Understanding the Relationship Between Weight Discrimination and Cardiometabolic Risk Factors in Diabetes: Findings from the English Longitudinal Study of Ageing (ELSA)

BACKGROUND: Weight discrimination is associated with negative psychological and physical health. However, in those with diabetes, a high risk-group for weight discrimination, this association is not well-understood. This study examined the extent to which weight discrimination is longitudinally associated with cardiometabolic risk factors in adults with diabetes. METHODS: Participants were 833 people (aged ≥ 50 years) with diabetes at wave 5 (2010/2011) of the English Longitudinal Study of Ageing (ELSA). Perceived weight discrimination was measured at wave 5. Participants provided outcome data at waves 6 (2012/2013) and 8/9 (2016/17, 2018/2019) including psychological (depressive symptoms), anthropometric (body mass index [BMI]), and cardiometabolic biomarkers (glycated haemoglobin [HbA1c], triglycerides, total cholesterol/high density lipoprotein [HDL] ratio, fibrinogen). Linear regressions controlled for baseline age, sex, wealth, BMI, and baseline measures of the outcome of interest. RESULTS: Perceived weight discrimination was associated with greater depressive symptoms (B = 1.40, p < 0.001), higher triglycerides (B = 0.50, p = 0.014), poorer total cholesterol/HDL ratio (B = 0.59, p = 0.005), and greater fibrinogen (B = 0.25, p = 0.025) at wave 6. Effects were attenuated in fully adjusted models and at wave 8/9. Findings were not replicated using a general discrimination measure suggesting results are specific to weight discrimination. CONCLUSION: Findings suggest that weight discrimination has deleterious effects on a range of cardiometabolic risk factors in those living with diabetes, at least in the short-term. Interventions targeted to help individuals with diabetes cope with weight stigma are warranted to help reduce the risk of future diabetes-related complications.