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ObesityNCT05714696

Weight Discrimination and Poor Cardiovascular Health

A study testing Weight discrimination experience in people with Obesity, run by Florida State University at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

People with obesity regularly experience discrimination on the basis of their body weight and such experiences are associated with increased risk for poor cardiovascular health. The goal of this clinical trial is to identify cognitive, affective, behavioral, and physiological factors that explain the relationship… Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Obesity
What is being tested?
Weight discrimination experience
Could I receive a placebo?
No, everyone receives an active treatment
How many people
333 participants
Where
1 siteUnited States
Study dates
5 Feb 2023to 26 Apr 2024
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • (1) body mass index (BMI) greater than or equal to 30 (units: weight in kilograms divided by height in meters squared; BMI criteria for obesity)
  • (2) 18 years of age or older
  • (3) able to read and understand English
  • (4) have Internet access (to complete the baseline survey)
  • (5) able to come to FSU's campus to take part in a lab-based study

Who cannot join

  • (1) having participated in any of our pilot studies on weight stigma
  • (2) diagnosed with a current major psychiatric disorder (e.g., major depressive disorder, eating disorder)
  • (3) pregnant or nursing
  • (4) diagnosed with Cushing syndrome or taking steroid-based medications
  • (5) having allergies to ingredients in the foods being offered during the taste test (e.g., gluten, peanuts).

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Florida State University

    Tallahassee, Florida, 32306

Other trials in United States

About this study

Official title: Mechanisms Explaining the Link Between Weight Discrimination and Poor Cardiovascular Health

People with obesity regularly experience discrimination on the basis of their body weight and such experiences are associated with increased risk for poor cardiovascular health. The goal of this clinical trial is to identify cognitive, affective, behavioral, and physiological factors that explain the relationship between weight discrimination and poor health outcomes.

A diverse sample of adults with obesity will be randomly assigned to a social interaction encounter that simulates a typical weight discrimination experience (experimental manipulation) vs. a control manipulation that does not involve discrimination. The investigators will examine the immediate effects of the experimental manipulation on cognitive (e.g., self-regulation), affective (e.g., negative emotion), behavioral (e.g., comfort eating), and physiological (e.g., cortisol secretion) outcomes.

Two additional aims of the study are to identify psychological traits that moderate responses to weight discrimination and to assess whether the negative health effects of weight discrimination differ by age, sex/gender, race, or ethnicity.

Read the detailed description

Discrimination is a critical social determinant of health that underlies poor health outcomes. One common but understudied form of discrimination is weight discrimination. Weight discrimination is the behavioral manifestation of weight stigma-the social devaluation of people with excess body weight. Findings suggest that the stress produced by weight discrimination prompts weight gain, creating a vicious cycle between weight discrimination and obesity. Further, there is now well-documented evidence that experiencing weight discrimination is associated with increased risk for cardiovascular disease. Little is known, however, about mechanisms explaining the link between weight discrimination and poor cardiovascular health. Using a rigorous experimental approach, this project will identify mechanisms through which weight discrimination harms health. Findings will facilitate the long-term goal of this research: interventions to decrease the negative health consequences of weight discrimination.

As a step toward this goal, this project proposes to conduct an experiment in which a diverse sample of adults with obesity will be randomly assigned to experience (vs. not experience) weight discrimination in a controlled experimental setting. Drawing on previous research and the investigators' pilot data, the interpersonal context chosen for the study simulates situations in which people with obesity commonly experience weight discrimination in their daily lives (e.g., employment settings).

The study will involve two parts: a pre-session baseline survey and an experimental session that will take place in the lab. The baseline survey will be completed online and will assess individual difference variables/psychological variables and demographic characteristics. The in-person lab visit will take place on campus about one week after completion of the baseline survey. The study manipulation (i.e., intervention) will be delivered during the lab visit. Primary outcome variables will be assessed during the lab visit, after delivery of the intervention.

The following aims will be tested: (1) Identify early-stage cognitive, affective, behavioral, and physiological mechanisms activated by experimentally manipulated weight discrimination; (2) Identify psychological variables (e.g., internalized weight bias) that moderate effects of weight discrimination; and (3) Identify demographic characteristics (e.g., gender, race) that moderate effects of weight discrimination. Exposure to weight discrimination (vs. control) is hypothesized to result in elevated responses on early-stage mechanisms that culminate in poor cardiovascular health (e.g., impaired self-regulation, higher negative emotion, more social withdrawal and comfort eating, increased cortisol secretion). This research will identify novel and highly modifiable targets for interventions designed to reduce the negative health effects of weight discrimination. In testing moderator variables, this work will identify individuals who display vulnerability vs. resilience to the harmful effects of discrimination. Information about moderators will thus help future intervention efforts target those individuals most likely to benefit from intervention. Given the high prevalence of obesity and the millions of Americans affected by weight discrimination, this research will address a crucial public health issue.

