青少年到青年之肥胖變化模式與成年親密關係延遲:心理及社會機制

Abstract

研究背景與目的：肥胖污名是嚴重的公共衛生議題，且會影響到青少年及青年的親密關係發展，但目前尚不清楚肥胖到建立親密關係困難的影響機制。考量青少年到青年過渡期的身心劇烈變化後，可以結合肥胖污名理論和親密關係發展理論建構出青少年到青年肥胖變化模式到成年親密關係延遲及成年親密關係缺乏的心理社會機制，並基於肥胖污名中的性別差異，額外建立性別分層模型。 研究方法：本固定連續樣本研究，使用｢台灣教育長期追蹤資料庫｣的2007年 (受試者年齡為18~19歲)、2014年(25/26歲)及2019年(30/31歲)調查資料進行分析(N=2684)。為檢驗研究假設，採用結構方程模型之路徑分析，建構青少年到青年｢變為/持續肥胖｣透過青年心理因素(低主觀社會地位、憂鬱情緒)及社會因素(較少朋友、沒有親密交往機會)到青年及成年親密關係延遲(25/26歲前從未有親密關係經驗、30/31歲當下沒有親密關係)的心理社會因素廣義線性模型，並建立男女樣本個別模型，以探討肥胖污名之性別差異。 研究結果：變為/持續肥胖者青少年到青年比起無肥胖/肥胖逆轉者，更容易在25/26歲前從未有親密關係經驗，並且也預示其在30/31歲當下沒有親密關係。另外，在全樣本模型中，變為/持續肥胖者容易透過擁有較少的朋友、較低的主觀社會地位及/或缺乏親密交往機會，進一步導致其在25/26歲前從未有親密關係經驗及30/31歲當下沒有親密關係。關於性別差異探討，變為/持續肥胖的女性、男性除了共享｢透過較低的主觀社會地位及/或沒有親密交往機會，導致其在25/26歲前從未有親密關係經驗｣外，變為/持續肥胖的女性，可以直接透過沒有親密交往機會，在建立親密關係上產生困難；另一方面，變為/持續肥胖的男性則會透過擁有較少朋友、較低的主觀社會地位及較多的憂鬱情緒，在建立親密關係上產生困難。 結論：本研究發現｢變為/持續肥胖｣者，可能會透過較少朋友、低主觀社會地位、憂鬱情緒及沒有親密交往機會，導致親密關係延遲的問題；並發現女性及男性的心理社會機制不同。

Background and Objectives: Weight stigma is a serious public health issue and affects the development of romantic relationships in adolescents and young adults; however, it is not yet clear how obesity makes it difficult to build romantic relationships. After considering the drastic changes in the body and mind during the transitional period from adolescents to young adult, based on weight stigma theory and the phase-based models of romantic relationships, a psychosocial mechanism from weight change pattern from adolescent to young adult to delayed romantic relationships of adults and lack of romantic relationships of adults can be established. Additionally, based on the gender differences in weight stigma, gender stratified models will be constructed at the same time. Methods: In this panel study (N=2684), we adopt the three waves of data, 2007 (the subjects are 18-19 years old), 2014 (25-26 years old), and 2019 (30-31 years old), from Taiwan Education Panel Survey (TEPS) and its follow-up survey (TEPS-B). To test research hypotheses, pathway analysis of the structural equation model will be used for generalized linear modeling of the psychosocial mechanism from 'developing/persistent obesity' to “delayed romantic relationship outcomes (lack of romantic-relationship experience before age 25/26 and lack of romantic relationship at age 30/31)” through psychological factors (low subjective social status and depressed affect) and social factors (fewer friends and lack of chance of romantic dating). Then, models of male and female samples will be built respectively to explore gender differences in the obesity stigma. Results: Adolescents to young adults who are developing/persistent obesity are more likely to lack romantic-relationship experience before age 25/26 than those who are no obesity/obesity reversal and are also predicted to lack of romantic relationships at age 30/31. In the full-sample model, these participants who are developing/persistent obesity are more likely to lack romantic-relationship experience before age 25/26 and lack of romantic relationships at age 30/31, through fewer friends, lower subjective social status, or/and lack of chance of romantic dating. With regard to gender differences, both females and males share the effect path from 'developing/persistent obesity' to 'lack romantic-relationship experience' through “lower subjective social status' or/and ' lack of chance of romantic dating'. Besides, females who are developing/persistent obesity will face problems when establishing romantic relationships directly through lack of chance of romantic dating. On the other hand, males who are developing/persistent obesity will face problems when establishing romantic relationships through having fewer friends, lower subjective social status, more depressed affect, and lack of chance of romantic dating. Conclusion: This study found that people who are developing/persistent obesity further cause their delayed romantic relationships through having fewer friends, lower subjective social status, more depressed affect, and lack of chance of romantic dating. This study also found that females and males differed in the psychosocial mechanisms.