Objective: This study evaluated the relation among weightbased stigmatization, ideological beliefs about weight, and psychological functioning in an obese, treatment-seeking sample. Research Methods and Procedure: Ninety-three obese, treatment-seeking adults (24 men and 69 women) completed a battery of self-report questionnaires measuring psychological adjustment, attitudes about weight, belief in the controllability of weight, and the frequency of weight-based stigmatization. Results: Weight-based stigmatization was a common experience for participants. Frequency of stigmatizing experiences was positively associated with depression, general psychiatric symptoms, and body image disturbance, and negatively associated with self-esteem. Further, participants' own negative attitudes about weight problems were associated with their psychological distress and moderated the relation between the experience of stigmatization and body image. Discussion:Weight-based stigmatization is a common experience for obese individuals seeking weight loss treatment and appears to contribute to poor mental health adjustment. The negative effects of these experiences are particularly damaging for those who hold strong antifat beliefs.

be triggered by negative mood states such as anger, anxiety, or depression. This has been described as "dysfunctional mood modulatory behavior" (12). That is, overeating behavior may serve to buffer negative mood by distracting from the mood state directly or interfering with cognitions responsible for the negative mood state. This process has been described as the "escape theory" of binge eating (13) and results in negatively reinforcing the eating behaviors.Taken together, current theories of binge eating and data demonstrating the association between stigmatization and mental health functioning suggest that negative events such as stigmatizing experiences may be associated with psychological distress and binge eating behavior. However, a major weakness among published stigmatization studies is that they have investigated lifetime experiences of stigmatization as it relates to current psychological functioning and behavior. No study to our knowledge has investigated the association between recent or current experiences of stigmatization and current functioning. Thus, the purpose of this study was Since the 1960s research has documented the pervasive and deleterious effects of weight-based stigmatization (1-9). Attention to this topic has increased as weight bias has intensified (10) and the rates of overweight and obesity have risen (11). Historically, research has focused on weight bias from the perspective of the nonoverweight person (i.e., how society treats overweight individuals), and observational and laboratory studies consistently have shown that society in general has negative expectations and anti-fat beliefs about overweight and obese individuals (see ref. 3 for review). Less is known about how overweight individuals perceive these biases or how these biases effect well-being and behavior.A few studies have evaluated weight-based stigmatization from the perspective of the overweight individual. This research has shown that the experience of weight-related stigmatization is associated with negative psychological (e.g., depression, anxiety) and behavioral (e.g., binge eating) consequences (1,2,4), and these findings support current theories of binge eating. For example, binge eating behavior, in part, may objective: This study evaluated the association between experiences of weight-based stigmatization (e.g., job discrimination, inappropriate comments from physicians) within the past month, psychological functioning, and binge eating among a sample of individuals seeking weight loss surgery. Methods and Procedure: Ninety-four obese adults (25 males and 69 females) seeking weight loss surgery underwent a diagnostic clinical interview and completed a battery of self-report questionnaires measuring experiences of weight-related stigmatization, psychological adjustment, and binge eating behavior. Results: Weight-based stigmatization was a common experience within the past month among participants. Frequency of stigmatizing experiences was negatively associated with self-esteem and positively associated wi...

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Our results demonstrate that a feasible and generalizable home-based coaching intervention may decrease sedentary behavior and increase physical activity levels. In those with severe chronic obstructive pulmonary disease, this intervention may reduce lung disease-related health care utilization. Clinical trial registered with www.clinicaltrials.gov (NCT01108991).

Rationale: Physical inactivity is associated with poor outcomes among patients with chronic obstructive pulmonary disease (COPD).Objectives: To determine effectiveness of a behavioral intervention intended to increase daily physical activity with the goal of improving health-related quality of life and functional performance. Methods:We conducted a randomized trial among patients with COPD cared for in primary care and pulmonary clinics. The patients were at least 45 years of age and eligible for pulmonary rehabilitation. All patients received self-management education during a 6-week run-in period. Subsequently, patients were randomized to usual care or the intervention delivered over 20 weeks.Measurements and Main Results: Co-primary outcomes were change from baseline in Chronic Respiratory Questionnaire dyspnea domain score and 6-minute-walk distance measured at 6, 12, and 18 months after randomization. A total of 325 patients were enrolled, with 156 randomized to receive usual care and 149 to receive the intervention. At 18 months, there was no overall statistical or clinically significant change in the dyspnea domain in either group. However, for 6-minute-walk distance, there were statistically significant declines in both groups. In contrast, 6-minute-walk distance remained stable (5.3 m; P = 0.54) among patients in the intervention group with moderate spirometric impairment, but it was associated with clinically and statistically significant declines (228.7 m; P = 0.0001) among usual care patients with moderate spirometric impairment. Overall, there was no increase in adverse events associated with the intervention, which was associated with a lower prevalence of hospitalization for COPD exacerbations (28.3%) compared with usual care (49.5%).