Conditions
Obesity
Being tested
Weight discrimination experience, Control experience
Medical subject headings
Obesity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Weight discrimination experienceBehavioural

    In the experimental condition, participants will learn that their group members are biased against overweight people but not elderly or racial/ethnic minority individuals, as indicated by the "getting to know you" summary ratings handout. Participants will also receive negative feedback about their personal attributes by being labeled with negative weight-based stereotypes. Although some ratings will be positive (e.g., they will receive high ratings on being friendly and kind), participants will be rated poorly on attributes viewed as necessary to develop a strong marketing campaign (i.e., motivation to work hard, possessing self-discipline to persist at the task, and competence). After (ostensibly) assembling the group's preferences, the experimenter will inform participants that no one selected them to be their partner, thus they will perform the next few tasks alone. This manipulation has been shown to prompt feelings of social exclusion.

  • Control experienceBehavioural

    In the control condition, participants will learn that their group members have positive attitudes toward people with higher body weight, as well as elderly and racial/ethnic minority individuals, as indicated by the "getting to know you" summary ratings handout. Participants will also receive positive feedback about their personal attributes, as indicated by the summary ratings averaged across the three members. Finally, participants in the control condition will be told that one of their group members had to leave unexpectedly for a family emergency, so pairs cannot be assembled as usual, thus they will perform the next few tasks alone. This manipulation should not prompt feelings of social exclusion.

Study groups in NCT05714696
Study groupRoleWhat they receive
Weight discrimination experienceExperimentalParticipants in the experimental condition will: 1. Learn that their group mates are biased against overweight people (i.e., they have negative attitudes toward people with higher body weight), 2. Receive feedback about their personal attributes that is consistent with negative weight-based stereotypes (e.g., lacking self-discipline), and 3. Not be selected as a partner for the remaining lab tasks (i.e., this experience may prompt feelings of social exclusion).
Receives: Behavioral: Weight discrimination experience
Control experienceActive comparatorParticipants in the control condition will: 1. Learn that their group mates are very accepting of overweight people (i.e., they have positive attitudes toward people with higher body weight), 2. Receive positive feedback about their personal attributes that is not consistent with negative weight-based stereotypes, and 3. Will be told that one of their group members had to leave early for an emergency so the pairs cannot be assembled as usual (i.e., this experience should not prompt feelings of social exclusion).
Receives: Behavioral: Control experience

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Negative Affect

    A modified version of the Positive and Negative Affect Scale-Expanded Form (PANAS-X) will be used to assess emotions in response to the experimental manipulation. The scale demonstrates good validity and reliability. Emotions will be assessed with 46 adjectives (e.g., angry, confident) by indicating the extent to each emotion is felt at that moment (1=very slightly or not at all to 5=extremely). A composite score for negative affect will be created by taking the average of the relevant adjectives. Scores will range from 1 to 5, with higher scores indicating more negative emotion.

    Measured: 2 minutes after delivery of the intervention

  2. Positive Affect

    A modified version of the Positive and Negative Affect Scale-Expanded Form (PANAS-X) will be used to assess emotions in response to the experimental manipulation. The scale demonstrates good validity and reliability. Emotions will be assessed with 46 adjectives (e.g., angry, confident) by indicating the extent to each emotion is felt at that moment (1=very slightly or not at all to 5=extremely). A composite score for positive affect will be created by taking the average of the relevant adjectives. Scores will range from 1 to 5, with higher scores indicating more positive emotion.

    Measured: 2 minutes after delivery of the intervention

  3. Self-efficacy for Weight Control Behavior

    Self-efficacy (perceived confidence) in one's ability to engage in weight control behaviors (e.g., dietary restraint, physical activity) over the next six months will be assessed. Self-efficacy for dietary restraint will be assessed with the short form of the Weight Efficacy Lifestyle Questionnaire (e.g., I can resist eating … when I am depressed or down; 8 items). Self-efficacy for physical activity will be assessed with the Exercise Self-efficacy Scale (e.g., I am confident I can participate in regular exercise when … I am tired; 5 items). Weight control items will be interspersed with items assessing self-efficacy for other health behaviors (e.g., flu vaccination, sleep). Each item will be rated on an 8-point scale (0=not at all confident to 7=very confident). Items will be averaged to create a composite score. Scores will range from 0 to 7, with higher scores indicating higher self-efficacy for weight control behavior.

