Obesity represents a serious health issue affecting millions of people in Western industrialized countries. The severity of the medical problems it causes is paralleled by the fact that obesity has become a social stigma that affects the psychological health-related quality of life of individuals with weight problems. Our study, with 111 obese patients of a Spanish hospital, focused specifically on how overt and subtle discrimination is related to subjective well-being (affect balance and life satisfaction) and physical health-related quality of life. It was shown that overt (r = -.28, p < .01 with affect balance; r = -.26, p < .01 with life satisfaction) and subtle discrimination (r = -.28, p < .01 with affect balance; r = -.27, p < .01 with life satisfaction) were negatively linked with subjective well-being, and that there was a negative correlation between overt discrimination and physical health-related quality of life (r = -.26, p < .01). Additionally, it was found that overt discrimination was a mediator variable in the relationship between physical health-related quality of life and subjective well-being using the Baron and Kenny procedure. Finally, it is discussed the relationship between discrimination, subjective well-being and physical health-related quality of life in obese people.

Obesity may be considered a social stigma. In addition, people with obesity are frequently aware of stigma directed at others who have a similar weight and come to think stigmatized thoughts about themselves. Our study focused specifically on how blatant and subtle discrimination and weight self-stigma are related to depression and anxiety in people with obesity. The sample comprised 170 participants from the Clinical Nutrition Unit of the "Hospital de Valme" (Seville, Spain). The Weight Self-Stigma Questionnaire, the Multidimensional Perceived Discrimination Scale, and the Hospital Anxiety and Depression Scale were used. It was found that blatant and subtle discrimination and weight self-stigma were positively related to depression (.31, .38, and .45 respectively) and anxiety (.30, .36, and .49 respectively; all ps < .01). The path analysis conducted showed that there was a mediational effect of weight self-stigma between blatant (β = .36) and subtle discrimination (β = .40) and depression (β = .24) and anxiety (β = .49; all ps < .01). According to these results, it can be said that weight self-stigma was a full mediator in the model found because the relationships between the independent and the dependent variables were non-significant. Finally, results are discussed in the frame of the obesity stigma literature, and some clinical implications of the results of the study are suggested.

Purpose Weight self-stigma may be defined as a self-devaluation due to one’s identification with the group of people with obesity. The Weight Self-Stigma Questionnaire (WSSQ) is an instrument specifically designed to measure weight self-stigma in populations with overweight or obesity. The objective of this study was to adapt the WSSQ to the Spanish population (S-WSSQ) following the guidelines for cross-cultural adaptations. Methods The sample comprised 165 participants with obesity seeking weight loss treatment (65% women) at the “Hospital de Valme” (Seville, Spain). Scales to measure life satisfaction, self-esteem, positive and negative affect, and antifat attitudes were used to analyze the convergent and divergent validity of the S-WSSQ. Results A confirmatory factor analysis showed adequate values of the goodness of fit indexes of a two-factor model (χ2/df = 2.01 CFI = 0.92, IFI = 0.92, SRMR = 0.08, RMSEA = 0.078), replicating the structure found by the original authors. Cronbach’s alphas of the two factors were 0.76 (self-devaluation) and 0.77 (fear of enacted stigma). Composite Reliability values were 0.72 (self-devaluation) and 0.76 (fear of enacted stigma). Self-devaluation and fear of enacted stigma were negatively related to self-esteem, and positive affect, and positively related to negative affect and antifat attitudes. Finally, life satisfaction was negatively correlated to fear of enacted stigma. Conclusions Based on these results, it is concluded that the S-WSSQ has good psychometric properties and might be used by the Spanish-speaking scientific community to measure weight self-stigma. Level of evidence Level V, descriptive study.