Dimensões psicossociais da obesidade: explorando interconexões da solidão, depressão e estigma internalizado do peso

Abstract

Introduction: Obesity is a complex and prevalent public health condition in which multifactorial etiology has a strong interface with mental health. Psychosocial factors such as depression, loneliness, and weight stigma present interrelationships that can negatively impact quality of life and treatment adherence. Objective: To analyze the relationship between obesity, loneliness, depression, and weight stigma, describing the frequency of these conditions in patients with and without obesity and associating the variables. Method: A cross-sectional, quantitative, and analytical study was conducted with patients from a Primary Health Care Unit in the Federal District, Brazil. The BDI-PC (depression), UCLA Loneliness Scale (loneliness), and Weight Bias Internalization Scale (WBIS) (internalized stigma) questionnaires were applied, and self-reported sociodemographic and anthropometric data were collected. The WBIS was administered only to individuals who responded positively to the statement "I consider myself to be overweight." Participants were classified into "without obesity" (Body Mass Index <30kg/m²) and "with obesity" (Body Mass Index >30kg/m²). Analyses were performed to verify the relationship between obesity and depression risk, and between obesity and loneliness, using Pearson's chi-square test. The influence of biological sex on the evaluated parameters was also assessed via Pearson's chi-square test. The association between internalized weight stigma and (a) risk of depression, (b) loneliness, and (c) sex was evaluated using Student's t-test (p < 0,05). Results: The final sample consisted of 260 participants. The prevalence of depression risk (67.3% vs 46.7%; p=0.005) and loneliness (70.3% vs 54.1%; p=0.009) was significantly higher in patients with obesity. Internalized weight stigma, assessed only among individuals who considered themselves overweight (n = 138), was higher in those at risk of depression (p<0.001) and in those experiencing loneliness (p<0.001). Females showed a higher frequency of risk of depression (p = 0.018) and loneliness (p=0.004), as well as higher internalized weight stigma scores (p<0.001). Conclusion: People with obesity showed a higher risk of depression and loneliness, and internalized weight stigma was associated with both outcomes. Females exhibited greater psychosocial vulnerability and higher levels of internalized weight stigma. These findings reinforce the need for biopsychosocial approaches to obesity care, incorporating mental health support and strategies to address weight stigma.