A longitudinal study on coping and emotional well-being in cardiac patients.

Emotions and coping play a role in the prognosis of cardiac patients. This two-wave longitudinal study aims to analyze the ability of adaptive and maladaptive coping to predict the emotional well-being of cardiac patients after controlling for their functional physical capacity. Emotional well-being (positive and negative affect), coping strategies, and functional physical capacity were evaluated both at Time 1 (n = 253) and at Time 2 (n = 186), 8 weeks later. At Time 1, positive affect was positively predicted by adaptive coping and negatively predicted by maladaptive coping, while the opposite pattern was found when negative affect was considered. At Time 2, after controlling for sociodemographic variables and for negative affect and functional physical capacity at T1, negative affect was negatively predicted by adaptive coping and positively predicted by maladaptive coping. In addition, positive affect was only predicted by adaptive coping after controlling for functional physical capacity and positive affect at Time 1. Relationships between coping and emotional well-being remain after controlling for the functional physical capacity of cardiac patients, which has a big impact on their emotional state. Finally, it is suggested that specific modules to improve coping and emotional state of cardiac patients should be included in Cardiac Rehabilitation Programs.

The influence of partner appearance in the assessment of a person with obesity: an experimental study.

PURPOSE: This study analyzes whether knowing that a male with obesity has a romantic relationship with a normal weight woman improves impressions about him. METHODS: An online experiment was conducted with a sample of 3024 adult participants (1828 women and 1196 men) with a mean age of 36.11 (SD = 13.49). Each participant was shown two photographs: one of a male target with obesity and one of his female partner (who had either normal weight or obesity depending on the condition). The respondents' sex was added as a fixed factor into the analyses. Physical attractiveness was rated using an item with a scale ranging from 0 to 100. Competence, warmth, and morality were measured using a 17-item adjective list. RESULTS: The target was assessed as more attractive when he had a partner with normal weight (F(1, 3009) = 4.85, p = .028, [Formula: see text] = .002), and was also given higher scores for competence (F(1, 3009) = 4.93, p = .026, [Formula: see text] = .002), warmth (F(1, 3009) = 4.32, p = .038, [Formula: see text] = .001), and morality (F(1, 3009) = 11.16, p = .001, [Formula: see text] = .004). There was a significant interaction between partner weight and the respondents' sex for physical attractiveness, as the difference between the scores in each condition was only significant for women. CONCLUSION: It is possible that women perceived that the male target who had a normal weight partner had a higher status or some hidden quality besides his physical appearance, and thus rated him as more attractive. LEVEL OF EVIDENCE: Level I, experimental study.

Psychometric properties of the Spanish version of the Weight Self-Stigma Questionnaire (S-WSSQ) in a sample of participants with obesity seeking weight loss treatment.

PURPOSE: Weight self-stigma may be defined as a self-devaluation due to one's identification with the group of people with obesity. The Weight Self-Stigma Questionnaire (WSSQ) is an instrument specifically designed to measure weight self-stigma in populations with overweight or obesity. The objective of this study was to adapt the WSSQ to the Spanish population (S-WSSQ) following the guidelines for cross-cultural adaptations. METHODS: The sample comprised 165 participants with obesity seeking weight loss treatment (65% women) at the "Hospital de Valme" (Seville, Spain). Scales to measure life satisfaction, self-esteem, positive and negative affect, and antifat attitudes were used to analyze the convergent and divergent validity of the S-WSSQ. RESULTS: A confirmatory factor analysis showed adequate values of the goodness of fit indexes of a two-factor model (χ2/df = 2.01 CFI = 0.92, IFI = 0.92, SRMR = 0.08, RMSEA = 0.078), replicating the structure found by the original authors. Cronbach's alphas of the two factors were 0.76 (self-devaluation) and 0.77 (fear of enacted stigma). Composite Reliability values were 0.72 (self-devaluation) and 0.76 (fear of enacted stigma). Self-devaluation and fear of enacted stigma were negatively related to self-esteem, and positive affect, and positively related to negative affect and antifat attitudes. Finally, life satisfaction was negatively correlated to fear of enacted stigma. CONCLUSIONS: Based on these results, it is concluded that the S-WSSQ has good psychometric properties and might be used by the Spanish-speaking scientific community to measure weight self-stigma. LEVEL OF EVIDENCE: Level V, descriptive study.

