目前在全球范围内普遍存在老年歧视和消极的老化态度。2~3岁的幼儿就已经具有了老化的消极刻板印象,家庭、社会、媒体和图书资料是为人们提供消极老化态度的主要来源,而缺少代际接触、缺乏对老化知识的了解是人们形成老年歧视的主要原因。老年歧视会影响个体的行为、自我老化接受度、心理健康状况、生活方式以及择业。了解老化知识信息、讨论老龄化问题,以及与老年人直接接触等方法可以帮助人们改变老化消极刻板印象,并且代际接触的质量比数量更重要。目前,老年歧视的研究横向研究多,纵向研究少;特点描述、干预研究多,机制研究较少;研究方法多样,测量工具不同,导致研究结果不同,各研究间难以进行比较,如直接测量主观态度的老年歧视调查,人们表现出更多的积极态度,而采用间接方法测量时,人们则表现出更多的消极态度。我国对老年歧视的研究有待进一步深入和扩展。

心理疾病污名是加诸于患者身上的耻辱标记,妨碍患者的治疗和康复。心理疾病污名的成因理论包括功能主义和生物文化两个派别,污名的发展模型解释了污名的形成过程,身份威胁模型对污名的作用机制进行了阐述。通过抗议、教育和接触可以有效地减少污名。在中国开展相关研究应注重分析传统文化、心理疾病类型与污名的关系,探讨各种减少污名策略的可行性。

艾滋病污名主要包括实际污名、感知污名和自我污名，这些不同形式的污名给艾滋病患者带来了精 神上的痛苦、社会资源的剥夺等一系列的负面影响。归因理论、社会文化理论和道德理论分别从社会心理学、社会不平等和文化道德的角度阐述了艾滋病污名的形成 机制。从这些机制出发，减少艾滋病污名可以结合接触假设、知识传播以及认知行为疗法，并注意改变艾滋病患者的自身观念。未来的艾滋病污名研究应更多地从社 会文化以及道德的角度进行跨文化的量化研究。

目的 引入对肥胖者态度(attitudes toward obese persons,ATOP)量表,并分析其信度和效度.方法 对ATOP量表进行翻译和文化调适,修订形成中文版量表.采用专家小组评价法检验中文版ATOP量表的内容效度.采用整群抽样法抽取407名护理大学生(护生),用中文版ATOP量表进行问卷调查,收集数据,进行结构效度(包括项目分析、探索性因素分析和验证性因素分析)、效标关联效度、内部一致性信度分析;随机选取样本中20名受试者,间隔2周重复测评,用组内相关系数(ICC)分析重测信度.结果 中文版ATOP量表各条目的平均内容效度指数为0.97.经项目分析和探索性因素分析,提取到3个因子(12个条目),可解释变异量的52.45％.验证性因素分析支持量表的三因子结构(x2=93.75,df=51,x2/df=1.84,RMSEA=0.06,NNFI=0.91,CFI=0.93,IFI=0.93,GFI=0.93,AGFI=0.89).量表及其因子与体重心理控制源的外控性因子得分呈正相关.量表及各因子的Cronbach's α系数为0.59～0.71,重测信度ICC为0.52～0.83.护生的体质指数与其自尊因子得分呈弱负相关;自感超重的护生对自尊因子的评分更低,但对个体差异因子评分更高.结论 中文版ATOP量表具有较好的信度和效度,可用于测评护生对肥胖人群的态度.

Abstract Previous research supports a positive association between weight stigmatization experiences and binge eating. However, the extent to which weight stigmatization accounts for binge eating in the context of other risk factors requires further investigation. Using a cumulative risk model, we examine previously studied risk factors (environmental stress, psychological functioning, negative coping, body dissatisfaction) as well as weight stigmatization as predictors of binge eating bariatric patients and undergraduate students. Results show a unique contribution of weight stigmatization. Analyses by sample indicated that this was only the case for the undergraduate student sample. Results support weight stigmatization as a meaningful predictor of binge eating and highlight the need for further work investigating how these experiences work to promote eating pathology. 2010 Wiley Periodicals, Inc. J Clin Psychol 00:1-15, 2010.

Abstract Even as obesity rates reach new highs, the social stigmatization of obesity seems to be strengthening and globalizing. This review identifies at least four mechanisms by which a pervasive environment of fat stigma could reinforce high body weights or promote weight gain, ultimately driving population-level obesity. These are direct effects through behavior change because of feeling judged, and indirect effects of social network changes based on stigmatizing actions and decisions by others, psychosocial stress from feeling stigmatized, and the structural effects of discrimination. Importantly, women and children appear especially vulnerable to these mechanisms. The broader model provides an improved basis to investigate the role of stigma in driving the etiology of obesity, and explicates how individual, interpersonal, and structural dimensions of stigma are connected to variation in health outcomes, including across generations. Copyright 2014 Elsevier Ltd. All rights reserved.

Abstract This purpose of this study was to evaluate the Nutrition and Exercise for Wellness and Recovery (NEW-R) weight loss intervention. Using a pretest/posttest design, 18 participants recruited from a community-based mental health program were assessed at baseline, immediately following the intervention (8 weeks), and at 6-month follow-up. The intervention was delivered by an occupational therapist and occupational therapy graduate students and consisted of 8 weekly sessions lasting 2 hr. Outcomes included changes in weight, and levels of knowledge about nutrition and exercise. Participants lost an average of 3 pounds at immediate postintervention, and lost an average of 10 pounds at the 6-month follow-up. Participants also demonstrated significant increases in their knowledge about nutrition and physical activity. The results of this study provide preliminary support for the impact of the NEW-R intervention on weight loss and knowledge about diet and exercise. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Abstract Objective: Whether weight bias occurs in the graduate school admissions process is explored here. Specifically, we examined whether body mass index (BMI) was related to letter of recommendation quality and the number of admissions offers applicants received after attending in-person interviews. Design and Methods: Participants were 97 applicants to a psychology graduate program at a large university in the United States. They reported height, weight, and information about their applications to psychology graduate programs. Participants' letters of recommendation were coded for positive and negative statements as well as overall quality. Results: Higher BMI significantly predicted fewer post-interview offers of admission into psychology graduate programs. Results also suggest this relationship is stronger for female applicants. BMI was not related to overall quality or the number of stereotypically weight-related adjectives in letters of recommendation. Surprisingly, higher BMI was related to more positive adjectives in letters. Conclusions: The first evidence that individuals interviewing applicants to graduate programs may systematically favor thinner applicants is provided here. A conscious or unconscious bias against applicants with extra body weight is a plausible explanation. Stereotype threat and social identity threat are also discussed as explanations for the relationship between BMI and interview success.

Abstract This study examined the prevalence, distribution and correlates of successful weight loss and successful weight maintenance over three years in a community-based sample of 854 subjects aged 20-45 at baseline. More than half (53.7%) of the participants in the study gained weight within the first twelve months, only one in four (24.5%) successfully avoided weight gain over three years, and less than one in twenty (4.6%) lost and maintained weight successfully. The findings underscore the importance of current public health efforts to prevent weight gain, and suggest that without much greater efforts to promote and support weight control the prevalence of obesity will continue to rise.

