The roles of weight stigma, emotion dysregulation, and eating pathology in suicide risk

Douglas, Valerie; Kwan, Mun Yee; Gordon, Kathryn H.

doi:10.1016/j.bodyim.2021.04.005

Cited by 12 publications

(9 citation statements)

References 62 publications

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“…Similarly, in multiple studies of LGBTQ+ youth between the ages of 15 and 21, coming-out stress (i.e., the degree to which participants experienced stress upon first disclosing their sexual orientation), sexual orientation victimization, and internalized homophobia were all found to be indirectly associated with higher levels of depressive symptoms and SI through increases in perceived burdensomeness, but not thwarted belonging (Baams et al, 2015, 2018). Similarly, Douglas et al (2021) found increased weight-based stigmatization was linked to increased suicide risk through feelings of being a burden, as well as higher emotional dysregulation, but not belonging.…”

Section: Discussionmentioning

confidence: 95%

An examination of theory-based suicidal ideation risk factors in college students with multiple marginalized identities.

Shepherd¹,

Kelly²,

Brochu³

et al. 2023

American Journal of Orthopsychiatry

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Social marginalization increases the risk of suicidal ideation (SI) among individuals with diverse identities, yet research examining the effects of marginalization has focused on one identity. Emerging adulthood is a critical period of identity development and the age group with the highest rates of SI. Considering the challenges of living in potentially heterosexist, cissexist, racist, and sizeist environments, we tested whether possessing multiple marginalized identities was associated with severity of SI through factors proposed in the interpersonal–psychological theory (IPT) and the three-step theory (3ST) of suicide and if mediation paths were moderated by sex. A sample of 265 college students completed a cross-sectional online survey assessing SI and constructs related to IPT and 3ST. The number of marginalized identities was generated by adding minoritized sexual orientation, race/ethnicity other than non-Hispanic White, body mass index >25 kg/m2, sexual attraction to same sex but identified as heterosexual, and gender-fluid identity. In IPT multiple mediation analyses, possessing more marginalized identities was associated with SI severity through burdensomeness and hopelessness, but not belonging. Indirect paths through burdensomeness and belonging were moderated by sex. For 3ST, possessing more marginalized identities was associated with SI severity through hopelessness and psychological pain, but not social connection or meaning in life. Future research should consider intersecting social identities and test mechanisms by which multiply marginalized college students develop resilience to SI risk factors, such as support within their marginalized groups, to inform suicide assessment and intervention efforts on college campuses.

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Section: Discussionmentioning

confidence: 95%

An examination of theory-based suicidal ideation risk factors in college students with multiple marginalized identities.

Shepherd¹,

Kelly²,

Brochu³

et al. 2023

American Journal of Orthopsychiatry

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“…The potential explanation for this finding was that screen time increased obesity risk in children and adolescents ( 30 , 31 ). Adolescents who are overweight or self-perceived overweight fear negative social evaluations and stress from others, and these harmful psychological effects may trigger distress and suicidality ( 32 , 33 ). In addition, our study found that the mediating role of overweight/obesity in the association between screen time and suicidality was observed only in females, whereas there were no sex differences in the mediating effect of self-perceived overweight.…”

Section: Discussionmentioning

confidence: 99%

Mediation of the association between screen time and suicidality by overweight/obesity and perceived overweight: results from the youth risk behavior surveillance system of the United States

