Exploring the relationships among weight stigma, weight bias internalisation, feeling fat, and self-esteem across preconception, pregnancy, and postpartum.
Michelle Dever, Angela C Incollingo Rodriguez, Helen Skouteris, Briony Hill
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引用次数: 0
Abstract
Introduction: Weight stigma permeates women's reproductive experiences with significant psychological consequences, yet remains understudied across different reproductive stages and country contexts. This study addresses this gap by investigating weight stigma experiences and their associations with weight bias internalisation (WBI), feeling fat, and self-esteem across preconception, pregnancy, and postpartum (PPP) stages in Western and non-Western contexts.
Methods: In this cross-sectional study, a convenience sample of women aged 18-45 years from five countries completed an anonymous online survey assessing weight stigma experiences, WBI, feeling fat, and self-esteem. For exploratory comparison, countries were grouped into Western (Australia, United Kingdom, United States) and non-Western (Singapore, Philippines) contexts. Hierarchical regressions and mediation analyses examined relationships between variables.
Results: In total, 511 women completed the survey (preconception n = 216, pregnant n = 125, postpartum n = 170). Overall, 62.6% of women reported experiencing weight stigma, with sources varying by PPP stage. Weight stigma from the media was most prevalent during preconception, workplace during pregnancy, and family in postpartum. Women residing in Western countries reported more healthcare-related stigma (p = .01), while non-Western women reported more stigma from friends (p < .001) and workplace (p = .001). Weight bias internalisation, feeling fat, and self-esteem levels were similar across countries. Weight bias internalisation consistently mediated the relationship between weight stigma experiences and both feeling fat and self-esteem across all PPP stages; weight stigma promoted greater WBI, which in turn promoted higher scores on feeling fat and lower scores on self-esteem.
Conclusion: While sources of weight stigma differed by reproductive stage and between Western and non-Western contexts, WBI consistently mediated how these experiences related to both feeling fat and self-esteem. Interventions should target stage-specific stigma sources while addressing WBI as a key mediating mechanism to improve health and wellbeing outcomes for PPP women.
体重耻辱感渗透到妇女的生殖经历中，具有显著的心理后果，但在不同的生殖阶段和国家背景下仍未得到充分研究。本研究通过调查西方和非西方背景下孕前、怀孕和产后（PPP）阶段的体重耻辱经历及其与体重偏见内化（WBI）、感觉肥胖和自尊的关系，解决了这一差距。方法：在这项横断面研究中，来自五个国家的18-45岁的方便女性样本完成了一项匿名在线调查，评估体重耻辱经历、WBI、感觉肥胖和自尊。为了进行探索性比较，将国家分为西方国家（澳大利亚、英国、美国）和非西方国家（新加坡、菲律宾）。层次回归和中介分析检验了变量之间的关系。结果：共511例妇女完成调查（孕前216例，孕期125例，产后170例）。总体而言，62.6%的女性报告称经历过体重耻辱感，其来源因PPP阶段而异。媒体对体重的耻辱感在孕前、孕期工作场所和产后家庭中最为普遍。居住在西方国家的妇女报告了更多与医疗保健相关的耻辱(p =。01)，而非西方女性报告来自朋友的耻辱感更多（p p = .001）。体重偏见内化、感觉肥胖和自尊水平在各国都是相似的。在所有PPP阶段，体重偏见内化始终介导体重污名体验与感觉肥胖和自尊之间的关系；体重耻辱感提高了WBI，这反过来又提高了感觉肥胖的得分，降低了自尊的得分。结论：虽然体重耻辱感的来源因生育阶段和西方与非西方环境而异，但WBI一致地介导了这些经历与感觉肥胖和自尊的关系。干预措施应针对特定阶段的污名来源，同时将WBI作为改善PPP妇女健康和福祉结果的关键中介机制。
期刊介绍：
Health Psychology and Behavioral Medicine: an Open Access Journal (HPBM) publishes theoretical and empirical contributions on all aspects of research and practice into psychosocial, behavioral and biomedical aspects of health. HPBM publishes international, interdisciplinary research with diverse methodological approaches on: Assessment and diagnosis Narratives, experiences and discourses of health and illness Treatment processes and recovery Health cognitions and behaviors at population and individual levels Psychosocial an behavioral prevention interventions Psychosocial determinants and consequences of behavior Social and cultural contexts of health and illness, health disparities Health, illness and medicine Application of advanced information and communication technology.
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