| Objective1.Investigate the current situation and influencing factors of weight stigma among obese populations.2.Explore the relationship between weight stigma,dietary self-efficacy,social comparison tendency,and weight loss effects among obese populations,verify the mediating role of dietary self-efficacy and the moderating role of social comparison tendency,and clarify the path mechanism by which weight stigma affects weight loss effects.Methods1.The study will use cross-sectional and longitudinal tracking research methods.2.General information survey questionnaires,the Stigma Scale for Chronic Illness(SSCI),the Weight Efficacy Lifestyle Questionnaire Short Form(WEL-SF),and the Social Comparison Orientation(SCO)scale will be used.From July 2021 to June 2022,a convenience sampling method will be used to select 168 obese patients from the obesity clinic of the tertiary hospital in Yangzhou City,Jiangsu Province,who meet the inclusion and exclusion criteria.A questionnaire survey will be conducted,followed by a four-week weight loss treatment.From August 2021 to July 2022,the 168 obese patients will be followed up by telephone and outpatient visits to understand their weight loss effects.3.This study will use Excel to build a database,and data will be double-entered.SPSS 26.0 and its PROCESS plugin will be used for statistical analysis,including descriptive analysis,univariate analysis,multiple linear regression,Pearson correlation analysis,mediation effect testing,and moderated mediation effect testing.Results1.Analysis of the current status and influencing factors of weight stigma in the obese populationThis study included 152 obese patients with varying degrees of weight stigma.The total score of the SSCI,SSCI-ET,and SSCI-IT were(58.95± 19.76)points,(25.68±9.01)points,and(33.21 ± 11.61)points,respectively.The results of univariate analysis showed that age,education level,employment status,place of residence,marital status,average monthly income per capita,duration of obesity,BMI range,main sources of weight stigma,frequency of weight stigma experienced in childhood,self-efficacy for diet,and social comparison orientation were statistically significant(P<0.05).The results of multivariate analysis showed that employment status,average monthly income per capita,BMI range,frequency of weight stigma experienced in childhood,and self-efficacy for diet were independent risk factors for weight stigma in the obese population(F=30.334,P<0.001),and could explain 69.98%of the total variation.2.Correlation analysis of weight stigma,dietary self-efficacy,social comparative tendency and weight loss effect among obese peopleIn this study,the dietary self-efficacy score of 152 subjects was(45.96±12.81),which was at the average level or below.The social comparative tendency score was 31.78±7.08,which was average.After weight loss,the average BMI decreased from(34.96±5.01)kg/m2 to(33.97±5.33)kg/m2,and the average weight loss ratio was(26.60±14.40)‰.Weight stigma was negatively correlated with dietary self-efficacy and weight loss ratio(r=-0.55,r*=-0.74,P<0.01),and positively correlated with social comparative tendency(r=0.27,P<0.01).Dietary self-efficacy was positively correlated with weight loss ratio(r=0.68,P<0.01),and significantly negatively correlated with social comparative tendency(r=-0.29,P<0.01),and significantly negatively correlated with social comparative tendency(r=-0.24,P<0.01).3.Moderated mediating effect model test of weight stigma on weight loss in obese peopleIn this study,dietary self-efficacy had a partial mediating effect between weight stigma and weight loss ratio.The total effect was-0.536 and the direct effect was-0.377.29.7%of the effect of weight stigma on weight loss in obese people was mediated by dietary self-efficacy.Secondly,the social comparison tendency played a moderating role in the influence of weight stigma on dietary self-efficacy.The negative prediction of weight stigma on dietary self-efficacy was stronger in obese people with low social comparison tendency(βlow social comparison tendency=-0.435,t=-6.453,P<0.001).There were significant differences in the indirect effect between the high and low levels.The difference was 0.087,95%CI=[0.011,0.176].Conclusion1.Weight stigma in obese patients needs to be reduced.Attention should be paid to the education of patients with low social and economic status,high BMI,low dietary self-efficacy,frequent childhood stigma and children who have experienced weight stigma in school,so as to comprehensively improve the weight stigma level of obese patients.Medical staff should also carefully consider the discourse when serving this group of people,so as to avoid increasing the degree of stigma of patients.2.Weight stigma,dietary self-efficacy,social comparison tendency and weight loss effect of obese people are correlated.Weight stigma negatively predicted weight loss effect,and dietary self-efficacy played a mediating role between the two.Social comparison propensity moderated the first half of weight stigma--dietary self-efficacy--weight loss effect,that is,weight stigma had a stronger negative effect on dietary self-efficacy in obese people with high social comparison propensity.The results elucidated the internal mechanism of weight stigma affecting the weight loss effect of obese people,and also provided a basis for the future development of weight stigma intervention measures for obese people. |
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