Object : The 20-item Attitudes toward Obese Persons Scale (ATOP) and the 8-item Beliefs about Obese Persons Scale (BAOP) are used in English speaking countries to measure attitudes and beliefs about obese persons. The purpose of this study was to test the validity and reliability of the ATOP and the BAOP in Turkish language. Methods: It is a methodological study. The study was conducted in Celal Bayar University. The study subjects comprised of 103 School of Health, 105 Faculty of Economics and Administrative Sciences, 94 School of Physical Education, and Sports students. The data were collected by a questionnaire consisting of socio-demographic characteristics, the level of obesity knowledge and the Turkish version of the ATOP (T-ATOP) and the Turkish version of the BAOP (T-BAOP). The psychometric properties of both scales were examined by exploratory and confirmatory factor analysis, internal consistency, intra-rater reliability. Cronbach alpha coefficients and Spearman Brown split-half were used to assess internal consistency reliability of the scales. Intra-rater reliability of the scales was examined by intraclass correlation coefficients (ICC). Results: Three factors (i.e., Different Personality, Social Difficulties, and Self-Esteem) of the T-ATOP were established by exploratory factor analysis, and confirmatory factor analysis demonstrated three-factor structure. Internal consistency was supported by Cronbach alpha (0.86), Spearman Brown split-half value (0.75 for the first half) and (0.72 for the second half), and intra-rater reliability (ICC=0.78). The results of the exploratory and confirmatory factor analysis demonstrated that the T-BAOP has a structure of the one factor. As for internal consistency of T-BAOP, it was supported by Cronbach alpha (0.84), Spearman Brown split-half value (0.79 for the first half and 0.74 for the second half) and intra-rater reliability (ICC=0.80). Conclusions: The T-ATOP and the T-BAOP showed initial evidence of the reliability and validity that can be used in Turkish speaking countries in order to measure attitudes and beliefs about obese persons.

Background Underweight and severe and morbid obesity are associated with highly elevated risks of adverse health outcomes. We estimated trends in mean body-mass index (BMI), which characterises its population distribution, and in the prevalences of a complete set of BMI categories for adults in all countries. Methods We analysed, with use of a consistent protocol, population-based studies that had measured height and weight in adults aged 18 years and older. We applied a Bayesian hierarchical model to these data to estimate trends from 1975 to 2014 in mean BMI and in the prevalences of BMI categories (<18·5 kg/m2 [underweight], 18·5 kg/m2 to <20 kg/m2, 20 kg/m2 to <25 kg/m2, 25 kg/m2 to <30 kg/m2, 30 kg/m2 to <35 kg/m2, 35 kg/m2 to <40 kg/m2, ≥40 kg/m2 [morbid obesity]), by sex in 200 countries and territories, organised in 21 regions. We calculated the posterior probability of meeting the target of halting by 2025 the rise in obesity at its 2010 levels, if post-2000 trends continue. Findings We used 1698 population-based data sources, with more than 19·2 million adult participants (9·9 million men and 9·3 million women) in 186 of 200 countries for which estimates were made. Global age-standardised mean BMI increased from 21·7 kg/m2 (95% credible interval 21·3–22·1) in 1975 to 24·2 kg/m2 (24·0–24·4) in 2014 in men, and from 22·1 kg/m2 (21·7–22·5) in 1975 to 24·4 kg/m2 (24·2–24·6) in 2014 in women. Regional mean BMIs in 2014 for men ranged from 21·4 kg/m2 in central Africa and south Asia to 29·2 kg/m2 (28·6–29·8) in Polynesia and Micronesia ; for women the range was from 21·8 kg/m2 (21·4–22·3) in south Asia to 32·2 kg/m2 (31·5–32·8) in Polynesia and Micronesia. Over these four decades, age-standardised global prevalence of underweight decreased from 13·8% (10·5–17·4) to 8·8% (7·4–10·3) in men and from 14·6% (11·6–17·9) to 9·7% (8·3–11·1) in women. South Asia had the highest prevalence of underweight in 2014, 23·4% (17·8–29·2) in men and 24·0% (18·9–29·3) in women. Age-standardised prevalence of obesity increased from 3·2% (2·4–4·1) in 1975 to 10·8% (9·7–12·0) in 2014 in men, and from 6·4% (5·1–7·8) to 14·9% (13·6–16·1) in women. 2·3% (2·0–2·7) of the world's men and 5·0% (4·4–5·6) of women were severely obese (ie, have BMI ≥35 kg/m2). Globally, prevalence of morbid obesity was 0·64% (0·46–0·86) in men and 1·6% (1·3–1·9) in women. Interpretation If post-2000 trends continue, the probability of meeting the global obesity target is virtually zero. Rather, if these trends continue, by 2025, global obesity prevalence will reach 18% in men and surpass 21% in women ; severe obesity will surpass 6% in men and 9% in women. Nonetheless, underweight remains prevalent in the world's poorest regions, especially in south Asia.

Abstract OBJECTIVE: The present study examined the relationship between experiences of discrimination and occurrence of binge eating among overweight and obese persons, a population which has previously shown elevated rates of binge eating. METHODS: Internet-based questionnaires were used to measure frequency and impact of discrimination, binge eating frequency, and emotional eating. RESULTS: Pearson correlation analyses demonstrated significant positive relationships between the measures of discrimination and measures of eating behaviors (r = 0.12-0.37). Regression models significantly predicted between 17 and 33% of the variance of emotional eating scores and frequency of binge eating; discrimination measures contributed significantly and independently to the variance in emotional eating and binge eating. Weight bias internalization was found to be a partial mediator of the relationship between discrimination and eating disturbance. CONCLUSION: Results demonstrate the relationship of discrimination to binge eating. Weight bias internalization may be an important mechanism for this relationship and a potential treatment target. Copyright 2012 S. Karger GmbH, Freiburg

Abstract Objective: Widespread bias against obese individuals may lead to the internalization of weight bias in obese persons. This study examined correlates of internalized weight bias (IWB) in obese patients with binge eating disorder (BED). Method: One hundred treatment-seeking obese patients with BED were administered with the eating disorders examination interview and questionnaires assessing IWB, fat phobia, depression, and self-esteem. Results: The mean IWB score in this group of patients with BED was significantly greater than the mean IWB score observed previously in a community sample of overweight adults. IWB was positively associated with eating disorder psychopathology, fat phobia, and depression, and negatively associated with self-esteem. IWB made significant independent contributions to the variance in eating disorder psychopathology even after accounting for fat phobia, depression, and self-esteem. Discussion: Treatment-seeking obese patients with BED demonstrate high levels of IWB. IWB may contribute to the variance in eating disorder psychopathology in BED patients, beyond the contributions of fat phobia, depression, and self-esteem. 2011 by Wiley Periodicals, Inc. Int J Eat Disord 2012

Abstract OBJECTIVE: Discrimination can have a negative impact on psychological well-being, attitudes and behaviour. This research evaluates the impact of experiences of weight-based discrimination upon emotional eating and body dissatisfaction, and also explores whether people's beliefs about an ingroup's social consensus concerning how favourably overweight people are regarded can moderate the relationship between experiences of discrimination and negative eating and weight-related cognitions and behaviours. RESEARCH METHODS AND PROCEDURES: 197 undergraduate students completed measures about their experiences of weight-based discrimination, emotional eating and body dissatisfaction. Participants also reported their beliefs concerning an ingroup's attitude towards overweight people. RESULTS: Recollections of weight-based discrimination significantly contributed to emotional eating and body dissatisfaction. However, the relationships between experiencing discrimination and body dissatisfaction and emotional eating were weakest amongst participants who believed that the ingroup held a positive attitude towards overweight people. DISCUSSION: Beliefs about ingroup social consensus concerning overweight people can influence the relationships between weight-based discrimination and emotional eating and body dissatisfaction. Changing group perceptions to perceive it to be unacceptable to discriminate against overweight people may help to protect victims of discrimination against the negative consequences of weight-based stigma.

