Abstract
The present study aimed to understand characteristics of weight discrimination (i.e., attributions, settings, domains) and their associations with cardiometabolic health, as defined by metabolic syndrome and its individual components as well as self-rated health (SRH), among adults with overweight and obesity from the All of Us research program (n = 46,994). Multiple linear and logistic regression analyses were used to model the associations between discrimination attribution (i.e., whether due to weight, another social identity, or both) and cardiometabolic health. The associations between scores on the Everyday Discrimination Scale as well as the Discrimination in Medical Settings Scale and cardiometabolic health were also examined. Structural equation modeling tested specific domains of discrimination within these scales that have been identified in the literature (disrespect and condescension, character-based discrimination and hostility, healthcare discrimination) and their associations with cardiometabolic health. Participants reporting weight discrimination in addition to other forms of discrimination had greater odds of meeting criteria for metabolic syndrome than those reporting no discrimination (OR = 1.17, 95% CI [1.01, 1.35], p = .04). Weight discrimination, whether alone or along with other forms of discrimination, was negatively associated with SRH. Independent of discrimination attribution, both everyday discrimination as well as discrimination in medical settings were positively associated with metabolic syndrome and negatively associated with SRH. Confirmatory factor analysis showed that three distinct domains of discrimination fit the data best. Among the three discrimination domains, only healthcare discrimination was associated with lower SRH. These results underscore the importance of considering the heterogeneity of discrimination experiences due to weight, including how discrimination attributions and the setting of discrimination may be associated with cardiometabolic health.