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FINDING SLIDES FOR TODAYS COPE WEBINAR SERIES FOR HEALTH WEBINAR PROFESSIONALS April 8, 2020 www.villanova.edu/COPE Str ess, Obesity and Weight Stigma Click on Tomiyama Moderator: Lisa Diewald, MS, RD, LDN webinar description page

  1. FINDING SLIDES FOR TODAY’S COPE WEBINAR SERIES FOR HEALTH WEBINAR PROFESSIONALS April 8, 2020 www.villanova.edu/COPE Str ess, Obesity and Weight Stigma Click on Tomiyama Moderator: Lisa Diewald, MS, RD, LDN webinar description page Program Manager MacDonald Center for Obesity Prevention and Education M. Louise Fitzpatrick College of Nursing Nursing Education Continuing Education Programming Research Nursing Education Continuing Education Programming Research 1 2 DID YOU USE YOUR PHONE TO OBJECTIVES ACCESS THE WEBINAR? If you are calling in today rather 1. To identify specific examples of cognitive, than using your computer to log behavioral, physiological and biochemical on, and need CE credit, please pathways linking stress and obesity. email cope@villanova.edu and 2. To explore the negative consequences of provide your name so we can send weight stigma 3. To discuss potential solutions for reducing your certificate. the impact of weight stigma and stress on individuals with weight struggles. Nursing Education Continuing Education Programming Research Nursing Education Continuing Education Programming Research 3 4 CE DETAILS CE CREDITS Villanova University College of Nursing is •This webinar awards 1 contact hour for nurses accredited as a provider of continuing nursing and 1 CPEU for dietitians education by the American Nurses Credentialing Center Commission on Accreditation •Suggested CDR Learning Need Codes: 5370, 6000, 9000, 9020 Villanova University College of Nursing Continuing Education/COPE is a Continuing Professional Education (CPE) Accredited • Level 2 Provider with the Commission on Dietetic Registration •CDR Performance Indicators: 6.2.3, 6.2.5, 8.2.1, 9.1.3 Nursing Education Continuing Education Programming Research Nursing Education Continuing Education Programming Research 5 6 1

  2. DISCLOSURE Stress, Obesity and Weight Stigma The planners and presenter of this program have no conflicts of interest to disclose. A. Janet Tomiyama Associate Professor Accredited status does not imply endorsement by Department of Psychology Villanova University, COPE or the American University of California, Los Angeles Nurses Credentialing Center of any commercial products or medical/nutrition advice displayed in conjunction with an activity. 7 8 What is stress? Types of Stressors Types of Stressors Quiz on Lecture Stress, Obesity, and Weight Stigma “When challenged to provide a definition of stress, most of us fall back on textbook definitions with no soul or shrug our shoulders and agree that it is not a good construct.” (p. 653) COPE Webinar Villanova April 8, 2020 A. Janet Tomiyama, Ph.D. Associate Professor Department of Psychology, UCLA (Baum, 1990, Health Psych ) 9 10 Conclusions from Lab Studies of Consumption After a High ‐ Fat Preload My favorite definition Stress is widespread What is Stress? Quiz on Lecture Psychology of Eating Eating, Part I Stress is a negative emotional experience accompanied by predictable biochemical, physiological, cognitive, and behavioral changes that are directed either toward altering the stressful event or accommodating to its effects. (Baum, 1990, Health Psych ) 11 12 2

  3. Conclusions from Lab Studies of Conclusions from Lab Studies of Consumption After a High ‐ Fat Preload Consumption After a High ‐ Fat Preload Pathways from stress to obesity? Pathways from stress to obesity Psychology of Eating Psychology of Eating Eating, Part I Eating, Part I ? (Tomiyama, 2019, Ann Rev Psych ) 13 14 Conclusions from Lab Studies of Conclusions from Lab Studies of Consumption After a High ‐ Fat Preload Consumption After a High ‐ Fat Preload www.dishlab.org Cognitive pathways Psychology of Eating Psychology of Eating Eating, Part I Eating, Part I • Stress knocks out executive function • …which is necessary for self-regulation/self-control • …of both behaviors and emotions! 15 16 Conclusions from Lab Studies of Conclusions from Lab Studies of Consumption After a High ‐ Fat Preload Consumption After a High ‐ Fat Preload Behavioral pathways 1 Behavioral pathways 3 Psychology of Eating Psychology of Eating Eating, Part I Eating, Part I Eating • Sleep • Stress-induced comfort eating • People who get less than 5.5 hours are 55% • 39% of Americans are comfort eaters! more likely to have obese BMI • For every hour more a person sleeps, their Solve these anagrams: average BMI is 0.35 points less oneci • For the average height woman (5’5’’) that amoos equals 2.2 lbs acelo rtean filru 17 18 3

