Internalized weight bias and cortisol reactivity to social stress
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Internalized weight bias and cortisol reactivity to social stress F. U. Jung 1
&
Y. J. Bae 2 & J. Kratzsch 2 & S. G. Riedel-Heller 1 & C. Luck-Sikorski 3,4
# The Psychonomic Society, Inc. 2019
Abstract Weight-associated stigmatization and discrimination may induce chronic stress in individuals with obesity. As a consequence, this stressor may cause an imbalance of HPA stress axis leading to increased eating behavior, and ultimately, weight gain. However, the direct link between internalized weight bias and stress response to acute stressors via cortisol secretion has not been investigated so far. Therefore, the purpose of this study was to investigate the interaction between internalized weight stigma as a stressor and cortisol reactivity in an acute psychosocial stress situation induced by the Trier Socials Stress Test for groups (TSST-G). Participants with BMI >30 kg/m2 (n = 79) were included in the study. Results reveal that while individuals with low internalized stigma reacted as predicted with an increase in cortisol secretion to acute psychosocial stress, individuals with medium or high internalized stigma did not show a typical cortisol response. However, these findings depend on the several factors, for instance on gender. In sum, acute stress in individuals with internalized weight bias seems to blunt HPA axis reactions to acute psychosocial stress. The study contributes to the understanding of the psychological and endocrinological consequences of internalized weight bias and underlines the importance of interventions to reduce stigmatization. Keywords Cortisol . Stigma . Obesity . Trier socials stress test . Stress
Introduction The recent increase in the prevalence of obesity and overweight has been observed in many different countries worldwide (Abarca-Gómez, Abdeen, Hamid, Abu-Rmeileh, Acosta-Cazares, Acuin, 2017). In this context, psychosocial stress has been suggested to be an important risk factor for development of overweight and obesity by acting as a chronical stressor (Tomiyama, 2014). Usually, stress can be seen as a typical response to a variety of strains or stimuli. The human body reacts to stress by stimulating the hypothalamic* F. U. Jung [email protected] 1
Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
2
Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Paul-List Strasse 13-15, D-04103 Leipzig, Germany
3
Integrated Research and Treatment Center (IFB) Adiposity Diseases, University Hospital Leipzig, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany
4
SRH University of Applied Health Sciences, Neue Straße 28-30, 07548 Gera, Germany
pituitary (HPA) axis leading to cortisol secretion from the adrenal cortex. This reaction should diminish after successfully coping with the stressful event (Papadimitriou & Priftis, 2009). However, studies suggest that individuals with obesity may respond dif
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