Background: Internalized weight stigma has gained growing interest due to its association with multiple health impairments in individuals with obesity. Especially high internalized weight stigma is reported by individuals undergoing bariatric surgery. For assessing this concept, two different self-report questionnaires are available, but have never been compared: the Weight Self-Stigma Questionnaire (WSSQ) and the Weight Bias Internalization Scale (WBIS). The purpose of the present study was to provide and to compare reliability, convergent validity with and predictive values for psychosocial health outcomes for the WSSQ and WBIS. Methods: The WSSQ and the WBIS were used to assess internalized weight stigma in N = 78 prebariatric surgery patients. Further, body mass index (BMI) was assessed and body image, quality of life, self-esteem, depression, and anxiety were measured by well-established self-report questionnaires. Reliability, correlation, and regression analyses were conducted. Results: Internal consistency of the WSSQ was acceptable, while good internal consistency was found for the WBIS. Both measures were significantly correlated with each other and body image. While only the WSSQ was correlated with overweight preoccupation, only the WBIS was correlated with appearance evaluation. Both measures were not associated with BMI. However, correlation coefficients did not differ between the WSSQ and the WBIS for all associations with validity measures. Further, both measures significantly predicted quality of life, self-esteem, depression, and anxiety, while the WBIS explained significantly more variance than the WSSQ total score for self-esteem.

Over the last few decades, the prevalence of overweight and obesity has increased dramatically, with increased interest in the issue of stigmatization of overweight and obese people. The theoretical part of this thesis summarizes the existing knowledge in this area and describes the form of weight stigma in various areas of life - in the work area, in medical care and in the media. Foreign studies claim that weight stigma is not only present in these and other areas of life, but that it has various negative effects on the psyche and health of a stigmatized individual. Although research in this area is at an early stage, there is already evidence of a relationship of weight stigma and pathological eating behavior, affective disorders or negative body image. However, psychological intervention and therapy offer satisfactory tools to work with the stigmatization theme. The weight stigma is not a topic in the Czech Republic, despite its expanding abroad. The research carried out within the empirical part of the thesis is an initial attempt to map out the phenomenon of stigmatization of overweight and obese people in the Czech environment. For the purpose of the thesis, a questionnaire was drawn up and subsequently used in experimental design. The questionnaire investigated whether the assessment of...

The present thesis provides insight into health psychology aspects of overweight and obesity prevention and therapy. Participation behavior, psychosocial well-being and mental health have been examined closely. Continuous adherence to physical activity programs designed to avoid development or progression of juvenile overweight and obesity is difficult to maintain in everyday-life of participants. Motivation for participation and a personal schedule, that complements intervention time requirements, is essential for success and sustainability of physical activity interventions. Media support in promoting adherence is a topic of controversial discussion, but might help to promote motivation for health behavior change if used appropriately for the right target group. Therefore, means of communicating with young people need to be analyzed and integrated into health messages in order to make them convincing and interesting. Further media devices and channels need to be investigated to achieve an up-to-date understanding of health promotion technology. Telephone counseling is as effective as face-to-face counseling regarding BMI reduction. However, its effect on psychosocial well-being and body image seems to be minor. The effect of parental delivery of health messages and information on psychosocial well-being and stress to their children regarding body image and related constructs needs to be further elucidated. Mediators and moderators should be investigated in order to be able to control health promotion content. Mental health plays a crucial role in the development and progression of extreme obesity in adolescence. Early mental health impairments such as internalizing and externalizing behavior may lead to pathological eating and pathological health behavior habits and consequent weight gain. During the course of a treatment program it is of great importance to focus on psychiatric comorbidities in order to achieve stable and long-lasting effects on weight loss and lifestyle behavior. Adolescents undergoing bariatric surgery often suffer from moderate to severe depressive symptoms or clinically diagnosed depression. The interdependency between depression and obesity impedes predictability of bariatric surgery on weight loss outcomes and compliance with lifestyle requirements after surgery. In any case, mental health needs to be closely examined before a patient undergoes surgery. Monitoring and stabilization of psychological well-being after invasive treatment could lead to the practice of beneficial health behavior, enduring weight stabilization and improved quality of life.

No description available.

