Examining associations among weight stigma, weight bias internalization, body dissatisfaction, and eating disorder symptoms: Does weight status matter?

Romano, Kelly A.; Heron, Kristin E.; Henson, James M.

doi:10.1016/j.bodyim.2021.01.006

Cited by 56 publications

(69 citation statements)

References 31 publications

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“…There were several measures of perceived/experienced weight stigma used across studies. Six studies [ 29 , 31 , 41 – 44 ] used the Stigmatizing Situations Inventory [ 7 ] (or the brief/modified version of this scale). Three studies [ 30 , 32 , 45 ] used either the original or modified version (or the original translated to German) of the Perception of Teasing Scale [ 46 ].…”

Section: Resultsmentioning

confidence: 99%

“…Three studies [ 30 , 32 , 45 ] used either the original or modified version (or the original translated to German) of the Perception of Teasing Scale [ 46 ]. Five studies used a range of different, psychometrically validated measures [ 33 , 44 , 47 – 49 ]. The three remaining studies used ad-hoc measures, and of these, one reported good internal consistency [ 34 ], and the other two only had two [ 50 ] and three items [ 40 ], respectively.…”

Section: Resultsmentioning

confidence: 99%

“…That is, higher experienced/perceived weight stigma was positively related with higher internalised weight stigma, which in turn was positively related with more adverse outcomes (e.g., higher levels of body shame and disordered eating, and lower levels of exercise). The two exceptions include one article that found that internalised weight stigma was negatively related to anxiety (albeit non-significantly) [ 43 ], and the other article found that internalised weight stigma was negatively related to dietary restriction (in one study this mediation was significant, but non-significant in the other study) [ 44 ].…”

Section: Resultsmentioning

confidence: 99%

“…The consistent finding across studies was that internalised weight stigma significantly mediated the relationship between perceived/experienced weight stigma and disordered eating outcomes. Specifically, internalised weight stigma mediated the relationship between perceived/experienced weight stigma and eating disturbance (eating-related pathology and emotional eating) [ 49 ], eating behaviour outcomes (binge eating, dietary restraint and disinhibition) [ 41 ], emotional and uncontrolled eating [ 32 , 47 ], loss of control over eating [ 32 ], disordered eating (in adolescents and young adults) [ 30 ], dietary restraint (in non-clinical, primary school-aged students) [ 45 ] and purging [ 44 ]. Interestingly, Romano et al [ 44 ] had additional but somewhat mixed findings across two samples for disordered eating.…”

Section: Resultsmentioning

confidence: 99%

“…Specifically, internalised weight stigma mediated the relationship between perceived/experienced weight stigma and eating disturbance (eating-related pathology and emotional eating) [ 49 ], eating behaviour outcomes (binge eating, dietary restraint and disinhibition) [ 41 ], emotional and uncontrolled eating [ 32 , 47 ], loss of control over eating [ 32 ], disordered eating (in adolescents and young adults) [ 30 ], dietary restraint (in non-clinical, primary school-aged students) [ 45 ] and purging [ 44 ]. Interestingly, Romano et al [ 44 ] had additional but somewhat mixed findings across two samples for disordered eating. When experienced weight stigma was measured by the EDS, internalised weight stigma was a mediator of the relationship between experienced weight stigma and binge eating but not dietary restriction; and when experienced weight stigma was measured by the SSI, internalised weight stigma was a mediator for dietary restriction but not binge eating [ 44 ].…”

Section: Resultsmentioning

confidence: 99%

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Internalised weight stigma as a mediator of the relationship between experienced/perceived weight stigma and biopsychosocial outcomes: a systematic review

et al. 2021

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Objective To systematically review studies that have assessed the mediating role of internalised weight stigma on the relationship between experienced/perceived weight stigma and any biopsychosocial outcomes. Methods PsycINFO, PsycExtra, Web of Science, CINAHL, Medline and Embase were systematically searched. Identified studies were double screened (HB and XPG). Results Seventeen studies (across 16 articles) met our inclusion criteria ( N = 21,172), and almost all studies measured only psychological outcomes ( n = 15). Eight studies found consistent evidence for internalised weight stigma as a mediator of the relationship between experienced/perceived weight stigma and disordered eating outcomes. Preliminary evidence was found for the mediating role of internalised weight stigma on the relationship between experienced/perceived weight stigma and body shame, body dissatisfaction, exercise behaviour, healthcare experiences and behaviours, bodily pain and parental weight talk. However, the findings were inconsistent for depression and anxiety, although only two studies reported these. Conclusion This review provides preliminary evidence for internalised weight stigma as an intervening variable in the relationship between experienced/perceived weight stigma and adverse health outcomes. Results suggest that there are potential benefits of interventions addressing internalised weight stigma to improve health outcomes. However, these findings must be considered in the context of the psychometric limitations of the Weight Bias Internalisation Scale, which was used in all but one study.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Internalised weight stigma as a mediator of the relationship between experienced/perceived weight stigma and biopsychosocial outcomes: a systematic review

et al. 2021

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Does dissection influence weight bias among doctor of physical therapy students?

