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Perceived Weight Discrimination and 10-Year Risk of Allostatic Load Among US Adults

  • Original Article
  • Published:
Annals of Behavioral Medicine

An Erratum to this article was published on 22 December 2016

Abstract

Background

Discrimination promotes multisystem physiological dysregulation termed allostatic load, which predicts morbidity and mortality. It remains unclear whether weight-related discrimination influences allostatic load.

Purpose

The aim of this study was to prospectively examine 10-year associations between weight discrimination, allostatic load, and its components among adults 25–75 years in the Midlife Development in the US Biomarker Substudy.

Methods

Participants with information on weight discrimination were analyzed (n=986). At both timepoints, participants self-reported the frequency of perceived weight discrimination across nine scenarios as “never/rarely” (scored as 0), “sometimes” (1), or “often” (2). The two scores were averaged and then dichotomized as “experienced” versus “not experienced” discrimination. High allostatic load was defined as having ≥3 out of 7 dysregulated systems (cardiovascular, sympathetic/parasympathetic nervous systems, hypothalamic pituitary axis, inflammatory, lipid/metabolic, and glucose metabolism), which collectively included 24 biomarkers. Relative risks (RR) were estimated from multivariate models adjusted for sociodemographic and health characteristics, other forms of discrimination, and BMI.

Results

Over 41% of the sample had obesity, and 6% reported weight discrimination at follow-up. In multivariable-adjusted analyses, individuals who experienced (versus did not experience) weight discrimination had twice the risk of high allostatic load (RR, 2.07; 95 % CI, 1.21; 3.55 for baseline discrimination; 2.16, 95 % CI, 1.39; 3.36 for long-term discrimination). Weight discrimination was associated with lipid/metabolic dysregulation (1.56; 95 % CI 1.02, 2.40), glucose metabolism (1.99; 95 % CI 1.34, 2.95), and inflammation (1.76; 95 % CI 1.22, 2.54), but no other systems.

Conclusions

Perceived weight discrimination doubles the 10-year risk of high allostatic load. Eliminating weight stigma may reduce physiological dysregulation, improving obesity-related morbidity and mortality.

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Acknowledgments

This work was supported by the NHLBI (grant numbers HL49086, HL60692). Funding was also provided by a Mentored Career Development Award to Promote Faculty Diversity in Biomedical Research from the NHLBI (J.M., grant number K01-HL120951), and an NIH Ruth L Kirschstein Postdoctoral Fellowship (M.V., grant number 5 T32 DK 7703-19). NIH had no role in the design, analysis, or writing of this article.

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Authors and Affiliations

  1. Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, 02881, USA

    Maya Vadiveloo PhD, RD

  2. Department of Nutrition, Harvard T. H. Chan School of Public Health, 665 Huntington Ave, Bldg 2, Boston, MA, 02115, USA

    Josiemer Mattei PhD, MPH

Authors
  1. Maya Vadiveloo PhD, RD
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Correspondence to Josiemer Mattei PhD, MPH.

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Authors’ Statement of Conflict of Interest and Adherence to Ethical Standards Authors

Maya Vadiveloo and Josiemer Mattei declare that they have no conflict of interest. All procedures, including the informed consent process, were conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.

Additional information

An erratum to this article is available at http://dx.doi.org/10.1007/s12160-016-9870-0.

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Vadiveloo, M., Mattei, J. Perceived Weight Discrimination and 10-Year Risk of Allostatic Load Among US Adults. ann. behav. med. 51, 94–104 (2017). https://doi.org/10.1007/s12160-016-9831-7

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