Weight Stigma Model on Quality of Life Among Children in Hong Kong: A Cross-Sectional Modeling Study

Chia-Wei Fan; Chieh-Hsiu Liu; Hsin-Hsiung Huang; Chung-Ying Lin; Amir H Pakpour

doi:10.3389/fpsyg.2021.629786

Weight Stigma Model on Quality of Life Among Children in Hong Kong: A Cross-Sectional Modeling Study

Front Psychol. 2021 Apr 22:12:629786. doi: 10.3389/fpsyg.2021.629786. eCollection 2021.

Authors

Chia-Wei Fan¹, Chieh-Hsiu Liu², Hsin-Hsiung Huang³, Chung-Ying Lin^{4

5

6

7}, Amir H Pakpour^{8

9}

Affiliations

¹ Department of Occupational Therapy, AdventHealth University, Orlando, FL, United States.
² National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
³ Department of Statistics and Data Science, University of Central Florida, Orlando, FL, United States.
⁴ Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁵ Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁶ Department of Public Health, National Cheng Kung University Hospital, College of Medicien, National Cheng Kung University, Tainan, Taiwan.
⁷ Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
⁸ Social Determinants of Health Research Center, Research Institute for Prevention of Non-communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
⁹ Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.

Abstract

We proposed a model to examine the relationship among different types of weight-related stigmas and their relationship to quality of life (QoL). We recruited 430 dyads of elementary school children [mean age = 10.07 years; n_boy = 241 (56.0%); n_overweight = 138 (32.1%)] and their parents. Parents completed QoL instruments about their children assessing generic QoL and weight-related QoL. Children completed QoL instruments assessing generic QoL and weight-related QoL and stigma scales assessing experienced weight stigma, weight-related self-stigma, and perceived weight stigma. Experienced weight stigma was significantly associated with perceived weight stigma, and in turn, perceived weight stigma was significantly associated with weight-related self-stigma. However, experienced weight stigma was not directly associated with weight-related self-stigma. In addition, experienced stigma was negatively associated with both child-rated and parent-rated QoL. Perceived weight stigma was associated only with parent-rated weight-related QoL but not child-rated QoL. Self-stigma was associated with child-rated QoL but not parent-rated QoL. Moreover, perceived weight stigma and weight-related self-stigma were significant mediators in the association between body weight and children's QoL; experienced weight stigma was not a significant mediator. The study findings can be used to inform healthcare providers about the relationship among different types of stigmas and their influence on child-rated and parent-rated QoL and help them develop interventions to address the global trend of overweight/obesity in youth and pediatric populations.

Keywords: Asia; children; quality of life; structural equating modeling; weight-related stigma.