Background:Physical inactivity is a major public health problem worldwide that results in physical and mental health problems.One major issue for physical inactivity is weight stigma(WS),especially perceived WS,which ...Background:Physical inactivity is a major public health problem worldwide that results in physical and mental health problems.One major issue for physical inactivity is weight stigma(WS),especially perceived WS,which could lead to a tendency to avoid physical activity(PA).To better understand the association between perceived WS and PA,knowledge of the likely mediators in this association such as weight bias internalization(WBI)and psychological distress were investigated in the present study.Methods:Using a two-wave longitudinal study and convenient sampling,388 Taiwan residents participants(55%females;mean age=29.7 years[SD±6.3])completed two surveys six months apart.Body mass index(BMI),Perceived Weight Stigma Scale(PWSS),Weight Bias Internalization Scale(WBIS),Depression,Anxiety,Stress Scale(DASS-21),and Tendency to Avoid Physical Activity and Sport Scale(TAPAS)were assessed.Results:A mediation model controlling for age,gender,and BMI with 5000 bootstrapping resamples was performed.Perceived WS exerted significant direct effects on WBI(β=0.25;p<0.001),psychological distress(β=0.15;p=0.003),and tendency to avoid PA(β=0.10;p=0.027);WBI exerted a significant direct effect on tendency to avoid PA(β=0.47;p<0.001).Standardized indirect effects of WBI and psychological distress on the association between perceived WS and tendency to avoid PA were 0.12 and 0.01,respectively.Conclusion:Given the direct association of perceived WS on the tendency to avoid PA and the mediating role of WBI in this association,interventions addressing perceived WS and WBI may contribute to promoting PA.Therefore,health interventionists(both when planning and executing PA programs)need to consider weight stigmawhen encouraging physical activity.展开更多
The use of body mass index(BMI)to determine eligibility for gender-affirming surgery in transgender and nonbinary individuals has been contested.While BMI thresholds are often meant to be protective,restricting patien...The use of body mass index(BMI)to determine eligibility for gender-affirming surgery in transgender and nonbinary individuals has been contested.While BMI thresholds are often meant to be protective,restricting patients from access to surgery can also cause harm.There is a rationale for the continued use of BMI,but the inherent problems with it must also be recognized,including how weight stigma impacts patients’access to gender-affirming surgery and influences clinical care.This article uses a narrative review of current literature to discuss how high BMI affects surgical outcomes in gender-affirming genital surgeries,as well as analogous procedures,existing de facto BMI thresholds,and how to both minimize the harms of proceeding with surgery in patients with a high BMI or the harms of delaying for weight loss.BMI factors into surgical decision-making based on the existing literature,which demonstrates that high BMI is associated with increased surgical risk,including higher incidences of surgical site infections and poor wound healing,as well as the possibility of free flap complications,which are a component of certain genital procedures.This patient population is at higher risk for eating disorders,and it is prudent to find alternatives to requiring patient self-monitored weight management.The impacts of weight stigma should be considered when treating gender-affirming surgery patients,and further data and research are needed to augment shared decision-making and lead to practice change.展开更多
Background: The obesity rate is rising. The aims of this study were to elucidate the connection among body image disturbance and dissatisfaction, scorn and stigma in severely obese individuals using a case-control met...Background: The obesity rate is rising. The aims of this study were to elucidate the connection among body image disturbance and dissatisfaction, scorn and stigma in severely obese individuals using a case-control method. Method: The study group consisted of 112 individuals receiving permanent disability pensions primarily for obesity. The controls were selected by random sampling. The controls were matched with the subjects by place of residence, gender, age, the time since the pension was granted and occupation. Psychiatric interviews and psychological assessments were conducted with all participants. The results were analyzed via chi-squared tests (χ2-tests) and percent distributions. The subject and control groups were compared via paired t-tests. Conditional logistic regression analysis was also conducted. Results: In the Draw a Person test, we found disorganization of the body image to some degree in the subject group. Some significant differences were found between the Machover index and the wholeness index. The Rorschach variables obtained some differences in the responses between the subject and control groups. Obesity was a problem in all age groups. In the study group, half of the participants thought that they were obese. Most of the participants had endured scorn and contempt directed at them due to being overweight. Conclusions: We believe that our study provides a novel and necessary overview of the connection among body image disturbance and dissatisfaction, scorn and stigma.展开更多
基金funded by the Ministry of Science and Technology,Taiwan(MOST 110-2410-H-006-115,MOST 111-2410-H-006-100,NSTC 112-2410-H-006-089-SS2)E-Da Hospital(EDAHS112032,EDAHS113021 and EDAHS113036)the Higher Education Sprout Project,Ministry of Education to the Headquarters of University Advancement at National Cheng Kung University(NCKU).