Gao,

Wang,

Wang

et al. 2024

Front. Psychiatry

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AimAdolescent suicide is a major public health concern, and modifiable risk factors associated with adolescent suicide remain poorly understood. This study aimed to assess the association between screen time and overweight/obesity and self-perceived overweigh and suicidality in adolescents.MethodsAdolescents from the United States Youth Risk Behavior Surveillance System (YRBSS) between 2013 and 2019 were included in this cross-sectional study. The outcome was suicidality, including considered suicide, made a suicide plan, attempted suicide, and injurious suicide attempt. Multivariable logistic regression model was used to investigate the associations between screen time, overweight/obesity, self-perceived overweight, and suicidality, and expressed as odds ratio (OR) and 95% confidence interval (CI). Mediation analysis was used to explore the role of overweight/obesity and self-perceived overweight on the association between screen time and suicidality.ResultsA total of 30,731 adolescents were included, of which 6,350 (20.65%) had suicidality, including 5,361 (17.45%) with considered suicide, 4,432 (14.42%) with made a suicide plan, 2,300 (7.45%) with attempted suicide, and 677 (2.21%) with injurious suicide attempt. Adolescents with screen time ≥3h were related to higher odds of suicidality (OR=1.35, 95%CI: 1.23-1.46), overweight/obesity (OR=1.27, 95%CI: 1.19-1.38), and self-perceived overweight (OR=1.38, 95%CI: 1.30-1.48) after adjusting confounders. Adolescents with overweight/obesity (OR=1.30, 95%CI: 1.19-1.43) and self-perceived overweight (OR=1.54, 95%CI: 1.39-1.70) were associated with higher odds of suicidality. The association between screen time and suicidality was 4.67% mediated by overweight/obesity and 9.66% mediated by self-perceived overweight. Moreover, the mediating role of overweight/obesity was observed only in females, whereas there were no sex differences in the mediating effect of self-perceived overweight.ConclusionBoth overweight/obesity and self-perceived overweight mediated the association between screen time and suicidality.

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“…Maladaptive eating is especially influential in the context of weight stigma as one of the mechanisms in which people gain weight and become more vulnerable to further experiences of weight stigma (Tomiyama, 2014). Potentially most concerning, eating pathology is a mechanism by which weight stigma may increase suicide risk (Douglas et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

Constant vigilance: The impact of weight stigma, vigilance, and internalization on maladaptive eating behaviors.

Wetzel,

Himmelstein

2023

Health Psychology

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Objective: Weight stigma (social devaluation because of weight) and weight bias internalization (self-stigma due to weight) have been independently implicated in maladaptive eating, which ultimately contributes to poor cardiometabolic health. Additionally, vigilance (being on the lookout for social devaluation) is connected to stress, poor sleep, and depression. Most research considers these factors separately but establishing how these variables interact with one another is essential to understanding their cumulative impact on health behaviors. Method: Using a diverse national panel of adults in the United States (N = 1,051), this study tested several statistical moderated mediations in which weight stigma was both directly associated with maladaptive eating and indirectly associated with maladaptive eating via vigilance. We simultaneously examined whether the relationship between weight stigma and vigilance was moderated by self-stigma. Results: Results indicated that experiencing weight stigma was directly related to each of the maladaptive eating behaviors (eating to cope, restrictive dieting frequency, and binge eating). Weight stigma was also indirectly related to each eating behavior through vigilance; this indirect relationship was stronger among those with high levels of weight bias internalization, compared to those with low levels of weight bias internalization. Race moderated the relationship between weight stigma and vigilance, such that participants identifying as Black had a stronger relationship between them. Conclusions: These results provide support for a theoretical model which explains how weight stigma, self-stigma, and vigilance interact with one another to produce negative health behaviors and highlight the importance of further investigation of vigilance in the context of weight stigma. Public Significance StatementPoor treatment due to someone's body weight leads to increases in disordered eating such as restricting food, eating to cope, and binge eating. This study finds that one reason this might be happening is chronic stress and worry over the possibility of being treated poorly in the future. This is especially likely if somebody already thinks about themselves poorly because of their body weight.

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The roles of weight stigma, emotion dysregulation, and eating pathology in suicide risk

Cited by 12 publications

References 62 publications

An examination of theory-based suicidal ideation risk factors in college students with multiple marginalized identities.

An examination of theory-based suicidal ideation risk factors in college students with multiple marginalized identities.

Mediation of the association between screen time and suicidality by overweight/obesity and perceived overweight: results from the youth risk behavior surveillance system of the United States

Constant vigilance: The impact of weight stigma, vigilance, and internalization on maladaptive eating behaviors.

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