Perceived weight discrimination amplifies the link between central adiposity and nondiabetic glycemic control (HbA1c)

Abstract

Background: While the preclinical development of type 2 diabetes is partly explained by obesity and central adiposity, psychosocial research has shown that chronic stressors such as discrimination have health consequences as well. Purpose: We investigated the extent to which the well-established effects of obesity and central adiposity on nondiabetic glycemic control (indexed by HbA1c) were moderated by a targeted psychosocial stressor linked to weight: perceived weight discrimination. Methods: The data came from the nondiabetic subsample (n=938) of the Midlife in the United States (MIDUS II) survey. Results: Body mass index (BMI), waist-to-hip ratio, and waist circumference were linked to significantly higher HbA1c (p<0.001). Multivariate-adjusted models showed that weight discrimination exacerbated the effects of waist-to-hip ratio on HbA1c (p<0.05), such that people who had higher waist-to-hip ratios and reported weight discrimination had the highest HbA1c levels. Conclusion: Understanding how biological and psychosocial factors interact at nondiabetic levels to increase vulnerability could have important implications for public health and education strategies. Effective strategies may include targeting sources of discrimination rather than solely targeting the health behaviors and practices of overweight and obese persons. © The Society of Behavioral Medicine 2010.