Research Article: The role of stress and health behaviour in linking weight discrimination and health: a secondary data analysis in England
Abstract:
Objective To examine the role of stress and health-risk behaviours in relationships between weight discrimination and health and well-being. Design Secondary data analysis of an observational cohort study. Setting The English Longitudinal Study of Ageing. Participants Data were from 4341 adults (?50?years) with overweight/obesity. Primary outcome measures We tested associations between perceived weight discrimination at baseline (2010/2011) and self-rated health, limiting long-standing illness, depressive symptoms, quality of life and life satisfaction over 4-year follow-up (2010/2011; 2014/2015). Potential mediation by stress exposure (hair cortisol) and health-risk behaviours (smoking, physical inactivity, alcohol consumption) was assessed. Results Cross-sectionally, perceived weight discrimination was associated with higher odds of fair/poor self-rated health (OR=2.05 (95% CI 1.49 to 2.82)), limiting long-standing illness (OR=1.76 (95% CI 1.29 to 2.41)) and depressive symptoms (OR=2.01 (95% CI 1.41 to 2.85)) and lower quality of life (B=?5.82 (95% CI ?7.01 to ?4.62)) and life satisfaction (B=?2.36 (95% CI ?3.25 to ?1.47)). Prospectively, weight discrimination was associated with higher odds of fair/poor self-rated health (OR=1.63 (95% CI 1.10 to 2.40)) and depressive symptoms (OR=2.37 (95% CI 1.57 to 3.60)) adjusting for baseline status. Those who reported discrimination had higher hair cortisol concentrations (B=0.14 (95% CI 0.03 to 0.25)) and higher odds of physical inactivity (OR=1.90 (95% CI 1.18 to 3.05)). These variables did not significantly mediate associations between discrimination and health outcomes. Conclusions Weight discrimination is associated with poor health and well-being. While this discrimination is associated with stress exposure and physical inactivity, these variables explain little of the association between discrimination and poorer outcomes.
Introduction:
The average person in the UK carries excess weight. 1 2 Recent decades have seen an increase in the proportion of adults with a body mass index (BMI) in the overweight (25–29.9?kg/m 2 ) or obesity (?30?kg/m 2 ) range, and a shift in the distribution of cases such that a greater proportion have ‘morbid’ obesity (BMI?40?kg/m 2 ). 3 Despite the increasingly normative nature of obesity, it is widely stigmatised with those with obesity characterised as lazy, unintelligent and lacking in self-discipline. 4 These…
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