title: Attributing discrimination to weight: associations with well-being, self-care, and disease status in patients with type 2 diabetes mellitus.
abstract: This study examined the association between attributing self-reported discrimination to weight and diabetes outcomes (glycemic control, diabetes-related distress, and diabetes self-care). A community dwelling sample of 185 adults (mean age 55.4; 80 % White/Caucasian 65 % female) with poorly controlled type 2 diabetes (HbA1c level ≥ 7.5 %) provided demographic and several self-report measures (including diabetes-related distress, diabetes self-care activities, discrimination, and attributions of discrimination), and had height, weight, and glycated hemoglobin (HbA1c) assessed by trained research staff as part of a larger research study. Individuals who attributed self-reported discrimination to weight had significantly higher HbA1c levels, higher levels of diabetes-related distress, and worse diabetes-related self-care behaviors (general diet, exercise, and glucose testing). These relationships persisted even when controlling for BMI, overall discrimination, depressive symptoms, and demographic characteristics. Results indicate that the perception of weight stigma among individuals with type 2 diabetes is strongly associated with a range of poor diabetes outcomes. Efforts to reduce exposure to and/or teach adaptive coping for weight stigma may benefit patients with type 2 diabetes.
authors.affiliation: Department of Biobehavioral Health, The Pennsylvania State University, State College, PA, 16802, USA.
authors.forename: Lindsey
authors.initials: L
authors.lastname: Potter
authors.affiliation: Vanderbilt University, Nashville, TN, USA.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Wallston
authors.affiliation: SUNY Upstate Medical University, Syracuse, NY, USA.
authors.forename: Paula
authors.initials: P
authors.lastname: Trief
authors.affiliation: Department of Biobehavioral Health, The Pennsylvania State University, State College, PA, 16802, USA.|Mount Nittany Health, State College, PA, USA.
authors.forename: Jan
authors.initials: J
authors.lastname: Ulbrecht
authors.affiliation: Department of Biobehavioral Health, The Pennsylvania State University, State College, PA, 16802, USA.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Juth
authors.affiliation: Department of Biobehavioral Health, The Pennsylvania State University, State College, PA, 16802, USA. Smyth@psu.edu.
authors.forename: Joshua
authors.initials: J
authors.lastname: Smyth
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D001835:Body Weight; D003863:Depression / Q000150:complications / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000523:psychology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012648:Self Care / Q000523:psychology*; D057566:Self Report; D063508:Social Discrimination / Q000523:psychology*
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin
keywords: Diabetes; Discrimination; Distress; Obese; Self-care behavior; Weight