Analysis of Cardiometabolic Outcomes Associated with Self-Perceived Obesity in Korean Adults
A growing body of evidence is suggesting that self-perception of overweight/obese status is associated with poor cardiometabolic outcomes, above and beyond actual body weight. This study, conducted in Korea, used survey data from 21,629 people to determine whether there was a correlation between self-perceived obesity and metabolic syndrome (MetS) and cardiometabolic risk factors (CMRs).
In South Korea there has been a worsening of metabolic health indicators over the past decade, with obesity increasing as well as the prevalence of MetS and CMRs. This study found that individuals who identified their weight status as being slightly/very obese (vs. normal weight), were 18-54% more likely to meet MetS criteria. This was greater in men compared with women.
The findings were also in line with previous evidence showing a protective association of perception of normal weight with weight change and depressive symptoms among adolescents and young adults with overweight and obesity.
Recent studies have focussed on emotional responses related with perception of size when trying to understand the link between weight perception, cardiometabolic and emotional responses. They suggest that due to negative societal values towards obesity, self-evaluation of being obese could be associated with weight bias internalization, low self esteem and body dissatisfaction. Weight stigma is prevalent across diverse social groups and weight discrimination can induce sustained psychological distress and maladaptive coping behaviours, which can lead to biological alterations, such as prolonged activation of the hypothalamic-pituitary-adrenal axis and cortisol secretion.
Although this data can not infer any reverse causality between weight perception and metabolic outcomes, it does add to the growing body of evidence that these two are related and it is also the first to demonstrate this in a solely Asian study population. Their findings raise concerns regarding awareness orientated weight management approaches, such as BMI cards, as these may have the unintended consequence of “accurate” perception among individuals with obesity, leading to side-effects on the psychological and metabolic health of the patient. The implication of these findings on clinical practice, could be that clinicians should now take information on patients weight perception, when assessing risk of cardiometabolic dysregulation. Furthermore at policy level, intervention strategies could place the emphasis on lifestyle adjustments, such as healthy eating and increased physical activity, rather than just on the weight aspect.
Read MoreEffects of Characterising ‘Obesity as a Disease’ on Weight Bias
This study sought to work out the implications of categorising obesity as a disease on weight bias. A sample of 309 participants were recruited and measures of demographics, ideology, general attitudes and previous contact with people living with obesity were taken. Participants then read one of three articles as part of an experimental manipulation, one framing obesity as a disease, one framing it not as a disease and a control article on an unrelated topic. After reading, the participants were reassessed for measures including disgust, empathy, blame and weight bias.
The ‘obesity is a disease’ manipulation had a direct positive effect on the emotional response of the participants towards individuals with obesity, because of a reduction in blameworthiness and controllability. However, this was complicated due to a heightening of essentialism; by perceiving obesity as an inherent component of the individual, the individual becomes bad because obesity is bad. This means that framing obesity as a disease which is out of the control of the individual, is not without its consequences to weight stigma.
Another interesting finding was that those participants that had a strong ‘just-world’ beliefs, defined as those that think that people get what they deserve, and thus readily attribute blame to others misfortune in order maintain that belief. This subgroup were most susceptible to a change in emotion when given the article on ‘obesity is a disease’. This suggests that prejudice reduction strategies may need to be more specific and targeted, depending on the group that one is seeking to influence.
This study highlights the nuanced approach that must be taken when trying to implement a stigma reduction programme. Characterising obesity as a disease does not straightforwardly reduce stigma. It also highlights the importance of understanding the target audience when conducting a stigma reduction programme, as a huge number of personal variables, such as political and philosophical views, affects how they react to the information, and these must be taken into account in order to make the programme effective.
Read MoreWeight-Related Stigma is Associated with Bodily Pain Among Females with Overweight or Obesity
Pain is a common comorbidity among individuals living with overweight or obesity, however the mechanism linking the two is not clear. This studyevaluated the relationship between perceived weight-stigma and self reported bodily pain in a sample of obese/overweight adult women through questionnaires designed to measure both.
