Weight Discrimination Research Articles

Patient-Centered Care for Obesity: How Health Care Providers Can Treat Obesity While Actively Addressing Weight Stigma and Eating Disorder Risk

Patient-Centered Care for Obesity: How Health Care Providers Can Treat Obesity While Actively Addressing Weight Stigma and Eating Disorder Risk

Weight Location Moderates Weight-Based Self-Devaluation and Perceived Social Devaluation in Women

Overweight and obese (“heavyweight”) people devalue themselves because, it has been proposed, they are socially devalued. However, for women, social valuation depends not only on how much weight they carry but also on where on their bodies they carry it. Here, we investigated whether weight-based self-valuation and perceived social valuation similarly depend on body shape. Study 1, using a nationally representative sample from National Health and Nutrition Examination Survey (NHANES; N = 1,093 reproductive-aged women), showed that, controlling for body fat, weight labeling (by self and others) and wanting to lose weight depended on body shape. Study 2, in a direct test of predictions using an undergraduate sample of women (N = 215), showed that with increased body fat, women with an abdominal weight distribution reported more self-devaluation (e.g., lower self-esteem) and perceived social devaluation (e.g., higher perceived weight discrimination); women with a gluteofemoral weight distribution, however, were shielded—partially or fully—from these adverse effects of increased body fat.

Multi-Scale Deep Subspace Clustering With Discriminative Learning

Deep subspace clustering methods have achieved impressive clustering performance compared with other clustering algorithms. However, most existing methods suffer from the following problems: 1) they only consider the global features but neglect the local features in subspace self-expressiveness learning; 2) they neglect the discriminative information of each self-expressiveness coefficient matrix; 3) they ignore the useful long-range dependencies and positional information in feature representation learning. To solve these problems, in this paper, we propose a novel multi-scale deep subspace clustering with discriminative learning (MDSCDL) to obtain a high-quality self-expressiveness coefficient matrix. Specifically, MDSCDL bridges multiple fully-connection layers between encoder and decoder to learn multi-scale self-expressiveness coefficient matrices from global and local features, representing the more comprehensive relationship among data. By modeling the interdependencies of the multi-scale self-expressiveness coefficient matrices, MDSCDL adaptively assigns discriminative weights for each matrix and fuses them with convolution operation. Moreover, to increase representation power, MDSCDL introduces the coordinate attention mechanism to extract the long-range dependencies and positional features for subspace self-expressiveness learning. Extensive experiments on the face and object datasets have shown the superiority of MDSCDL compared with several state-of-the-art methods.

Racial and weight discrimination associations with pain intensity and pain interference in an ethnically diverse sample of adults with obesity: a baseline analysis of the clustered randomized-controlled clinical trial the goals for eating and moving (GEM) study

BackgroundEveryday experiences with racial (RD) and weight discrimination (WD) are risk factors for chronic pain in ethnically diverse adults with obesity. However, the individual or combined effects of RD and WD on pain in adults with obesity is not well understood. There are gender differences and sexual dimorphisms in nociception and pain, but the effect of gender on relationships between RD, WD, and pain outcomes in ethnically diverse adults with obesity is unclear. Thus, the purposes of this study were to: 1) examine whether RD and WD are associated with pain intensity and interference, and 2) explore gender as a moderator of the associations between RD, WD, and pain.MethodsThis is a baseline data analysis from a randomized, controlled clinical trial of a lifestyle weight-management intervention. Eligible participants were English or Spanish-speaking (ages 18–69 years) and had either a body mass index of ≥30 kg/m2 or ≥ 25 kg/m2 with weight-related comorbidity. RD and WD were measured using questions derived from the Experiences of Discrimination questionnaire (EOD). Pain interference and intensity were measured using the PROMIS 29 adult profile V2.1. Linear regression models were performed to determine the associations between WD, RD, gender, and pain outcomes.ResultsParticipants (n = 483) reported mild pain interference (T-score: 52.65 ± 10.29) and moderate pain intensity (4.23 ± 3.15). RD was more strongly associated with pain interference in women (b = .47, SE = .08, p < 001), compared to men (b = .14, SE = .07, p = .06). Also, there were no significant interaction effects between RD and gender on pain intensity, or between WD and gender on pain interference or pain intensity.ConclusionsPain is highly prevalent in adults with obesity, and is impacted by the frequencies of experiences with RD and WD. Further, discrimination against adults with obesity and chronic pain could exacerbate existing racial disparities in pain and weight management. Asking ethnically diverse adults with obesity about their pain and their experiences of RD and WD could help clinicians make culturally informed assessment and intervention decisions that address barriers to pain relief and weight loss.Trial registrationNCT03006328

