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.

项目概要/摘要 歧视是健康的一个重要社会决定因素，也是造成不良健康结果的一个常见原因。 未得到充分研究的歧视形式是体重歧视 体重歧视是行为方面的。 体重耻辱的表现——对体重超标的人的社会贬低。 体重歧视产生的压力会促使体重增加，从而在体重和体重之间形成恶性循环。 此外，现在有充分的证据表明体重的增加。 然而，歧视与心血管疾病风险增加之间的关系却知之甚少。 解释体重歧视与心血管健康不良之间联系的机制。 该项目将采用严格的实验方法，确定体重歧视的机制 研究结果将有助于实现本研究的长期目标：制定干预措施以减少有害健康。 作为实现这一目标的一步，该项目提出了体重歧视对健康的负面影响。 三个实验，其中肥胖成年人的不同样本将被随机分配进行体验 （与非经验相比）受控实验环境中的体重歧视借鉴了先前的研究。 以及我们的试点数据，为这些研究选择的人际环境模拟了患有以下疾病的人的情况： 肥胖者在日常生活中普遍遭受体重歧视（例如医疗保健和就业方面） 将测试以下目标：(1) 确定早期认知、情感、行为和行为。 (2) 识别由实验操纵的体重歧视激活的生理机制； 调节体重歧视影响的心理变量（例如，内在体重偏差）；以及（3） 确定可减轻体重歧视影响的人口特征（例如性别、种族）。 暴露于体重歧视（与对照）会导致早期反应升高 最终导致心血管健康状况不佳的机制（例如，自我调节能力受损、认知警惕性受损） 社会不认可、更高的负面情绪、更多的社交退缩和舒适饮食的迹象增加 这项研究将确定新的和高度可修改的目标。 旨在减少体重歧视对健康的负面影响的干预措施。 变量，这项工作将识别那些对有害因素表现出特定脆弱性和复原力的个人 因此，有关主持人的信息将有助于未来的干预工作针对这些影响。 鉴于肥胖症的高患病率和数以百万计的人最有可能从干预中受益。 受到体重歧视影响的美国人，这项研究将解决一个重要的公共卫生问题。 更广泛的层面上，这项工作将为其他因素对健康造成不利影响的机制提供重要的见解。 常见的社会耻辱形式，例如基于种族、民族、性取向或社会阶层的歧视。