Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-25T21:06:49.477Z Has data issue: false hasContentIssue false

Overt and Subtle Discrimination, Subjective Well-Being and Physical Health-Related Quality Of Life in an Obese Sample

Published online by Cambridge University Press:  27 October 2014

Alejandro Magallares*
Affiliation:
Universidad Nacional de Educacion a Distancia (Spain)
Pilar Benito de Valle
Affiliation:
Hospital Nuestra Señora de Valme (Spain)
Jose Antonio Irles
Affiliation:
Hospital Nuestra Señora de Valme (Spain)
Ignacio Jauregui-Lobera
Affiliation:
Universidad Pablo de Olavide (Spain)
*
*Correspondence concerning this article should be addressed to Alejandro Magallares. Departamento de Psicología Social y de las Organizaciones. Facultad de Psicología UNED. C/ Juan del Rosal, 10. 28040. Madrid (Spain). E-mail: [email protected]

Abstract

Obesity represents a serious health issue affecting millions of people in Western industrialized countries. The severity of the medical problems it causes is paralleled by the fact that obesity has become a social stigma that affects the psychological health-related quality of life of individuals with weight problems. Our study, with 111 obese patients of a Spanish hospital, focused specifically on how overt and subtle discrimination is related to subjective well-being (affect balance and life satisfaction) and physical health-related quality of life. It was shown that overt (r = –.28, p < .01 with affect balance; r = –.26, p < .01 with life satisfaction) and subtle discrimination (r = –.28, p < .01 with affect balance; r = –.27, p < .01 with life satisfaction) were negatively linked with subjective well-being, and that there was a negative correlation between overt discrimination and physical health-related quality of life (r = –.26, p < .01). Additionally, it was found that overt discrimination was a mediator variable in the relationship between physical health-related quality of life and subjective well-being using the Baron and Kenny procedure. Finally, it is discussed the relationship between discrimination, subjective well-being and physical health-related quality of life in obese people.

Type
Research Article
Copyright
Copyright © Universidad Complutense de Madrid and Colegio Oficial de Psicólogos de Madrid 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alonso, J., Regidor, E., Barrio, G., Prieto, L., Rodriguez, C., & de la Fuente, L. (1998). Valores poblacionales de referencia de la versión española del Cuestionario de Salud SF-36 [Population-based reference values for the Spanish version of the Health Survey SF-36]. Medicina Clinica, 111, 410–146.Google Scholar
Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 11731182. http://dx.doi.org/10.1037/0022-3514.51.6.1173 Google Scholar
Böckerman, P., Johansson, E., Saarni, S. I., & Saarni, S. E. (2014). The negative association of obesity with subjective well-being: Is it all about health? Journal of Happiness Studies, 15, 857867. http://dx.doi.org/10.1007/s10902-013-9453-8 Google Scholar
Brandheim, S., Rantakeisu, U., & Starrin, B. (2013). BMI and psychological distress in 68,000 Swedish adults: A weak association when controlling for an age-gender combination. BMC Public Health, 13, 68. http://dx.doi.org/10.1186/1471-2458-13-68 Google Scholar
Cabañero, M., Richart, M., Cabrero, J., Orts, M, Reig, A., & Tosal, B. (2004). Fiabilidad y validez de la Escala de Satisfacción con la Vida de Diener en una muestra de mujeres embarazadas y puérperas [Reliability and validity of Satisfaction with Life Scale in a sample of pregnant women]. Psicothema, 16, 448455.Google Scholar