Weight stigma predicts reduced psychological wellbeing and weight gain among sexual minority men: A 12-month longitudinal cohort study using random intercept cross-lagged panel models

Weight stigma among sexual minority men predicts negative health outcomes; however, existing research is cross-sectional. Therefore, we longitudinally examined the presence, strength, and direction of relationships between weight stigma and health outcomes in a multi-national cohort of 2953 sexual minority men (Mage = 37.70, SDage = 13.70). Participants reported their Body Mass Index (BMI), experiences of weight discrimination, internalized weight bias, and psychological quality of life at three time-points over 12 months (~August 2019–20). Analyses revealed feedback loops of internalized weight bias with BMI and psychological quality of life: over time, increases in internalized weight bias were associated with small BMI increases (β = 0.07) and small decreases in psychological quality of life (β = 0.12). Reciprocally, increases in BMI and decreases in psychological quality of life were associated with increases in internalized weight bias (βs = 0.18). Experiences of weight discrimination were not longitudinally predictive and were associated with higher BMI (β = 0.29), greater internalized weight bias (β = 0.29), and lower psychological quality of life (β = 0.26) between-persons/cross-sectionally only. Weight stigma is longitudinally and reciprocally associated with reduced psychological wellbeing and weight gain among sexual minority men. Internalized weight bias is a particularly promising intervention target.

Abstract 11531: Exploring Associative Pathways and Gender Effects of Racial and Weight Discrimination with Sleep Quality, Physical Activity, and Dietary Behavior in Adults with Higher Body Mass Index and Elevated Cardiovascular Disease Risk

Introduction: Racial disparities in obesity and cardiovascular disease can partly be attributed discrimination. Racial discrimination (RD) and weight discrimination (WD) have been linked to higher psychological distress, lower sleep quality, less physical activity, and unhealthy diet, which can negatively impact weight. Better understanding the processes by which discrimination influences weight-loss factors would help create strategies for mitigating obesity disparities. Methods: This is a cross-sectional study of 745 primary care patients with a BMI ≥ 25 kg/m 2 (43.1% Female, M age =51 years) who were enrolled in a weight-loss trial. To investigate the direct and indirect (via psychological distress) pathways by which RD and WD may be associated with sleep quality, physical activity, and diet, and to explore gender as a moderator, we used Ordinary Least Square regression with bootstrapping. Validated surveys included EOD, PROMIS-29, LDBQ, REAP-S, IPAQ-SF. Results: We found that RD and WD were indirectly associated with lower sleep quality via psychological distress (WD: indirect=2.11, CI[1.218;3.092]; RD: indirect=0.93, CI[0.057;0.134]). Further, we found that for men, RD and WD were indirectly associated with less physical activity via psychological distress (WD: moderated mediation=491.67, CI[75.565;1040.877]; RD: moderated mediation=22.60, CI[0.080;51.828]). Finally, we found that RD and WD were directly associated with unhealthy diet (WD: direct=0.195, CI[0.076;0.314]; RD: direct=0.007; CI[0.001;0.012]). Conclusions: Weight-loss factors were associated with both racial and weight discrimination through different pathways depending on gender and type of outcome. Lower sleep quality was associated with discrimination via psychological distress for both gender groups. Lower physical activity was also linked to discrimination via psychological distress, however for men only. Associations between unhealthy diet and discrimination were direct and could not be explained by increases in psychological distress. Although more research is needed, our findings suggest that interventions to address discrimination and its psychological impacts could mitigate obesity disparities and improve cardiovascular health.

Is weight stigma associated with physical activity? A systematic review.

Weight stigma is associated with impaired health, attributed in part to reductions in health-promoting behaviors. This review analyzed evidence of the association between weight stigma and physical activity (PA) in adults and youth. Three databases were searched for terms related to weight stigma and PA. Eligible studies reported the quantitative association between at least one measure of weight stigma and one behavioral measure of PA. A total of 38 studies met eligibility criteria. Of the 29 studies of adults, 3 used objective PA measures, and 79% used an observational, cross-sectional design. Findings of the relationship between weight stigma and PA were mixed. Everyday weight discrimination and internalizing weight stigma were associated with reduced PA in most studies. Several studies found indirect, and not direct, effects of weight stigma on PA when analyses included other individual-level factors. In the nine studies of youth, two used objective PA measures, all were observational, and only one study was longitudinal. Most youth studies found a relationship between weight-based teasing and reduced PA. Weight teasing, everyday discrimination, and internalization were associated with reduced PA. However, associations were inconsistent and often indirect. Future studies should include objective PA measures with larger samples and longitudinal assessments.

