Multiple marginalization, discrimination, and disordered eating among youth aged 10-11.

OBJECTIVE: Although rates of weight discrimination are on-par with racial, ethnic, and gender discrimination, comparatively less work has examined impacts of weight-based discrimination in youth, including on disordered eating. Knowing whether experiences of weight-based discrimination, including in youth with multiply-marginalized identities, are associated with disordered eating could identify vulnerable youth and inform intervention efforts. METHOD: Youth (N = 11,875) ages 10-11 were recruited through the Adolescent Brain Cognitive Development (ABCD) study. Logistic regressions using cross-sectional data examined discrimination experiences (weight, perceived sexual orientation, race/ethnicity, national origin) and disordered eating (binge-eating, vomiting, weight-gain fear, weight self-worth). Models included race/ethnicity, age, sex, parental income, and degree of elevated weight. Raked poststratification weights were used. RESULTS: Rates of weight-based discrimination (6.2%) were similar to rates of race/ethnicity (4.4%) and sexual orientation discrimination (4.5%). Weight-based discrimination was associated with more disordered eating. Youth reporting multiple experiences of discrimination had significantly increased disordered eating compared to youth who did not report discrimination. DISCUSSION: Weight-based discrimination is common in youth and associated with disordered eating. Youth with elevated weight are more likely to be multiply marginalized and experience disordered eating. These findings suggest discrimination, including weight-based discrimination, is a critical intervention target to prevent and treat eating disorders. PUBLIC SIGNIFICANCE: Experiences of discrimination contribute to poorer health; however, weight-based discrimination is relatively understudied. Data from a large sample of youth ages 10-11 showed that youth with elevated weight reported experiencing multiple types of discrimination, and multiply-marginalized youth had increased odds of disordered eating with each additional type of discrimination. Together, this suggests that weight-based discrimination is a critical target to prevent and treat eating disorders, especially in multiply-marginalized youth.

Long-term Engagement in Physical Activity Among Bariatric Surgery Patients: Associations with Treatment Outcomes at 5-Year Follow-up.

PURPOSE: Physical activity studies involving bariatric surgery patients tend to be short-term or cross-sectional investigations. Longer-term studies are limited and typically consist of relatively brief objective measurement periods used to generalize activity patterns. Very little research combines objective measurements with structured interviews to determine both the patterns and related factors of long-term physical activity among patients undergoing bariatric surgery. MATERIALS AND METHODS: Previous volunteers in a perioperative physical activity study were invited to participate in a mixed methods study investigating physical activity among bariatric patients over a 5-year postoperative period. Fifty-one patients (Mage = 45.4 years; 76.5% female, 90.2% White; 86.3% Roux-en-Y procedure) provided interview, survey, accelerometer, and anthropometric data. RESULTS: Participants were divided into four exercise quartiles, based on self-report of their length of regular exercise involvement from 1 year before through 5 years after surgery. Those reporting the most periods of regular exercise took the most measured steps per day, had greater moderate-to-vigorous physical activity and more bout-related activity, experienced the largest decrease in BMI, and reported the most adherence to nutritional guidelines. Participants reporting the most and least physical activity found the measurement periods to be most similar to their normal activity patterns. While physical activity increased significantly after surgery, measured physical activity did not reach recommended levels for steps or exercise bout minutes. CONCLUSIONS: Measured physical activity and self-reported physical activity show congruent trends among patients undergoing bariatric surgery. More research is needed to determine optimal long-term monitoring and promotion of physical activity among patients.

Spiritual practices are associated with improved weight management following bariatric surgery.

BACKGROUND: Research shows that spirituality and religiosity may positively impact various health outcomes, but little is known about their role in supporting weight management efforts, particularly in the context of bariatric surgery. OBJECTIVE: This study examined spiritual practices and health-related behaviors of bariatric surgery patients 1-2 years postoperatively. SETTING: Large bariatric center in the Midwest of the United States. METHODS: Patients (n = 152) completed questionnaires 1-2 years postoperatively examining weight, physical activity, eating behaviors, and spiritual practices and experiences related to bariatric surgery. RESULTS: Participants were primarily married (59.2%), Caucasian (81.6%), and female (84.2%) who had undergone Roux-en-Y gastric bypass (64.5%) or sleeve gastrectomy (32.9%) 17.3 months previously. Most participants (71%) believed their spirituality did or could impact weight loss after surgery. Practices including connecting with nature, art and music, meditation, yoga, and attending spiritual or religious-based activities were positively correlated with weight loss, healthy eating, or exercise participation. CONCLUSION: Findings provide preliminary evidence for the benefits of spirituality in bariatric patients making lifestyle changes after surgery.