Carr, D., & Friedman, M. A. (2005). Is obesity stigmatizing? Body weight, perceived discrimination, and psychological well-being in the United States. Journal of Health and Social Behavior, 46, 244259. http://dx.doi.org/10.1177/002214650504600303 Google Scholar
Cronbach, L. J., & Shavelson, R. J. (2004). My current thoughts on coefficient alpha and successor procedures. Educational and Psychological Measurement, 64, 391418. http://dx.doi.org/10.1177/0013164404266386 Google Scholar
de Wit, L., Luppino, F., van Straten, A., Penninx, B., Zitman, F., & Cuijpers, P. (2010). Depression and obesity: A meta-analysis of community-based studies. Psychiatry Research, 178, 230235. http://dx.doi.org/10.1016/j.psychres.2009.04.015 Google Scholar
Diener, E. (2000). Subjective well-being: The science of happiness, and a proposal for national index. American Psychologist, 55, 3443. http://dx.doi.org/10.1037/0003-066X.55.1.34 Google Scholar
Diener, E., & Diener, C., (1996). Most people are happy. Psychological Science, 7, 181185. http://dx.doi.org/10.1111/j.1467-9280.1996.tb00354.x Google Scholar
Díez-Fernández, A., Sánchez-López, M., Mora-Rodríguez, R., Notario-Pacheco, B., Torrijos-Niño, C., & Martínez-Vizcaíno, V. (2014). Obesity as a mediator of the influence of cardiorespiratory fitness on cardiometabolic risk: A mediation analysis. Diabetes Care, 37, 855862. http://dx.doi.org/10.2337/dc13-0416 Google Scholar
Falkner, N. F., Neumark-Sztainer, D., Story, M., Jeffery, R. W., Beuhring, T., & Resnick, M. D. (2001). Social, educational, and psychological correlates of weight status in adolescents. Obesity Research, 9, 3242. http://dx.doi.org/10.1038/oby.2001.5 Google Scholar
Gariepy, G., Nitka, D., & Schmitz, N. (2010). The association between obesity and anxiety disorders in the population: A systematic review and meta-analysis. International Journal of Obesity, 34, 407419. http://dx.doi.org/10.1038/ijo.2009.252 Google Scholar
Giel, K., Thiel, A., Teufel, M., Mayer, J., & Zipfel, S. (2010). Weight bias in work settings - a qualitative review. Obesity Facts, 3, 3340. http://dx.doi.org/10.1159/000276992 Google Scholar
Gutiérrez-Fisac, J. L., Guallar-Castillón, P., León-Muñoz, L. M., Graciani, A., Banegas, J. R., & Rodríguez-Artalejo, F. (2012). Prevalence of general and abdominal obesity in the adult population of Spain, 2008–2010: The ENRICA study. Obesity Review, 13, 388392. http://dx.doi.org/10.1111/j.1467-789X.2011.00964.x Google Scholar
Hansson, L. M., Näslund, E., & Rasmussen, F. (2010). Perceived discrimination among men and women with normal weight and obesity. A population-based study from Sweden. Scandinavian Journal of Public, 38, 587596. http://dx.doi.org/10.1177/1403494810372266 Google Scholar
Haslam, D. W., & James, P. T. (2005). Obesity. Lancet, 366, 11971209. http://dx.doi.org/10.1016/S0140-6736(05)67483-1 Google Scholar
Hatzenbuehler, M. L., Keyes, K. M., & Hasin, D. S. (2009). Associations between perceived weight discrimination and the prevalence of psychiatric disorders in the general population. Obesity, 17, 20332039. http://dx.doi.org/10.1038/oby.2009.131 Google Scholar
Holmbeck, G. N. (2002). Pos-hoc probing of significant moderation and mediational effects in studies of pediatric populations. Journal of Pediatric Psychology, 27, 8796. http://dx.doi.org/10.1093/jpepsy/27.1.87 Google Scholar
Jalbert, L., & Wright, C. (2012). Making room for pp in the field of bariatrics. Psynopsis: Canada's Psychology Newspaper, 34, 2023.Google Scholar
Jones, K. P., Peddie, C. I., Gilrane, V. L., King, E. B., & Gray, A. L. (2013). Not so subtle: A meta-analytic investigation of the correlates of subtle and overt discrimination. Journal of Management, 11. http://dx.doi.org/10.1177/0149206313506466 Google Scholar