  4. Conclusions from Lab Studies of Consumption After a High ‐ Fat Preload Physiological pathways 1 Psychology of Eating Eating, Part I Hypothalamic-Pituitary-Adrenal (HPA) axis •And cortisol, its end product 19 20 Conclusions from Lab Studies of Conclusions from Lab Studies of Consumption After a High ‐ Fat Preload Consumption After a High ‐ Fat Preload Physiological pathways 1 Physiological pathways 2 Psychology of Eating Psychology of Eating Eating, Part I Eating, Part I Cortisol also drives eating Reward processing •Stress drives motivation for high sugar, high fat, and high calorie foods •Dopamine system drives food seeking and eating •Stress sensitizes reward centers in the brain •High-sugar/fat/calorie foods relieve stress (Epel et al., 2001 PNE ) 21 22 Conclusions from Lab Studies of Conclusions from Lab Studies of Consumption After a High ‐ Fat Preload Consumption After a High ‐ Fat Preload Physiological pathways 3 Biochemical pathways 1 Psychology of Eating Psychology of Eating Eating, Part I Eating, Part I Gut microbiome Leptin •Gut microbiota can increase HPA axis activity •And manufacture appetite- regulating hormones •And maybe even regulate body weight …but this is still speculative 23 24 4

  5. Conclusions from Lab Studies of Conclusions from Lab Studies of Consumption After a High ‐ Fat Preload Consumption After a High ‐ Fat Preload Biochemical pathways 1 Biochemical pathways 2 Psychology of Eating Psychology of Eating Eating, Part I Eating, Part I Leptin Ghrelin • Leptin may protect against stress eating •Stimulates reward pathways • …but individuals with obesity have higher leptin In stress-eaters: levels, indicating leptin resistance Ghrelin stays high even after eating 25 26 Conclusions from Lab Studies of Conclusions from Lab Studies of Consumption After a High ‐ Fat Preload Consumption After a High ‐ Fat Preload Biochemical pathways 3 Pathways from stress to obesity Psychology of Eating Psychology of Eating Eating, Part I Eating, Part I Neuropeptide Y (NPY) •Stimulates hunger, conversion of sugars into fat •NPY in combination with stress leads to greater obesity (Tomiyama, 2019, Ann Rev Psych ) 27 28 ���� � �� � ���� � �� � �� ��� � ������ �� � �� � Stressors that are (a) social and (b) evaluative elicit the most cortisol � �� �� ���� � � ���� (Dickerson & Kemeny, 2004, Psychological Bulletin ) (Tomiyama, 2014, Appetite ) 29 30 5

  6. ���� � �� � ���� � �� � �� ��� � ������ �� � �� � � �� �� ���� � � ���� It’s not about your actual BMI, it’s how you perceive it (Tomiyama et al., 2014, Health Psychology ) (Tomiyama, 2014, Appetite ) 31 32 Conclusions from Lab Studies of Conclusions from Lab Studies of Consumption After a High ‐ Fat Preload Consumption After a High ‐ Fat Preload “Shopping room” Methods, continued Psychology of Eating Psychology of Eating Eating, Part I Eating, Part I • Weighed • Sit in waiting room with a very thin confederate • …who is accepted into the shopping activity (Himmelstein, Incollingo Belsky, Tomiyama, 2014, Obesity ) 33 34 Conclusions from Lab Studies of Conclusions from Lab Studies of Consumption After a High ‐ Fat Preload Consumption After a High ‐ Fat Preload Manipulation Study 2: Results Psychology of Eating Psychology of Eating Eating, Part I Eating, Part I “Unfortunately your shape and size just aren’t ideal for this style of clothing and we really do want everyone to have fun and feel good. Plus, we want to return the clothing to the designer in good condition.” (Himmelstein, Incollingo Belsky, Tomiyama, 2014, Obesity ) 35 36 6

  7. Study 1 : Stigma correlated with cortisol Study 2 : Stigma causes cortisol secretion 37 38 39 40 Conclusions from Lab Studies of Consumption After a High ‐ Fat Preload Study 3: Outcome measures Psychology of Eating Eating, Part I Study 1 : Stigma correlated with cortisol Study 2 : Stigma • Psychological: Anger, causes cortisol depression, anxiety, rejection, secretion self ‐ esteem, antifat attitudes • Behavioral: M&Ms, potato Study 3 : Stigma chips, Coca ‐ Cola consumption causes unhealthy eating (Heldreth, Incollingo Rodriguez, & Tomiyama, 2018, Obesity ) 41 42 7

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