Contexte : Etant donné la forte progression de la prévalence du surpoids et de l'obésité à l'adolescence ces dernières décennies, la prévention est devenue une priorité de santé publique internationale. Objectif : L'essai PRALIMAP (PRomotion de l'ALIMentation et de l'Activité Physique) évalue l'impact de trois stratégies de prévention du surpoids et de l'obésité - « Education », « Environnement », « Dépistage » - chez les adolescents en milieu scolaire, sur la corpulence, les connaissances, attitudes et comportements des adolescents vis-à-vis de la nutrition (alimentation et activité physique). Méthode : Les trois stratégies ont été affectées à 24 lycées de la région Lorraine (Nord-est de la France) sur 2 années (en classe de seconde et de première) par randomisation en grappe (=lycée), selon un plan factoriel 2x2x2. La stratégie Éducation consistait en des cours et des travaux de groupe sur la nutrition et une fête nutritionnelle annuelle. La stratégie Environnement consistait à améliorer l'offre nutritionnelle des lycées et organiser une fête nutritionnelle annuelle. La stratégie Dépistage consistait en un repérage des adolescents en surpoids ou obèses suivi d'une prise en charge adaptée collective. Les données ont été recueillies à 3 reprises : à l'entrée en classe de seconde (T0), de première (T1) et de terminale (T2). L'indice de masse corporelle (IMC), son z-score et la proportion d'adolescents en surpoids ou obèses étaient les critères de jugement principaux. Les critères de jugement secondaires étaient les connaissances et comportements nutritionnels. Les différences d'évolution T0-T2 des critères de jugement entre les 12 lycées ayant bénéficié d'une stratégie et les 12 lycées témoins de cette stratégie a été analysée à l'aide de modèles mixtes. Une évaluation du processus a permis d'estimer la dose réelle d'intervention de chaque stratégie dans chacun des lycées. Résultats : La stratégie Dépistage a entrainé une amélioration de la corpulence : augmentation moins importante de l'IMC avec la stratégie Dépistage (+0,6 vs +0,7, p=0,0303), diminution plus importante du z-score de l'IMC (-0,9 vs -0,5, p=0,0173) et de la prévalence du surpoids et de l'obésité (-2,3% vs -0,6%, p=0,0386). La stratégie Education a entrainé une amélioration de certains comportements nutritionnels : augmentation plus importante de la proportion d'adolescent suivant la recommandation nutritionnelle sur les féculents (3,6% vs -0,7%, p=0,0357) et du nombre d'activités physiques pratiquées (+0,02 vs -0,10, p=0,0047). La stratégie Environnement a amélioré les comportements et les connaissances nutritionnels : diminution moins importante de la proportion d'adolescents suivant la recommandation nutritionnelle sur le nombre de repas hebdomadaire (-4,5% vs -8,5%, p=0,0101) et amélioration plus importante du score de connaissances nutritionnelles (+1,9 point vs +1,0 point, p=0,0094). Des différences dans la réalisation des activités et la participation ont été mises en évidence suite à l'estimation de la dose d'intervention et peuvent expliquer certains résultats observés. Conclusion : Une stratégie de dépistage structurée en milieu scolaire apparaît bénéfique sur la réduction du surpoids et de l'obésité. L'addition d'activités d'éducation nutritionnelles dans le cursus n'induit pas d'effets sur la corpulence à court terme. La modification de l'environnement nutritionnel scolaire semble avoir un effet sur les indicateurs intermédiaires de connaissances et comportements nutritionnels / Background: Given the increasing prevalence of youth overweight and obesity in the last decade, prevention as become an international public health priority.Objective: The aim of The PRALIMAP (PRomotion de l'ALIMentation et de l'Activité Physique) trial was to evaluate the 2-year effectiveness of three strategies - « Education », « Screening » et « Environment »- aimed at preventing overweight and obesity among adolescents in high school setting on body size and nutritional knowledge and behaviours. Method: PRALIMAP was a school-based randomized controlled trial beginning in 24 state-run high schools (clusters) in Lorraine (north-eastern France). Each study high school was assigned to receive or not, over a 2-year period (grades 10 and 11), each of the three prevention strategies according to a 2x2x2 factorial school randomization. The prevention strategies were: ?education? (development of nutritional knowledge and skills), "environment" (creation of favourable environment by improving availability of dietary items with a good nutritional quality and physical activity), and "screening" (detection of overweight and obesity and, if necessary, adapted care management). The follow-up consisted of three visits: at the entry of grade 10(T0), grade 11(T1) and grade 12(T2). Body mass index (BMI), BMI z-score and prevalence of overweight and obesity were the main outcomes measures. Secondary outcomes measures were nutritional knowledge and behaviours. Comparisons of changes (T2-T0) of outcomes measures between each strategy schools and their control were carried out using a three-level hierarchical mixed model. A process evaluation allowed estimating an intervention dose really received by adolescents. Results: The 2-year change of anthropometric outcomes was more favourable in the 12 screening high schools as compared with the no-screening ones: a lower increase in BMI (+0,6 vs +0,7, p=0,0303), a greater decrease in BMI z-score (-0,9 vs -0,5, p=0,0173) and a greater decrease in overweight / obesity prevalence (-2,3% vs -0,6%, p=0,0386). The education strategy resulted in improved nutritional behaviours: a greater increase in achievement of starchy food guidelines (3,6% vs -0.7%, p=0.0357) and physical activity practice (+0,02 vs -0,10, p=0,0047). The environment strategy resulted in improved nutritional attitudes: a lower decrease in achievement of number of weekly meals guidelines (-4.5% vs -8.5%, p=0.0101) and greater increase in nutritional knowledge (+1,9 point vs +1,0 point, p=0.0094). Some differences in activity implementation and participation were highlighted and can explain some of the results observed. Conclusions: The screening strategy is an effective way to prevent, at two years, overweight and obesity among adolescents in a high school setting. Nutritional education added to the curriculum is not effective in the short term on body size. The school nutritional environment modification is slightly associated with improved nutritional knowledge and behaviours