Mental and physical health-related quality of life in obese patients before and after bariatric surgery: a meta-analysis.

In this meta-analysis, we review studies that compare mental and physical health-related quality of life measured with the Short-Form 36 of obese patients before and after bariatric surgery with a follow-up measure until one year. Twenty-one studies were selected to conduct the meta-analysis about the relationship between quality of life in obesity before (2680 subjects) and after (2251 subjects) bariatric surgery. Results reveal that obese patients scored less in the mental health component of the Short-Form 36 before bariatric surgery than after (d = -9.00). The same pattern could be observed in the case of the physical health component of the Short-Form 36 (d = -22.84). The results show the strong improvement that obese patients experience in both mental and physical components of the Short-Form 36 after receiving bariatric surgery.

Perceived vulnerability to disease and antifat attitudes in a sample of children and teenagers.

PURPOSE: Perceived vulnerability to disease (beliefs about personal susceptibility to contracting an infectious disease) is usually related to the expression of prejudice towards different stigmatized groups. In this study, the relationship between this variable and the expression of the prejudice towards obese people was analyzed. METHOD: The sample comprised a total of 137 children and teenagers, aged between 12 and 17 years, from a Spanish high school who fulfilled several scales which measure perceived vulnerability to disease, antifat attitudes and perceived controllability of weight. Additionally, body mass index (BMI) was calculated by means of the participants' height and weight. RESULTS: Perceived infectability (one of the factors of the perceived vulnerability to disease scale) was negatively related to controllability of weight, and germ aversion (the second factor of the vulnerability scale), showed a positive relationship with the antipathy towards obese people. Finally, perceived controllability of weight was positively correlated with BMI. CONCLUSIONS: The implications of these results in the field of the study of the prejudice toward obese people are discussed. To our knowledge, no other studies have investigated the relationship between perceived vulnerability to disease and antifat attitudes in minors. Additionally, this is the first time that the measured BMI has been used instead of the self-reported one.

Factor structure and measurement invariance of the Weight-Related Abuse Questionnaire (WRAQ).

Weight-related abuse is defined as verbal or physical maltreatment specific to one's weight. The Weight-Related Abuse Questionnaire (WRAQ) is an instrument specifically designed to measure weight-related abuse. The main goal of this research was to study the factor structure and measurement invariance of the Spanish version of the WRAQ in a non-clinical and a clinical sample. The clinical sample included 150 participants with obesity (60 % women) from the Hospital de Valme (Sevilla, Spain). The non-clinical sample included 301 students (79 % women) from the Spanish Open University (UNED). Scales to measure weight self-stigma and fear of gaining weight were used to analyze the convergent validity of the WRAQ. A confirmatory factor analysis showed that a two-factor model (verbal and physical abuse) was an acceptable fit for the data in both the clinical and non-clinical samples. Multigroup Confirmatory Factor Analysis revealed scalar measurement invariance by sample and gender. Cronbach's alpha coefficients and composite reliability for both samples were found to be good, with values ranging from 0.83 to 0.96. Fear of gaining weight was correlated to verbal (r = 0.36, p < .01) and physical (r = 0.12, p < .05) abuse, and weight self-stigma was also related to physical (r = 0.21, p < .01) and verbal (r = 0.41, p < .01) abuse. These results suggest that the WRAQ can be used in clinical and non-clinical samples to assess verbal and physical abuse in both men and women.

Well-being and prejudice toward obese people in women at risk to develop eating disorders.

The literature has found that eating disorders (ED) patients usually have a depression and anxiety diagnosis. However, not many investigations have studied the relationship between ED and well-being. One of the main problems of patients with ED is their body image. These individuals usually see themselves too big but there are not many investigations that focus on how these patients see people with real weight problems. For this reason in this study it is analyzed how women in risk to develop ED see obese people. 456 female students were selected. It was found that women with high scores in the different subscales of the Eating Attitudes Test 26 (EAT-26; dieting, bulimia and oral control) had lower well-being (both subjective and psychological) and worse attitudes toward obese people (measured with Antifat Attitudes Test, AFA, Beliefs About Obese People Scale, BAOP, and Attitudes Toward Obese People Scale, ATOP) compared with women with low scores in the EAT-26.

Factor Structure of the Gratitude Questionnaire in a Spanish Sample.

