Pilotstudie zur Anwendbarkeit einer kognitiv-behavioralen Gruppenintervention für internalisiertes Stigma bei Menschen mit Adipositas

Zusammenfassung

Ziel der Studie Bisherige Interventionen zur Reduzierung gesellschaftlicher Gewichtsdiskriminierung haben wenig Erfolg gezeigt; die Arbeit mit Betroffenen wird zunehmend fokussiert.

Methode Pilotierung einer Intervention zur Reduktion des internalisierten gewichtsbedingten Stigmas mit sechs wöchentlichen Gruppensitzungen (N=14 Teilnehmer*innen) zu zwei Messzeitpunkten mit den Endpunkten Stigmatisierung, Diskriminierung, depressive Symptome, Essverhalten, Stresssituationen, Haarcortisolanalyse und Bewältigungsstrategien.

Ergebnisse Hohe Reduktion der depressiven Symptomatik, hohe allgemeine Zufriedenheit, geringe Auswirkungen auf die Wahrnehmung von Diskriminierung und kleine Veränderungen im Haarcortisol. Besonders effektiv bei Teilnehmer*innen mit erhöhter Stigma Internalisierung.

Schlussfolgerung Intervention zeigte eine Tendenz besonders effektiv bei Teilnehmer*innen mit einem hohen Grad an Internalisierung zu sein. Eine Etablierung von verhaltensbezogenen Interventionen zur Gewichtsabnahme kann vielversprechend sein.

Abstract

Purpose Weight bias has a negative influence on mental and physiological well-being. Interventions to reduce weight bias in the public have shown only limited success. We conducted a proof-of-concept study to determine the feasibility.

Methods The intervention consisted of six weekly 90-minute group sessions with 4–6 participants with obesity per group (N=14 participants). Primary endpoints (internalized stigma and perception of teasing) and secondary endpoints (depressive symptoms, eating behavior, stressful situations and coping strategies, resilience) were assessed before and after the last session. Hair samples were collected to measure cortisol levels as a physiological outcome. Hedges g was calculated to measure effect size. Overall satisfaction was surveyed.

Results Overall, participants showed a high level of satisfaction with the intervention. After the intervention, the results showed large reductions in depressive symptoms (p<0.01, g=0.891), small effects for the perception of teasing (p=0.188, g=0.425), and small changes in levels of hair cortisol (p=0.530, r=0.2). The intervention tended to be particularly effective in participants with high levels of weight bias internalization for the main outcome (p=0.065, g=2.161).

Conclusion The intervention showed a tendency to be particularly effective in participants with high levels of internalization. Including in behavioral weight loss interventions for this group may be promising to help with the negative effects of weight bias.

Schlüsselwörter

Kognitiv-behaviorale Intervention - Adipositas - internalisiertes Stigma

Key words

Cognitive-behavioral intervention - obesity - internalized stigma

Publication History

Article published online:
04 September 2023

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