Internalized Shame in Treatment-Seeking Adults with Obesity Class II-III and Its Association with Quality of Life, Body Image, and Self-Esteem.

IF 4.7 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Obesity Facts Pub Date : 2025-01-01 Epub Date: 2025-02-05 DOI:10.1159/000543448

Marcus Lagerström, Per Johnsson, Bengt Orrenius, Kajsa Järvholm, Torsten Olbers, My Engström

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Abstract

Introduction: Health-related quality of life (HRQoL) may be impaired in individuals living with obesity, possibly due to exposure to obesity-related stigma which may in turn activate shame. Few studies have been conducted on shame in relation to obesity and its potential association with other constructs such as HRQoL, self-esteem, and body image. In this study, internalized shame and the potential association with HRQoL, self-esteem, and body image were investigated in treatment-seeking patients with obesity class II-III.

Methods: In total, 228 patients referred for obesity treatment at a tertiary clinic in Sweden participated in the study. The cohort was stratified into two groups using a clinical cutoff (≥50) indicating pathological levels of shame as reported on the Internalized Shame Scale (ISS): a high shame group (HSG) and low shame group (LSG).

Results: The mean ISS score for the overall cohort was 41.6, with a mean of 28.1 for the LSG and 66.5 for the HSG. Compared to the LSG, the HSG reported a lower quality of life in seven of eight HRQoL domains as well as a lower obesity-specific health-related quality of life. Furthermore, a higher shame score was associated with poorer body image and lower self-esteem.

Conclusion: Taken together, these findings indicate that a substantial number of patients with obesity report high internalized shame and that these individuals could benefit from extra support in treatment settings.

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寻求治疗的 II-III 级肥胖成人的内化羞耻感及其与生活质量、身体形象和自尊的关系。

肥胖症患者的健康相关生活质量（HRQoL）可能受损，这可能是由于暴露于与肥胖相关的耻辱感，而耻辱感反过来又可能激活耻辱感。很少有研究是关于羞耻感与肥胖的关系，以及羞耻感与其他结构（如HRQoL、自尊和身体形象）的潜在联系。本研究调查了II-III级肥胖求诊患者的内化羞耻感及其与HRQoL、自尊和身体形象的潜在关联。方法：共有228名在瑞典三级诊所接受肥胖治疗的患者参与了这项研究。根据内化羞耻感量表（ISS）报告的羞耻感病理水平的临床临界值（≥50），将该队列分为两组：高羞耻感组（HSG）和低羞耻感组（LSG）。结果：整个队列的ISS平均评分为41.6，其中LSG的平均评分为28.1，HSG的平均评分为66.5。与LSG相比，HSG在8个HRQoL领域中的7个领域的生活质量较低，并且肥胖相关的健康相关生活质量较低。此外，较高的羞耻感得分与较差的身体形象和较低的自尊有关。综上所述，这些发现表明，相当多的肥胖患者报告了高度的内化羞耻感，这些人可以从治疗环境中的额外支持中受益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Obesity Facts 医学-内分泌学与代谢

CiteScore

6.80

自引率

5.60%

发文量

审稿时长

6-12 weeks

期刊介绍： ''Obesity Facts'' publishes articles covering all aspects of obesity, in particular epidemiology, etiology and pathogenesis, treatment, and the prevention of adiposity. As obesity is related to many disease processes, the journal is also dedicated to all topics pertaining to comorbidity and covers psychological and sociocultural aspects as well as influences of nutrition and exercise on body weight. The editors carefully select papers to present only the most recent findings in clinical practice and research. All professionals concerned with obesity issues will find this journal a most valuable update to keep them abreast of the latest scientific developments.