Estigma del peso y conductas alimentarias en estudiantes universitarios: Resultados de un estudio transversal

Abstract

Introducción. El estigma del peso inicia con experimentar el estigma mediante creencias, actitudes y acciones descalificantes que se internalizan e incrementa la anticipación a ser estigmatizado por motivo del peso. Esto modifica conductas de alimentación: mal adaptativas (comer emocional, restricción cognitiva y comer sin control) y conductas adaptativas (comer intuitivo) como respuestas de regulación emocional. El objetivo general fue analizar el efecto de mediación de las facetas del estigma del peso (experimentado, internalizado y anticipado) en las conductas de alimentación mal adaptativas y adaptativas. Metodología. Estudio transversal. Participaron 766 estudiantes universitarios del área de la salud. Se aplicaron: a) Escala Modificada de Internalización del Estigma, b) Escala Miedo del Estigma, c) Cuestionario de Tres Factores R-18 y d) Escala de Comer Intuitivo. Se realizaron modelos de mediación con MPLUS8 con Bootstraping e intervalos de confianza 95%. Resultados. El 68% (n = 524) fueron mujeres. El estigma internalizado presentó efecto directo en comer emocional (p = .001), comer sin control (p = .001) y restricción cognitiva (p = .001), negativo con comer intuitivo (p = .001). Estigma anticipado en comer emocional (p = .001), comer sin control (p < .001), pero no con restricción cognitiva (p = .392), negativo con comer intuitivo (p = .011). El estigma anticipado es mediador entre estigma experimentado y comer emocional (ß = .103, p = .001) y comer sin control (ß = .225, p < .001). El estigma internalizado fue mediador en restricción cognitiva (ß = .194, p = .001), comer sin control (ß = .136, p = .001) y comer emocional (ß = .082, p = .001). Conclusión. La relación entre estigma experimentado y comer emocional, restricción cognitiva y comer sin control está mediada por el estigma internalizado, el estigma anticipado es mediador entre comer emocional y comer sin control.Introduction. Weight stigma begins with experiencing stigma through disqualifying beliefs, attitudes and actions, which are internalized and increase the anticipation of being stigmatized due to weight. This modifies eating behaviors: maladaptive (emotional eating, cognitive restriction and uncontrolled eating) and adaptive behaviors (intuitive eating) as an emotional regulation response. The aim was to analyze the effect of facets of weight stigma (experienced, internalized, and anticipated stigma) on maladaptive and adaptive eating behaviors. Methods: Cross-sectional study. 766 university students in health area participated. The following were applied: a) Modified Internalization of Stigma Scale, b) Fear of Stigma Scale, c) Three-Factor Questionnaire R-18 and d) Intuitive Eating Scale. Descriptive analysis was performed in SPSS V.23 and mediation model with MPLUS8 with Bootstraping and 95% confidence intervals. Results: 68% (n = 524) were women. Internalized stigma had a direct effect with emotional eating (p = .001), uncontrolled eating (p = .001) and cognitive restriction (p = .001), and a negative effect with intuitive eating (p = .001). Anticipated stigma with emotional eating (p = .001), uncontrolled eating (p < .001), but not with cognitive restriction (p = .392), negative with intuitive eating (p = .011). Anticipated stigma is a mediator between experienced stigma and emotional eating (ß = .103, p = .001) and uncontrolled eating (ß = .225, p < .001). Internalized stigma was a mediator with cognitive restraint (ß = .194, p = .001), uncontrolled eating (ß = .136, p = .001), and emotional eating (ß = .082, p = .001). Conclusions: The relationship between experienced stigma and emotional eating, cognitive restriction and uncontrolled eating is mediated by internalized stigma, anticipated stigma is a mediator for emotional eating and uncontrolled eating.