Coping with weight discrimination: Findings from a qualitative study.

Coping with weight discrimination: Findings from a qualitative study.

Policies to address weight discrimination and bullying: Perspectives of adults engaged in weight management from six nations.

Across the world, it remains legal to discriminate against people because of their weight. Although US studies demonstrate public support for laws to prohibit weight discrimination, multinational research is scarce. The present study conducted a multinational comparison of support for legislative measures to address weight discrimination and bullying across six countries. Participants were adults (n = 13,996) enrolled in an international weight-management program and residing in Australia, Canada, France, Germany, the UK, and the US. Participants completed identical online surveys that assessed support for antidiscrimination laws and policies to address weight bullying, demographic characteristics, and personal experiences of weight stigma. Across countries, support was high for laws (90%) and policies (92%) to address weight-based bullying, whereas greater between-country variation emerged in support for legislation to address weight-based discrimination in employment (61%, 79%), as a human rights issue (57%), and through existing disability protections (47%). Findings highlight few and inconsistent links between policy support and sociodemographic correlates or experienced or internalized weight stigma. Support for policies to address weight stigma is present among people engaged in weight management across Westernized countries; findings offer an informative comparison point for future cross-country research and can inform policy discourse to address weight discrimination and bullying.

A striking take on mass inferences from collisions

Our everyday activities – e.g., packing groceries, building sandcastles – require knowledge about the physical properties of the objects and surfaces in our environments. We often learn about properties such as weight, hardness, and slipperiness by interacting with the world, but we also learn about latent physical properties by observing events. Among the best-studied examples is people’s ability to infer objects’ relative masses based on seeing them collide, and work on this front has shown that people’s inferences sometimes show marked biases. For example, when an incoming object strikes a stationary one, people consistently overestimate the mass of the incoming object. Why? Various accounts attribute the effect to heuristics that fail in certain conditions, simplified stimuli that lack realistic cues, or a characteristic of rational Newtonian decisions made under sensory uncertainty. Here we sought to disentangle these competing accounts by asking observers to judge the relative weights of bowling balls in videos of real collisions. Balls ranged from 6 to 16 pounds; subjects saw all possible pairings and reported whether the incoming ball or the initially static one was heavier. Under these realistic conditions, participants still consistently overestimated the incoming ball’s weight. We found reliable individual differences in the size of this bias, and in overall performance in weight discrimination. While weight discrimination performance was predictive of intuitive physics abilities in general (assessed with an independent task battery), bias in weight estimation showed no relationship, suggesting it is not a hindrance in other tasks. In a final experiment, we occluded cues in the videos that the purported heuristics would rely on, and we found it had little impact on overall weight discrimination or bias. Our results argue against accounts based on heuristics or oversimplified stimuli and support the idea that the bias is a characteristic of a well-tuned Newtonian system.

Weight Discrimination Experienced Prior to Enrolling in a Behavioral Obesity Intervention is Associated with Treatment Response Among Black and White Adults in the Southeastern U.S.

The current study evaluated the associations between history of weight discrimination and race on pre-treatment depressive symptoms, treatment session attendance, and weight loss among Black and White adults enrolled in a 16-week obesity intervention. Participants (N = 271; mean BMI = 35.7kg/m2; 59% Black; 92% women) reported prior experiences of weight discrimination and completed the Center for Epidemiological Studies Depression (CES-D) Scale at baseline. Weekly attendance at group sessions was recorded, and weight was measured at baseline and post-treatment. All models adjusted for baseline BMI, age, and sex. Participants with a history of weight discrimination scored 2.4 points higher on the CES-D (B = 2.432, p = .012) and lost 2% less weight relative to those without weight discrimination (B = 0.023, p = .002). Race modified the association between weight discrimination and treatment session attendance, such that Black individuals attended fewer sessions if they had prior experience of weight discrimination, but prior weight discrimination was not significantly associated with treatment attendance among White individuals. Weight discrimination is associated with pre-treatment depressive symptoms and may hinder weight loss regardless of race. Black individuals may attend fewer weight loss treatment sessions if they have prior experience of weight discrimination.