Abstract Despite the growing epidemic of extreme obesity in the United States, weight management is not adequately addressed in primary care. This study assessed family physicians' practices and attitudes regarding care of extremely obese patients and factors associated with them. A cross-sectional, self-administered survey was mailed to 500 family physicians in New Jersey (NJ) during March-ay 2008. Measures included knowledge, weight management approaches, attitudes toward managing obesity, challenges with examinations, availability of supplies, and strategies to improve care. Response rate was 53% ( N = 255). Bariatric surgery and weight loss medications were infrequently recommended, particularly in physicians with higher volume of extremely obese patients (odds ratio (OR) 0.38; 95% confidence interval (CI) 0.23, 0.62 and OR 0.51; 95% CI 0.31, 0.85 for surgery and medications, respectively). Higher knowledge was associated with increased frequency of recommendations of weight loss medications ( P < 0.0001) and bariatric surgery ( P < 0.0001). There was a high prevalence of negative attitudes, particularly in younger physicians and those with lower patient volume. Increased knowledge of weight-loss diets was associated with less dislike in discussing weight loss ( P < 0.0001), less frustration ( P = 0.0001), less belief that treatment is often ineffective ( P < 0.0001), and less pessimism about patient success ( P = 0.0002). Many providers encountered challenges performing examinations on extremely obese patients. More education of primary care physicians, particularly on bariatric surgery, specific examination techniques, and availability of community resources for obese persons is needed. Further research is needed to determine if interventions to increase knowledge of physicians will lead to less negative attitudes toward weight loss and extremely obese patients.

Cette revue s'appuie sur une exploration de la littérature publiée au cours des 20 dernières années en matière de préjugés, de honte et de discrimination liés au poids, et leur lien avec le traitement de l'obésité. Les organisations nationales et internationales sur l'obésité ont considéré la honte de l'obésité comme l'obstacle majeur à une lutte efficace contre l'épidémie d'obésité et ont fait appel aux interventions fondées sur la théorie pour la réduire. Le Réseau canadien en obésité ( http://www.obesitynetwork.ca/french ) et l'Obesity Society ( http://www.obesity.org ) ont des orientations stratégiques, des énoncés de mission et des collaborations qui s'opposent fortement aux préjugés liés au poids et reconnaissent les répercussions négatives qu'a le potentiel de ces préjugés sur le traitement de l'obésité. Des revues exhaustives de la littérature en ce qui concerne les préjugés liés au poids ont été publiées et ont subséquemment fait prendre conscience des répercussions potentielles de la discrimination et des préjugés liés au poids sur la santé et le bien-être des individus atteints d'obésité. Le but de cette revue est de mettre l'accent sur les déterminants des préjugés liés au poids et de discuter de leurs répercussions sur le traitement de l'obésité.

Despite evidence that individual fitness levels rather than body weight are more closely linked to health outcomes, stereotypes held about overweight and obese people have resulted in pervasive levels of discrimination. It is of little wonder that overweight and obese people have been found to be unhappy. The current investigation explored the psychological burden being experienced by overweight and obese people while also examining their perceived ability to engage in exercise. Depression, anxiety and stress levels were all found to be unacceptably high for the current sample, while exercise self-efficacy or perceived ability to engage in exercise was low. Given these characteristics, messages exhorting obese people to eat less and exercise more may do little except increase the stigmatisation and levels of despair experienced by them. Those designing public health promotion and education campaigns aimed at decreasing obesity need to be cognisant of the harm that a focus on obese and overweight individuals can potentially cause. A public health focus on greater fitness for all, regardless of weight, would serve the entire population while minimising the risk of perpetuating discriminatory stereotypes about overweight and obese individuals.

Weight-related stigma is established as a major psychosocial stressor and correlate of depression among people living with obesity in high-income countries. Anti-fat beliefs are rapidly globalizing. The goal of the study is to (1) examine how weight-related stigma, enacted as teasing, is evident among women from a lower-income country and (2) test if such weight-related stigma contributes to depressive symptoms. Modeling data for 12,074 reproductive-age women collected in the 2008–2009 Guatemala National Maternal-Infant Health Survey, we demonstrate that weight-related teasing is (1) experienced by those both underweight and overweight, and (2) a significant psychosocial stressor. Effects are comparable to other factors known to influence women’s depressive risk in lower-income countries, such as living in poverty, experiencing food insecurity, or suffering sexual/domestic violence. That women’s failure to meet local body norms—whether they are overweight or underweight—serves as such a strong source of psychological distress is particularly concerning in settings like Guatemala where high levels of over- and under-nutrition intersect at the household and community level. Current obesity-centric models of weight-related stigma, developed from studies in high-income countries, fail to recognize that being underweight may create similar forms of psychosocial distress in low-income countries.

OBJECTIVE: To identify shared risk and protective factors for purging, binge eating, and overweight. DESIGN: Prospective cohort study. SETTING: Population-based questionnaires of children and adolescents residing across the United States. PARTICIPANTS: Girls (n = 6022) and boys (n = 4518), aged 11 to 17 years in 1998, in the ongoing Growing Up Today Study. MAIN EXPOSURES: Putative risk and protective factors within the psychological, behavioral, and socioenvironmental domains. MAIN OUTCOME MEASURES: Overweight, use of laxatives or purging (vomiting), and binge eating. Because of the low prevalence of purging, we did not examine shared factors for this behavior among boys. RESULTS: In 1998, a total of 219 girls (3.7%) and 30 boys (0.7%) reported purging behaviors, 426 girls (7.1%) and 90 boys (2.0%) reported binge eating, and 1019 girls (17.4%) and 1040 boys (24.6%) were overweight. From 1999 through 2001, 331 girls (7.8%) initiated purging behaviors, 503 girls (11.8%) and 132 boys (4.5%) initiated binge eating behaviors, and 424 girls (10.0%) and 382 boys (13.6%) became overweight. Concern for weight was directly associated with all 3 weight-related problems among boys and girls. Among girls, dieting, parental weight-related teasing, and family meal frequency had a shared effect on the weight-related problems examined. CONCLUSIONS: Factors within the psychological, behavioral, and socioenvironmental domains may have a shared effect on purging, binge eating, and overweight. Further research is needed to determine if an intervention designed to address these shared risk and protective factors is effective in simultaneously reducing these weight-related problems.

