STudy characterising the physIological response to weiGht stigMA
Research type
Research Study
Full title
A proof of principle pilot study to assess the impact of exposure to weight stigma and discrimination on the physiological responses in patients with obesity
IRAS ID
281784
Contact name
Adrian Brown
Contact email
Sponsor organisation
University College London Joint Research Office
Clinicaltrials.gov Identifier
Z6364106/2020/08/69, Data Protection Registration
Duration of Study in the UK
1 years, 1 months, 0 days
Research summary
Summary of Research
The prevalence of obesity continues to rise and has been classified as a major public health issue, with over two thirds of UK adults currently living with obesity. Despite the causes of obesity being complex, there is a belief by many that a person’s weight is their responsibility. This belief reinforces negative stereotypes of patients with obesity, being portrayed lazy, gluttonous, lacking will-power, a rhetoric known as weight stigma. Additionally, there is a belief that ‘fat-shaming’ is effective at achieving weight loss. However, evidence shows the opposite, with affected people increasing food intake and actually avoiding exercise. Furthermore, weight stigma negatively impacts depression, anxiety and is suggested to directly impact physical health. To date, limited studies have shown physiological effects of weight stigma, however, alterations in blood pressure (BP) and cortisol levels have been reported. As such, stress and inflammation triggered by weight stigmatisation could be contributing to the development of non-communicable diseases (NCD), therefore, presenting a highly relevant pathway to explore.
This is a proof of principle pilot study that will evaluate the feasibility of recruitment, randomisation, assessment procedures and implementation of the intervention with the aim to facilitate the planning and the conduct of a full-scale randomised controlled trial.
The overall aim of this study is to characterise the physiological responses of patients with obesity to a weight stigmatising experience.
20 female patients with obesity (Body Mass Index equal or greater than 30kg/m2) fulfilling study criteria will be recruited from UCLH Bariatric Centre for Weight Management and through social media advertisement.
This study will consist of a single visit during which the physiological response to a weight stigmatising experience or a non-weight stigmatising experience will be characterised. Physiological measurements will include blood pressure, heart rate, inflammatory markers, glucose level and gut hormone concentrations. The visit will take approximately 6 hours.
Summary of Results
Background Experimental evidence indicates that exposure to weight stigma can lead to sustained elevations in cortisol and ambulatory blood pressure. However, little is known about its acute effects on other physiological markers. This study aimed to explore the feasibility of measuring the physiological response of weight stigma, a novel weight stigmatising paradigm and preliminary efficacy signals.
Methods
In a prospective randomised feasibility study, women living with obesity were assigned to either a weight stigmatising or non-weight stigmatising paradigm (15 minutes) and physiological response measured from baseline to 120 minutes.Results
Eighteen women living with obesity were recruited (nine participants in each group; mean age 43.2years (SD 10.3); body mass index of 45.8kg/m2 (SD 5.9); 72.2% White ethnicity). Preliminary efficacy showed an observed acute increase in plasma cortisol (26.7pg/mL, 95%CI -5.5 to 58.9), alongside increased systolic blood pressure (12.7mmHg, 95%CI 0.6 to 24.8), self-reported stress (17.4 95% CI 1.6 to 33.3), appetite (hunger/desire to eat; 16.8, 95%CI 2.0 to 31.7; 20.9 95%CI 5.1 to 36.7, respectively), reduction in peptide YY (-11.8 pg/mL 95%CI-21.6 to -2.01) and fullness (-13.9 95%CI -27.6 to -0.3). No differences were found between the intervention and control group in all measured parameters. Furthermore this study showed that recruitment, randomisation and measuring real-time physiological response was feasible.Conclusions
This is the first feasibility study attempting to comprehensively characterise the acute physiological impact of experiencing weight stigma in people living with obesity in an experimental setting. Future appropriately powered studies are needed to confirm the preliminary efficacy findings.REC name
London - Dulwich Research Ethics Committee
REC reference
20/PR/0916
Date of REC Opinion
23 Feb 2021
REC opinion
Further Information Favourable Opinion