ Ϫ4.5 Ϯ 1.0%, BWL ϭ Ϫ5.9 Ϯ 1.0%, p ϭ .28). Conclusion: A psychological intervention for WBI produced short-term reductions in some aspects of weight self-stigma in persons with obesity. What is the public health significance of this article?This study demonstrates the efficacy of a cognitive-behavioral weight stigma-reduction intervention, combined with behavioral weight loss.
Background: Weight bias against persons with obesity impairs health care delivery and utilization and contributes to poorer health outcomes. Despite rising rates of pet obesity (including among dogs), the potential for weight bias in veterinary settings has not been examined. Subjects/Methods: In two online, 2×2 experimental studies, the effects of dog and owner body weight on perceptions and treatment recommendations were investigated in 205 practicing veterinarians ( Study 1 ) and 103 veterinary students ( Study 2 ). In both studies, participants were randomly assigned to view one of four vignettes of a dog and owners with varying weight statuses (lean vs. obesity). Dependent measures included emotion/liking ratings toward the dog and owners; perceived causes of the dog’s weight; and treatment recommendations and compliance expectations. Other clinical practices, such as terms to describe excess weight in dogs, were also assessed. Results: Veterinarians and students both reported feeling more blame, frustration, and disgust toward dogs with obesity and their owners than toward lean dogs and their owners ( p values<0.001). Interactions between dog and owner body weight emerged for perceived causes of obesity, such that owners with obesity were perceived as causing the dog with obesity’s weight, while lean owners were perceived as causing the lean dog’s weight. Participants were pessimistic about treatment compliance from owners of the dog with obesity, and weight loss treatment was recommended for the dog with obesity when presenting with a medical condition ambiguous in its relationship to weight. Veterinarians and students also reported use of stigmatizing terms to describe excess weight in dogs. Conclusions: Findings from this investigation, with replication, have implications for training and practice guidelines in veterinary medicine.
This study of 459 subjects from prenatal clinics for teenagers at three universities across the United States, addresses questions about gestational weight gain in adolescents raised by the 1990 Institute of Medicine Report. Rate and pattern of gain, independent of pregravid weight, are based on serial measures of mothers with favorable and unfavorable outcomes. Rate of gain (determined by using regression statistics) from weeks 15 to 40 was 0.588, 0.510, and 0.488 kg/wk for mothers of term infants weighing 3000-4000 g, term infants weighing < 3000 g, and preterm infants, respectively. The significantly lower percentage of infants weighing 3000-4000 g vs < 3000 g needing intensive care at birth (6% vs 15%, respectively, P < 0.05) further indicates the superior outcome among mothers with higher rates of gain. Rate of gain of mothers of infants weighing 3000-4000 g (favorable outcome) equaled the highest amount provisionally recommended, suggesting that restricting natural gain of adolescents to recommended rates may result in smaller than optimal infants.
Objective The aim of this study was to investigate the 6‐month nonintervention follow‐up effects of a cognitive behavioral intervention for weight bias internalization (WBI; i.e., self‐stigma) combined with behavioral weight loss (BWL). Methods Adults with obesity and elevated WBI were previously randomized to receive BWL alone or in combination with the Weight Bias Internalization and Stigma program (BWL + BIAS). Participants attended weekly group meetings for 12 weeks, followed by two biweekly and two monthly meetings (26 weeks total). Follow‐up assessments were conducted at week 52. Changes on the Weight Bias Internalization Scale and Weight Self‐Stigma Questionnaire at week 52 were the principal outcomes. Other outcomes included changes in eating, coping, and weight. Results Of 72 randomized participants, 54 (75%) completed week 52 assessments. Linear mixed models showed improvements across groups, but no significant differences between groups, in week 52 change on the Weight Bias Internalization Scale (P = 0.25) or Weight Self‐Stigma Questionnaire (P = 0.27). BWL + BIAS participants reported significantly greater benefits than BWL participants on measures of eating and affective coping with weight stigma. Percent weight loss at week 52 did not differ significantly between groups (BWL + BIAS = −3.1% [SE 1.0%], BWL = −4.0% [SE 1.0%], P = 0.53). Conclusions Reductions in WBI did not differ between groups at 6‐month follow‐up. Further research is needed to determine the potential benefits of a stigma‐reduction intervention beyond BWL.
Prior research has demonstrated that individuals with a higher body weight (i.e., obesity) have a relatively high incidence of adverse childhood experiences (ACEs; e.g., abuse, neglect). Individuals with obesity are also susceptible to experiencing and internalizing weight stigma. Negative physical and mental health consequences have been associated with both ACEs and weight stigma, yet the interplay between these factors has not been explored. The present study examined ACEs in a sample of 105 treatment-seeking adults with obesity who all reported having experienced and internalized weight stigma (90.5% women, 70.5% non-Hispanic White, M age = 49.1 years). The study aimed to (a) provide a descriptive overview of rates of ACEs in this unique sample of adults with potentially high psychological vulnerability and (b) assess associations between ACEs, weight stigma, and psychological well-being. Over three fourths of participants (76.2%) reported experiencing at least one ACE. The total number of ACEs was significantly associated with more frequent experiences of and greater distress about weight stigma during childhood, as well as higher current perceived stress. Experiencing weight stigma for the first time in childhood was also associated with more reported ACEs. ACEs of abuse were associated with more lifetime reported experiences of weight stigma and greater internalization, use of eating as a strategy to cope with weight stigma, and higher perceived stress. These findings have implications for early identification of and tailored interventions for individuals who have experienced adverse events and weight stigma at a young age.
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