No abstract

Weight stigma is pervasive and is associated with psychosocial distress. Little research has examined the association between weight stigma and weight loss treatment outcomes. The current investigation examined overt weight stigma, depression, binge eating, and weight loss treatment outcomes in a sample of 55 overweight and obese adults. Overt weight stigma was significantly associated with greater depression and binge eating and poorer weight loss treatment outcomes in a 14-week behavioral weight loss program, suggesting that overt weight stigma may be detrimental to overweight and obese individuals' ability to lose weight and engage in behaviors consistent with weight loss.

Background Few studies have explored the relationship between weight bias and weight loss treatment outcomes. Purpose This investigation examined the relationship between implicit and explicit weight bias and (a) program attrition, (b) weight loss, (c) self-monitoring adherence, (d) daily exercise levels and overall caloric expenditure, (e) daily caloric intake, and (f) daily caloric deficit among overweight/obese treatment-seeking adults. Methods Forty-six overweight/obese adults (body mass index≥27 kg/m2) participating in an 18-week, stepped-care, behavioral weight loss program completed implicit and explicit measures of weight bias. Participants were instructed to self-monitor and electronically report daily energy intake, exercise, and energy expenditure. Results Greater weight bias was associated with inconsistent self-monitoring, greater caloric intake, lower energy expenditure and exercise, creation of a smaller caloric deficit, higher program attrition, as well as less weight loss during the self-help phase of the stepped-care treatment. Conclusions Weight bias may interfere with overweight/obese treatment-seeking adults' ability to achieve optimal health.

In a stepped-care approach to treatment, patients are transitioned to more intensive treatments when less intensive treatments fail to meet treatment goals. Self-help programs are recommended as an initial, low intensity treatment phase in stepped-care models. This investigation examined the effectiveness of a self-help, stepped-care weight loss program. Fifty-eight overweight/obese adults (BMI ≥ 27 kg/m2) participated in a weight loss program. Participants were predominately Caucasian (93.1%) and female (89.7%) with a mean BMI of 36.6 (SD = 7.1). Of those completing the program, 57% of participants (N = 21) who remained in self-help maintained an 8% weight loss at follow-up. Participants who were stepped-up self-monitored fewer days and reported higher daily caloric intake than self-help participants. Once stepped-up, weight loss outcomes were equivalent between individuals who remained in self-help compared to those who were stepped-up. Individuals who were stepped-up benefited from early intensive intervention when unsuccessful at losing weight with self-help.

There are significant economic and psychological costs associated with the negative weight-based social stigma that exists in American society. This pervasive anti-fat bias has been strongly internalized among the overweight/obese. While the etiology of weight stigma is complex, research suggests that it is often greater among individuals who embrace certain etiological views of obesity or ideological views of the world. This investigation examined 1) the level of internalized weight stigma among overweight/obese treatment seeking adults, and 2) the association between internalized weight stigma and perceived weight controllability and ideological beliefs about the world (‘just world beliefs’, Protestant work ethic). Forty-six overweight or obese adults (BMI ≥27 kg/m2) participating in an 18- week behavioral weight loss program completed implicit (Implicit Associations Test) and explicit (Obese Person's Trait Survey) measures of weight stigma. Participants also completed two measures of ideological beliefs about the world (“Just World Beliefs”, Protestant Ethic Scale) and one measure of beliefs about weight controllability (Beliefs about Obese Persons). Significant implicit and explicit weight bias was observed. Greater weight stigma was consistently associated with greater endorsement of just world beliefs, Protestant ethic beliefs and beliefs about weight controllability. Results suggest that the overweight/obese treatment seeking adults have internalized the negative weight-based social stigma that exists in American society. Internalized weight stigma may be greater among those holding specific etiological and ideological beliefs about weight and the world.