Validation of the Weight Bias Internalization Scale for Mainland Chinese Children and Adolescents

Abstract

Weight stigma internalization among adolescents across weight categories leads to adverse psychological consequences. This study aims to adapt and validate a Chinese version of the Weight Bias Internalization Scale for Mainland Chinese children and adolescents(C-WBIS). A total of 464 individuals aged 9 to 15 years participated in the present study. Based on item response theory (IRT) and classical test theory (CTT), we selected the items for the C-WBIS and evaluated its reliability and validity. The item response theory yields support for the one-dimensional factor mode. All item parameters fit the IRT model (albeit within an adequate range), eight items were adopted. No evidence of significant differential item functioning (DIF) was found for gender and age groups. The C-WBIS was correlated with the Core Self-Evaluation Scale (CSES) and two subscales of the Social Anxiety Scale for Children (SAS), which indicated an acceptable criterion-related validity. The C-WBIS is a reliable and valid measure that can be used as a psychometrically sound and informative tool to assess weight bias internalization among children and adolescents.

Spanish validation of the Modified Weight Bias Internalization Scale (WBIS-M) for adolescents

“…A similar result was found with WBIS versions for adolescents with obesity seeking bariatric surgery [53]. Regarding WBIS-M versions, the German WBIS-C for children also removed item 1 [27], as did the Mainland Chinese version for children and adolescents [26]. In the Chinese version with children and adolescents from Hong Kong, item 1 was retained, although it showed a very low factor loading [25].…”

“…The mean WBIS-M score was slightly below the middle range. When compared with other versions of the WBIS-M, which used the original 1-7 range scores, our mean WBIS-M score was slighly lower than in versions focused on adults, including the original version [23,30], and similar to other versions with youth and adolescents [24,26]. Because WBI research has mainly focused on adults, and few studies have been developed with adolescents across different weight statuses, more studies are needed to confirm this trend.…”

“…Although studies conducted with adults have provided stability data for the WBIS-M (e.g. Macho et al [30]), up to now only the Mainland Chinese version with a general population sample [26] and the German version with participants seeking weight loss [56] have reported satisfactory stability with adolescent samples. Another limitation is related to the sample.…”

“…A Turkish validation was conducted with college students [24]. Two Chinese versions for children and adolescents have been developed based on the samples from Hong Kong [25] and mainland China [26]. Two different German versions are also available.…”

Reliability and validity of the Japanese version of the weight bias internalization scale

“…A previous study compared the WBIS and the Weight Self-Stigma Questionnaire and showed a higher reliability of the former [16]. The original version of the WBIS is in English, and it has been translated into several languages [17][18][19], including Asian languages [20]. However, a Japanese version of the WBIS has not yet been developed.In Japan, the government began a health checkup for abdominal obesity in 2008, but the prevalence of obesity has not decreased between 2009 and 2019, with approximately 30% in males and 20% in females [21].…”