Associations among enacted weight stigma, weight self-stigma, and multiple physical health outcomes, healthcare utilization, and selected health behaviors.

BACKGROUND: This study examined the relationship among enacted weight stigma, weight self-stigma, and multiple health outcomes. Weight stigma, a stressor experienced across all body sizes, may contribute to poorer physical health outcomes by activating the nervous and endocrine system or by triggering counterproductive health behaviors like lower physical activity, maladaptive eating patterns, and delayed health care, as well as provider bias that may cause a medical concern to be discounted. While associations of weight stigma with mental health issues are well documented, less is known about its association with physical health. METHODS: We enrolled 3821 adults who completed an online survey assessing enacted weight stigma, weight self-stigma, multiple self-reported physical health outcomes, healthcare utilization, and selected health behaviors. RESULTS: After controlling for BMI, health care delay or avoidance, sedentary behavior, and selected demographic characteristics, enacted weight stigma, significantly increased the odds of six physical health problems including hypertension (OR 1.36; CI 1.08, 1.72), hyperglycemia (OR 1.73; CI 1.29, 2.31), thyroid disorder, (OR 1.65; CI 1.27, 2.13), any arthritis (OR 1.70; CI 1.27, 2.26), non-arthritic chronic pain (OR 1.76; CI 1.4, 2.29), and infertility (OR 1.53; CI 1.14, 2.05). Weight self-stigma significantly increased the odds for three physical health problems including hypertension (OR 1.43; CI 1.16, 1.76), hyperglycemia (OR 1.37; CI 1.03, 1.81), and non-arthritic chronic pain (OR 1.5; CI 1.2,1.87). Enacted stigma was associated with more than a four-fold increase in odds of believing that a medical concern was disregarded by a health care provider. CONCLUSIONS: In this study, enacted stigma and weight self-stigma were independently associated with heightened risk for multiple physical health problems, as well as, believing health concerns were discounted by providers. Reducing weight stigma may be an important component of managing multiple physical health conditions.

Effect of positioning on blood pressure measurement in pregnancy.

Blood pressure is the key vital sign to detecting hypertensive disorders in pregnancy. The importance of taking blood pressure properly was recently underscored by the publication of updated ACC/AHA guidelines for measuring blood pressure in patients. However, the recommended position of seating with arms and back supported is not always feasible to achieve clinically, especially for inpatient women who are pregnant. Therefore, it is clinically important to understand the effects of alternative patient positioning on blood pressure measurements. We conducted a review of studies which considered patient position on the effect of blood pressure in pregnancy. This review demonstrates that clinically significant differences may occur based on patient positioning. Despite the small number of primary studies that include pregnant women, notable reductions in blood pressure measurements have been observed in the left lateral recumbent position, a common position during labor or during monitoring, in comparison to measurements taken in the supported seated position. Ultimately, these differences could affect the clinical management of patients and care should be taken to document and consider the position in which the reading was taken.

Enacted weight stigma and weight self stigma prevalence among 3821 adults.

BACKGROUND: Weight stigma is associated with several negative health issues such as anxiety, depression, maladaptive eating, and metabolic and cardiovascular disease, independent of weight and problematic for individuals of all ages and body sizes. To reduce harmful effects of weight stigma, it is imperative we accurately capture the prevalence of weight stigma in the population to better understand the magnitude of the problem. The purpose of this study was to describe the prevalence of both enacted weight stigma and weight-self stigma and include important contextual factors such as demographic characteristics and the belief about personal controllability of body weight. METHODS: This cross-sectional study included over 3800 adults who completed an online survey that captured their experiences with weight-based discrimination, teasing and beliefs about obesity. Using multivariate logistic regression, we predicted the odds of weight stigma across demographic characteristics and beliefs about obesity. RESULTS: The prevalence of weight stigma in this sample was 57%. We found that the odds of weight discrimination and teasing are higher across BMI categories and that the odds of weight self-stigma are highest among those who are categorized as overweight or obese. Additionally, the odds of weight self-stigma are higher for those who believe individuals are personally responsible for body weight. CONCLUSIONS: Our findings are comprehensive and offer new information crucial to our overall understanding of weight-based stigma and discrimination. Most people have weight stigma and it is prevalent in individuals of all body sizes. This study has significant implications for research and clinical practice.