The Gratitude Questionnaire is a short, self-report measure of the disposition to experience gratitude. The Gratitude Questionnaire has been validated in several countries but its factor structure remains controversial. Therefore, the main goal of the study was to examine the factor structure of the Gratitude Questionnaire in a Spanish sample. Two samples were recruited (957 and 920 participants). The confirmatory factor analyses showed that the best fit was the five-item model with errors of item four and five correlated (CFI = .99, NFI = .99, RMSEA = .02). This model demonstrated partial cross-validity based on an analysis of factorial invariance. The Composite Reliability of the five-item Gratitude Questionnaire was .81. In addition, it was found that gratitude was positively related to subjective and psychological well-being. Specifically, the Gratitude Questionnaire was positively correlated to life satisfaction (r = .56, p < .01), affect balance (r = .46, p < .01), self-acceptance (r = .54, p < .01), positive relations (r = .44, p < .01), autonomy (r = .17, p < .01), environmental mastery (r = .49, p < .01), personal growth (r = .36, p < .01), and purpose in life (r = .50, p < .01). According to the results, it can be concluded that the Spanish version of the five-item Gratitude Questionnaire possessed better psychometric properties than the original six-item model.

Perceived Discrimination and Emotional Reactions in People with Different Types of Disabilities: A Qualitative Approach.

The purpose of this study is to assess the discourse of people with disabilities regarding their perception of discrimination and stigma. Semi-structured interviews were conducted with ten adults with physical disabilities, ten with hearing impairments and seven with visual impairments. The agreement between the coders showed an excellent reliability for all three groups, with kappa coefficients between .82 and .96. Differences were assessed between the three groups regarding the types of discrimination they experienced and their most frequent emotional responses. People with physical disabilities mainly reported being stared at, undervalued, and subtly discriminated at work, whereas people with hearing impairments mainly reported encountering barriers in leisure activities, and people with visual impairments spoke of a lack of equal opportunities, mockery and/or bullying, and overprotection. Regarding their emotional reactions, people with physical disabilities mainly reported feeling anxious and depressed, whereas people with hearing impairments reported feeling helpless, and people with visual impairments reported feeling anger and self-pity. Findings are relevant to guide future research and interventions on the stigma of disability.

Spanish adaptation of the Patient Health Engagement scale (S.PHE-s)in patients with chronic diseases.

BACKGROUND: The Patient Health Engagement scale is an instrument based on evidence about the experiences and preferences of patients with chronic diseases regarding their engagement with the treatment they receive. AIMS: The main goal of this study was to adapt the Patient Health Engagement scale to the Spanish population (S.PHE-s) following the guidelines for cross-cultural adaptations. METHODS: The sample comprised 413 patients with different chronic diseases. RESULTS: The confirmatory factor analysis showed a one factor model corresponding to the structure proposed by the original authors. The factor structure was invariant by gender. Furthermore, a Rasch Model showed that the S.PHE-s was unidimensional. In addition, every polychoric correlation coefficient was higher than .60. The Ordinal Alpha of the S.PHE-s was .85. Finally, the S.PHE-s was found to be positively related to life satisfaction, positive affect, and treatment adherence and negatively correlated to negative affect, depression, and anxiety. CONCLUSIONS: In light of these results, it may be concluded that the S.PHE-s has good psychometric properties and it may be used by the Spanish-speaking scientific community to measure patient engagement.

The Mediational Effect of Weight Self-Stigma in the Relationship between Blatant and Subtle Discrimination and Depression and Anxiety.

Obesity may be considered a social stigma. In addition, people with obesity are frequently aware of stigma directed at others who have a similar weight and come to think stigmatized thoughts about themselves. Our study focused specifically on how blatant and subtle discrimination and weight self-stigma are related to depression and anxiety in people with obesity. The sample comprised 170 participants from the Clinical Nutrition Unit of the "Hospital de Valme" (Seville, Spain). The Weight Self-Stigma Questionnaire, the Multidimensional Perceived Discrimination Scale, and the Hospital Anxiety and Depression Scale were used. It was found that blatant and subtle discrimination and weight self-stigma were positively related to depression (.31, .38, and .45 respectively) and anxiety (.30, .36, and .49 respectively; all ps < .01). The path analysis conducted showed that there was a mediational effect of weight self-stigma between blatant (ß = .36) and subtle discrimination (ß = .40) and depression (ß = .24) and anxiety (ß = .49; all ps < .01). According to these results, it can be said that weight self-stigma was a full mediator in the model found because the relationships between the independent and the dependent variables were non-significant. Finally, results are discussed in the frame of the obesity stigma literature, and some clinical implications of the results of the study are suggested.