Abstract BACKGROUND/AIMS: This study examined the association between experiences of health care stigmatization and BMI changes in men and women with normal weight and obesity in Sweden. METHODS: The participants were drawn from a population-based survey in Sweden (1996-2006), and data on their perceived health care stigmatization were measured in 2008. They were categorized in individuals with normal weight (n = 1,064), moderate obesity (n = 1,273), and severe obesity (n = 291). The main outcome measure was change in BMI. RESULTS: Individuals with severe obesity experiencing any health care stigmatization showed a BMI increase by 1.5 kg/m2 more than individuals with severe obesity with no such experience. For individuals with moderate obesity, insulting treatment by a physician and avoidance of health care were associated with a relative BMI increase of 0.40 and 0.75 kg/m2, respectively, compared with their counterparts who did not experience stigmatization in these areas. No difference in experience of any form of health care stigmatizing associated BMI change was observed for men and women with normal weight. CONCLUSION: In this large, population-based study, perceived health care stigmatization was associated with an increased relative BMI in individuals with severe obesity. For moderate obesity, the evidence of an association was inconclusive.

Abstract OBJECTIVE: Emerging evidence suggests that psychosocial stress may influence weight gain. The relationship between stress and weight change and whether this was influenced by demographic and behavioral factors was explored. DESIGN AND METHODS: A total of 5,118 participants of AusDiab were prospectively followed from 2000 to 2005. The relationship between stress at baseline and BMI change was assessed using linear regression. RESULTS: Among those who maintained/gained weight, individuals with high levels of perceived stress at baseline experienced a 0.20 kg/m(2) (95% CI: 0.07-0.33) greater mean change in BMI compared with those with low stress. Additionally, individuals who experienced 2 or 3 stressful life events had a 0.13 kg/m(2) (0.00-0.26) and 0.26 kg/m(2) (0.14-0.38) greater increase in BMI compared with people with none. These relationships differed by age, smoking, and baseline BMI. Further, those with multiple sources of stressors were at the greatest risk of weight gain. CONCLUSION: Psychosocial stress, including both perceived stress and life events stress, was positively associated with weight gain but not weight loss. These associations varied by age, smoking, obesity, and multiple sources of stressors. Future treatment and interventions for overweight and obese people should consider the psychosocial factors that may influence weight gain. Copyright 2013 The Obesity Society.

Abstract Despite the increased prevalence of weight discrimination, few studies have examined the association between perceived weight discrimination and the prevalence of current psychiatric disorders in the general population. This study utilized a subsample of overweight and obese individuals ( N = 22,231) from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a cross-sectional nationally representative study of noninstitutionalized US adults. Perceived weight discrimination is associated with substantial psychiatric morbidity and comorbidity. These results remained significant after adjusting for a potential confound, perceived stress. Moreover, social support did not buffer against the adverse effects of perceived weight discrimination on mental health. Controlling for BMI did not diminish the associations, indicating that perceived weight discrimination is potentially harmful to mental health regardless of weight. These results highlight the urgent need for a multifaceted approach to address this important public health issue, including interventions to assist overweight individuals in coping with the mental health sequelae of perceived weight discrimination.

Hypothesizes that body image dissatisfaction is not always a negative process. It is argued that some degree of dissatisfaction may be helpful and necessary to motivate individuals to engage in healthy behaviors such as exercise and restricting fats and calories. The assumption that dissatisfaction with weight is universally deleterious is questioned. It is suggested that to further analyze the role of body image dissatisfaction in eating disorders, one might examine how body dissatisfaction interacts with motivation and participation in healthy behaviors. Theoretical background and empirical support for these hypotheses are offered. The following issues are reviewed: the relationship between body image dissatisfaction and dieting behavior; the public health problem of obesity, body image, and dieting behavior in overweight and obese populations; the research examining the possible beneficial aspects of body image dissatisfaction in predicting weight loss and exercise behavior; and theories from the health psychology literature supporting the notion that distress may serve as a motivating factor for engaging in health behaviors. Implications for this reconceptualization of the hazards of body image dissatisfaction are offered and research directions are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Objective Internalizing the pervasive weight bias commonly directed towards individuals with overweight and obesity, co-occurs with increased psychopathology and impaired quality of life. This study sought to establish population norms and psychometric properties of the most widely used self-report questionnaire, the Weight Bias Internalization Scale (WBIS), in a representative community sample. Design and Methods In a survey of the German population, N = 1158 individuals with overweight and obesity were assessed with the WBIS and self-report measures for convergent validation. Results Item analysis revealed favorable item-total correlation of all but one WBIS item. With this item removed, item homogeneity and internal consistency were excellent. The one-factor structure of the WBIS was confirmed using confirmatory factor analysis. Convergent validity was shown through significant associations with measures of depressive and somatoform symptoms. The WBIS contributed to the explanation of variance in depressive and somatoform symptoms over and above body mass index. Higher WBIS scores were found in women than in men, in individuals with obesity than in individuals with overweight, and in those with lower education or income than those with higher education or income. Sex-specific norms were provided. Conclusions The results showed good psychometric properties of the WBIS after removal of one item. Future research is warranted on further indicators of reliability and validity, for example, retest reliability, sensitivity to change, and prognostic validity.

Objective Rates of weight-based stigmatization have steadily increased over the past decade. The psychological and physiological consequences of weight stigma remain understudied. Methods This study examined the effects of experimentally manipulated weight stigma on the stress-responsive hypothalamic–pituitary–adrenal axis (HPA) in 110 female undergraduate participants (BMI: M 65=6519.30, SD65=651.55). Objective BMI and self-perceived body weight were examined as moderators of the relationship between stigma and HPA reactivity. Results Results indicated participants' perceptions of their own body weight (but not objective BMI) moderated the effect of weight stigma on cortisol reactivity: F (1,102)65=6513.48, P 652</sup>p65=650.12 (interaction 95% CI range [612.06 to 611.44, 611.31 to 610.99]). Specifically, participants who perceived themselves as heavy exhibited sustained cortisol elevation post-manipulation compared with individuals who did not experience the weight-related stigma. Cortisol change did not vary by condition for participants who perceived themselves as average weight. Conclusions In the first study to examine physiological consequences of active interpersonal exposure to weight stigma, experiencing weight stigma was stressful for participants who perceived themselves as heavy, regardless of their BMI. These results are important because stress and cortisol are linked to deleterious health outcomes, stimulate eating, and contribute to abdominal adiposity.

Weight stigma is pervasive in the United States. We tested the hypothesis that stigma may be a mechanism through which obesity negatively affects self-reported health. Two studies examined whether perceived weight-based discrimination and concerns over weight stigma mediated the association between BMI and self-reported psychological health (Study 1) and physical health (Study 2).In 2 online studies, adult community members completed measures of stigma-relevant mediators (perceived weight discrimination, weight stigma concerns) and provided their height and weight. In Study 1 (N = 171) participants also completed measures of psychological health (depression, self-esteem, quality of life), whereas participants in Study 2 (N = 194) also completed a measure of self-reported physical health. Process modeling was used to simultaneously test for mediation through perceived discrimination and stigma concerns independently as well as for serial mediation through both variables.Across both studies, we hypothesized and found support for serial mediation such that BMI was indirectly related to poorer self-reported health through its effect on perceived discrimination and concerns about stigma. Additionally, concerns about stigma mediated the association between BMI and health independent of perceived discrimination.Weight stigma is an important mediator of the association between BMI and self-reported health. Furthermore, results indicate that concerns about facing stigma in the future mediate the link between perceived past experiences of discrimination and psychological and physical health.

