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Biological and Psychological Aspects of Diabetes and Obesity

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (30 September 2022) | Viewed by 39430

Special Issue Editors


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Guest Editor
School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, L3 3AF, United Kingdom
Interests: qualitative; obesity; weight management; health psychology; health improvement; public health; health promotion; smoking; behaviour change; diabetes; cardiac rehabilitation
Research Institute for Sport and Exercise Sciences, School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
Interests: cardiometabolic risk markers; lipid; lipoprotein; lipidomic; metabolomic outcomes; mechanisms; diet; lifestyle
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Guest Editor
Applied Health & Social Care, Faculty of Health, Social Care & Medicine, Edge Hill University, Ormskirk, Lancashire L39 4QP, United Kingdom
Interests: maternal health; maternal nutrition; nutrition education; patient and public involvement

Special Issue Information

Dear Colleagues,  

Type 2 diabetes mellitus (T2D) increases the risk of cardiovascular disease (CVD). Globally, an estimated 17.8 million and 1.4 million deaths were caused by CVD and diabetes, respectively, in 2017—an increase of 21% in CVD and 34% in diabetes from 2007. In Europe, 19.9 million people are anticipated to be living with CVD and 60 million are living with diabetes. CVD costs the UK economy £7.4 billion annually, and the global economic burden of CVD is projected to reach USD 1044 billion by the year 2030—nearly a USD 200 billion rise from 2010. Similarly, the current global cost of diabetes is estimated to be USD 760 billion, and is projected to cost USD 825 billion by 2030.Obesity, especially visceral adipose tissue (VAT), is associated with T2D. The prevalence of obesity and overweight is approximately 25% in the UK, 40% in the US, and 13% worldwide. Obesity is linked to various metabolic abnormalities such as high triglycerides, low high-density lipoprotein cholesterol (HDL-C), elevated blood glucose, and hypertension, referred to as metabolic syndrome. Additionally, insulin resistance (IR), dyslipidaemia and low-grade inflammation often present with obesity and metabolic syndrome. This clustering of abnormalities is often referred to as cardiometabolic disease (CMD) and is highly associated with T2D and CVD. However, obesity is not a choice, and neither is T2D. Misconceptions regarding the onset, management and progression of obesity and type 2 diabetes exist, which reinforce stigma associated with these conditions. To reduce the onset initially, and to support those with established T2D or obesity, we must act. We must consider alternative approaches and strategies in their prevention and treatment. We must not simply assume that the science is static, and should be open to exploring new approaches. To change behaviours is not simply a process of engaging in knowledge and implementation; we must provide an environment which is all encompassing: to promote individual capacity, motivation and opportunity to engage.We propose this Special Issue to fully consider the bio-psycho-social model (Engel, 1977) to understand and work with people living with obesity or diabetes, and to further understand how these factors interact to influence the behaviours that contribute to, or maintain, obesity or type 2 diabetes.For this Special Issue, we call for papers which challenge the status quo: in understanding biology, services, interventions and treatments. We welcome papers which may affect policy, standards and guidelines for obesity or T2D; which may influence health professional training and supervision needs; or may explore the role of communication to the public, to patients or to health professionals.We welcome intervention studies, qualitative and quantitative empirical research, as well as reviews, position papers, brief reports and commentaries.

Dr. Lisa Newson
Dr. Ian Davies
Dr. Julie Abayomi
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • obesity
  • biology
  • psychology
  • communication
  • interventions

Published Papers (5 papers)

