Diffuse Idiopathic Skeletal Hyperostosis and the Osteological Paradox

Diffuse idiopathic skeletal hyperostosis (DISH) is of interest to bioarchaeologists due to its strong associations with male sex, increased age, and potential associations with obesity, related metabolic conditions, and high social status. However, these possible associations and DISH’s contested status as a pathologic condition raise issues concerning how DISH must be viewed through the lens of the osteological paradox, particularly relating to selective mortality and heterogeneity of frailty. This article explores these concerns by examining recent clinical and bioarchaeological research on the symptomatology, etiology, and epidemiology of DISH and examines how bioarchaeologists should approach the paleoepidemiological interpretation of DISH

Fat acceptance 101: Midwestern American women’s perspective on cultural body acceptance

This is the author accepted manuscript. The final version is available from Taylor & Francis via the DOI in this record.Weight stigma is pervasive in the US, with body size being pathologised and weight loss urged for those of higher weights. However, there is a growing movement for fat acceptance and body positivity. The present study explored perceptions and experiences of cultural body acceptance trends among Midwestern American women who are trying to, or have tried to, ‘accept’ their bodies. Participants (n = 18) are self-identified women who have ever been labelled ‘obese’ on the Body Mass Index and have ever tried to develop a more positive relationship with their bodies. Participants were interviewed three times over the course of approximately one year using a semi-structured interview guide that explored their perceptions of how society represented and treated those of a higher weight. Interviews were recorded and transcribed verbatim, and interviews and field-notes analysed thematically. Emergent themes included greater (mixed) representation, lip service, and inclusive cultures. Ultimately, participants positioned shifting attitudes towards fat bodies within wider social trends toward greater inclusion and diversity in general, but remained frustrated by ceilings of acceptable size, disingenuous messaging, and cultural backsliding.Central Michigan UniversityEconomic and Social Research Council (ESRC), UK

Media, ‘Fat Panic’ and Public Pedagogy:Mapping Contested Terrain

Discourses regarding a ‘global obesity crisis’ and alternative frames (e.g. weight-inclusive approaches to health) have proliferated through various media of communication. These media range from traditional print and visual formats (e.g. newspapers and television shows) to digital media (e.g. Twitter, Facebook, YouTube), which enable different publics to produce, and not just consume, text, images and other data relating to the body. Reflecting a sociological understanding of educational practices as extending beyond formal schooling, mediated obesity discourse and counter-movements have also been conceptualised as public pedagogies, which instruct people how to relate to their own and other's bodies, health and subjectivities. This article examines what is critically known about various media at a time when governments and agencies are reinvigorating the global war on obesity, with populations being ‘advised’ to become and remain conscientious weight watchers. In conclusion, the article underscores the salience of social studies of the media when seeking to rethink obesity, incorporating critical reference to moral panic theory and the need to better understand what media can ‘do’ as enactments of public pedagogy.</p

Experiences of weight-related stigma among low-income rural women of higher weights from the midwestern United States

Weight-related stigma and stereotypes are widespread. Despite established research highlighting the disproportionate disparities rural individuals face, studies focusing on women in rural and low-income environments are underrepresented in the literature. The current study addressed these gaps in the literature using 25 in-depth interviews, which were analyzed using interpretive phenomenological procedures. The research questions were: i) what are low income rural women of higher weights’ understandings and experiences of weight stigma in healthcare? and ii) to what extent do their experiences of stigma affect or do not affect their healthcare-related behaviors? Sixteen women in the study experienced weight-related stigma in healthcare. Many delayed their care while others felt their care was essentially denied. Findings indicate that more can be done to address weight-related stigma

Psychosocial Interventions in the Treatment of Severe Adolescent Obesity: The SHINE Programme

Purpose: Psychosocial Interventions (PSI) are characterised by three phases: 1) an initial in-depth assessment, 2) an intensive multifaceted intervention to stem a condition, and 3) an extensive maintenance programme. PSIs are often used for treatment of mental health conditions, however applicability in the treatment of adolescent obesity is unknown. This paper sought to evaluate the service-level outcomes of a PSI for young people (aged 10-17) with severe obesity. Methods: A retrospective evaluation of participants attending the SHINE programme between 2011-2016 (n = 435; Age: 13.1±2.1 years, Male: 51%, White: 87.4%, BMI: 33.5±7.5 kg/m2, BMI SDS: 3.1±0.5 units). Anthropometric measurements (BMI and WC) were collected at baseline, 3-, 6-, 9-, and 12-months. Psychosocial measures (anxiety, depression, and self-esteem) were collected at baseline and 3 months. Participant retention was also assessed. Results: After 3 months, 95% of participants remained with a mean BMI SDS reduction of 0.19 units (95% CI: 0.17, 0.21). Anxiety, depression, and self-esteem improved by 50%, 54% and 38% respectively. BMI SDS reductions of 0.29, 0.35 and 0.41 were found at 6-, 9-, and 12- months. Fifty-four percent of participants chose to attend the final intervention phase. A higher baseline BMI SDS and a greater reduction in BMI SDS predicted final intervention phase attendance. Conclusion: The SHINE PSI demonstrated positive mean reductions in all measurements across all time points. In contrast to other community-based weight management services, these results suggest the utility of, and further exploration of, PSIs in the treatment of severe adolescent obesity

U.S. General Population Estimate for “Excellent” to “Poor” Self-Rated Health Item

BACKGROUND: The most commonly used self-reported health question asks people to rate their general health from excellent to poor. This is one of the Patient-Reported Outcomes Measurement Information System (PROMIS) global health items. Four other items are used for scoring on the PROMIS global physical health scale. Because the single item is used on the majority of large national health surveys in the U.S., it is useful to construct scores that can be compared to U.S. general population norms. OBJECTIVE: To estimate the PROMIS global physical health scale score from the responses to the single excellent to poor self-rated health question for use in public health surveillance, research, and clinical assessment. DESIGN: A cross-sectional survey of 21,133 individuals, weighted to be representative of the U.S. general population. PARTICIPANTS: The PROMIS items were administered via a Web-based survey to 19,601 persons in a national panel and 1,532 subjects from PROMIS research sites. The average age of individuals in the sample was 53 years, 52 % were female, 80 % were non-Hispanic white, and 19 % had a high school degree or lower level of education. MAIN OUTCOME MEASURES: PROMIS global physical health scale. KEY RESULTS: The product–moment correlation of the single item with the PROMIS global physical health scale score was 0.81. The estimated scale score based on responses to the single item ranged from 29 (poor self-rated health, 2.1 SDs worse than the general population mean) to 62 (excellent self-rated health, 1.2 SDs better than the general population mean) on a T-score metric (mean of 50). CONCLUSIONS: This item can be used to estimate scores for the PROMIS global physical health scale for use in monitoring population health and achieving public health objectives. The item may also be used for individual assessment, but its reliability (0.52) is lower than that of the PROMIS global health scale (0.81)