Workplace wellbeing study 2018-2019

This was an experimental study utilising a workplace wellness paradigm to explore the influence of high-weight individuals’ scores on the WSRS as a predictor of response to a potentially stigmatising cue – introduction of a workplace-sponsored weight-management programme, compared with a control cue – introduction of a workplace-sponsored stress-management programme. Dependent variables were attitudes toward the programme, the workplace, affect (PANAS-X subscales guilt, hostility, self-assurance), and self-rated health. Baseline data, including the WSRS, were collected at Time 1. Three filler measures were used to disguise the true nature of the study. These included the Modern Sexism scale, and two measures created for the study relating to (i) environmental/food/social justice concerns and intentions and (ii) to charitable giving and attitudes toward charitable institutions. The experimental manipulation and subsequent measures were collected at Time 2, two weeks later. Data for 197 high-weight UK-based adults were collected for the two time points. <p>The prevalence of high-weight status is increasing globally, with approximately 60% of people in the UK considered 'overweight' or 'obese' by BMI standards, and similar rates in many other countries. Despite this, higher-weight individuals experience prejudice and discrimination in practically every domain of daily living, including education, employment, healthcare, and interpersonal relationships. We know from other oppressed groups that stigma is associated with poorer health and life outcomes, and in the last ten years, these effects have been demonstrated also in the case of weight stigma. A better understanding of how these processes occur and identification of potential targets for intervention to reduce resulting harms is of critical importance to public policy.
Little is known about how the impact of weight stigma is transmitted, and even less on how the harms can be minimised. My PhD work focused predominantly on internalised weight stigma (IWS) - the phenomenon where higher-weight people devalue themselves because of their weight. IWS has been linked with a range of physical and psychological health problems, and unhelpful coping strategies such as disordered eating, avoidance of exercise, social isolation, and substance use. IWS is also an intermediary in many of the problems associated with experiencing stigma from others. However, we do not know why some people internalise societal stigma, others are largely unaffected, and some actively resist and challenge the stigma.
During my PhD, I developed the first questionnaire to measure weight stigma resistance and demonstrated that resistance was associated with improved psychological wellbeing. I also drew on research from the mental health stigma literature and identified a number of key characteristics of internalisers and resisters. One important factor was whether the individual had a strong group identity - that is, whether they feel a sense of kinship and belonging with other higher-weight people. People with high group identity were less likely to internalise and more likely to resist. Another important factor was whether or not they felt that body weight was under individual control and simply a matter of willpower. Those who believed they could become slimmer tended not to resist stigma and were more likely to internalise it. But perhaps most interestingly, believing that stigma of higher-weight people was not justified helped to define resisters even if they didn't have high group identity and whether or not they felt their weight status was controllable. This means that it may be possible to develop health promotion interventions that take a social justice-based approach: that stigma is wrong whatever the circumstances and people deserve to be treated equally and with respect whatever their weight. Such an intervention may improve psychological wellbeing in higher-weight individuals regardless of their current beliefs and feelings about their weight.</p>

本研究为一项实验性研究，采用职场健康范式，旨在探讨高体重个体在体重污名抵抗量表（Weight Stigma Resistance Scale, WSRS）上的得分，作为个体对两类潜在污名化线索反应的预测因子的效应：一类为职场赞助的体重管理项目引入线索，另一类为对照线索——职场赞助的压力管理项目引入线索。本研究的因变量包括对该项目的态度、对职场的态度、情感状态（采用积极和消极情感量表-扩展版（Positive and Negative Affect Schedule-Extended, PANAS-X）的愧疚、敌意、自信分量表）以及自评健康状况。基线数据（包含WSRS得分）于时间点1收集完成。本研究采用三项填充量表以掩盖真实研究目的，分别为现代性别歧视量表，以及两项为本研究定制的量表：其一涉及环境、食品与社会正义相关的担忧与意向，其二涉及慈善捐赠及对慈善机构的态度。实验操控与后续测量于两周后的时间点2完成。本研究共收集了197名英国籍高体重成年人的两阶段研究数据。
全球范围内高体重人群占比持续攀升，英国约有60%的成年人依据身体质量指数（Body Mass Index, BMI）标准被归类为“超重”或“肥胖”，其他多国的相关比例也与之相近。尽管如此，高体重个体在日常生活的几乎所有领域均会遭遇偏见与歧视，涵盖教育、就业、医疗保健及人际交往等场景。过往针对其他受压迫群体的研究表明，污名化经历与更差的健康及生活结局相关；近十年来，此类效应在体重污名场景中也得到了证实。深入理解这类过程的发生机制，并识别可干预的潜在靶点以减轻由此带来的伤害，对公共政策制定具有至关重要的意义。
目前学界对体重污名的影响传递路径知之甚少，而对如何最小化其危害的研究则更为匮乏。我的博士研究主要聚焦于内化性体重污名（internalised weight stigma, IWS）——即高体重个体因自身体重而自我贬低的现象。内化性体重污名与一系列躯体及心理健康问题相关，还会引发不良应对策略，比如失调性进食、回避运动、社交隔离及物质滥用。此外，内化性体重污名还是个体遭遇他人污名化后产生诸多问题的中介变量。然而，我们仍不清楚为何部分个体将社会污名内化，而另一些个体几乎不受影响，甚至有部分个体能够主动抵制并驳斥此类污名。
在博士研究期间，我开发了首个用于测量体重污名抵抗的问卷，并证实体重污名抵抗与更好的心理健康水平相关。我还借鉴了心理健康污名领域的研究成果，明确了内化者与抵抗者的若干关键特征。其中一项重要因素为个体是否拥有强烈的群体身份认同——即是否与其他高体重个体产生亲缘感与归属感。群体身份认同较强的个体更不易内化污名，也更倾向于抵制污名。另一关键因素为个体是否认为体重可由个人掌控，且仅取决于意志力。那些相信自己能够减重的个体往往不会抵制污名，反而更易将其内化。但或许最值得关注的是，即便个体没有较强的群体身份认同，也无论其是否认为体重状态可控，只要其认为针对高体重人群的污名是不合理的，这一信念就能将其界定为抵抗者。这意味着我们或许可以开发基于社会正义路径的健康促进干预方案：即无论具体情境如何，污名化行为都是错误的，无论个体体重如何，都理应获得平等且尊重的对待。此类干预方案或可改善高体重个体的心理健康水平，而不受其当前对自身体重的信念与感受的制约。