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The role of stress and health behaviour in linking weight discrimination and health: a secondary data analysis in England

Hackett, Ruth A; Jackson, Sarah E; Corker, Elizabeth; Steptoe, Andrew; (2023) The role of stress and health behaviour in linking weight discrimination and health: a secondary data analysis in England. BMJ Open , 13 (9) , Article e072043. 10.1136/bmjopen-2023-072043. Green open access

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Abstract

Objective: To examine the role of stress and health-risk behaviours in relationships between weight discrimination and health and well-being.// Design: Secondary data analysis of an observational cohort study.// Setting: The English Longitudinal Study of Ageing.// Participants: Data were from 4341 adults (≥50 years) with overweight/obesity.// Primary outcome measures: We tested associations between perceived weight discrimination at baseline (2010/2011) and self-rated health, limiting long-standing illness, depressive symptoms, quality of life and life satisfaction over 4-year follow-up (2010/2011; 2014/2015). Potential mediation by stress exposure (hair cortisol) and health-risk behaviours (smoking, physical inactivity, alcohol consumption) was assessed.// Results: Cross-sectionally, perceived weight discrimination was associated with higher odds of fair/poor self-rated health (OR=2.05 (95% CI 1.49 to 2.82)), limiting long-standing illness (OR=1.76 (95% CI 1.29 to 2.41)) and depressive symptoms (OR=2.01 (95% CI 1.41 to 2.85)) and lower quality of life (B=−5.82 (95% CI −7.01 to −4.62)) and life satisfaction (B=−2.36 (95% CI −3.25 to −1.47)). Prospectively, weight discrimination was associated with higher odds of fair/poor self-rated health (OR=1.63 (95% CI 1.10 to 2.40)) and depressive symptoms (OR=2.37 (95% CI 1.57 to 3.60)) adjusting for baseline status. Those who reported discrimination had higher hair cortisol concentrations (B=0.14 (95% CI 0.03 to 0.25)) and higher odds of physical inactivity (OR=1.90 (95% CI 1.18 to 3.05)). These variables did not significantly mediate associations between discrimination and health outcomes.// Conclusions: Weight discrimination is associated with poor health and well-being. While this discrimination is associated with stress exposure and physical inactivity, these variables explain little of the association between discrimination and poorer outcomes.

Type: Article
Title: The role of stress and health behaviour in linking weight discrimination and health: a secondary data analysis in England
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/bmjopen-2023-072043
Publisher version: https://doi.org/10.1136/bmjopen-2023-072043
Language: English
Additional information: © The Author(s), 2023. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://creativecommons.org/licenses/by/4.0/
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
URI: https://discovery.ucl.ac.uk/id/eprint/10176907
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