Weight Stigma and Weight-Related Health: Associations of Self-Report Measures Among Adults in Weight Management. Issue 11 (25th April 2020)

• Record Type: Journal Article
• Authors: Pearl, Rebecca L; Puhl, Rebecca M; Himmelstein, Mary S; Pinto, Angela M; Foster, Gary D
• Is Part Of: Annals of behavioral medicine. Volume 54:Issue 11(2020)
• Page Start: 904
• Page End: 914
• Publication Date: 2020-04-25
• Subjects: Behaviors -- Health -- Weight bias internalization -- Weight management -- Weight stigma; Medicine and psychology -- Periodicals; Sick -- Psychology -- Periodicals; Behavioral Medicine; 616.0019
• DOI: 10.1093/abm/kaaa026
• Languages: English
• ISSNs: 0883-6612

Abstract

Abstract: Background: Weight stigma impairs health. Few studies have disentangled the associations of experienced versus internalized stigma with weight-related outcomes. Purpose: To examine weight and health variables associated with weight stigma experiences and internalization in the largest-to-date sample of adults in weight management. Methods: WW (formerly Weight Watchers) members ( N = 18, 769, 94.6% female, 91.1% white) completed an online survey from 2017 to 2018. Participants reported whether they had experienced weight stigma and, if so, the onset, past-year frequency and distress, and interpersonal sources of stigma. Participants completed the Modified Weight Bias Internalization Scale (WBIS-M) and self-reported: past-year weight and lifetime weight cycles; current self-monitoring behaviors; eating self-efficacy; physical activity; perceived stress; eating to cope; body image; and mental and physical health-related quality-of-life (HRQOL). Participants reported their demographic characteristics, including height and weight to compute body mass index. Results: In logistic and linear regression analyses (controlling for participant characteristics), WBIS-M scores were negatively associated with weight loss, self-monitoring, eating self-efficacy, body image, and mental HRQOL and positively associated with weight gain, weight cycling, perceived stress, and eating to cope ( p < .001). Experiencing weight stigma was associated with greater weight loss and less weight gain, although associations with other variables had small effect sizes (absolute β values < 0.10). WBIS-M scores remained significantly associated with all variables when including stigma onset, frequency/distress, and sources. Conclusions: Internalized, but not experienced, weight stigma was consistently associated with adverse weight and health factors. Developing and testing interventions targeting internalized stigma in the context of weight management should be a research priority. Abstract : Internalized, but not experienced, weight stigma was consistently associated with worse weight-related health in a large sample of adults enrolled in a weight management program