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Assessing the relationship between weight stigma, stress, depression, and sleep in Chinese adolescents

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Abstract

Introduction

Weight stigma is defined as the social devaluation of people with overweight or obesity, and its negative effects on the health of adolescents from western countries are well documented, but little is known about the relationships with health behaviors and outcomes in Asian youth. The prevalence of obesity among Chinese adolescents continues to increase, potentially causing negative evaluations of youth with obesity, and potentially reduced quality of life. The health effects of these negative evaluations of Chinese youth with obesity have received little attention.

Purpose

The purpose of this study was to examine relationships between weight stigma, stress, depression, and sleep in Chinese adolescents.

Methods

We utilized a cross-sectional study conducted in Wuhan, China. Sociodemographic, weight stigma, stress, depression, and sleep data were collected through a self-reported questionnaire. Descriptive statistics, t test, correlations, and mediation analyses were performed. A total of 1626 adolescents between 14 and 19 years of age were included in the analysis.

Results

The data showed that adolescents with weight stigma presented significantly higher level of stress and depression, lower global sleep quality, longer sleep latency, and shorter sleep duration than those without weight stigma (p < 0.05). Stress and depression mediated the relationship between weight stigma and global sleep quality (SE = 0.007, 95% CI = 0.053 to 0.081).

Conclusion

These findings suggest that adolescents who experience weight stigma may have increased stress and depressive symptoms, which are associated with poorer global sleep quality and more daytime dysfunction.

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Data availability

Deidentified data can be made available upon request.

Code availability

Coding for statistical analyses can be made available on request.

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Acknowledgements

We thank the teachers, staff, and students from Jiangxia No. 1 High School in Wuhan, China, for their help. This work was supported by the National Natural Science Foundation of China [Grant No. 81402668]. The sponsor had no role in study design; in the collection, analysis and interpretation of data; in the writing of the articles; or in the decision to submit it for publication.

Funding

This work was supported by the National Natural Science Foundation of China [Grant No. 81402668].

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Authors and Affiliations

  1. Department of Healthcare Management, School of Health Sciences, Wuhan University, 115 Donghu Road, Wuhan, 430071, Hubei, China

    Zhanxia Wang, Xinge Zhang & Rui Li

  2. Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, 430071, China

    Jiajia Dang

  3. Department of Implementation Science, Wake Forest School of Medicine, Winston-Salem, NC, 27101, USA

    Justin B. Moore

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  1. Zhanxia Wang
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by ZW, JD, and XZ. The first draft of the manuscript was written by ZW and JD and all authors commented on previous versions of the manuscript. Study oversight was provided by RL and JM. All authors read and approved the final manuscript.

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Correspondence to Rui Li.

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The study was conducted in accordance with the Declaration of Helsinki, and the ethical application and consent procedure of this study were approved by the Ministry of Education of the People’s Republic of China and Ethics Committee of Wuhan University.

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All participants provided written parental consent.

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Wang, Z., Dang, J., Zhang, X. et al. Assessing the relationship between weight stigma, stress, depression, and sleep in Chinese adolescents. Qual Life Res 30, 229–238 (2021). https://doi.org/10.1007/s11136-020-02620-4

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