Abstract Weight stigma is pervasive, and a number of scholars argue that this profound stigma contributes to the negative effects of weight on psychological and physical health. Some lay individuals and health professionals assume that stigmatizing weight can actually motivate healthier behaviors and promote weight loss. However, as we review, weight stigma is consistently associated with poorer mental and physical health outcomes. In this article, we propose a social identity threat model elucidating how weight stigma contributes to weight gain and poorer mental and physical health among overweight individuals. We propose that weight-based social identity threat increases physiological stress, undermines self-regulation, compromises psychological health, and increases the motivation to avoid stigmatizing domains (e.g., the gym) and escape the stigma by engaging in unhealthy weight loss behaviors. Given the prevalence of overweight and obesity in the US, weight stigma thus has the potential to undermine the health and wellbeing of millions of Americans.

We have investigated the psychometric properties of the Italian version of the weight bias internalization scale (WBIS) in overweight and obese patients who were attending weight loss programs. Participants were 386 overweight and obese patients admitted in two medical centers specializing in the treatment of obesity. All the patients were administered the WBIS, and measures of binge eating, depression, self-esteem, and body dissatisfaction. Confirmatory factor analysis failed to confirm the fit of the original 11-item unidimensional model. Item analysis and exploratory factor analysis indicated that 9 items included in the original measure (the items 1 and 9 were excluded because low item-total correlations) formed a reliable unidimensional measure of internalized weight bias (WBIS-9). The WBIS-9 was significantly correlated with convergent measures and was able to categorize individuals with different severity levels of depression (sensitivity of 0.72 and specificity of 0.70). The WBIS-9 may be useful in clinical practice to discriminate patients with more severe psychopathology, comorbid disordered eating patterns, and risk for poor outcomes.

To examine associations between perceived weight discrimination and changes in weight, waist circumference, and weight status.Data were from 2944 men and women aged ≥50 years participating in the English Longitudinal Study of Ageing. Experiences of weight discrimination were reported in 2010-2011 and weight and waist circumference were objectively measured in 2008-2009 and 2012-2013. ANCOVAs were used to test associations between perceived weight discrimination and changes in weight and waist circumference. Logistic regression was used to test associations with changes in weight status. All analyses adjusted for baseline BMI, age, sex, and wealth.Perceived weight discrimination was associated with relative increases in weight (+1.66 kg, P65<650.001) and waist circumference (+1.12 cm, P65=650.046). There was also a significant association with odds of becoming obese over the follow-up period (OR65=656.67, 95% CI 1.85-24.04) but odds of remaining obese did not differ according to experiences of weight discrimination (OR65=651.09, 95% CI 0.46-2.59).Our results indicate that rather than encouraging people to lose weight, weight discrimination promotes weight gain and the onset of obesity. Implementing effective interventions to combat weight stigma and discrimination at the population level could reduce the burden of obesity.

Anxiety, depression and eating disorders show peak emergence during adolescence and share common risk factors. School-based prevention programs provide a unique opportunity to access a broad spectrum of the population during a key developmental window, but to date, no program targets all three conditions concurrently. Mindfulness has shown promising early results across each of these psychopathologies in a small number of controlled trials in schools, and therefore this study investigated its use in a randomised controlled design targeting anxiety, depression and eating disorder risk factors together for the first time. Students ( M age 13.63; SD =.43) from a broad band of socioeconomic demographics received the eight lesson, once weekly.b (“Dot be”) mindfulness in schools curriculum ( N =132) or normal lessons ( N =176). Anxiety, depression, weight/shape concerns and wellbeing were the primary outcome factors. Although acceptability measures were high, no significant improvements were found on any outcome at post-intervention or 3-month follow-up. Adjusted mean differences between groups at post-intervention were .03 (95% CI:61.06 to 61.11) for depression, .01 (61.07 to 61.09) for anxiety, .02 (61.05 to 61.08) for weight/shape concerns, and .06 (61.08 to 61.21) for wellbeing. Anxiety was higher in the mindfulness than the control group at follow-up for males, and those of both genders with low baseline levels of weight/shape concerns or depression. Factors that may be important to address for effective dissemination of mindfulness-based interventions in schools are discussed. Further research is required to identify active ingredients and optimal dose in mindfulness-based interventions in school settings.

ABSTRACT Considerable attention has been given to the behaviors that need to be changed in individuals who are overweight and obese. Much less attention has been given to the behaviors that need to be changed in health care professionals who treat these individuals. Specifically, health care professionals, similar to the general population, have been shown to engage in weight-based discrimination. The impact this may have on patients is discussed.

Background. School performance of overweight children has been found to be inferior to normal weight children; however, the reason(s) for this link between overweight and academic performance remain unclear. Psychosocial factors, such as weight-based teasing, have been proposed as having a possible mediating role, although they remain largely unexplored. Methods. Random parental telephone surve...

Mindfulness based therapies (MBTs) for eating disorders show potential benefit for outcomes yet evidence is scarce regarding the mechanisms by which they influence remission from symptoms. One way that mindfulness approaches create positive outcomes is through enhancement of emotion regulation skills. Maladaptive emotion regulation is a key psychological feature of all eating disorders. The aim of the current study was to identify facets of emotion regulation involved in the relationship between mindfulness and maladaptive eating behaviours. In three cross-sectional studies, clinical (n=39) and non-clinical (n=137 and 119) female participants completed: 1) the Eating Disorder Inventory (EDI) eating specific scales (drive-for-thinness and bulimia) and the EDI psychological symptom scales (emotion dysregulation and interoceptive deficits); and 2) mindfulness, impulsivity, and emotion regulation questionnaires. In all samples mindfulness was significantly and inversely associated with EDI eating and psychological symptom scales, and impulsivity. In non-clinical samples interoceptive deficits mediated the relationship between mindfulness and EDI eating specific scales. Non-acceptance of emotional experience, a facet of interoceptive awareness, mediated the relationship between mindfulness and eating specific EDI scores. Further investigations could verify relationships identified so that mindfulness based approaches can be optimised to enhance emotion regulation skills in sufferers, and those at-risk, of eating disorders.

Abstract Although the stigma of obesity in our society is well documented, the measurement of antifat attitudes has been a difficult undertaking. Two studies were conducted to construct and validate the Antifat Attitudes Test (AFAT). In study 1, college students (110 men and 175 women) completed the preliminary 54-item AFAT and specific indices of body image and weight-related concerns. Psychometric and factor analysis revealed a 47-item composite scale and three internally consistent factors that were uncorrelated with social desirability: Social/Character Disparagement, Physical/Romantic Unattractiveness, and Weight Control/Blame. Several body images correlates of antifat prejudice were identified, and men expressed more negative attitudes than women. Study 2 experimentally examined the effects of information about the controllability of weight on the antifat attitudes of 120 participants. Exposure to information on behavioral vs. biogenetic control led to greater blame of persons who are fat for their body size. The implications of the findings and the potential utility of the AFAT are discussed.

