Perceived weight-related stigma, loneliness, and mental wellbeing during COVID-19 in people with obesity: A cross-sectional study from ten European countries

Abstract

Background Increased weight-related stigma during the COVID-19 pandemic has amplified the need to minimise the impacts on mental wellbeing. We investigated the relationship between the perceived changes in the representation of obesity in the media and mental wellbeing during the pandemic in a sample of people with obesity across 10 European countries. We also investigated the potential moderating effect of loneliness. Methods Between September to December 2020 during the COVID-19 pandemic, participants reported data on demographics, mental wellbeing (measured by World Health Organisation Five Wellbeing Index and Patient Health Questionaire-4), loneliness (measured by De Jong Gierveld short scale), and perceived change in the representation of obesity in media (measured by a study-specific question) using the online, cross-sectional EURopean Obesity PatiEnt pANdemic Survey (EUROPEANS). Data were analysed using linear mixed-effects models, controlling for age, gender, body mass index, and shielding status, with random incept for country. Results The survey was completed by 2882 respondents. Most identified as female (56%) and reported their ethnicity as White or White-mix (92%). The total sample had a mean age of 41 years and a BMI of 35.4 kg/m 2 . During the peak of the pandemic, compared to pre-pandemic, perceiving more negative representation of people with obesity on social media was associated with worse psychological distress, depression, and wellbeing. Perceiving more positive representation, compared to no change in representation, of people with obesity on television was associated with greater wellbeing, yet also higher psychological distress and anxiety. Loneliness, as a moderator, explained ≤0.3% of the variance in outcomes in any of the models. Conclusions Perceiving negative representation of obesity on social media was associated with poorer mental wellbeing outcomes during the pandemic; positive representation on television was associated with both positive and negative mental wellbeing outcomes. We encourage greater media accountability when representing people with obesity.

Association between weight, weight perception, weight teasing and mental health among adolescents

“…Second, social media has been influencing social beliefs and attitudes. Research has shown that the media could exacerbate weight stigma by reinforcing ideal body image, which could lead to deterioration in mental health [ 64 ]. In addition, it has been found that in overweight or obese individuals, frequent experience of weight stigma increased the internalization of weight bias and thus made them more likely to adopt inappropriate coping responses (e.g.…”

Neurobiology of eating behavior, nutrition, and health

“…On the one hand, sex hormones are implicated in the regulation of appetite, metabolism, microbiome, and energy homeostasis [150], which likely underly sex differences in eating behavior. On the other hand, gender‐related inequalities in social factors such as body shaming, weight‐stigma, education, and socioeconomic status can profoundly impact diet, eating behaviors, and related health outcomes, effects that may even have accelerated during the Covid‐19 pandemic [151]. Tailoring preventive interventions that account for sex‐ and gender‐differences in eating behavior, particularly during adolescence, may thus be of relevance.…”

Prevalence of loneliness and associations with health behaviours and body mass index in 5835 people living with and beyond cancer: a cross-sectional study

“…Despite qualitative data suggesting that experiencing loneliness may negatively impact eating habits in older adults [ 38 , 39 ], quantitative data exploring associations between loneliness and intake of different dietary components are lacking. Lastly, loneliness may impact body mass index (BMI) in people LWBC, as evidence from the general population suggests a complex association between loneliness and obesity due to factors such as weight-related stigma [ 40 , 41 ]. While there is conflicting evidence suggesting a BMI in the overweight range (25-29.9) may be associated with improved survival across some cancer types, explanations for this paradox have still yet to be established [ 42 , 43 ].…”