Summary: Background: Adverse childhood experiences (ACEs) and obesity are independently associated with brain/neurocognitive health. Despite a growing emphasis on the importance of early life adversity on health, the relationship between ACEs and neurocognition in adults with overweight/obesity is unclear. The objective was to examine associations between self‐reported ACEs and measured neurocognitive domains in a sample of adults with overweight/obesity.Methods: Participants were 95 predominantly white, highly educated adult women (76% female, 81% Caucasian, and 75% ≥ bachelor's degree) with excess adiposity enrolled in the Cognitive and Self‐regulatory Mechanisms of Obesity Study. ACEs and fluid/crystallized neurocognitive domains were measured at baseline using the Adverse Childhood Experiences Scale and the NIH Toolbox Cognition Battery and Automated Neuropsychological Assessment Metric, respectively.Results: Higher ACEs scores were negatively correlated with fluid cognition (r = −.34, P < .001) but not crystallized cognition (r = .01, ns). Individuals with 3 and 4+ ACEs displayed significantly lower fluid cognition scores than those with fewer ACEs F_4,89 = 3.24, P < .05. After accounting for body mass index (BMI), age, sex, race, and education, higher ACEs scores were still associated with poorer performance on overall fluid cognition (β = −.36, P < .01), along with the following subtests: Stroop Colour/Word test (β = −.23, P < .05), Go/No‐Go omissions (β = .29, P < .01), and Picture Sequence Memory task (β = −.30, P < .01).Conclusions: The role of ACEs in health may be related to their associations with executive function and episodic neurocognitive domains essential to cognitive processing and self‐regulation. Obesity science should further examine the role of ACEs and neurocognition in obesity prevention, prognosis, and treatment using more rigorous, prospective designs and more diverse samples.

Summary: Introduction: Intuitive eating (IE) has emerged as a weight‐neutral approach to health promotion for those with overweight/obesity. This weight‐neutral paradigm has some support, although research thus far has often neglected to control for potential confounds (i.e. objective weight status and demographics) and foundational studies are lacking. The objective of the current study was to observe the unique association of IE with physical health indicators in a sample of adults, independent of objective weight status.Methods: Participants were 248 adults (32 ± 14 years old, 73% female, 64% White) of all weight categories (18.2–55.3 kg m⁻²), with an average body mass index (BMI) of 30 ± 8 kg m⁻². IE was measured with the Intuitive Eating Scale‐2 (IES‐2). BMI was objectively measured in‐lab. Health indicators included blood pressure (BP) and fasting glucose.Results: A series of hierarchical linear regressions revealed no significant associations between IE and systolic BP (β = −0.076, P = 0.256), diastolic BP (DBP; β = −0.122, P = 0.073) or fasting glucose (β = 0.047, P = 0.500) after controlling for BMI. All effects sizes were small or below (f² = 0.00 to −0.04). Sensitivity analyses revealed significantly lower DBP in high intuitive eaters versus low when analysed with a t‐test, t(111.651) = 3.602, P < 0.001, Levene corrected; however, after controlling for relevant covariates (i.e. BMI and demographics), analysis of covariance revealed no difference in DBP between groups, F(1, 116) = 0.330, P = 0.567. No significant differences in systolic BP or fasting glucose were observed between low and high intuitive eaters before or after considering covariates.Conclusions: In sum, this study investigated associations between IE and common indicators of physical health after controlling for objective weight status. Findings revealed no unique relationship between IE and physical health, and any IE–physical health relationships that were observed were accounted for BMI and/or demographic factors.

