Background: Parents of children with high weight are often the target of blame and shaming.However, this form of stigma, termed weight stigma by association, is poorly understood.Objective: To investigate the sources, forms, and impacts of weight stigma by association among mothers of children with overweight or obesity.Methods: Mothers of 5 to 16-year-old children (N=34; 54% non-Hispanic White) participated in semi-structured interviews. A coding scheme was developed using the constant comparative method and reliably applied to interview transcripts. Mothers' self-reported sociodemographic information, and height and weight were measured.Results: Family members were a common source of negative comments to parents about children's weight; these comments were often critical of mothers' parenting and caused hurt feelings and family estrangement. Many mothers also reported negative feelings about their children's physicians due to interactions about their children's weight. Almost all mothers expressed guilt and sadness for not parenting differently; many internalized beliefs that they were bad parents because of their children's weight. Conclusion:Mothers of children with overweight and obesity are frequently the target of weight stigma by association. Additional research is needed to elucidate the impacts of this form of stigma on parents' health, the parent/child relationship, and children's health.
Transgender persons face frequent instances of stigma that may make them vulnerable to adverse mental and physical health outcomes. To date, however, few studies have assessed gender identity–related stigma and its psychosocial correlates among active duty transgender military personnel. To assess the associations of stigma with psychosocial functioning and health, U.S. military personnel self-identifying as transgender completed anonymous online measures of stigmatizing situations within the military, health, psychosocial functioning, eating pathology, risk behaviors, and coping strategies. Participants also described their worst experience of gender identity–related stigma within the military. In total, 174 service members (28.8 ± 6.3 years, 50.6% transmale, 71.3% non-Hispanic White, 7.8 ± 5.5 years in service) completed the survey. The majority (93%) reported at least 1 instance of gender identity–related stigma in the military, including bullying and barriers to obtaining gender-affirming services. Although service members reported generally good health and psychosocial functioning, stigma in the military was significantly associated with poorer overall mental health and greater depression, anxiety, and stress, after adjusting for age, gender identity, race, and service rank. Stigma was unrelated to self-reported physical health. Of 14 different coping behaviors assessed, only positive reframing was associated with better mental health. The current study indicates that stigma within the military is reported by the majority of service members self-identifying as transgender and is associated with poor mental health, above and beyond the contribution of relevant covariates. Additional research is needed to identify those at greatest risk for the adverse effects of stigma.
Weight-based teasing (WBT) by family members is commonly reported among youth and is associated with eating and mood-related psychopathology. Military dependents may be particularly vulnerable to family WBT and its sequelae due to factors associated with their parents’ careers, such as weight and fitness standards and an emphasis on maintaining one’s military appearance; however, no studies to date have examined family WBT and its associations within this population. Therefore, adolescent military dependents at-risk for adult obesity and binge-eating disorder were studied prior to entry in a weight gain prevention trial. Youth completed items from the Weight-Based Victimization Scale (to assess WBT by parents and/or siblings) and measures of psychosocial functioning, including the Beck Depression Inventory-II, The Rosenberg Self-Esteem Scale, and the Social Adjustment Scale. Eating pathology was assessed via the Eating Disorder Examination interview, and height and fasting weight were measured to calculate BMIz. Analyses of covariance, adjusting for relevant covariates including BMIz, were conducted to assess relationships between family WBT, eating pathology, and psychosocial functioning. Participants were 128 adolescent military dependents (mean age: 14.35 years old, 54% female, 42% non-Hispanic White, mean BMIz: 1.95). Nearly half the sample (47.7%) reported family WBT. Adjusting for covariates, including BMIz, family WBT was associated with greater eating pathology, poorer social functioning and self-esteem, and more depressive symptoms (ps ≤ 0.02). Among military dependents with overweight and obesity, family WBT is prevalent and may be linked with eating pathology and impaired psychosocial functioning; prospective research is needed to elucidate the temporal nature of these associations.
Population data indicate that sexual and gender minority adolescents may be at increased risk for excess weight gain compared with cisgender, heterosexual youth.However, no studies, to our knowledge, have systematically reviewed the literature on weight disparities in this population nor explored risk for overweight and obesity by sexual and gender minority subgroup across studies. The current systematic review, therefore, identified 21 studies that assessed the relationship between sexual and gender minority status and weight among adolescents. Results indicated an overall greater prevalence of overweight and obesity among sexual and gender minority adolescents compared with cisgender, heterosexual youth. However, cisgender sexual minority males demonstrated lower or no added risk for overweight and obesity, whereas cisgender sexual minority females demonstrated greater risk for overweight and obesity. Findings were mixed among gender minority adolescents. This study highlights weight disparities in sexual and gender minority youth, although important subgroup differences exist. Additional research is needed to elucidate the mechanisms that may contribute to differential weight trajectories in this population and to develop tailored approaches for prevention and treatment.
Department of Defense policy prohibits, with limited exceptions, transgender individuals from serving in their affirmed gender in the U.S. Military, citing potential impact on unit cohesion and military readiness. To date, however, little is known about the sociodemographic profile and health of transgender military personnel. Methods: U.S. Military personnel who self-identified as transgender completed anonymous online measures of demographics and military service. Participants also completed measures of health, mood, eating pathology, and risk behaviors. Results: One hundred ninety-five service members (mean age: 28.9-7.2 years, 48.7% transmale, 70.3% non-Hispanic White, 7.83-5.9 years in service) completed the survey. The majority of respondents first identified as transgender before military accession. Most had disclosed their gender identity to their command and providers, and had undertaken steps toward gender affirmation. The sample as a whole reported above average physical health, with mood symptoms within normal ranges and few reported risk behaviors. Analyses of covariance indicated that transmales reported significantly better mental health and psychosocial functioning compared with transfemales. Conclusion: In light of current policy that precludes, with limited exceptions, transgender individuals from serving in the U.S. Military in their affirmed gender, the current study provides an initial sociodemographic profile of this understudied population and indicates that transgender service members report above average physical health and few risk behaviors. Preliminary analyses indicated that transfemales in the military may be at higher risk for mental health concerns, compared with transmales. Additional research is needed to elucidate risk and protective factors among transgender service members.
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