Social Stigma and Well-Being in a Sample of Schizophrenia Patients.

OBJECTIVE: The present study analyzes the existing relationship between three variables related to social rejection (perception of overt and subtle discrimination and stigma consciousness) and the psychological and subjective well-being among people with schizophrenia. Likewise, we will analyze the relationship between two possible strategies to cope with stigma (active coping and avoidant coping) and well-being. METHOD: A cross-sectional study was conducted in a sample of 50 people with schizophrenia recruited from the social care network for people with mental illness in the Community of Madrid. RESULTS: Results show, as expected, the existence of a negative association between the variables related to social rejection and psychological and subjective well-being. It was also found that avoidant coping is negatively related to well-being, while active coping is positively related, although in the latter case relations do not reach significance. CONCLUSIONS: In view of the implementation of interventions to improve the well-being of people with schizophrenia, our results suggest implementing strategies to reduce the perception of discrimination (especially subtle or indirect discrimination) and encouraging the use of active strategies to cope with stigma as opposed to avoidant-coping strategies.

Overt and subtle discrimination, subjective well-being and physical health-related quality of life in an obese sample.

Obesity represents a serious health issue affecting millions of people in Western industrialized countries. The severity of the medical problems it causes is paralleled by the fact that obesity has become a social stigma that affects the psychological health-related quality of life of individuals with weight problems. Our study, with 111 obese patients of a Spanish hospital, focused specifically on how overt and subtle discrimination is related to subjective well-being (affect balance and life satisfaction) and physical health-related quality of life. It was shown that overt (r = -.28, p < .01 with affect balance; r = -.26, p < .01 with life satisfaction) and subtle discrimination (r = -.28, p < .01 with affect balance; r = -.27, p < .01 with life satisfaction) were negatively linked with subjective well-being, and that there was a negative correlation between overt discrimination and physical health-related quality of life (r = -.26, p < .01). Additionally, it was found that overt discrimination was a mediator variable in the relationship between physical health-related quality of life and subjective well-being using the Baron and Kenny procedure. Finally, it is discussed the relationship between discrimination, subjective well-being and physical health-related quality of life in obese people.

Psychometric properties of Spanish version of the Three-Factor Eating Questionnaire-R18 (Tfeq-Sp) and its relationship with some eating- and body image-related variables.

The aims of this study were to analyze the psychometric properties of the Spanish version of the Three-Factor Eating Questionnaire-R18 (TFEQ-SP), as well as determine its validity by evaluating the relationship of the TFEQ-SP with different parameters related to body mass index, weight perception, perception of physical fitness, self-esteem, and food intake, as well as with weight control-related variables. A total of 281 participants (aged 18.38 ± 6.31) were studied. The factor analysis yielded three factors: cognitive restraint (CR), uncontrolled eating (UE), and emotional eating (EE). The internal consistency of the TFEQ-SP was determined by means of Cronbach's α coefficient, with values ranging between 0.75 and 0.87. Higher scores on CR were found in women (p < 0.5), overweight/obese participants (p < 0.001), participants with lower self-esteem (p < 0.05), participants who overestimated their weight (p < 0.001), participants who weighed themselves frequently (p < 0.001) and those who were about to go on a diet (p < 0.001). Higher EE scores were found in participants with lower self-esteem scores (p < 0.05), among participants with a poorer perception of their physical fitness (p < 0.01) and when participants were about to diet (p < 0.05). Higher scores on UE were observed in case of poorer perception of physical fitness (p < 0.05). The validation study of the TFEQ-SP meets the requirements for measuring the three different facets of eating behavior: CR, UE, and EE.

Psychological well-being in a sample of obese patients compared with a control group.