Exercise-based videogames, or exergames, provide a promising and novel way to improve exercise attitudes and behavior among overweight children. These digital interventions often allow for customizations of player characters and weave in narratives and goals. Theoretically, the presence of visual identity cues (e.g., avatars) and social category cues (e.g., stereotypes) within the virtual gaming environment are likely to motivate a player's exercise attitudes and behavior in various ways. This study examined the effects of both visual cues (via the Proteus effect) and social cues (via stereotype threat) on overweight children's exercise attitudes and game performance in a virtual running game.A 2 (avatar body size: Normal versus overweight) 2 (stereotype threat: Present versus absent) factorial design experiment was conducted with 140 overweight children between 9 to 12 years of age. Dependent variables measured were participants' exercise attitudes, exercise motivation, exercise motivation with regard to the Nintendo(庐) (Kyoto, Japan) Wii , and their in-game performance.Multivariate analysis of covariance tests showed that overweight children assigned to avatars of normal body size scored significantly better on all four variables compared with those assigned to avatars of large body size, whereas overweight children assigned to a stereotype threat absent condition scored significantly better on three of the four variables compared with those assigned to a stereotype threat present condition.Using avatars with normal body size and not being subjected to stereotypical messages has the potential to increase the effectiveness of exergames among overweight children. Exergame developers should consider designing avatars that are slim and toned and set "weight neutral" goals and challenges. These may provide more motivation and yield greater attitudinal and behavioral changes among overweight children.

Abstract BACKGROUND: Obesity is a growing epidemic. Weight control interventions can achieve weight loss, but most is regained over time. Stigma and low quality of life are significant problems that are rarely targeted. PURPOSE: A new model aimed at reducing avoidant behavior and increasing psychological flexibility, has shown to be relevant in the treatment of other chronic health problems and is worth examining for improving the lives of obese persons. METHODS: Patients who had completed at least 6 months of a weight loss program (N = 84) were randomly assigned to receive a 1-day, mindfulness and acceptance-based workshop targeting obesity-related stigma and psychological distress or be placed on a waiting list. RESULTS: At a 3-month follow-up, workshop participants showed greater improvements in obesity-related stigma, quality of life, psychological distress, and body mass, as well as improvements in distress tolerance, and both general and weight-specific acceptance and psychological flexibility. Effects on distress, stigma, and quality of life were above and beyond the effects due to improved weight control. Mediational analyses indicated that changes in weight-specific acceptance coping and psychological flexibility mediated changes in outcomes. CONCLUSION: Results provide preliminary support for the role of acceptance and mindfulness in improving the quality of life of obese individuals while simultaneously augmenting their weight control efforts.

ABSTRACT The authors theorized that overweight individuals experience social identity threat in situations that activate concerns about weight stigma, causing them to experience increased stress and reduced self-control. To test these predictions, women who varied in body mass index (BMI) gave a speech on why they would make a good dating partner. Half thought they were videotaped (weight visible); the remainder thought they were audiotaped (weight not visible). As predicted, higher BMI was associated with increased blood pressure and poorer performance on a measure of executive control when weight was visible and concerns about stigma were activated but not when weight was not visible. Compared to average weight women, overweight women also reported more stress-related emotions when videotaped versus audiotaped. Findings suggest that weight stigma can be detrimental to mental and physical health and deplete self-regulatory resources necessary for weight control.

Abstract Anti-fat sentiment is increasing, is prevalent in health professionals, and has health and social consequences. There is no evidence for effective obesity prejudice reduction techniques in health professionals. The present experiment sought to reduce implicit and explicit anti-fat prejudice in preservice health students. Health promotion/public health bachelor degree program students ( n = 159) were randomized to one of three tutorial conditions. One condition presented an obesity curriculum on the controllable reasons for obesity (i.e., diet/exercise). A prejudice reduction condition presented evidence on the uncontrollable reasons for obesity (i.e., genes/environment); whereas a neutral (control) curriculum focused on alcohol use in young people. Measures of implicit and explicit anti-fat prejudice, beliefs about obese people, and dieting, were taken at baseline and postintervention. Repeated measures analyses showed decreases in two forms of implicit anti-fat prejudice (decreases of 27 and 12%) in the genes/environment condition relative to other conditions. The diet/exercise condition showed a 27% increase in one measure of implicit anti-fat prejudice. Reductions in explicit anti-fat prejudice were also seen in the genes/environment condition ( P = 0.006). No significant changes in beliefs about obese people or dieting control beliefs were found across conditions. The present results show that anti-fat prejudice can be reduced or exacerbated depending on the causal information provided about obesity. The present results have implications for the training of health professionals, especially given their widespread negativity toward overweight and obesity.

Abstract PURPOSE: To assess the association among parent and peer weight-related teasing, emotional eating, and weight control behaviors in minority girls. METHODS: 141 Hispanic and African American preadolescent girls (mean age = 11.1 years, SD = 1.5 years) participated. Most of the participants were of Hispanic origin, had a bicultural orientation, and were obese. Participants completed surveys assessing weight-related teasing, emotional eating, weight control behaviors, demographic, and acculturation characteristics. Body weight and height were also assessed. Hierarchical regression analyses were run to determine the associations among study variables. RESULTS: Fifty-nine percent of participants reported being weight-related teased by peers and 42% participants reported weight-related teasing by parents. Weight-related teasing by parent was associated with emotional eating and binge eating, whereas peer weight-related teasing was only associated with emotional eating. CONCLUSIONS: Findings demonstrated the differential association of weight-related teasing from peers and parents to emotional and binge eating in minority girls. 2013.

Objective While evidence regarding associations between weight stigma and biopsychosocial outcomes is accumulating, outcomes are considered in isolation. Thus, little is known about their complex relationships. This article extends existing work by systematically reviewing the biopsychosocial consequences of stigma in adults with overweight/obesity. Methods Articles were identified through Medline, CINAHL, PsycINFO, Embase, Web of Science, and Cochrane databases. Independent extraction of articles was conducted using predefined data fields, including data on biopsychosocial correlates in each study. Results Twenty-three studies published from 2001 and addressing correlates of stigma in adults with overweight/obesity (body mass index 25 kg m 2; 18-65 years) were identified. Numerous biopsychosocial correlates of weight stigma were studied, particularly in treatment-seeking individuals. Available research shows that weight stigma is consistently associated with medication non-adherence, mental health, anxiety, perceived stress, antisocial behavior, substance use, coping strategies, and social support. Biopsychosocial correlates were not considered in combination in research. Psychological correlates were well documented in comparison to biological and social correlates for each weight stigma type. There were some indications that associations are stronger once stigma is internalized. Conclusions While there is evidence for biopsychosocial correlates of weight stigma, these are not considered in combination in research; thus their inter-relationships are unknown. Conclusions from the review are limited by this and the small number of studies, types of designs, and variables considered.

