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

Ruth Hackett, Sarah E. Jackson, Elizabeth Corker, Andrew Steptoe

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Objective: To examine the role of stress and health-risk behaviours in relationships between weight discrimination and health and wellbeing.

Design: Secondary data analysis of an observational cohort study

Setting: The English Longitudinal Study of Ageing

Participants: Data were from 4,341 adults (≥50y) with overweight/obesity.

Primary Outcome Measures: We tested associations between perceived weight discrimination at baseline (2010/11) and self-rated health, limiting long-standing illness, depressive symptoms, quality of life, and life satisfaction over four-year follow-up (2010/11; 2014/15). 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;2.82]), limiting long-standing illness (OR=1.76[1.29;2.41]) and depressive symptoms (OR=2.01[1.41;2.85]), and lower quality of life (B=-5.82[95%CI -7.01;-4.62]) and life satisfaction (B=-2.36[-3.25;-1.47]). Prospectively, weight discrimination was associated with higher odds of fair/poor self-rated health (OR=1.63[1.10;2.40]) and depressive symptoms (OR=2.37[95%CI 1.57;3.60]) adjusting for baseline status. Those who reported discrimination had higher hair cortisol concentrations (B=0.14[0.03;0.25]) and higher odds of physical inactivity (OR=1.90[1.18;3.05]). These variables did not significantly mediate associations between discrimination and health outcomes.

Conclusions: Weight discrimination is associated with poor health and wellbeing. While this discrimination is associated with stress exposure and physical inactivity, these variables explain little of the association between discrimination and poorer outcomes.
Original languageEnglish
JournalBMJ Open
Publication statusAccepted/In press - 29 Aug 2023

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