Examining the Conceptual and Measurement Overlap of Body Dissatisfaction and Internalized Weight Stigma in Predominantly Female Samples: A Meta-Analysis and Measurement Refinement Study

Abstract

Both body dissatisfaction and internalized weight stigma have been identified as risk factors for many negative health outcomes for women, including depression and eating disorders. In addition to these contributions, these concepts have been found to overlap to various degrees in existing literature. We conducted a systematic review and meta-analysis on articles published prior to February 2022 to demonstrate the conceptual and measurement overlap between body dissatisfaction and internalized weight stigma as currently quantified. We identified 48 studies examining the interrelation between body dissatisfaction and internalized weight stigma in predominantly female samples. Stronger correlations between these two constructs, some bordering on multicollinearity, were prevalent in community samples compared to clinical samples and with some but not all the commonly used measures in the body image and weight stigma fields. Body mass index (BMI) moderated these relations such that individuals with higher self-reported BMI were more likely to report lower correlations between the constructs. This concept proliferation, stronger for individuals with lower BMIs and community samples, necessitates the need change how we conceptualize and measure body dissatisfaction and internalized weight stigma. To this end, we conducted study two to refine existing measures and lessen the degree of measurement overlap between internalized weight stigma and body dissatisfaction, particularly in community samples of women. We aimed to clarify the boundaries between these two concepts, ensuring measurement error is better accounted for. Female university students completed existing measures of body satisfaction and internalized weight stigma, which were analyzed using an exploratory followed by a confirmatory factor analysis. In our attempts to modify two existing measures of internalized weight stigma and body dissatisfaction, the majority of the internalized weight stigma items were retained. In contrast, most of the body dissatisfaction items either cross-loaded onto both factors or loaded on to the internalized weight stigma factor despite being intended for the body dissatisfaction factor, suggesting that the measurement issues identified in recent prior research may be due not only to the way we conceptualize and quantify weight stigma, but also the ways in which we quantify body dissatisfaction, across the existing corpus of body dissatisfaction scales.

Exploring the prospective relationships between food addiction symptoms, weight bias internalization, and psychological distress in Chinese adolescents

“…Finally, some issues of content validity may exist across measures (e.g., item on the C‐WBIS that reflects body dissatisfaction: “I am less attractive than other people because of my weight.”) which may complicate the interpretation of the present findings. However, a recent meta‐analysis which also aimed to clarify content validity issues between weight bias internalization and body dissatisfaction suggested that most of the weight bias internalization items (WBIS‐modified) were retained and instead most of the body dissatisfaction items (body dissatisfaction subscale of the Multidimensional Body Self Relations Questionnaire) either cross‐loaded onto both weight bias internalization and body dissatisfaction factors or loaded only on the weight bias internalization factor in female university students (Saunders et al, 2022). Still, such issues are not new to the literature (Long et al, 2015; Saunders et al, 2022; Ziauddeen & Fletcher, 2013) and future research devoted to the development of measures that remove this content overlap may help clarify the nature of associations between food addiction symptoms, weight bias internalization, and psychological distress.…”

“…Future research using experimental designs (e.g., Pearl & Puhl, 2016) eating disorder) and people with elevated weight status may report significantly higher rates food addiction symptoms, weight bias internalization, and psychological distress (e.g., Campana et al, 2019;Gearhardt et al, 2011) which may correspond to differences in these relationships over time. Future research testing these questions in diverse populations tor in female university students (Saunders et al, 2022). Still, such issues are not new to the literature (Long et al, 2015;Saunders et al, 2022;Ziauddeen & Fletcher, 2013) and future research devoted to the development of measures that remove this content overlap may help clarify the nature of associations between food addiction symptoms, weight bias internalization, and psychological distress.…”

“…Future research testing these questions in diverse populations tor in female university students (Saunders et al, 2022). Still, such issues are not new to the literature (Long et al, 2015;Saunders et al, 2022;Ziauddeen & Fletcher, 2013) and future research devoted to the development of measures that remove this content overlap may help clarify the nature of associations between food addiction symptoms, weight bias internalization, and psychological distress.…”

Body Checking and Body Image Avoidance as Partial Mediators of the Relationship between Internalized Weight Bias and Body Dissatisfaction

“…Second, this study was conducted using a sample of young, college-aged women, potentially limiting its generalizability to samples of different ages and genders. The conceptual overlap between IWB and body dissatisfaction may be higher in such samples [ 35 , 36 , 37 ]. Future research should examine these research questions in samples of people who identify as male or non-binary to see if the results are consistent.…”

Current trends and future directions in internalized weight stigma research: a scoping review and synthesis of the literature

“…Recently, researchers have examined the measurement overlap between internalized weight stigma and body dissatisfaction, prompting calls for further examination into whether these constructs are independent, or if they represent a jangle fallacy (i.e., when the same construct has been similarly conceptualized in multiple ways [ 14 , 33 – 35 ]). In one recent study, internalized weight stigma and body image were found to uniquely contribute to psychological outcomes of self-esteem, depression, and body shame among a sample of racially diverse participants [ 36 ].…”