Stigma Related to Weight and Diabetes
abstract
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Access this abstract now Full Text Available for ClinicalKey SubscribersAIMS
Diabetes stigma and weight stigma have been identified as important but neglected issues that warrant attention among people with type 2 diabetes. This study assessed associations of diabetes stigma and weight stigma with diabetes self-care behaviors and health care in adults with type 2 diabetes.
METHODS
U.S. adults with type 2 diabetes (N = 1,227) completed self-report questionnaires to assess their experiences of weight stigma, diabetes stigma, diabetes self-management, diabetes-specific distress, healthcare utilization, perceptions of diabetes-specific health care. They also provided sociodemographic information. Linear regressions examined relationships among stigma and diabetes self-care and related health care, controlling for participants' age, education, income, gender, race/ethnicity, and body mass index.
RESULTS
Internalized weight stigma and diabetes self-stigma were both significantly associated with higher diabetes-specific distress. Adults who expressed self-stigma for their diabetes reported less diabetes self-management and lower self-efficacy, and those who reported being judged about their weight by a doctor exhibited greater diabetes-specific distress. While a history of experienced weight stigma (in general) did not reduce frequency of seeking health care, lower quality interactions with health care professionals were reported by adults who expressed diabetes self-stigma and those who experienced weight stigma from a doctor.
CONCLUSIONS
Self-stigma for diabetes and body weight, as well as experiencing judgment about weight from doctors, may have negative implications for diabetes-specific self-care behaviors and perceived quality of health care. Efforts to promote wellbeing in individuals with type 2 diabetes need to consider reducing both diabetes and weight stigma and their potentially harmful consequences.
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Additional Info
Weight Stigma and Diabetes Stigma in U.S. Adults With Type 2 Diabetes: Associations With Diabetes Self-Care Behaviors and Perceptions of Health Care
Diabetes Res. Clin. Pract. 2020 Aug 26;168(xx)108387, RM Puhl, MS Himmelstein, JL Hateley-Browne, J SpeightFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
Weight stigma and diabetes stigma are common in the US and world and preclude the level of self-care needed for these conditions and add to the associated distress. In this study, persons with diabetes and excess weight were questioned about their experiences with weight stigma, diabetes stigma, diabetes self-management, diabetes-specific distress, healthcare utilization, and perceptions of diabetes-specific health care. Puhl and colleagues utilized self-report questionnaires to assess 1227 people with type 2 diabetes regarding the aforementioned. They also obtained sociodemographic information. When persons internalized their weight and/or diabetes stigma, they experienced higher degrees of diabetes-specific stress. It is important to note that when persons internalize stigma of any form, they are highly affected by the stigma that they are subjected to. However, not all persons internalize such stigma. When adults did have self-stigma regarding their diabetes, they did not perform as well with their diabetes self-management and had less ability to be self-effective. Persons were particularly bothered when their physicians judged them about their weight, and this judgement led to an increase in diabetes-specific distress. When persons experienced diabetes self-stigma, they reported lower-quality interactions with healthcare professionals. Persons who experience self-stigma regarding their diabetes and weight while also experiencing judgement about their weight from physicians reduce diabetes-specific self-care behaviors and their perceived quality of healthcare is lower.