Adverse childhood experiences (ACEs) may be an early life factor associated with adult weight stigma via biological (e.g., stress response), cognitive (e.g., self-criticism/deprecation), and/or emotional (e.g., shame) mechanisms. This pilot study investigated relationships between ACEs and internalized and experienced weight stigma in adult women with overweight/obesity and explored differential relationships between weight stigma and ACE subtypes (i.e., abuse, neglect, household dysfunction). Adult women (68% white, M_age = 33 ± 10 years, M_BMI = 33.7 ± 7.2 kg/m²) completed measures of ACEs (ACE Questionnaire), internalized weight stigma (IWS; Weight Bias Internalization Scale—Modified; WBIS—M), and lifetime experiences of weight stigma (yes/no). Data were analyzed with linear and logistic regression (n = 46), adjusting for age, race, and body mass index (BMI). Linear regressions revealed a positive association between ACE and WBIS—M scores (β = 0.40, p = 0.006), which was driven by Abuse-type ACEs (β = 0.48, p = 0.009). Relationships between WBIS—M scores and Neglect- and Household-Dysfunction-type ACEs did not reach significance (β = 0.20, p = 0.173; β = −0.16, p = 0.273). Though descriptive statistics revealed greater rates of experienced weight stigma endorsement by those with high-3+ ACEs (81%) vs. medium-1–2 ACEs (67%) or low/no-0 ACEs (60%), ACE scores were not significantly associated with experienced weight stigma in logistic regression (Wald = 1.36, p = 0.244, OR = 1.324, 95%, CI = 0.825–2.125). ACEs may be an early life factor that increase the risk for internalizing weight stigma in adulthood. Larger studies should confirm this relationship and follow-up on descriptive findings suggesting a potential association between ACEs and experienced weight stigma.

Weight stigma is a chronic stressor and may contribute to cardiometabolic health risk. This pilot study tests an experimental protocol exploring acute inflammation as a potential biological mechanism connecting weight stigma and disease risk. Preliminary effect sizes and protocol feasibility were assessed. Women (N=44, 68% white) with overweight/obesity (M _BMI =33.2±6.7 kg/m²) were randomized to either weight stigma (n=22) or control (n=22) stress reactivity tasks. Serum cytokines (interleukin [IL]-6, tumor necrosis factor [TNF]-α, interferon [IFN]-γ) were measured at baseline and serially over 90 minutes via peripheral intravenous catheter (PIVC) to assess inflammatory responses. The absolute change (Δ; baseline-to-peak) and incremental area under the curve (AUC_i) were calculated for all outcomes. Within the weight stigma group, pre/post-task increases in IL-6 (d=.20, p=.365), TNF-α (d=.43, p=.047), and IFN-γ (p=.078, d=.48) were consistent with small effects. Within the control group, only IL-6 increased and displayed a medium effect (d=.62, p=.004). When comparing weight stigma versus control, the between-group difference in ΔTNF-α displayed a small effect (d=.21, p=.495), consistent with a greater TNF-α increase in weight stigma. Similarly, a small effect size was observed for weight stigma displaying greater ΔIFN-γ (d=.46, p=.153) and IFN-γ AUC_i (d=.27, p=.502) versus control. Experimental procedures were feasible to conduct with minimal attrition/data loss. Based on the small effect sizes observed in this pilot study, the impact of weight stigma on acute inflammatory responses warrants further investigation in larger samples. Use of in-lab weight stigma stress tasks with repeated blood draws via PIVC was supported as a feasible future protocol.

This study investigated the relationship between internalized weight stigma (IWS) and visceral adipose tissue (VAT), an independent predictor of cardiometabolic disease risk, and how this relationship is moderated by gender. Participants (N=70, 81% white, 51% women, M_age=30.4±7.8 years, M_BMI=28.7±5.5 kg/m², M_BF%=32.4±8.9%) completed in-lab measures of demographic factors (age, gender, race/ethnicity), IWS (Weight Bias Internalization Scale-Modified; WBIS-M) and visceral adiposity. VAT mass was measured via DXA. Primary moderation analysis investigated the effect of gender on associations between IWS and VAT mass. Covariates were age, race/ethnicity, and total body fat percent. After adjusting for covariates in the primary moderation analysis, WBIS-M scores displayed a positive association with VAT mass (b=32.58, p=0.033). The relationship between WBIS-M scores and VAT mass was moderated by gender (b=68.63, p=0.020); no relationship between WBIS-M scores and VAT mass was observed in men (b=−2.71, p=0.894), whereas a positive association between WBIS-M scores and VAT mass was observed in women (b=65.92, p=0.003). Internalization of weight stigma was associated with greater visceral adiposity in women across the BMI spectrum, suggesting it as a chronic stressor. Future studies should investigate directionality and causality of this relationship to elucidate mechanisms of stigma-associated CVD risk.