    Measured: 6 minutes after delivery of the intervention

  4. Intentions for Weight Control Behavior

    Using the same health behaviors assessed for self-efficacy, intentions for weight control behavior will be assessed (i.e., intentions to engage in each behavior over the next six months). Each item will be rated on an 8-point scale (0=strongly disagree to 7=strongly agree). Items will be averaged to create a composite score. Scores will range from 0 to 7, with higher scores indicating higher intentions to engage in weight control behavior.

    Measured: 10 minutes after delivery of the intervention

  5. Executive control_accuracy

    The Stroop task provides a measure of executive control by assessing the ability to inhibit an automatic response (reading) in favor of performing a more controlled task (color naming). The task is a classic, widely used and well-validated measure of executive control. Eight blocks of 20 trials will be performed that will take approximately 5 minutes to complete. Executive control scores will be calculated for response accuracy and speed. Metric: accuracy (percentage of correct answers on mismatched trials). A lower percentage of correct answers on mismatched trials indicates worse executive control.

    Measured: 15 minutes after delivery of the intervention

  6. Executive control_speed

    The Stroop task provides a measure of executive control by assessing the ability to inhibit an automatic response (reading) in favor of performing a more controlled task (color naming). The task is a classic, widely used and well-validated measure of executive control. Eight blocks of 20 trials will be performed that will take approximately 5 minutes to complete. Executive control scores will be calculated for accuracy and speed (reaction time). Metric: reaction time (average reaction time in milliseconds on mismatched trials). Longer reaction times on mismatched trials indicate worse executive control.

    Measured: 15 minutes after delivery of the intervention

  7. Delay Discounting

    Delay discounting involves the subjective depreciation of an incentive based on its timing. The measure assesses the ability to delay gratification, that is, a tendency to prioritize larger long-term rewards over smaller short-term rewards. The task involves choosing short vs. long-term rewards from a set of five dichotomous choices (e.g., to receive $1 immediately or $10 in one month). The task takes about 1 minute to administer, is highly reliable, and correlates well with longer and more extensive measures of delay discounting (metric: discount rate (k)). Scores will range from 0.000110 to 24, with higher scores indicating more impulsivity/lower ability to delay gratification.

    Measured: 20 minutes after delivery of the intervention

  8. Change in Cortisol From Baseline to First Follow-up Assessment

    The investigators will measure cortisol secretion via saliva (passive drool) 25 minutes after delivery of the intervention (first follow-up) and compare it to baseline cortisol levels.

    Measured: 25 minutes after delivery of the intervention

  9. Comfort Eating

    Comfort eating will be assessed via an eating task to objectively measure hyper-palatable (high-fat, -sodium, -sugar, and -carbohydrate) food intake. To avoid floor effects, the eating task will take place under the guise of a faux taste test, which will ostensibly guide the development of the food marketing campaign later during the study. To avoid ceiling effects and to allow eating behavior without fear that the experimenter will negatively judge the amount eaten, large quantities of each food will be made available. The task will take 10 minutes to complete and will be conducted in a private room. Bowls will be weighed (unobtrusively) before and after the task to compute the difference in grams, which will then be converted to kilocalories based on published nutrition information from the food maker. Higher kilocalorie consumption indicates a tendency to engage in more comfort eating during times of stress.

    Measured: 30 minutes after delivery of the intervention

  10. Social Withdrawal

    Social withdrawal will be assessed with a measure from previous research. The experimenter will present three options for working on the final task: alone, with a former group member, or with a new partner. Choosing to work alone reflects a desire to avoid social interaction. Each response will be assigned a numerical code (work alone = 0; work with a former group member = 1; work with a new partner = 2). Scores of zero indicate a greater tendency to withdraw socially during times of stress.

    Measured: 45 minutes after delivery of the intervention

  11. Change in Cortisol From Baseline to Second Follow-up Assessment

    The investigators will measure cortisol secretion via saliva (passive drool) 60 minutes after delivery of the intervention (second follow-up) and compare it to baseline cortisol levels.

    Measured: 60 minutes after delivery of the intervention

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Feb 2023
  2. Study start5 Feb 2023
  3. Primary completion26 Apr 2024
  4. Study completion26 Apr 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Basic science
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Participant
Enrolment
333 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05714696
Sponsor's protocol ID
R56HL159177
Other IDs
R56HL159177
Status last verified
Apr 2025
First submitted
6 Jan 2023
Last updated
15 May 2025
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: The research team agrees to develop a transportable de-identified database, codebook, and mechanism by which data could be shared with other investigators upon approval of the PI.

Questions about this trial

What is this clinical trial studying?

A study testing Weight discrimination experience in people with Obesity, run by Florida State University at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 15 May 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 15 May 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Negative Affect (time frame: 2 minutes after delivery of the intervention). The study lists 11 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 May 2025.

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