King, E. B., Shapiro, J. R., Hebl, M. R., Singletary, S. L., & Turner, S. (2006). The stigma of obesity in customer service: A mechanism for remediation and bottom-line consequences of interpersonal discrimination. The Journal of Applied Psychology, 91, 579593. http://dx.doi.org/10.1037/0021-9010.91.3.579 Google Scholar
Latner, J., Durso, L., & Mond, J. (2013). Health and health-related quality of life among treatment-seeking overweight and obese adults: Associations with internalized weight bias. Journal of Eating Disorders, 13, 1. http://dx.doi.org/10.1186/2050-2974-1-3 Google Scholar
Leontopoulou, S., & Triliva, S. (2012). Explorations of subjective well-being and character strengths among a Greek University student sample. International Journal of Wellbeing, 2, 251270. http://dx.doi.org/10.5502/ijw.v2.i3.6 CrossRefGoogle Scholar
Magallares, A., & Pais-Ribeiro, J. L. (2013). Mental health and obesity: A meta-analysis. Applied Research in Quality of Life, 9, 295308. http://dx.doi.org/10.1007/s11482-013-9226-x Google Scholar
McClure, K. J., Puhl, R. M., & Heuer, C. A. (2011). Obesity in the news: Do photographic images of obese persons influence antifat attitudes? Journal of Health Communication, 16, 359371. http://dx.doi.org/10.1080/10810730.2010.535108 Google Scholar
Miller, C. T., & Downey, K. T. (1999). A meta-analysis of heavyweight and self-esteem. Personality and Social Psychology Review, 3, 6884. http://dx.doi.org/10.1207/s15327957pspr0301_4 Google Scholar
Molero, F., Recio, P., García-Ael, C., Fuster, M. J., & Sanjuán, P. (2012). Measuring dimensions of perceived discrimination in 5 stigmatized groups. Social Indicators Research, 114, 901914. http://dx.doi.org/10.1007/s11205-012-0179-5 Google Scholar
Muennig, P. (2008). The body politic: The relationship between stigma and obesity- associated disease. BMC Public Health, 8, 128138. http://dx.doi.org/10.1186/1471-2458-8-128 Google Scholar
Noh, S., Kaspar, V., & Wickrama, K. A. S. (2007). Overt and subtle racial discrimination and mental health: Preliminary findings for Korean immigrants. American Journal of Public Health, 97, 12691274. http://dx.doi.org/10.2105/AJPH.2005.085316 Google Scholar
Ortiz-Hernández, L., Compeán-Dardón, S., Verde-Flota, E., & Flores-Martínez, M. N. (2011). Racism and mental health among university students in Mexico City. Salud Pública México, 53, 125133. http://dx.doi.org/10.1590/S0036-36342011000200005 Google Scholar
Pavot, W., & Diener, E. (1993). Review of the satisfaction with Life Scale. Psychological Assessment, 5, 164172. http://dx.doi.org/10.1037//1040-3590.5.2.164 Google Scholar
Pettigrew, T. F., & Meertens, R. W. (1995). Subtle and blatant prejudice in Western Europe. European Journal of Social Psychology, 25, 5775. http://dx.doi.org/10.1002/ejsp.2420250106 Google Scholar
Puhl, R. M., & Heuer, C. A. (2009). The stigma of obesity: A review and update. Obesity, 17, 941964. http://dx.doi.org/10.1038/oby.2008.636 Google Scholar
Puhl, R., Heuer, C., & Brownell, K. (2010). Stigma and social consequences of obesity. In Kopelman, P., Caterson, I., & Dietz, W. (Eds.), Clinical obesity in adults and children (pp. 2540). New York, NY: Wiley-Blackwell.Google Scholar
Ryan, R. M., & Deci, E. L. (2001). On happiness and human potentials: A review of research on hedonic and eudaimonic well-being. Annual Review of Psychology, 52, 141166. http://dx.doi.org/10.1146/annurev.psych.52.1.141 Google Scholar