The stigma of obesity is a common and overt social bias. Negative attitudes and derogatory humor about overweight/obese individuals are commonplace among health care providers and medical students. As such, medical school may be particularly threatening for students who are overweight or obese.The purpose of our study was to assess the frequency that obese/overweight students report being stigmatized, the degree to which stigma is internalized, and the impact of these factors on their well-being.We performed cross-sectional analysis of data from the Medical Student Cognitive Habits and Growth Evaluation Study (CHANGES) survey.A total of 4,687 first-year medical students (1,146 overweight/obese) from a stratified random sample of 49 medical schools participated in the study.Implicit and explicit self-stigma were measured with the Implicit Association Test and Anti-Fat Attitudes Questionnaire. Overall health, anxiety, depression, fatigue, self-esteem, sense of mastery, social support, loneliness, and use of alcohol/drugs to cope with stress were measured using previously validated scales.Among obese and overweight students, perceived stigma was associated with each measured component of well-being, including anxiety (beta coefficient [b] = 0.18; standard error [SE]-= 0.03; p < 0.001) and depression (b = 0.20; SE = 0.03; p < 0.001). Among the subscales of the explicit self-stigma measure, dislike of obese people was associated with several factors, including depression (b = 0.07; SE = .01; p < 0.001), a lower sense of mastery (b = -0.10; SE = 0.02; p < 0.001), and greater likelihood of using drugs or alcohol to cope with stress (b = .05; SE = 0.01; p < 0.001). Fear of becoming fat was associated with each measured component of well-being, including lower body esteem (b = -0.25; SE = 0.01; p < 0.001) and less social support (b = -0.06; SE = 0.01; p < 0.001). Implicit self-stigma was not consistently associated with well-being factors. Compared to normal-weight/underweight peers, overweight/obese medical students had worse overall health (b = -0.33; SE = 0.03; p < 0.001) and body esteem (b = -0.70; SE = 0.02; p < 0.001), and overweight/obese female students reported less social support (b = -0.12; SE = 0.03; p < 0.001) and more loneliness (b = 0.22; SE = 0.04; p < 0.001).Perceived and internalized weight stigma may contribute to worse well-being among overweight/obese medical students.

Abstract The objective of this study was to critically review the empirical evidence from all relevant disciplines regarding obesity stigma in order to (i) determine the implications of obesity stigma for healthcare providers and their patients with obesity and (ii) identify strategies to improve care for patients with obesity. We conducted a search of Medline and PsychInfo for all peer-reviewed papers presenting original empirical data relevant to stigma, bias, discrimination, prejudice and medical care. We then performed a narrative review of the existing empirical evidence regarding the impact of obesity stigma and weight bias for healthcare quality and outcomes. Many healthcare providers hold strong negative attitudes and stereotypes about people with obesity. There is considerable evidence that such attitudes influence person-perceptions, judgment, interpersonal behaviour and decision-making. These attitudes may impact the care they provide. Experiences of or expectations for poor treatment may cause stress and avoidance of care, mistrust of doctors and poor adherence among patients with obesity. Stigma can reduce the quality of care for patients with obesity despite the best intentions of healthcare providers to provide high-quality care. There are several potential intervention strategies that may reduce the impact of obesity stigma on quality of care. 2015 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of International Association for the Study of Obesity (IASO).

This paper considers effects of body mass on wages in the years following labor market entry. The preferred models allow current wages to be affected by both past and current body mass, as well as past wages, while also addressing the endogeneity of body mass. I find that a history of severe obesity has a large negative effect on the wages of white men. White women face a penalty for a history of being overweight, with additional penalties for both past and current BMI that begin above the threshold for severe obesity. Furthermore, the effects of past wages on current wages imply that past body mass has additional, indirect effects on wages, especially for white women.

Abstract Obesity is one of the leading causes of preventable diseases and disability worldwide, and depression is among the leading causes of burden of disease. Both disorders are increasingly prevalent and comorbid. This comorbidity compounds associated health. While there is consistent evidence of a bidirectional obesity depression relationship, little is known about the biopsychosocial variables associated with this relationship. A systematic review was undertaken to identify variables associated with the relationship between obesity (Body mass index090009>09000930090009kg090009m(-2) ) and depression. Forty-six studies were identified. Obesity, educational attainment, body image, binge eating, physical health, psychological characteristics and interpersonal effectiveness were consistently associated with the relationship between obesity and depression. The current review identified potential biopsychosocial variables associated with the relationship between obesity and depression. This knowledge can inform future research examining moderators, mediators and mechanisms of the relationship between obesity and depression. Improved understanding of this relationship will inform identification, prevention and intervention efforts. 0008 2013 The Authors. obesity reviews 0008 2013 International Association for the Study of Obesity.

This article provides an update of scientific evidence on weight bias toward overweight and obese adults through a systematic review of published literature since 2001. The review expands on previous findings of weight bias in major domains of living, documents new areas where weight bias has been studied, and highlights research questions that need to be addressed to advance this field of stud...

Stigma and discrimination toward obese persons are pervasive and pose numerous consequences for their psychological and physical health. Despite decades of science documenting weight stigma, its public health implications are widely ignored. Instead, obese persons are blamed for their weight, with common perceptions that weight stigmatization is justifiable and may motivate individuals to adopt healthier behaviors. We examine evidence to address these assumptions and discuss their public health implications. On the basis of current findings, we propose that weight stigma is not a beneficial public health tool for reducing obesity. Rather, stigmatization of obese individuals threatens health, generates health disparities, and interferes with effective obesity intervention efforts. These findings highlight weight stigma as both a social justice issue and a priority for public health.

Despite decades of research documenting consistent stigma and discrimination against individuals with obesity, weight stigma is rarely considered in obesity prevention and treatment efforts. In recent years, evidence has examined weight stigmatization as a unique contributor to negative health outcomes and behaviors that can promote and exacerbate obesity. This review summarizes findings from published studies within the past 4 years examining the relationship between weight stigma and maladaptive eating behaviors (binge eating and increased food consumption), physical activity, weight status (weight gain and loss and development of obesity), and physiological stress responses. Research evaluating the effects of weight stigma present in obesity-related public health campaigns is also highlighted. Evidence collectively demonstrates negative implications of stigmatization for weight-related health correlates and behaviors and suggests that addressing weight stigma in obesity prevention and treatment is warranted. Key questions for future research to further delineate the health effects of weight stigmatization are summarized.

Objective. We investigated the long-term effect of weight teasing during childhood.Methods. Young adult women (n = 1533; aged 18-26 years) from 3 large universities participated in a survey (Fall 2009 to Spring 2010) that assessed disturbed eating behaviors; weight status at ages 6, 12, and 16 years; and weight-teasing history.Results. Nearly half of the participants were weight-teased as a child. Participants who experienced childhood weight teasing were significantly more likely to have disturbed eating behaviors now than non-weight-teased peers. As the variety of weight teasing insults recalled increased, so did disturbed eating behaviors and current body mass index. Those who recalled their weight at ages 6, 12, or 16 years as being heavier than average endured weight teasing significantly more frequently and felt greater distress than their lighter counterparts.Conclusions. Weight teasing may contribute to the development of disturbed eating and eating disorders in young women. Health care professionals, parents, teachers, and other childcare givers must help shift social norms to make weight teasing as unacceptable as other types of bullying. To protect the health of children, efforts to make weight teasing unacceptable are warranted.