Benchmarking of provider competencies and current training for prevention and management of obesity among family medicine residency programs: a cross-sectional survey

BackgroundU.S. physicians lack training in caring for patients with obesity. For family medicine, the newly developed Obesity Medicine Education Collaborative (OMEC) competencies provide an opportunity to compare current training with widely accepted standards. We aimed to evaluate the current state of obesity training in family medicine residency programs.MethodsWe conducted a study consisting of a cross-sectional survey of U.S. family medicine residency program leaders. A total of 735 directors (including associate/assistant directors) from 472 family medicine residency programs identified from the American Academy of Family Physicians public directory were invited via postal mail to complete an online survey in 2018.ResultsSeventy-seven program leaders completed surveys (16% response rate). Sixty-four percent of programs offered training on prevention of obesity and 83% provided training on management of patients with obesity; however, 39% of programs surveyed reported not teaching an approach to obesity management that integrates clinical and community systems as partners, or doing so very little. Topics such as behavioral aspects of obesity (52%), physical activity (44%), and nutritional aspects of obesity (36%) were the most widely covered (to a great extent) by residency programs. In contrast, very few programs extensively covered pharmacological treatment of obesity (10%) and weight stigma and discrimination (14%). Most respondents perceived obesity-related training as very important; 65% of the respondents indicated that expanding obesity education was a high or medium priority for their programs. Lack of room in the curriculum and lack of faculty expertise were reported as the greatest barriers to obesity education during residency. Only 21% of the respondents perceived their residents as very prepared to manage patients with obesity at the end of the residency training.ConclusionFamily medicine residency programs are currently incorporating recommended teaching to address OMEC competencies to a variable degree, with some topic areas moderately well represented and others poorly represented such as pharmacotherapy and weight stigma. Very few program directors report their family medicine residents are adequately prepared to manage patients with obesity at the completion of their training. The OMEC competencies could serve as a basis for systematic obesity training in family medicine residency programs.

Joint energy‐efficient user scheduling and power allocation scheme for a millimeter‐wave‐NOMA system

SummaryThe combination of non‐orthogonal multiple access in millimeter‐wave communication called as mmWave‐NOMA is capable of supporting more data streams with a larger number of users to cope up with the increasing traffic demand. In this paper, an energy‐efficient scheme for downlink mmWave‐NOMA systems with joint user grouping, scheduling, and optimal power allocation with the objective of energy efficiency maximization is proposed. Enhanced k‐means clustering for user grouping which can handle the possible simultaneous access of network to enhance the sum throughput is proposed. Weighted sum algorithm‐based scheduling where weights are calculated based on the service requirement of the users to maximize the sum rate and a proportional‐based scheme of power allocation modeled as a resource allocation problem considering the beam gain and discrimination weight of each user for energy‐efficient power allocation is discussed. The simulation results show that the proposed scheme is energy efficient than the conventional mmWave orthogonal multiple access systems.

Weight discrimination: Are colleges preparing their graduates for successful employment and careers?

Background: Colleges are uniquely positioned to influence both the short and long-term health and well-being of students through implementation of interventions to prevent and/or treat obesity among students; and have a vested interest given obesity has the potential to impact students' matriculation, graduation, and career prospects.Aim: To illustrate the essential roles of colleges to influence obesity prevention and treatment given the potential to influence the students' matriculation, graduation, and career prospects.Methods: The discussion begins with an overview of the prevalence and societal implications of obesity. Next the implications for higher education with respect to matriculation and graduation, the influence of higher education on lifestyle behaviors, and the influence of obesity on academic performance. This is followed by the influence of obesity on students' post-higher education lives, including potential discrimination when seeking employment, and the impact that the nature of the jobs that graduates attain may have on their health and well-being.Results: There exists a great need to reduce the prevalence of obesity and colleges are well positioned to provide leadership and direction.Conclusions: Implications for colleges are set forth, with ways in which they can play a role in promoting student health detailed.

Selecting the Most Relevant Brain Regions to Classify Children with Developmental Dyslexia and Typical Readers by Using Complex Magnocellular Stimuli and Multiple Kernel Learning.

Increasing evidence supports the presence of deficits in the visual magnocellular (M) system in developmental dyslexia (DD). The M system is related to the fronto-parietal attentional network. Previous neuroimaging studies have revealed reduced/absent activation within the visual M pathway in DD, but they have failed to characterize the extensive brain network activated by M stimuli. We performed a multivariate pattern analysis on a Region of Interest (ROI) level to differentiate between children with DD and age-matched typical readers (TRs) by combining full-field sinusoidal gratings, controlled for spatial and temporal frequencies and luminance contrast, and a coherent motion (CM) sensitivity task at 6%-CML6, 15%-CML15 and 40%-CML40. ROIs spanning the entire visual dorsal stream and ventral attention network (VAN) had higher discriminative weights and showed higher act1ivation in TRs than in children with DD. Of the two tasks, CM had the greatest weight when classifying TRs and children with DD in most of the ROIs spanning these streams. For the CML6, activation within the right superior parietal cortex positively correlated with reading skills. Our approach highlighted the dorsal stream and the VAN as highly discriminative areas between children with DD and TRs and allowed for a better characterization of the “dorsal stream vulnerability” underlying DD.