Rompolski,

Pascoe

2024

Anatomical Sciences Ed

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Anatomy with human dissection may help to develop respect for the human body and professionalism; however, dissection may worsen students' attitudes about body weight and adiposity. The purpose of this study was to measure weight bias among Doctor of Physical Therapy (DPT) students enrolled in gross anatomy and determine if, and how the experience of dissection impacts weight bias. Ninety‐seven DPT students (70 University of Colorado [CU], 27 Moravian University [MU]) were invited to complete a survey during the first and final weeks of their anatomy course. The survey included demographic items, two measures of weight bias—the Modified Weight Bias Internalized Scale (M‐WBIS) and the Attitudes Towards Obese Persons (ATOP) Scale—and open‐ended questions for the students who participated in dissection (CU students) that explored attitudes about body weight and adiposity. At baseline, there were no significant differences (p > 0.202) in ATOP, M‐WBIS, or BMI between the two universities. The mean scores on both the ATOP and M‐WBIS indicated a moderate degree of both internalized and externalized weight bias. There were no significant changes in ATOP (p = 0.566) or M‐WBIS scores (p = 0.428). BMI had a low correlation with initial M‐WBIS scores (⍴ = 0.294, p = 0.038) and a high correlation with change scores in CU students (⍴ = 0.530, p = 0.011). Future studies should utilize the same measures of weight bias in other healthcare trainees to facilitate comparison and incorporate larger populations of DPT students.

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Daily weight stigma experiences, and disordered and intuitive eating behaviors among young adults with body dissatisfaction

Romano

Heron

2022

Intl J Eating Disorders

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Objective: The present study aimed to extend naturalistic weight stigma research by examining the following aims among young adults with body dissatisfaction and varied body mass indices (BMIs): (1) characterize the frequency of individuals' daily weight stigma experiences, and contextual variations, over a 14-day period; (2) examine whether BMI moderated daily associations between weight stigma experiences relative to eating disorder symptoms and intuitive eating behaviors.Method: Women (n = 174) and men (n = 24) completed a 14-day daily diary protocol. Concurrent and time-lagged multilevel models examined associations between daily weight stigma, and eating disorder and intuitive eating behaviors among women only due to the small subsample of men.Results: Over the 14-day assessment, 43.94% (n = 87) of participants experienced weight stigma. Weight stigma rates varied based on how, where, and by whom weight stigma was expressed, and via BMI. Further, among women, multiple concurrent within-person associations were identified between women's daily weight stigma experiences and daily eating disorder symptoms (skipping meals, binge eating, and body dissatisfaction). Time-lagged associations also showed that women's weight stigma experiences on a given day were associated with a greater likelihood that they would limit the amount of food they consumed the next day. These associations did not differ via women's BMIs.Discussion: Collectively, these findings provide important information on how weight stigma experiences unfold in daily life among individuals with body dissatisfaction and varied BMIs, and the proximal and more enduring impact of women's daily weight stigma experiences on their use of multiple adverse eating behaviors that can promote poor health.Public Significance: The present findings provide important information on how, where, and by whom weight stigma experiences unfold in daily life among young adults with body dissatisfaction and varied body weights, as well as the proximal and more enduring impact of women's daily weight stigma experiences on their use of a variety of adverse eating behaviors that can promote poor health.

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Examining associations among weight stigma, weight bias internalization, body dissatisfaction, and eating disorder symptoms: Does weight status matter?

Cited by 56 publications

References 31 publications

Internalised weight stigma as a mediator of the relationship between experienced/perceived weight stigma and biopsychosocial outcomes: a systematic review

Internalised weight stigma as a mediator of the relationship between experienced/perceived weight stigma and biopsychosocial outcomes: a systematic review

Does dissection influence weight bias among doctor of physical therapy students?

Daily weight stigma experiences, and disordered and intuitive eating behaviors among young adults with body dissatisfaction

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