While the preclinical development of type 2 diabetes is partly explained by obesity and central adiposity, psychosocial research has shown that chronic stressors such as discrimination have health consequences as well.
We investigated the extent to which the well-established effects of obesity and central adiposity on nondiabetic glycemic control (indexed by HbA1c) were moderated by a targeted psychosocial stressor linked to weight: perceived weight discrimination.
The data came from the nondiabetic subsample (n = 938) of the Midlife in the United States (MIDUS II) survey.
Body mass index (BMI), waist-to-hip ratio, and waist circumference were linked to significantly higher HbA1c (p < 0.001). Multivariate-adjusted models showed that weight discrimination exacerbated the effects of waist-to-hip ratio on HbA1c ( p < 0.05), such that people who had higher waist-to-hip ratios and reported weight discrimination had the highest HbA1c levels.
Understanding how biological and psychosocial factors interact at nondiabetic levels to increase vulnerability could have important implications for public health and education strategies. Effective strategies may include targeting sources of discrimination rather than solely targeting the health behaviors and practices of overweight and obese persons.
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This research was supported by a grant from the National Institute on Aging (P01-AG020166; Carol D. Ryff, Principal Investigator) to conduct a longitudinal follow-up of the MIDUS (Midlife in the US) investigation. The original study was supported by the John D. and Catherine T. MacArthur Foundation Research Network on Successful Midlife Development. We thank the staff of the Clinical Research Center at the University of Wisconsin—Madison, at the University of California—Los Angeles, and at Georgetown University for their support in conducting this study. Data collection was supported by the following grants M01-RR023942 (Georgetown), M01-RR00865 (UCLA) from the General Clinical Research Centers Program, and 1UL1RR025011 (UW) from the Clinical and Translational Science Award (CTSA) program of the National Center for Research Resources, National Institutes of Health. The first author of this study was also supported, in part, by award number T32HD049302 from the Eunice Kennedy Shriver National Institute of Child Health And Human Development. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Eunice Kennedy Shriver National Institute of Child Health and Human Development or the National Institutes of Health.
Conflicts of interest
The authors have no financial disclosures related to products or corporate holdings mentioned in this manuscript.
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Tsenkova, V.K., Carr, D., Schoeller, D.A. et al. Perceived Weight Discrimination Amplifies the Link Between Central Adiposity and Nondiabetic Glycemic Control (HbA1c). ann. behav. med. 41, 243–251 (2011). https://doi.org/10.1007/s12160-010-9238-9
- Weight discrimination
- Individual differences