Obesity research remains a high priority worldwide, given the sustained high levels of obesity (body mass index ≥30 kg/m2) and class III obesity (body mass index ≥40 kg/m2) across many demographic groups. One component of obesity research is the study of how diet can contribute to obesity, and thus it is crucial to evaluate how existing dietary assessment methods perform for people with obesity, and to develop or refine methods to enhance their accuracy. Researchers should be prepared to include more individuals with obesity and class III obesity, a growing demographic, in studies that assess dietary intake. With the inclusion of these groups, it is vital to consider the potential impact of weight bias and weight stigma on dietary research. Weight bias is negative attitudes and stereotypes about people with obesity, while weight stigma is how these attitudes collectively devalue people with obesity, which could result in acts of discrimination. This dissertation: 1) defined the issues of weight bias and weight stigma, and how they affect dietetics practice, including research, 2) determined the representation of participants with class III obesity in studies validating self-reported measures of dietary assessment using doubly-labeled water, and 3) explored how weight bias and weight stigma might impact misreporting of energy intake among people with overweight and obesity.
Findings include that: 1) weight bias and weight stigma are important issues when working with people with obesity, and dietetics professionals can address these in many areas of practice; 2) in studies validating self-reported dietary assessment methods using doubly-labeled water, people with class III obesity are underrepresented, and thus the validity of existing methods to assess diet among people with class III obesity requires further research; 3) in a sample of participants with self-reported overweight and obesity, previous experiences of weight stigma were common, though internalized weight bias, weight bias toward others, and experiences of weight stigma were not predictive of the validity of energy intake reporting. Researchers should consider the potential impact of weight stigma on recruitment, retention, and participant experience when working with participants with obesity. / Doctor of Philosophy / One part of obesity research is the study of how food intake can contribute to obesity. It is crucial to evaluate how well existing methods perform that measure what and how much people eat, especially in people with obesity. As obesity levels rise, researchers should be prepared to include more people with obesity (body mass index ≥30 kg/m2) and class III obesity (body mass index ≥40 kg/m2) in studies that measure dietary intake. When including people with obesity in studies, it is important to consider the potential impact of weight bias and weight stigma on nutrition research. Weight bias is the idea of negative attitudes and stereotypes about people with obesity, while weight stigma is how these attitudes collectively devalue people with obesity. This dissertation 1) defined the issues of weight bias and weight stigma, and how they affect dietetics practice, including nutrition research, 2) determined the representation of people with class III obesity in studies testing the accuracy of methods collecting information about food intake and 3) explored how weight bias and weight stigma might affect how accurately people with overweight and obesity report the number of calories that they eat.
This work found: 1) weight bias and weight stigma are important emerging issues when working with people with obesity, and dietetics professionals can address weight bias and weight stigma in many areas of practice; 2) in studies testing the accuracy of measures that collect food information, people with class III obesity are underrepresented, and more research is needed to determine how accurate these measures are in this group; and 3) in a group of people with overweight and obesity, previous experiences of weight stigma were common, though internalized weight bias, weight bias toward others, and experiences of weight stigma did not predict how well a person reported their calorie intake. Future studies should include more people with class III obesity. Researchers should consider how weight stigma might affect a person's willingness to participate in nutrition studies. Minimizing weight stigma in research may decrease participation barriers for people with obesity in research about nutrition, weight, and health.
| Identifer | oai:union.ndltd.org:VTETD/oai:vtechworks.lib.vt.edu:10919/114792 |
| Date | 25 April 2023 |
| Creators | Howes, Erica Marie |
| Contributors | Human Nutrition, Foods and Exercise, Hedrick, Valisa E., Misyak, Sarah A., DiFeliceantonio, Alexandra G., Davy, Brenda M., Brown, Letisha |
| Publisher | Virginia Tech |
| Source Sets | Virginia Tech Theses and Dissertation |
| Language | English |
| Detected Language | English |
| Type | Dissertation |
| Format | ETD, application/pdf, application/pdf |
| Rights | Creative Commons Attribution 4.0 International, http://creativecommons.org/licenses/by/4.0/ |
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