Thesis (M.Sc.)--Memorial University of Newfoundland, 2005. / Restricted until October 2006. Bibliography: leaves 103-113.

<p>Over the past three decades, the phenomenon of children's health in China has been marked by a co-existence of overweight and underweight. As the primary institution for a child, family is an opportune place for child malnutrition intervention. By advancing a framework that addresses the contextual factors which shape the heterogeneity of socioeconomic gradients of child overweight/obesity, this dissertation has sought to understand the channels through which access to family resources influences child overweight/obesity in China. Based on these developed understandings, I identified the mechanisms by which having any younger siblings and three generation living together or proximately affect child malnutrition in China. Using data drawn from China Health and Nutrition Survey, this dissertation uncovered remarkable differences in multiple levels of contextual factors that shape a child's risk of overweight/obesity and underweight in China as compared to Western society. China's stage of economic development together with the drastically increasing income inequality has created an ever-increasing socioeconomic gap in child overweight/obesity, especially after 1997. This finding confirmed the position of the Ecological System framework that access to obesogenic environment is much more important than willpower based on knowledge in shaping one's obesity-related risk behavior. Although the fertility level has been lowered by One Child Policy, resource dilution effect still affects girls' nutrition status, especially for those exposed to poverty and food insecurity. Children in the care of grandparents are healthier, probably due to the generally low degree of access to obesogenic foods and a closer intergenerational relationship that facilitates effective communication and promotes healthy lifestyle formation.</p> / Dissertation

In recent years, physical activity and fitness transitions, described as declines in physical activity and aerobic fitness, coupled with increased sedentary behaviour, have been observed among school-aged children. Consequently, the prevalence of childhood overweight/obesity has also increased considerably. While there is a wealth of evidence supporting such behavioural transitions in higher income countries, there exists a paucity of data on the situation in lower income countries, such as those in Sub-Saharan Africa (SSA). The premise of this thesis was to investigate the robustness of these relationships in other global regions. The first objective was to investigate the evidence for an overweight/obesity, physical activity, and fitness transition among SSA’s school-aged children. Systematic review methodology was used to examine temporal trends and correlates of overweight/obesity, physical activity, fitness, and sedentary behaviour in apparently healthy or population based samples of children (5 - 17 years). The second objective of this thesis was to determine the prevalence and correlates of overweight/obesity and physical activity among Kenyan children aged 9 to 11 years, having contextualised Kenya within the broader situation in SSA. Further, the relationships between self-reported and directly assessed measures of physical activity and sedentary time by weight status in Kenyan children were investigated. The third objective was to examine moderate-to-vigorous physical activity (MVPA) patterns accrued by time of day among Kenyan children using the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE)-Kenya data. Activity patterns in the Kenyan setting were then compared to similar ISCOLE-Canada data from Canadian children, revealing differences and similarities in the accumulation of MVPA, light physical activity, and sedentary time. Systematic review data syntheses revealed a trend towards increasing proportions of overweight/obesity among Sub-Saharan Africa’s school-aged children. Further, urbanization and higher socioeconomic status (SES) were associated with decreased physical activity and aerobic fitness, and increased sedentary behaviours and body composition measures. ISCOLE-Kenya data analyses found a prevalence of childhood overweight/obesity of 20.8% in Nairobi, with few children meeting global physical activity guidelines (12.6%). Mean daily sedentary time was 398 minutes, time spent in light physical activity was 463 minutes, and time spent in MVPA was 36 minutes. Higher SES and parental education attainment were associated with a higher likelihood of children being overweight/obese and a lower likelihood of children meeting the physical activity recommendations. Data analyses also revealed considerable discrepancies in both self-report and direct measures of physical activity by weight status, and weak to moderate correlations between self-report and direct measures of physical activity. Under/healthy weight children had significantly higher directly measured mean daily minutes of MVPA compared to overweight/obese children (39 verses 20 minutes); had lower mean weekend-day minutes of sedentary time (346 verses 365 minutes); and had a higher proportion who met physical activity guidelines (15.5% versus 2.6%). Lastly, while MVPA patterns among urban Kenyan children were largely similar to those of urban Canadian children with regard to relationships by sex, BMI category, and weekday/weekend days; in the Kenyan sample, much unlike many higher income countries, lower SES was associated with higher MVPA.