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Research

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16 pages, 1027 KiB  
Article
A Cross-Sectional Analysis of the Stigma Surrounding Type 2 Diabetes in Colombia
by Victor Pedrero, Jorge Manzi and Luz Marina Alonso
Int. J. Environ. Res. Public Health 2021, 18(23), 12657; https://doi.org/10.3390/ijerph182312657 - 1 Dec 2021
Cited by 10 | Viewed by 2519
Abstract
Type 2 diabetes is a global epidemic, and many people feel stigmatized for having this disease. The stigma is a relevant barrier to diabetes management. However, evidence in this regard is scarce in Latin America. This study aimed to analyze the level of [...] Read more.
Type 2 diabetes is a global epidemic, and many people feel stigmatized for having this disease. The stigma is a relevant barrier to diabetes management. However, evidence in this regard is scarce in Latin America. This study aimed to analyze the level of stigma surrounding type 2 diabetes in the Colombian population and its relationships with sociodemographic, clinical, psychosocial variables and behaviors related to management of the disease (self-management behaviors). This cross-sectional study included 501 Colombian adults with type 2 diabetes. We estimated the relation between stigma and selected variables through linear regression models. Additionally, we analyzed the mediator role of psychosocial variables in the relationship between stigma and self-management behaviors through structural equation models. A total of 16.4% of patients showed concerning levels of stigma. The time elapsed since diagnosis (β = −0.23) and socioeconomic status (β = −0.13) were significant predictors of the level of stigma. Stigma was negatively correlated with self-efficacy (β = −0.36), self-esteem (β = −0.37), and relationship with health care provider (β = −0.46), and positively correlated with stress (β = 0.23). Self-efficacy, self-esteem, and the relationships with health care providers had a mediation role in the relationship between stigma and self-management behaviors. These variables would be part of the mechanisms through which the perception of stigma harms self-management behaviors. The stigma of type 2 diabetes is frequent in the Colombian population and negatively associated with important aspects of disease management. Full article
(This article belongs to the Special Issue Biological and Psychological Aspects of Diabetes and Obesity)
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13 pages, 2181 KiB  
Article
Exploring Weight Stigma in Saudi Arabia: A Nationwide Cross-Sectional Study
by Nora A. Althumiri, Mada H. Basyouni, Norah AlMousa, Mohammed F. AlJuwaysim, Adel A. Alhamdan, Faisal Saeed Al-Qahtani, Nasser F. BinDhim and Saleh A. Alqahtani
Int. J. Environ. Res. Public Health 2021, 18(17), 9141; https://doi.org/10.3390/ijerph18179141 - 30 Aug 2021
Cited by 10 | Viewed by 23117
Abstract
Background: Weight stigma (WS) in the Middle East, especially in Saudi Arabia, is widely ignored. People with obesity are blamed for their weight, and there is a common perception that weight stigmatization is justifiable and may motivate individuals to adopt healthier behaviors. The [...] Read more.
Background: Weight stigma (WS) in the Middle East, especially in Saudi Arabia, is widely ignored. People with obesity are blamed for their weight, and there is a common perception that weight stigmatization is justifiable and may motivate individuals to adopt healthier behaviors. The authors of this study aimed to explore WS prevalence and factors associated with WS in a large nationwide study of Saudi Arabian adults. Methods: This study was a nationwide cross-sectional survey conducted via phone interviews in June 2020. A proportional quota-sampling technique was adopted to obtain equal distributions of participants by age and sex across the 13 regions of Saudi Arabia. In total, 6239 people were contacted, and 4709 (75.48%) responded and completed the interview. The authors of the study collected data about WS using the Arabic Weight Self-Stigma Questionnaire (WSSQ), BMI, smoking, nutritional knowledge, bariatric surgery, risk of depression, and demographic variables. Results: Participants had a mean age of 36.4 ± 13.5 (18–90), and 50.1% were female. The prevalence of higher WS was 46.4%. Among other risk factors, there was a significant association between WS and obesity (odds ratio (OR): 3.93; 95% CI: 2.83–5.44; p < 0.001), waterpipe smoking (OR: 1.80; 95% CI: 1.20–2.69; p < 0.001), bariatric surgery (OR: 2.07; 95% CI: 1.53–2.81; p < 0.001), and risk of depression (OR: 1.68; 95% CI: 1.36–2.09; p < 0.001). Conclusion: This was the first study to explore WS and its associated factors among adults in a community setting in Saudi Arabia. This study revealed some risk factors associated with WS that may help to identify people at risk of WS and to develop interventions to reduce WS, such as improving nutritional knowledge, correcting the ideas about bariatric surgery and obesity in general, and ceasing waterpipe smoking. Full article
(This article belongs to the Special Issue Biological and Psychological Aspects of Diabetes and Obesity)
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Review