Sandin, B., Chorot, P., Lostao, L., Joiner, T. E., Santed, M. A., & Valiente, R. M. (1999). Escalas PANAS de Afecto Positivo y Negativo: Validacion factorial y convergencia transcultural [Positive and Negative Affect Scales (PANAS): Factorial validity and cross-cultural convergence]. Psicothema, 11, 3751.Google Scholar
Schafer, M. H., & Ferraro, K. F. (2011). The stigma of obesity: Does perceived weight discrimination affect identity and physical health? Social Psychology Quarterly, 74, 7697. http://dx.doi.org/10.1177/0190272511398197 Google Scholar
Seligman, M. E., & Csikszentmihalyi, M. (2000). Positive psychology: An introduction. American Psychologist, 55, 514. http://dx.doi.org/10.1037/0003-066X.55.1.5 Google Scholar
Sikorski, C., Luppa, M., Kaiser, M., Glaesmer, H., Schomerus, G., König, H., & Riedel-Heller, S. (2011). The stigma of obesity in the general public and its implications for public health - a systematic review. BMC Public Health, 11, 661. http://dx.doi.org/10.1186/1471-2458-11-661 Google Scholar
Siwik, V., Kutob, R., Ritenbaugh, C., Cruz, L., Senf, Aickin, , M., … & Shatte, A. (2013). Intervention in overweight children improves body mass index (BMI) and physical activity. Journal of the American Board of Family Medicine, 26, 126137. http://dx.doi.org/10.3122/jabfm.2013.02.120118 Google Scholar
Sobel, M. (1988). Direct and indirect effects in linear structural equation models. In Long, J. (Ed.), Common problem/proper solutions: Avoiding error in quantitative research (pp. 4664). Beverly Hills, CA: Sage.Google Scholar
Swencionis, C., Wylie-Rosett, J., Lent, M. R., Ginsberg, M., Cimino, C., Wassertheil-Smoller, S., … Segal-Isaacson, , , C. J. (2013). Weight change, psychological well-being, and vitality in adults participating in a cognitive–behavioral weight loss program. Health Psychology, 32, 439446. http://dx.doi.org/10.1037/a0029186 CrossRefGoogle Scholar
Tsenkova, V. K., Carr, D., Schoeller, D. A., & Ryff, C. D. (2011). Perceived weight discrimination amplifies the link between central adiposity and nondiabetic glycemic control (HbA1c). Annals of Behavioral Medicine, 41, 243251. http://dx.doi.org/10.1007/s12160-010-9238-9 Google Scholar
Vilhena, E., Pais-Ribeiro, J. L., Silva, I., Cardoso, H., & Mendonça, D. (2014). Predictors of quality of life in Portuguese obese patients: A structural equation modeling application. Journal of Obesity, ID684919. http://dx.doi.org/10.1155/2014/684919 Google Scholar
Wardle, J., Chida, Y., Gibson, E. L., Whitaker, K., & Steptoe, A. (2011). Stress and adiposity: A meta-analysis of longitudinal studies. Obesity, 19, 771778. http://dx.doi.org/10.1038/oby.2010.241 CrossRefGoogle ScholarPubMed
Ware, J. E., & Sherbourne, C. D. (1992). The MOS 36-Item Short-Form Health Survey (SF-36). I. Conceptual framework and item selection. Medical Care, 30, 473483. http://dx.doi.org/10.1097/00005650-199206000-00002 CrossRefGoogle ScholarPubMed
Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect. The PANAS scales. Journal of Personality and Social Psychology, 54, 10631070. http://dx.doi.org/10.1037/0022-3514.54.6.1063 CrossRefGoogle ScholarPubMed
Williams, D. R., Neighbors, H. W., & Jackson, J. S. (2003). Racial/ethnic discrimination and health: Findings from community studies. American Journal of Public Health, 93, 200208. http://dx.doi.org/10.2105/AJPH.93.2.200 Google Scholar
World Health Organization (2011). Waist Circumference and Waist–Hip Ratio. Geneva, Suiza: World Health Organization.Google Scholar
Zeller, M. H., Ingerski, L. M., Wilson, L., & Modi, A. C. (2010). Factors contributing to weight misperception in obese children presenting for intervention. Clinical Pediatrics, 49, 330336. http://dx.doi.org/10.1177/0009922809346571 Google Scholar