Background The objective of this study was to identify 10-year longitudinal predictors of overweight incidence during the transition from adolescence to young adulthood. Methods Data were from Project EAT (Eating and Activity in Teens and Young Adults). A diverse, population-based cohort (N???=???2,134) completed baseline surveys in 1998???1999 (mean age???=???15.0??1.6, ???adolescence???) and follow-up surveys in 2008???2009 (mean age???=???25.4??1.7, ???young adulthood???). Surveys assessed personal, behavioral and socio-environmental factors hypothesized to be of relevance to obesity, in addition to height and weight. Multivariable logistic regression was used to estimate the adjusted odds for each personal, behavioral and socio-environmental factor at baseline, and 10-year changes for these factors, among non-overweight adolescents (n???=???1,643) being predictive of the incidence of overweight (BMI?????????25) at 10-year follow-up. Results At 10-year follow-up, 51% of young adults were overweight (26% increase from baseline). Among females and males, higher levels of body dissatisfaction, weight concerns, unhealthy weight control behaviors (e.g., fasting, purging), dieting, binge eating, weight-related teasing, and parental weight-related concerns and behaviors during adolescence and/or increases in these factors over the study period predicted the incidence of overweight at 10-year follow-up. Females with higher levels of whole grain intake and breakfast and dinner consumption frequency during adolescence were protected against becoming overweight. Among males, increases in vegetable intake protected against the incidence of overweight 10 years later. Conclusions Findings suggest that obesity prevention interventions for adolescents should address weight-specific factors from within the domains of personal, behavioral, and socio-environmental factors such as promoting positive body image, decreasing unhealthy weight control behaviors, and limiting negative weight talk.

The authors provide a definition of positive psychology and suggest that psychologists should try to cultivate a more appreciative perspective on human nature. Examples are given of a negative bias that seems to pervade much of theoretical psychology, which may limit psychologists' understanding of typical and successful human functioning. Finally, a preview of the articles in the special section is given.

Do positive psychology interventions-that is, treatment methods or intentional activities aimed at cultivating positive feelings, positive behaviors, or positive cognitions-enhance well-being and ameliorate depressive symptoms? A meta-analysis of 51 such interventions with 4,266 individuals was conducted to address this question and to provide practical guidance to clinicians. The results revealed that positive psychology interventions do indeed significantly enhance well-being (mean r=.29) and decrease depressive symptoms (mean r=.31). In addition, several factors were found to impact the effectiveness of positive psychology interventions, including the depression status, self-selection, and age of participants, as well as the format and duration of the interventions. Accordingly, clinicians should be encouraged to incorporate positive psychology techniques into their clinical work, particularly for treating clients who are depressed, relatively older, or highly motivated to improve. Our findings alsosuggest that clinicians would do well to deliver positive psychology interventions as individual (versus group) therapy and for relatively longer periods of time.

Perceived weight discrimination has been linked to health outcomes, including risk of obesity. Less is known about how discrimination is associated with intermediate physiological markers of health, such as systemic inflammation. This research examined the association between weight discrimination and C‐reactive protein (CRP) and whether it varied by participants' body mass index (BMI).

Background: Weight bias is an important clinical issue that the educators of tomorrow's healthcare professionals cannot afford to ignore. This study, therefore, aimed to pilot a randomized controlled trial of the effects of educational films designed to reduce weight stigmatization toward obese patients on trainee dietitians' and doctors' attitudes. Methods: A pre-post experimental design with a 6-week follow-up, which consisted of an intervention group (n = 22) and a control group (n = 21), was conducted to assess the efficacy of brief anti-stigma films in reducing weight bias, and to test whether future, larger-scale studies among trainee healthcare professionals are feasible. Results: Participants at baseline demonstrated weight bias, on both implicit and explicit attitude measures, as well as strong beliefs that obesity is under a person's control. The intervention films significantly improved explicit attitudes and beliefs toward obese people, and participant evaluation was very positive. The intervention did not significantly improve implicit anti-fat bias. Conclusion: The current study suggests both that it is possible to conduct a substantive trial of the effects of educational films designed to reduce weight stigma on a larger cohort of trainee healthcare professionals, and that brief educational interventions may be effective in reducing stigmatizing attitudes in this population. Copyright (C) 2013 S. Karger GmbH, Freiburg

Abstract Weight stigma is highly pervasive, but its consequences are understudied. This review draws from theory in social psychology, health psychology, and neuroendocrinology to construct an original, generative model called the cyclic obesity/weight-based stigma (COBWEBS) model. This model characterizes weight stigma as a "vicious cycle" - a positive feedback loop wherein weight stigma begets weight gain. This happens through increased eating behavior and increased cortisol secretion governed by behavioral, emotional, and physiological mechanisms, which are theorized to ultimately result in weight gain and difficulty of weight loss. The purpose of this review is to evaluate the existing literature for evidence supporting such a model, propose ways in which individuals enter, fight against, and exit the cycle, and conclude by outlining fruitful future directions in this nascent yet important area of research. Copyright 2014 Elsevier Ltd. All rights reserved.

Abstract Experiences with weight stigma negatively impact both psychological outcomes (e.g., body dissatisfaction, depression) and behavioral outcomes (e.g., dieting, exercise). However, not everyone is equally affected by experiences with weight stigma. This study examined whether internalized societal attitudes about weight moderated the impact of weight stigma. Adult participants (n = 111) completed measures of experiences with weight stigma, as well as two indexes of internalized societal attitudes (the moderators): Internalized anti-fat attitudes and internalization of societal standards of attractiveness. Psychological outcomes included self-esteem, body dissatisfaction, drive for thinness, and bulimic symptoms; behavioral outcomes included avoidance of exercise and self-reported exercise behavior. Weight stigma was positively correlated with body dissatisfaction, drive for thinness, and bulimic symptoms, and was negatively correlated with state and trait self-esteem. Both indexes of internalized attitudes moderated the association between weight stigma and avoidance of exercise: Individuals high in anti-fat attitudes and high in internalization of societal standards of attractiveness were more motivated to avoid exercise if they also experienced a high degree of weight stigma; individuals low in anti-fat attitudes and low in internalization were relatively unaffected. Avoidance of exercise was negatively correlated with self-reported strenuous exercise. These findings suggest that weight stigma can negatively influence motivation to exercise, particularly among individuals who have internalized societal attitudes about weight. Reducing internalization might be a means of minimizing the negative impact of weight stigma and of facilitating healthy weight management efforts.

Weight stigma is a pervasive social problem, and this paper reviews the evidence linking weight stigma to eating behavior. Correlational studies consistently find that experiences with weight stigma are associated with unhealthy eating behaviors and eating pathology (such as binge eating, skipping meals), although results vary somewhat depending on the sample being studied and the specific stigma/eating constructs being assessed. Experimental studies consistently find that manipulations such as priming overweight stereotypes, exposure to stigmatizing content, and social exclusion all lead to increased food intake, but whether or not those manipulations capture the impact of weight stigma experiences per se is less clear. Finally, studies of stigma experiences in daily life show that more frequent stigma experiences are associated with decreased motivation to diet and with less healthy eating behaviors. Overall, this research highlights the potential for weight stigma to negatively impact individuals' eating behavior, which in turn could have consequences for their overall health and well-being.

This paper provides an overview of the evidence on the current epidemic of obesity in the United States. The prevalence of overweight and obesity now exceeds 60% among US adults, and the rate is rapidly increasing among children and adolescents. Dismal medical, social, and economic consequences are already apparent and likely to worsen without multipronged intervention. Increased rates of hypertension, diabetes, and dyslipidemia, among other medical conditions, threaten to shorten the longevity of the American populace by as much as 5 years. The incidence of depression is increasing and experts suggest this is linked with the increased prevalence of obesity. The cost of obesity-related medical care has increased astronomically since 1987, in addition to lost productivity and income. Novel multidisciplinary, preventive, and therapeutic approaches, and social changes are needed that address the complex interplay of biologic, genetic, and social factors that have created the current obesity epidemic.