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15 pages, 713 KiB  
Review
Exposure to Bisphenol A Substitutes, Bisphenol S and Bisphenol F, and Its Association with Developing Obesity and Diabetes Mellitus: A Narrative Review
by Hend F. Alharbi, Raya Algonaiman, Rana Alduwayghiri, Thamer Aljutaily, Reham M. Algheshairy, Abdulkarim S. Almutairi, Razan M. Alharbi, Leena A. Alfurayh, Amjad A. Alshahwan, Amjad F. Alsadun and Hassan Barakat
Int. J. Environ. Res. Public Health 2022, 19(23), 15918; https://doi.org/10.3390/ijerph192315918 - 29 Nov 2022
Cited by 15 | Viewed by 2812
Abstract
Bisphenol A, a well-known endocrine-disrupting chemical, has been replaced with its analogs bisphenol S (BPS) and bisphenol F (BPF) over the last decade due to health concerns. BPS and BPF are present in relatively high concentrations in different products, such as food products, [...] Read more.
Bisphenol A, a well-known endocrine-disrupting chemical, has been replaced with its analogs bisphenol S (BPS) and bisphenol F (BPF) over the last decade due to health concerns. BPS and BPF are present in relatively high concentrations in different products, such as food products, personal care products, and sales receipts. Both BPS and BPF have similar structural and chemical properties to BPA; therefore, considerable scientific efforts have investigated the safety of their exposure. In this review, we summarize the findings of relevant epidemiological studies investigating the association between urinary concentrations of BPS and/or BPF with the incidence of obesity or diabetes. The results showed that BPS and BPF were detected in many urinary samples at median concentrations ranging from 0.03 to 0.4 µg·L−1. At this exposure level, BPS median urinary concentrations (0.4 µg·L−1) were associated with the development of obesity. At a lower exposure level (0.1–0.03 µg·L−1), two studies showed an association with developing diabetes. For BPF exposure, only one study showed an association with obesity. However, most of the reported studies only assessed BPS exposure levels. Furthermore, we also summarize the findings of experimental studies in vivo and in vitro regarding our aim; results support the possible obesogenic effects/metabolic disorders mediated by BPS and/or BPF exposure. Unexpectedly, BPS may promote worse obesogenic effects than BPA. In addition, the possible mode of action underlying the obesogenic effects of BPS might be attributed to various pathophysiological mechanisms, including estrogenic or androgenic activities, alterations in the gene expression of critical adipogenesis-related markers, and induction of oxidative stress and an inflammatory state. Furthermore, susceptibility to the adverse effects of BPS may be altered by sex differences according to the results of both epidemiological and experimental studies. However, the possible mode of action underlying these sex differences is still unclear. In conclusion, exposure to BPS or BPF may promote the development of obesity and diabetes. Future approaches are highly needed to assess the safety of BPS and BPF regarding their potential effects in promoting metabolic disturbances. Other studies in different populations and settings are highly suggested. Full article
(This article belongs to the Special Issue Biological and Psychological Aspects of Diabetes and Obesity)
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15 pages, 511 KiB  
Review
The Role of Acceptance and Commitment Therapy in Cardiovascular and Diabetes Healthcare: A Scoping Review
by Amineh Rashidi, Lisa Whitehead, Lisa Newson, Felicity Astin, Paramjit Gill, Deirdre A. Lane, Gregory Y. H. Lip, Lis Neubeck, Chantal F. Ski, David R. Thompson, Helen Walthall and Ian D. Jones
Int. J. Environ. Res. Public Health 2021, 18(15), 8126; https://doi.org/10.3390/ijerph18158126 - 31 Jul 2021
Cited by 8 | Viewed by 4557
Abstract
Acceptance and commitment therapy (ACT) is an adapted form of cognitive behavioural therapy. ACT focuses on how thinking affects behaviour and promotes psychological flexibility. The prevalence of psychological distress among people living with cardiovascular disease (CVD) and/or type 2 diabetes mellitus (T2DM) is [...] Read more.
Acceptance and commitment therapy (ACT) is an adapted form of cognitive behavioural therapy. ACT focuses on how thinking affects behaviour and promotes psychological flexibility. The prevalence of psychological distress among people living with cardiovascular disease (CVD) and/or type 2 diabetes mellitus (T2DM) is high, and ACT may offer an alternative treatment approach. This scoping review explored the use of ACT as an intervention to support adults living with CVD and/or T2DM. A systematic search of the literature resulted in the inclusion of 15 studies. Studies were reviewed using the Joanna Briggs Institute approach to conducting scoping reviews. Most studies (n = 13) related to people living with T2DM, and most (n = 10) used a pre-post design, four studies were randomised controlled trials, and one was a qualitative study. Eight studies reported an improvement in the outcome(s) assessed post-intervention, suggesting that ACT was an acceptable and valid intervention to support people living with CVD or T2DM. However, studies were underpowered and only limited studies involved people living with CVD. ACT was assessed as a valuable approach to improve a range of patient-reported outcomes for those living with CVD or T2DM, and further research involving robust study designs and larger cohorts are warranted. Full article
(This article belongs to the Special Issue Biological and Psychological Aspects of Diabetes and Obesity)
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Other

