Abstract
ObjectiveTo examine whether the adverse effect of obesity on psychological well‐being can be explained by weight discrimination.MethodsThe study sample included 5056 older (≥50 y) men and women living in England and participating in the English Longitudinal Study of Ageing. Participants reported experiences of weight discrimination in everyday life and completed measures of quality of life (CASP‐19 scale), life satisfaction (Satisfaction With Life Scale), and depressive symptoms (eight‐item CES‐D scale). Height and weight were objectively measured, with obesity defined as BMI ≥30 kg/m2. Mediation analyses were used to test the role of perceived weight discrimination in the relationship between obesity and each psychological factor.ResultsObesity, weight discrimination, and psychological well‐being were all significantly inter‐related. Mediation models revealed significant indirect effects of obesity through perceived weight discrimination on quality of life (β = −0.072, SE = 0.008), life satisfaction (β = −0.038, SE = 0.008), and depressive symptoms (β = 0.057, SE = 0.008), with perceived weight discrimination explaining approximately 40% (range: 39.5‐44.1%) of the total association between obesity and psychological well‐being.ConclusionsPerceived weight discrimination explains a substantial proportion of the association between obesity and psychological well‐being in English older adults. Efforts to reduce weight stigma in society could help to reduce the psychological burden of obesity.
Highlights
In addition to the well-documented physical health risks associated with obesity [1], adverse effects on psychological well-being have long been recognized
Weight discrimination was reported by 4.6% but was strongly related to weight status, with 12.9% of individuals with obesity reporting weight discrimination (6.7% of class I obese, 26.8% of class II/III obese) and only 0.9% of nonobese individuals (2.6% of underweight, 0.7% of normal weight, 0.9% of overweight; adjusted OR [obese vs. nonobese] 5 15.18, 95% confidence interval (CI) 5 10.26 to 22.48, P < 0.001)
We examined associations between obesity, perceived weight discrimination, and three markers of psychological well-being: quality of life, life satisfaction, and depressive symptoms
Summary
In addition to the well-documented physical health risks associated with obesity [1], adverse effects on psychological well-being have long been recognized. In 1985, the National Institutes of Health drew attention to the “enormous psychological burden” created by obesity [2]. This may to some extent overstate the case, but there is certainly evidence that individuals with obesity experience poorer quality of life [3], body image disturbance [4], and lower selfesteem [5] and are at increased risk of depression and other psychiatric disorders [6,7]. Given that weight stigma and discrimination have both been shown to have a negative impact on psychological health outcomes, including well-being [10], depression [13,14], self-esteem and selfacceptance [13,15], and body image dissatisfaction [13,16], this might explain why people with obesity suffer psychologically
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