Mechanisms Explaining the Link Between Weight Discrimination and Poor Cardiovascular Health

解释体重歧视与心血管健康不良之间联系的机制

• 批准号: 10705356
• 负责人: Mary A Gerend
• 金额: $ 45.76万
• 依托单位: FLORIDA STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-23 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10705356
• 关键词: Address; Adverse effects; Affect; Affective; American; Behavioral; Body Weight; Body mass index; Characteristics; Cognitive; Compassion; Coupled; Data; Data Correlations; Discrimination; Eating; Education; Effect Modifiers (Epidemiology); Emotions; Employment; Ethnic Origin; Exposure to; Future; Gender; Goals; Health; Healthcare; High Prevalence; Hydrocortisone; Impairment; Individual; Inflammation; Informal Social Control; Intervention; Knowledge; Link; Literature; Methodology; Methods; Obesity; Outcome; Participant; Persons; Physiological; Pilot Projects; Procedures; Psychological Factors; Public Health; Published Comment; Race; Randomized; Research; Risk; Sampling; Sex Orientation; Social Class; Stereotyping; Stress; Testing; Weight; Weight Gain; Withdrawal; Work; adult obesity; bullying; cardiovascular disorder risk; cardiovascular health; effective intervention; experience; experimental study; improved; insight; mortality risk; novel; perceived discrimination; positive emotional state; psychologic; racial discrimination; recruit; resilience; response; sex; social; social health determinants; social stigma; therapy design; vigilance

Project Summary/Abstract Discrimination is a critical social determinant of health that underlies poor health outcomes. One common but understudied form of discrimination is weight discrimination. Weight discrimination is the behavioral manifestation of weight stigma—the social devaluation of people with excess body weight. Findings suggest that the stress produced by weight discrimination prompts weight gain, creating a vicious cycle between weight discrimination and obesity. Further, there is now well-documented evidence that experiencing weight discrimination is associated with increased risk for cardiovascular disease. Little is known, however, about mechanisms explaining the link between weight discrimination and poor cardiovascular health. Using a rigorous experimental approach, this project will identify mechanisms through which weight discrimination harms health. Findings will facilitate the long-term goal of this research: developing interventions to decrease the negative health consequences of weight discrimination. As a step toward this goal, this project proposes three experiments in which a diverse sample of adults with obesity will be randomly assigned to experience (vs. not experience) weight discrimination in a controlled experimental setting. Drawing on previous research and our pilot data, the interpersonal contexts chosen for these studies simulate situations in which people with obesity commonly experience weight discrimination in their daily lives (e.g., health care and employment settings). The following aims will be tested: (1) Identify early-stage cognitive, affective, behavioral, and physiological mechanisms activated by experimentally manipulated weight discrimination; (2) Identify psychological variables (e.g., internalized weight bias) that moderate effects of weight discrimination; and (3) Identify demographic characteristics (e.g., gender, race) that moderate effects of weight discrimination. Exposure to weight discrimination (vs. control) is hypothesized to result in elevated responses on early-stage mechanisms that culminate in poor cardiovascular health (e.g., impaired self-regulation, cognitive vigilance to signs of social disapproval, higher negative emotion, more social withdrawal and comfort eating, increased cortisol secretion and inflammation). This research will identify novel and highly modifiable targets for interventions designed to reduce the negative health effects of weight discrimination. In testing moderator variables, this work will identify individuals who display particular vulnerability vs. resilience to the harmful effects of discrimination. Information about moderators will thus help future intervention efforts target those individuals most likely to benefit from intervention. Given the high prevalence of obesity and the millions of Americans affected by weight discrimination, this research will address a crucial public health issue. At a broader level, this work will provide critical insight into mechanisms that underlie adverse health effects of other common forms of social stigma such as discrimination due to race, ethnicity, sexual orientation, or social class.

项目摘要/摘要 歧视是健康状况不佳的健康的关键社会决定者。一个常见，但是 歧视的研究形式是权重歧视。体重歧视是行为 体重污名的表现 - 体重过多的人的社会定义。发现建议 体重歧视产生的压力会促使体重增加，从而在体重之间产生恶性循环 歧视和肥胖。此外，现在有充分的证据表明体重 歧视与心血管疾病的风险增加有关。但是，关于 解释体重歧视与心血管健康不良之间的联系的机制。使用 严格的实验方法，该项目将确定权重歧视的机制 伤害健康。调查结果将促进这项研究的长期目标：制定干预措施以减少 体重歧视的负面影响。作为朝着这个目标的一步，该项目的提议 三个实验，其中将随机分配肥胖成年人的潜水样本 （vs.没有经验）在受控的实验环境中的权重歧视。利用先前的研究 以及我们的飞行员数据，为这些研究选择的人际背景模拟了与患有的情况 肥胖通常在日常生活中经历体重歧视（例如，医疗保健和就业 设置）。将测试以下目标：（1）确定早期认知，情感，行为和 通过实验操纵的体重歧视激活的生理机制； （2）识别 心理变量（例如内部体重偏见），使体重歧视的影响适度； （3） 确定体重歧视的中等影响的人口特征（例如性别，种族）。 假设暴露于体重歧视（与控制）可以导致早期反应升高 最终导致心血管健康的机制（例如，自我调节受损，认知警惕性 社交反对的迹象，更高的负面情绪，更多的社交戒断和舒适饮食，增加了 皮质醇分泌和炎症）。这项研究将确定新颖且高度可修改的目标 旨在减少体重歧视的负面影响的干预措施。在测试主持人中 变量，这项工作将确定显示出特殊脆弱性与对有害的韧性的个人 歧视的影响。因此，有关主持人的信息将帮助未来的干预工作针对这些 个人最有可能受益于干预。鉴于肥胖症的高流行和数百万 受体重歧视影响的美国人将解决一个至关重要的公共卫生问题。在 更广泛的水平，这项工作将提供对其他不利健康影响的机制的重要洞察力 社会污名的常见形式，例如由于种族，种族，性取向或社会阶层而引起的歧视。