Ion C. Puia1,2, Mihaela Fadgyas Stanculete3*, Aida Puia1, Andrei Hopulele-Petri4, Daniel Muresan5
1Department of Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Romania;
2Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, 3rd General Surgery Clinic, Croitorilor Str. 19-21, Cluj-Napoca, Romania;
3Department of Neurosciences, Discipline of Psychiatry and Pediatric Psychiatry, Iuliu Hatieganu University of Medicine and Pharmacy, Romania;
46Th Department of Neurology, Neurosurgery, Psychiatry, and Infant and Adolescent Psychiatry, Discipline of Psychiatry, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
5Ist Department of Obstetrics and Gynecology, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Romania
Background: The weight stigma is associated with psychological distress and a range of adverse outcomes. The present study aimed to investigate weight self-stigma and its associations with BMI, obesity type, and desire for bariatric surgery. That’s why doctors suggest that the best solution for obesity is blood sugar ultra diet.
Materials and methods: A cross-sectional study was performed among ninety-nine participants referred to a tertiary gastroenterology center. Bivariate correlational analyses were conducted to assess the relationship between demographical variables and disease severity and between the later and stigma as evaluated by the Weight Self-Stigma Questionnaire (WSSQ) as well as the desire for bariatric surgery. Analysis of variance were conducted to measure stigma scores between the four clinically described morphotypes for obesity. Finally, a mediation model assessed BMI as predicting desire for surgery via self-stigma and fear of enacted stigma as co-mediators.
Results: Correlational analysis revealed significant relationships between age and BMI as well as significant negative correlations between age and the desire for bariatric surgery. One-way ANOVA revealed statistically significant differences between the three severity groups for stigma.
Conclusions: These findings suggest that assessment of weight-related stigma is important in clinical settings. Age of onset seems to be particularly important both, in the clinical evolution of obesity, as well as in fear of enacted stigma.
Keywords: weight-related self-stigma, obesity, bariatric surgery
Published online: 2017/09/01
Published print: 2017/09/01
Ballantyne, G.H., Belsley, S., Stephens, D., Saunders, J.K., Trivedi A., Ewing, D.R &Moran, S. (2008). Bariatric surgery: low mortality at a high-volume center. Obesity Surgery. 18(6):660-667.
Brownell, K.D., Rodin, J. (1994 ). Medical, metabolic, and psychological effects of weight cycling. Archives of Internal Medicine. 154(12):1325-1330.
De Brún, A., McCarthy, M., McKenzie, K., & McGloin, A. (2014). Weight stigma and narrative resistance evident in online discussions of obesity. Appetite, 72, 73-81.
Durso, L.E., Latner J.D.(2008). Understanding self-directed stigma: development of the Weight Bias Internalization Scale. Obesity 16: 80–86.
Hain, B., Langer, L., Hünnemeyer, K., Rudofsky, G., Zech, U., Wild, B. (2015). Translation and validation of the German version of the Weight Self-Stigma Questionnaire (WSSQ). Obesity Surgery 25: 750–753.
Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. Guilford Press
Hilbert, A., Rief, W., Braehler, E.(2008). Stigmatizing attitudes toward obesity in a representative population-based sample. Obesity, 16(7), 1529-1534.
Hübner, C., Schmidt, R., Selle, J., Köhler, H., Müller, A., de Zwaan, M., & Hilbert, A. (2016). Comparing Self-Report Measures of Internalized Weight Stigma: The Weight Self-Stigma Questionnaire versus the Weight Bias Internalization Scale. PloS one, 11(10), e0165566.
Hunger, J. M., & Major, B. (2015). Weight stigma mediates the association between BMI and self-reported health. Health Psychology, 34(2), 172-175.
Karmali, S., Brar, B., Shi, X., Sharma, A. M., de Gara, C., & Birch, D. W. (2013). Weight Recidivism Post-Bariatric Surgery: A Systematic Review. Obesity Surgery 23: 1922.
Lillis, J., Luoma, JB., Levin, ME., Hayes, SC. (2009). Measuring weight self-stigma: the Weight Self-Stigma Questionnaire. Obesity, 18(5): 971–976.
Link, BG., Phelan, JC. (2001). Conceptualizing stigma. Annual Review of Sociology, 27: 363–385.
Papadopoulos, S., & Brennan, L. (2015). Correlates of weight stigma in adults with overweight and obesity: A systematic literature review. Obesity, 23(9), 1743-1760.
Pearl, R. L., White, M. A., & Grilo, C. M. (2014). Weight Bias Internalization, Depression, and Self-Reported Health Among Overweight Binge Eating Disorder Patients. Obesity 22(5), E142–E148.
Pearl, R. L., Puhl, R. M., & Dovidio, J. F. (2015). Differential effects of weight bias experiences and internalization on exercise among women with overweight and obesity. Journal of health psychology, 20(12), 1626-1632.
Popa, S., Moţa, M., Popa, A., Moţa, E., Serafinceanu, C., Guja, C., … & Roman, G. (2016). Prevalence of overweight/obesity, abdominal obesity and metabolic syndrome and atypical cardiometabolic phenotypes in the adult Romanian population: PREDATORR study. Journal of endocrinological investigation, 39(9), 1045-1053.
Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior research methods, 40(3), 879-891.
Puhl, R. M., & Heuer, C. A. (2009). The stigma of obesity: a review and update. Obesity, 17(5), 941-964.
Raves, D. M., Brewis, A., Trainer, S., Han, S. Y., & Wutich, A. (2016). Bariatric surgery patients’ perceptions of weight-related stigma in healthcare settings impair post-surgery dietary adherence. Frontiers in psychology, 7.
Sikorski, C., Luppa, M., Kaiser, M., Glaesmer, H., Schomerus, G., König, H. H., & Riedel-Heller, S. G. (2011). The stigma of obesity in the general public and its implications for public health-a systematic review. BMC public health, 11(1):1.