INTRODUCTION: The literature has found that obese patients usually report more depression and anxiety than normal weight individuals. However, not many investigations have studied the relationship between obesity and quality of life from a Positive Psychology approach. OBJECTIVE: In this study it is analyzed if obese patients have less psychological well-being than a control group (normal weight participants). METHOD: A total of 221 participants (111 obese individuals and 110 controls) were selected to conduct the study. To measure psychological well-being, the Spanish version of the Ryff's Scales was used. To measure mental health, the Spanish version of the mental health component of the Short Form 36 Health Survey (SF-36) was used. RESULTS: It was found that obese participants reported less psychological well-being than normal weight individuals, but that there were not statistically significant differences in the case of mental health measured with the SF-36. DISCUSSION: According to the results, it can be concluded that reports of psychological well-being problems were much more common in participants with weight problems than in the control group.

INTRODUCCIÓN: La literatura ha puesto de manifiesto que los pacientes obesos suelen padecer más depresión y ansiedad que los individuos de peso normal. Sin embargo, no son muchas las investigaciones que han estudiado la relación entre obesidad y calidad de vida a partir del enfoque de la Psicología Positiva . OBJETIVO: En este estudio se analizó si los pacientes obesos tienen menor bienestar psicológico que los de un grupo de control (participantes de peso normal ). MÉTODO: Se seleccionaron un total de 221 participantes (111 individuos obesos y 110 de control) para realizar el estudio. Para medir el bienestar psicológico, se utilizó la versión española de las escalas de Ryff. Para medir la salud mental, se utilizó la versión española del componente de salud mental de la Forma Abreviada de la Encuesta de Salud (SF- 36 ). RESULTADOS: Los participantes obesos mostraron menos bienestar psicológico que las personas de peso normal, pero que no hubo diferencias estadísticamente significativas en el caso de la salud mental medida con el SF- 36. DISCUSIÓN: De acuerdo con los resultados, se puede concluir que la expresión de problemas acerca del bienestar psicológico es mucho más común en los participantes con problemas de peso que en los del grupo de control.

Antifat attitudes in a sample of women with eating disorders.

INTRODUCTION: One of the main problems of patients with eating disorders is their body dissatisfaction. Although these individuals usually are not satisfied with their bodies there are not many investigations that focus on how these patients see people with real weight problems. For this reason, in this study it is analyzed how women with eating disorders see obese people. METHODS: A total of 104 participants (35 with anorexia nervosa, 28 with bulimia nervosa, 16 with eating disorder not otherwise specified and 25 controls) were selected to conduct the study. To measure anti-fat attitudes the Spanish version of the Antifat Attitudes Questionnaire was used. To measure if participants had body dissatisfaction it was used the Spanish versions of the Body Shape Questionnaire. Finally, anthropometric measures (height and weight) were taken in order to calculate the BMI (kg/m(2)), as well as some socio-demographic information. RESULTS: It was found that participants with bulimia nervosa showed scores higher on antifat attitudes than the rest of the participants. Additionally, it was found that this result was influenced by the body dissatisfaction of the participants. DISCUSSION: These results suggest that negative attitudes toward obese people may influence an individual's body image. One way of maintaining a positive body image (especially, the subjective dimension, body satisfaction) is to compare oneself with those perceived as physically inferior (people with weight problems), a strategy that is especially relevant when the mass media insists in depict extreme thin women.

IntroducciÓn: Uno de los principales problemas de los pacientes con trastornos de la conducta alimentaria es la insatisfacciÓn corporal. Aunque estas personas por lo general no están satisfechos con sus cuerpos, no hay muchas investigaciones que se centran en cÓmo estos pacientes ven a la gente con problemas reales de peso. Por esta razÓn, en este estudio se analiza cÓmo las mujeres con trastornos alimentarios ven a las personas obesas. Métodos: Un total de 104 participantes (35 con anorexia nerviosa, 28 con bulimia nerviosa, 16 con trastornos alimentarios no especificados y 25 controles) fueron seleccionados para llevar a cabo el estudio. Para medir las actitudes anti-obesidad se utilizÓ la versiÓn española del Antifat Attitudes Questionnaire. Para medir si los participantes presentaban insatisfacciÓn corporal se utilizÓ la versiÓn española del Body Shape Questionnaire. Por último, se tomaron medidas antropométricas (peso y talla) a fin de calcular el índice de masa corporal (kg/m2), así como algunos datos socio-demográficos. Resultados: Se encontrÓ que los participantes con bulimia nerviosa mostraban puntuaciones más altas en las actitudes anti-obesidad que el resto de los participantes. Adicionalmente, se encontrÓ que este resultado estuvo influenciado por la insatisfacciÓn corporal de los participantes. DiscusiÓn: Estos resultados sugieren que las actitudes negativas hacia las personas obesas pueden influir en la imagen corporal de una persona. Una manera de mantener una imagen positiva del propio cuerpo (sobre todo, la dimensiÓn subjetiva, la satisfacciÓn corporal) es compararse con aquellos que son percibidos como físicamente inferiores (personas con problemas de peso), una estrategia que es especialmente relevante cuando los medios de comunicaciÓn insisten en representar mujeres extremadamente delgadas.

