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Weight discrimination tied to chronic stress in adults with obesity
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Weight discrimination was linked to elevated levels of cortisol in scalp hair of adults with obesity, indicating chronic biological stress, data from a population-based study showed.
Elevated cortisol levels may contribute to “a vicious circle of weight gain” in addition to contributing to obesity-related health problems, the researchers wrote.
“The rising prevalence of obesity over recent decades has been paralleled by growing evidence of weight-based stigma and discrimination,” Sarah E. Jackson, MSc, PhD, of the department of epidemiology and public health at University College London, and colleagues wrote. “Weight discrimination has also been shown to be related to increased blood pressure, chronic inflammation, poorer self-related health, greater disease burden and a decline in physical health over time. Importantly, in addition to having emotional and disease-related consequences, an association between weight discrimination and chronic stress may be implicated in the perpetuation of obesity.”
Jackson and colleagues reviewed hair cortisol concentrations, along with weight and height data, from 563 nonsmoking men and women with obesity who were part of the English Longitudinal Study of Ageing. Participants self-reported weight discrimination using questionnaires, and researchers examined associations between perceived discrimination and hair cortisol, as well as degree of obesity. Jackson and colleagues adjusted their analyses for sex, ethnicity, age, socioeconomic status and BMI.
Overall, 12.1% of participants reported weight discrimination. Discrimination increased along with the degree of obesity: 6.9% of those with class I obesity reported discrimination vs. 19.7% in those with class II obesity and 34.8% in those with class III obesity (P < .001). Participants who reported weight discrimination had a 33% higher mean concentration of hair cortisol than those who did not (adjusted mean, 1.241 log pg/mg vs. 0.933 log pg/mg; P = .001), the researchers reported. Those with severe obesity — defined as class II or class III — showed a greater association between discrimination and hair cortisol levels (P = .001). Younger participants were more likely to report having experienced weight discrimination (P < .001), although reports of discrimination were similar across ethnicity (P = .928), sex (P = .16) and hair treatment (P = .183).
“Exposure to chronically elevated cortisol levels has substantial implications for health and well-being, and as such, experiences of weight-based discrimination might play an important role in driving many of the adverse psychological and physiological consequences of obesity,” Jackson and colleagues wrote. “These findings underscore the need for initiatives to tackle the issues of weight stigma and discrimination in society in order to reduce the global burden on individuals with obesity.” – by Andy Polhamus
Disclosure: The researchers report no relevant financial disclosures.
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