They found that perceived stigma and internalised stigma were associated with physical pain. Weight-related stigma among women with overweight or obesity appears to be associated with greater experience of physical pain. There is evidence that social and physical pain may be processed through similar physiological mechanisms and that weight stigma may potentiate the experience of pain through those neuroanatomical pathways.
What is known so far is that social factors, such as major life stressors (eg. trauma) and chronic exposure to socially painful situations (eg. conflict or isolation), increase vulnerability to pain by causing heightened sensitivity to painful stimuli. Alongside this, permanent social stress is also thought to affect an individual’s resilience to pain. If they lack meaningful social ties and are in a negative emotional state then they’re less capable of sharing the burden and thus coping with pain.
Although more research needs to be done to evaluate the mechanisms behind this process, these findings suggest that clinicians should be considering stigma internalisation when treating obese patients suffering from chronic bodily pain.
Read MoreImpact of Early‐Life Weight on Cognitive Abilities in Children
A developing child’s mind is highly sensitive to environmental factors and it is now well known that overweight and obesity has a significant impact on the metabolic and endocrine profile of an individual. This new study, published in Obesity, sets sets out to try and determine if childhood obesity has any effect on cognitive ability, guided by the hypothesis that the production of adipocytokines and inflammatory molecules may adversely affect neurodevelopment.
The study included 233 children, who underwent measurements of weight and height to formulate a WHZ score, in the first two years of life. Then through ages 5 to 8 years, the children underwent a comprehensive assessment of cognitive abilities, including attention, impulsivity, working memory and reference memory.
Their findings suggest that early high WHZ, may be inversely associated with full scale IQ, perceptual reasoning index and working memory index, after adjusting for potential confounders. It also found slower reaction time and lower continuous performance test scores. The other cognitive tests conducted did not find an association with early-life WHZ.
The strength of this study is that it used prospective data which enabled them to investigate weight status in the first 2 years of life, which are critical to brain development. This allowed for better understanding of the direction of the association. Furthermore the cognitive tests were repeatedly administered by professionals, and encompassed a comprehensive array of cognitive abilities, which previous studies had not done. FInally they also accounted for covariates, such as socioeconomic status, perinatal factors and maternal IQ.
From this they are able to conclude that early-life obesity seems to affect full scale IQ, perceptual reasoning and working memory scores (boys only), as well as increasing reaction times among school aged children. More research needs to be conducted to confirm these findings, and the authors suggest also measuring school performance, ADHD diagnosis, learning disabilities or special education service use.
Read MoreA Study of Weight Stigma Experienced by Mature Patients with Obesity in Disadvantaged Areas of Australia
There is a growing recognition of the impact stigma has on the health seeking behaviors and self-efficacy of obese patients.This study,set out to identify predictors of perceived weight stigma among patients attending general practices in socioeconomically disadvantaged urban areas of Australia. The predictors selected were socioeconomic factors (age, sex, language spoken at home, education level, and occupation), obesity category and healthy literacy.
To measure stigma, they used two items from the The Impact of Weight on Quality-of-Life-Lite Measurethat focussed on direct experiences of stigma, such as being ridiculed or teased. From it’s sample size of 120, this study found that one-third of the sample had experienced direct forms of weight discrimination in the week prior to being interviewed. The strongest predictors of stigma were higher obesity category, coming from a home where english is not the first language, being unemployed, and scoring low on the health literacy questionnaire on questions relating to ability to engage healthcare providers.
Interestingly, this study found no significant correlation between age, sex or race, which have been well documented as predictors of stigma in the USA. This study highlights the importance of tackling stigma in the healthcare setting, as well as the need for equipping these patients with coping mechanisms. In patients that are already at a disadvantage with regards to receiving healthcare, it is imperative that programmes are implemented to tackle stigma, as it can compound the disadvantaged position of these individuals, and further act as a barrier to them seeking medical help.
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