Beyond Perceived Discrimination: Weight Discrimination in College Social Networks is associated with Poorer Mental and Behavioral Health.

Background: Weight discrimination is associated with poorer health but has not been studied using social network analysis. This is surprising, as discrimination is a highly social phenomenon, and peer relationships are associated with health, discrimination, and behavior.

Objective: The aim of this study was to analyze relationships between freshman health and weight discrimination in college social networks during October-December, 2021.

Design: This study used a cross-sectional design to analyze data from the Freshman Life And Student Health (FLASH) Project.

Participants/ Setting: Participants (N=1216, 64% of the class) included freshman over 17 years old who were living on a mid-size southeastern United States university campus (55% participants from racial and ethnic minoritized groups, 69% female, 32% first generation college students)).

Main Outcome Measures: Outcomes included disordered eating, physical activity, gym use, alcohol use, loneliness, stress, depression, and self-esteem.

Statistical Analyses Performed: Discrimination indices were calculated for each participant's unique position in the network, based on discriminatory behavior observed and perpetuated by one's direct connections (immediate network) and direct + indirect connections (e.g., friends-of-friends; peripheral network). Multivariate regressions tested whether these indices were associated with health, controlling for race, ethnicity, gender, first-generation college status, perceived weight discrimination, BMI, and network size.

Results: Immediate network discrimination related to poorer health (p=0.002, ηp2=0.023), including greater depression (p=0.035, ηp2=0.004), disordered eating (p<0.001, ηp2=0.013), perceived stress (p=0.020, ηp2=0.005), loneliness (p=0.006, ηp2=0.007), lower self-esteem (p=0.008, ηp2=0.007) and less gym use (p=0.012, ηp2=0.006). Similarly, peripheral network discrimination was associated with poorer health (p=0.013, ηp2=0.017), including greater disordered eating (p<0.001, ηp2=0.010), loneliness (p=0.009, ηp2=0.006), and perceived stress (p=0.005, ηp2=0.007), and lower self-esteem (p=0.003, ηp2=0.008).

Conclusion: Weight discrimination in college social networks related to poorer mental and behavioral health. Results suggest that network-level weight discrimination is related to poorer health, even after accounting for weight discrimination perceived by the individual.