文摘Background:Physical inactivity is a major public health problem worldwide that results in physical and mental health problems.One major issue for physical inactivity is weight stigma(WS),especially perceived WS,which could lead to a tendency to avoid physical activity(PA).To better understand the association between perceived WS and PA,knowledge of the likely mediators in this association such as weight bias internalization(WBI)and psychological distress were investigated in the present study.Methods:Using a two-wave longitudinal study and convenient sampling,388 Taiwan residents participants(55%females;mean age=29.7 years[SD±6.3])completed two surveys six months apart.Body mass index(BMI),Perceived Weight Stigma Scale(PWSS),Weight Bias Internalization Scale(WBIS),Depression,Anxiety,Stress Scale(DASS-21),and Tendency to Avoid Physical Activity and Sport Scale(TAPAS)were assessed.Results:A mediation model controlling for age,gender,and BMI with 5000 bootstrapping resamples was performed.Perceived WS exerted significant direct effects on WBI(β=0.25;p<0.001),psychological distress(β=0.15;p=0.003),and tendency to avoid PA(β=0.10;p=0.027);WBI exerted a significant direct effect on tendency to avoid PA(β=0.47;p<0.001).Standardized indirect effects of WBI and psychological distress on the association between perceived WS and tendency to avoid PA were 0.12 and 0.01,respectively.Conclusion:Given the direct association of perceived WS on the tendency to avoid PA and the mediating role of WBI in this association,interventions addressing perceived WS and WBI may contribute to promoting PA.Therefore,health interventionists(both when planning and executing PA programs)need to consider weight stigmawhen encouraging physical activity.
文摘The use of body mass index(BMI)to determine eligibility for gender-affirming surgery in transgender and nonbinary individuals has been contested.While BMI thresholds are often meant to be protective,restricting patients from access to surgery can also cause harm.There is a rationale for the continued use of BMI,but the inherent problems with it must also be recognized,including how weight stigma impacts patients’access to gender-affirming surgery and influences clinical care.This article uses a narrative review of current literature to discuss how high BMI affects surgical outcomes in gender-affirming genital surgeries,as well as analogous procedures,existing de facto BMI thresholds,and how to both minimize the harms of proceeding with surgery in patients with a high BMI or the harms of delaying for weight loss.BMI factors into surgical decision-making based on the existing literature,which demonstrates that high BMI is associated with increased surgical risk,including higher incidences of surgical site infections and poor wound healing,as well as the possibility of free flap complications,which are a component of certain genital procedures.This patient population is at higher risk for eating disorders,and it is prudent to find alternatives to requiring patient self-monitored weight management.The impacts of weight stigma should be considered when treating gender-affirming surgery patients,and further data and research are needed to augment shared decision-making and lead to practice change.
文摘Background: The obesity rate is rising. The aims of this study were to elucidate the connection among body image disturbance and dissatisfaction, scorn and stigma in severely obese individuals using a case-control method. Method: The study group consisted of 112 individuals receiving permanent disability pensions primarily for obesity. The controls were selected by random sampling. The controls were matched with the subjects by place of residence, gender, age, the time since the pension was granted and occupation. Psychiatric interviews and psychological assessments were conducted with all participants. The results were analyzed via chi-squared tests (χ2-tests) and percent distributions. The subject and control groups were compared via paired t-tests. Conditional logistic regression analysis was also conducted. Results: In the Draw a Person test, we found disorganization of the body image to some degree in the subject group. Some significant differences were found between the Machover index and the wholeness index. The Rorschach variables obtained some differences in the responses between the subject and control groups. Obesity was a problem in all age groups. In the study group, half of the participants thought that they were obese. Most of the participants had endured scorn and contempt directed at them due to being overweight. Conclusions: We believe that our study provides a novel and necessary overview of the connection among body image disturbance and dissatisfaction, scorn and stigma.
