Objectives: To assess levels of two types of anti-fat bias in obesity specialists, explicit bias, or consciously accessible anti-fat attitudes, and implicit bias, or attitudes that are activated outside of conscious awareness, were examined. This study also assessed changes over time by comparing levels of bias in 2013 to published data from 2001. Methods: In 232 attendees at the ObesityWeek 2013 conference, we measured explicit anti-fat bias and conducted the Implicit Association Test. These data were compared to those from a study conducted at the 2001 meeting of this group. Results: Participants exhibited significant implicit and explicit anti-fat/pro-thin bias. Positivity of professional experience with obesity, but not type of professional experience, was correlated with lower explicit anti-fat bias. Compared to 2001, the 2013 sample had lower levels of implicit bias and higher levels of explicit bias. Conclusions: Although implicit anti-fat attitudes appeared to decrease from 2001 to 2013, explicit antifat attitudes increased. Future research should examine whether increasing positive experiences with obese patients reduces anti-fat bias among health professionals. Together, these results suggest that despite the current climate of widespread anti-fat bias, there are pathways toward understanding and ameliorating this bias.

Ghrelin regulates homeostatic food intake, hedonic eating, and is a mediator in the stress response. In addition, ghrelin has metabolic, cardiovascular, and anti-aging effects. This cross-sectional study examined associations between total plasma ghrelin, caloric intake based on 3 day diet diaries, hedonic eating attitudes, stress-related and metabolic factors, and leukocyte telomere length in overweight (n=25) and obese women (n=22). We hypothesized associations between total plasma ghrelin and eating behaviors, stress, metabolic, cardiovascular, and cell aging factors among overweight women, but not among obese women due to lower circulating ghrelin levels and/or central resistance to ghrelin. Confirming previous studies demonstrating lowered plasma ghrelin in obesity, ghrelin levels were lower in the obese compared with overweight women. Among the overweight, ghrelin was positively correlated with caloric intake, giving in to cravings for highly palatable foods, and a flatter diurnal cortisol slope across 3 days. These relationships were non-significant among the obese group. Among overweight women, ghrelin was negatively correlated with insulin resistance, systolic blood pressure, and heart rate, and positively correlated with telomere length. Among the obese subjects, plasma ghrelin concentrations were negatively correlated with insulin resistance, but were not significantly correlated with blood pressure, heart rate or telomere length. Total plasma ghrelin and its associations with food intake, hedonic eating, and stress are decreased in obesity, providing evidence consistent with the theory that central resistance to ghrelin develops in obesity and ghrelin’s function in appetite regulation may have evolved to prevent starvation in food scarcity rather than cope with modern food excess. Furthermore, ghrelin is associated with metabolic and cardiovascular health, and may have anti-aging effects, but these effects may be attenuated in obesity.

Body Mass Index is a useful screening measure, but there are limitations to consider when using it to evaluate body fat.

Nurses' work is known to be stressful, and many nurses work shifts. Both stress and shift work are factors that can influence how and what nurses eat and may increase nurses' risk for weight gain and obesity. This literature review summarizes the evidence regarding the prevalence of obesity and overweight among nurses who work shifts and examine associations between stress and the eating behaviors of these nurses. The conclusion provides some implications for occupational health nurses who promote wellness for their employees.

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