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27 pages, 3371 KiB  
Systematic Review
Cultural Identity Conflict Informs Engagement with Self-Management Behaviours for South Asian Patients Living with Type-2 Diabetes: A Critical Interpretative Synthesis of Qualitative Research Studies
by Tasneem Patel, Kanayo Umeh, Helen Poole, Ishfaq Vaja and Lisa Newson
Int. J. Environ. Res. Public Health 2021, 18(5), 2641; https://doi.org/10.3390/ijerph18052641 - 5 Mar 2021
Cited by 9 | Viewed by 5326
Abstract
The prevalence of type-2 diabetes (T2D) is increasing, particularly among South Asian (SA) communities. Previous research has highlighted the heterogeneous nature of SA ethnicity and the need to consider culture in SA patients’ self-management of T2D. We conducted a critical interpretative synthesis (CIS) [...] Read more.
The prevalence of type-2 diabetes (T2D) is increasing, particularly among South Asian (SA) communities. Previous research has highlighted the heterogeneous nature of SA ethnicity and the need to consider culture in SA patients’ self-management of T2D. We conducted a critical interpretative synthesis (CIS) which aimed to a) develop a new and comprehensive insight into the psychology which underpins SA patients’ T2D self-management behaviours and b) present a conceptual model to inform future T2D interventions. A systematic search of the literature retrieved 19 articles, including 536 participants. These were reviewed using established CIS procedures. Analysis identified seven constructs, from which an overarching synthesizing argument ‘Cultural Conflict’ was derived. Our findings suggest that patients reconstruct knowledge to manage their psychological, behavioural, and cultural conflicts, impacting decisional conflicts associated with T2D self-management and health professional advice (un)consciously. Those unable to resolve this conflict were more likely to default towards cultural identity, continue to align with cultural preferences rather than health professional guidance, and reduce engagement with self-management. Our synthesis and supporting model promote novel ideas for self-management of T2D care for SA patients. Specifically, health professionals should be trained and supported to explore and mitigate negative health beliefs to enable patients to manage social-cultural influences that impact their self-management behaviours. Full article
(This article belongs to the Special Issue Biological and Psychological Aspects of Diabetes and Obesity)
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