Thesis (Ph.D. in Nursing) -- University of Colorado Denver, 2008. / Typescript. Includes bibliographical references (leaves 127-142). Free to UCD affiliates. Online version available via ProQuest Digital Dissertations;

In recent years, physical activity and fitness transitions, described as declines in physical activity and aerobic fitness, coupled with increased sedentary behaviour, have been observed among school-aged children. Consequently, the prevalence of childhood overweight/obesity has also increased considerably. While there is a wealth of evidence supporting such behavioural transitions in higher income countries, there exists a paucity of data on the situation in lower income countries, such as those in Sub-Saharan Africa (SSA). The premise of this thesis was to investigate the robustness of these relationships in other global regions. The first objective was to investigate the evidence for an overweight/obesity, physical activity, and fitness transition among SSA’s school-aged children. Systematic review methodology was used to examine temporal trends and correlates of overweight/obesity, physical activity, fitness, and sedentary behaviour in apparently healthy or population based samples of children (5 - 17 years). The second objective of this thesis was to determine the prevalence and correlates of overweight/obesity and physical activity among Kenyan children aged 9 to 11 years, having contextualised Kenya within the broader situation in SSA. Further, the relationships between self-reported and directly assessed measures of physical activity and sedentary time by weight status in Kenyan children were investigated. The third objective was to examine moderate-to-vigorous physical activity (MVPA) patterns accrued by time of day among Kenyan children using the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE)-Kenya data. Activity patterns in the Kenyan setting were then compared to similar ISCOLE-Canada data from Canadian children, revealing differences and similarities in the accumulation of MVPA, light physical activity, and sedentary time. Systematic review data syntheses revealed a trend towards increasing proportions of overweight/obesity among Sub-Saharan Africa’s school-aged children. Further, urbanization and higher socioeconomic status (SES) were associated with decreased physical activity and aerobic fitness, and increased sedentary behaviours and body composition measures. ISCOLE-Kenya data analyses found a prevalence of childhood overweight/obesity of 20.8% in Nairobi, with few children meeting global physical activity guidelines (12.6%). Mean daily sedentary time was 398 minutes, time spent in light physical activity was 463 minutes, and time spent in MVPA was 36 minutes. Higher SES and parental education attainment were associated with a higher likelihood of children being overweight/obese and a lower likelihood of children meeting the physical activity recommendations. Data analyses also revealed considerable discrepancies in both self-report and direct measures of physical activity by weight status, and weak to moderate correlations between self-report and direct measures of physical activity. Under/healthy weight children had significantly higher directly measured mean daily minutes of MVPA compared to overweight/obese children (39 verses 20 minutes); had lower mean weekend-day minutes of sedentary time (346 verses 365 minutes); and had a higher proportion who met physical activity guidelines (15.5% versus 2.6%). Lastly, while MVPA patterns among urban Kenyan children were largely similar to those of urban Canadian children with regard to relationships by sex, BMI category, and weekday/weekend days; in the Kenyan sample, much unlike many higher income countries, lower SES was associated with higher MVPA.