Psychological distress and quality of life in Iranian adolescents with overweight/obesity: mediating roles of weight bia
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ORIGINAL ARTICLE
Psychological distress and quality of life in Iranian adolescents with overweight/obesity: mediating roles of weight bias internalization and insomnia Chung‑Ying Lin1 · Vida Imani2 · Anders Broström3 · Karina Huus3 · Maria Björk3 · Eric A. Hodges4 · Amir H. Pakpour3,5 Received: 15 April 2019 / Revised: 20 August 2019 / Accepted: 5 October 2019 © Springer Nature Switzerland AG 2019
Abstract Purpose To examine whether weight-related self-stigma (aka weight bias internalization) and insomnia are potential predictors of psychological distress and quality of life (QoL) among Iranian adolescents with overweight (OW)/obesity (OB). To examine whether weight-related self-stigma and insomnia are potential mediators in the relationship between excess weight and health outcomes of distress and QoL. Methods All participants (n = 934; 444 males; mean age = 15.7 ± 1.2 years; zBMI = 2.8 ± 1.0) completed questionnaires on weight-related self-stigma and insomnia at baseline. Six months later, they completed questionnaires on psychological distress and QoL to assess health outcomes. Relationships among variables were tested using mediation analyses with bootstrapping method. Results Weight-related self-stigma significantly mediated the effects of zBMI on psychological distress (effect = 0.22; bootstrapping SE = 0.09; 95% CI = 0.08, 0.45), psychosocial QoL (effect = − 0.64; bootstrapping SE = 0.19; 95% CI = − 1.10, − 0.32), and physical QoL (effect = − 1.35; bootstrapping SE = 0.54; 95% CI = − 2.43, − 0.26). Insomnia also significantly mediated the effects of zBMI on psychological distress (effect = 2.18; bootstrapping SE = 0.31; 95% CI = 1.61, 2.81), psychosocial QoL (effect = − 0.89; bootstrapping SE = 0.33; 95% CI = − 1.60, − 0.28), and physical QoL (effect = − 0.83; bootstrapping SE = 0.42; 95% CI = − 1.69, − 0.02). Full mediations were found in psychosocial QoL; partial mediations were found in psychological distress and physical QoL. Conclusions Weight-related self-stigma and insomnia were significant mediators in the effects of excess weight on health outcomes. Therefore, it is important to identify and treat weight-related self-stigma and insomnia for adolescents with OW/OB. Level of evidence Level V, cross-sectional descriptive study. Keywords Insomnia · Mental health · Obese · Quality of life · Stigma
This article is part of topical collection on Sleep and Eating and Weight disorders. * Amir H. Pakpour [email protected]; [email protected] 1
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
2
Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
3
Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
4
School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
5
Social Determinants of Health Research Center, Research Institute for Prevention of Non‑Communicable Diseases, Qazvin University of Medical Sciences, Shahid Bahonar
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