Associations Between Women’s Body Mass Index Category and Positive Psychological Well-being, Health, Internalized Weight Bias, and Exercise Capacity
Date
2023-04-21
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Abstract
Background Improved cardiovascular disease outcomes and reduced mortality are associated with optimal fitness and optimal psychological wellbeing (PWB). Women with obesity are at risk for having lower fitness levels and lower PWB attributed, in part, to weight stigmatization. A deeper understanding of how obesity impacts both fitness and PWB in women is required. Methods Methods for three manuscripts include: a retrospective analysis of cardiorespiratory fitness (CFR) in women with differing BMI categories, following cardiac rehabilitation (CR), a scoping review synthesizing what is known about PWB in women with obesity, and a web-based survey examining relationships between general health, internalized weight bias (IWB), BMI and multiple constructs of PWB in a sample of community dwelling women. Results Women with obesity (BMI>30 kg/m2) had smaller gains in CRF (standard mean difference =0.79, p=.028; n=398), relative to women in the normal (BMI between 18.5 to 24.99 kg/m2) and overweight (BMI between 25.00-29.99 kg/m2) categories (SMD=1.03, n=454 and 0.92, n=461 respectively, p values<.001). Findings from thirty-two studies with over 57,000 women with obesity revealed women with obesity rated their PWB lower than women without obesity. However, this relationship was attenuated when self-health, body satisfaction, and social factors were included in the statistical model. In a survey of 1001 community dwelling women, those with obesity rated their positive emotions (p<.001), engagement (p=.007), relationships (p<.001) sense of meaning (p<.001) and accomplishments (p<.001) (acronym: PERMA), happiness (p<.001), and health (p<.001) lower and their IWB higher (p<.001) than women without obesity. Health accounted for up to 22% of the variance in PERMA and happiness scores whereas BMI and IWB contributed to 1-6% of the variance. Conclusion Women with obesity had lower fitness levels, smaller improvements in exercise capacity (METS) in CR, and generally lower PWB compared to women without obesity. This research offered initial insights into a complex relationship between fitness, health, IWB, BMI, and PERMA and happiness in women with obesity. This research highlights an opportunity to explore the causes of these differences, target interventions to improve exercise capacity, and determine how positive psychological interventions could be used as a psychological resource to support women with obesity.
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Keywords
women, well-being, obesity, cardiovascular health, cardiorespiratory fitness
Citation
Conradson, H. E. (2023). Associations between women’s body mass index category and positive psychological well-being, health, internalized weight bias, and exercise capacity (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.