Examining the impact of perceived weight discrimination on reported eating and exercise among White and Latino/a adults

A large body of research suggests that, among White individuals, perceived weight discrimination has deleterious consequences for eating and exercise outcomes; however, the research literature on perceived weight discrimination among other racial/ethnic groups is limited. The primary goal of the present study was to examine the associations of perceived weight discrimination with eating and exercise thoughts and behaviors among White versus Latino/a participants. A sample of White (N = 50) and Latino/a (N = 281) undergraduate college students with higher body weight (BMI: M = 30.65, SD = 5.42) completed self-report measures assessing perceived weight-based discrimination, frequency of intake of unhealthy and healthy foods, and frequency of both thoughts about exercise and exercise behaviors; we examined relationships among these variables within White versus Latino/a participants. Results showed that perceived weight discrimination was associated with more frequent intake of unhealthy foods, more frequent exercise thoughts, and less frequent exercise behaviors among White participants, and that there were no significant associations between perceived weight discrimination and the eating and exercise measures of interest among Latino/a participants. These findings highlight a number of potential avenues for future research to identify the mechanisms underlying these differential associations of perceived weight discrimination to eating and exercise behaviors across racial/ethnic groups.

Kindergarten Obesity and Academic Achievement: The Mediating Role of Weight Bias.

This study draws the attention towards the importance of reducing weight discrimination against children for their educational success, as an issue of social justice. We investigate the consequences of early-onset obesity identifying the mediating mechanisms in the relationship between childhood obesity and academic achievement. To do so, we employ the Early Childhood Longitudinal Study-Kindergarten Cohort (kindergarten to fifth grade) in the US (ECLS-K: 2011) and apply a parallel process latent growth model with a combination of quasi-experiments and econometrics. The results of this study suggest that teachers may serve as a significant source of weight bias, especially for girls (B = −0.09, 95% BC CI [−2.37 to −0.46]).

Frequency and Correlates of Weight-Based Discrimination among Adolescents in China.

Unfair treatment on the basis of body weight is common in the West and associated with lower well-being, starting at least as early as adolescence. We examine whether the frequency and predictors and correlates of weight discrimination seen in the West extend to adolescents in China. Participants (N=1539) were adolescents in China who took part in a longitudinal study of mental health and academic burnout in high school. At Wave 1, participants reported on their personality and well-being and completed a school health check that included measured height and weight. At Wave 2 approximately 6 months later, participants reported on experiences with unfair treatment and completed the same measures of well-being. Of 10 attributions for unfair treatment, weight was most common at 18%. Female gender and body mass index were associated with greater risk of reporting weight discrimination. Emotional stability, conscientiousness, and state happiness measured at Wave 1 were associated with lower risk of weight discrimination at Wave 2. Concurrently, weight discrimination was associated with lower happiness, less life satisfaction, and more distress. Adolescents in China report weight discrimination, and the patterns of association between weight discrimination and psychological function are similar to what is seen in the West.

The anti-stigma principle and legal protection from fattism

ABSTRACT ‘Fattism” has been described as the last acceptable prejudice. Discrimination on the grounds of weight is experienced regularly by women and men in relation to employment as well as access to goods and services. As I show in this article, it can also be seen as a form of intersectional discrimination. Yet a legal remedy for weight discrimination exists in just a few countries. In this essay, I consider why legal protection is so limited: I highlight the influence of the logic of immutability and suggest that an alternative logic – an anti-stigma principle – should be used to guide the evolution of anti-weight discrimination law.

91. Adolescent Body Mass Index and Future Health Outcomes and Weight Discrimination At 24-Year Follow-Up: Findings From the National Longitudinal Study of Adolescent to Adult Health

Although adolescent body mass index (BMI) is known to predict BMI later in adulthood, little is known about the associations between adolescent BMI and future health outcomes or weight discrimination (i.e. bias, prejudice, or discrimination due to weight/size) in later adulthood. The aim of this study was to analyze prospective associations between adolescent BMI and adult health outcomes and weight discrimination at 24-year follow-up using nationally representative data from the US.