Drive for thinness and pursuit of muscularity: the role of gender ideologies / Impulso a la delgadez y búsqueda de la muscularidad: el rol de las ideologías de género

The female sociocultural beauty ideal is ultra-thin, while the male beauty ideal is related with a muscular body. In this paper it is argued that these differences may be explained by the gender ideology that men and women have. Data obtained from 615 female students (with a Body Mass Index between 18 and 30) revealed that participants high in a gender ideology scale reported greater drive for thinness and less pursuit of muscularity. In addition, women with low scores in a gender ideology scale showed the opposite pattern: high scores on pursuit of muscularity and low in drive for thinness. Finally, it is discussed why men and women adopt different strategies to deal with these beauty ideals.

El ideal sociocultural femenino es ultra delgado, mientras que el ideal masculino tiene que ver con tener un cuerpo musculado. En este articulo se argumenta que estas diferencias pueden ser explicadas por las ideologías de genero que tienen hombres y mujeres. Los datos obtenidos de 615 mujeres estudiantes (con un Indice de Masa Corporal entre 18 y 30) mostraron que las participantes altas en una escala de ideología de género informaban de un mayor impulso a la delgadez y menos búsqueda de la muscularidad. Además, las mujeres con marcadores bajos en una escala de ideología de genero mostraban el patrón opuesto: puntuaciones altas de búsqueda de la muscularidad y bajas en impulso a la delgadez. Finalmente, se discute porqué hombres y mujeres adoptan diferentes estrategias para lidiar con estos ideales de belleza.

Right Wing Autoritharism, Social Dominance Orientation, Controllability of the Weight and their Relationship with Antifat Attitudes / Autoritarismo, orientación a la dominancia social, controlabilidad del peso y su relación con las actitudes antiobesos

Antifat attitudes (AFA) refer to stereotyping based on people's weight. Literature suggests that people who have an ideologically conservative outlook on life also report negative attitudes toward obese people. Also, it is well established that one of the roots of AFA is the perception that prejudiced individuals have about the controllability of the weight. Therefore, in the current study it is analyzed if Right Wing Autoritharism (RWA, predisposition that individuals have to follow the dictates of a strong leader and traditional and conventional values) and Social Dominance Orientation (SDO, the desire that one's ingroup dominates other outgroups) predicts prejudice toward obese people and if controllability of the weight mediates this relationship. 456 female students of the UNED (Spanish Open University) from 18 to 35 years were part of the final sample of the study. Results showed that RWA, SDO, controllability and AFA were positively correlated and that the relationship between RWA, SDO and AFA was mediated by the controllability of the weight.

Las actitudes antiobesos hacen referencia a los estereotipos sobre las personas con problemas de peso. La literatura sugiere que la gente que tiene una visión ideológica conservadora también presenta actitudes negativas hacia las personas obesas. Es un hecho bien establecido que una de las raíces de las actitudes negativas hacia los obesos es la percepción que tienen las personas prejuiciosas sobre la controlabilidad del peso. En el presente estudio se ha analizado si el autoritarismo (predisposición que tienen los individuos a seguir los dictados de un líder así como a tener valores convencionales y tradicionales) y la orientación a la dominancia social (el deseo de que el endogrupo domine al resto de exogrupos) predice el prejuicio hacia las personas obesas y si la controlabilidad del peso media esta relación. Para ello, se seleccionaron 456 mujeres estudiantes de la Universidad Nacional de Educación a Distancia (UNED) de 18 a 35 años. Los resultados pusieron de manifiesto que el autoritarismo, la orientación a la dominancia social, la controlabilidad del peso y las actitudes antiobesos estaban positivamente correlacionadas, y que la controlabilidad mediaba la relación entre las variables ideológicas y la actitud antiobesos.