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 In many cultures, people who are obese are viewed as stereotypically
lazy, lacking in willpower, incompetent, unattractive and personally
responsible for their excess weight, researchers note in the journal
Obesity. These negative beliefs, known as weight bias, can cause
obese people to experience discrimination, which is in turn
associated with an increased risk of “internalizing disorders” like
depression, anxiety and low self-esteem, previous research has
found.
For the current study, researchers focused on what's known as
metabolic syndrome, a group of risk factors for heart disease,
stroke and diabetes. People with this syndrome typically have at
least three of these five problems: excess belly fat, high
triglycerides, low levels of "good" cholesterol, elevated blood
pressure and high levels of sugar in the blood.
Participants who internalized weight-related stigma were 41 percent
more likely to experience metabolic syndrome than people who didn't
internalize stigma very much, after accounting for depression and
the degree of obesity, the study found.
"Experiencing weight stigma can elicit a physiological stress
response, marked by elevated blood pressure and inflammation, and
it's possible that self-directed weight stigma may be a form of
chronic stress as well," said lead study author Rebecca Pearl, a
psychiatry researcher at the University of Pennsylvania in
Philadelphia.
"Individuals who internalize weight bias may also engage in
unhealthy behaviors to cope with this stress – such as eating
high-caloric comfort foods – which could affect triglycerides and
other cardiometabolic risk factors measured in this study," Pearl
added by email. "Additionally, when people apply negative weight
stereotypes to themselves, such as being lazy or lacking willpower,
they have less confidence in their ability to engage in healthy
behaviors, such as physical activity."
For the study, Pearl and colleagues examined data from lab tests for
risk factors of metabolic syndrome and from questionnaires assessing
weight stigma in 178 obese adults.
Overall, 51 people, or 32 percent, had metabolic syndrome.
When researchers accounted for other patient characteristics in
addition to depression and the degree of obesity, the connection
between weight stigma and metabolic syndrome was no longer
statistically meaningful, the study found.
The study was funded by Eisai Pharmaceutical Co., which sells a
prescription weight-loss drug. One study author served on advisory
boards for Nutrisystem, Weight Watchers and Novo Nordisk, a maker of
diabetes treatments.
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The study wasn't an experiment designed to prove how different
levels of weight stigma directly cause metabolic syndrome, the
authors note. It's also possible that the results based on a group
of patients participating in an obesity treatment study might not
necessarily reflect what would happen with obese people in real
life.
Still, discrimination clearly can cause chronic stress, which can
result in biochemical changes that contribute to weight gain and
inflammation that lead to abnormalities in blood pressure, blood
sugar and cholesterol, said Dr. Kimberly Gudzune of Johns Hopkins
University in Baltimore.
"It can start you down a pathway that increases your risk for
cardiovascular disease," Gudzune, who wasn't involved in the study,
added by email.
In part to avoid making feelings of discrimination and stress worse,
doctors treating patients for obesity should choose their words
carefully, said Dr. Anne McTiernan, a researcher at Fred Hutchinson
Cancer Research Center and the University of Washington in Seattle
who wasn't involved in the study.
"I would like people with obesity and their health care providers
see the number on the scale as an indicator of health, just like
their blood pressure," McTiernan added by email. "The goal with
excess blood pressure is to get the number down, not to subject the
patient to shame. Similarly, let’s treat the number on the scale as
a measure of health risk, and help the patient get the number down
effectively and safely, and help them avoid gaining the weight
back."
SOURCE: http://bit.ly/2kmi4nF Obesity, online January 26, 2017.
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