Weight Bias Internalization and Psychosocial, Physical, and Behavioral Health: A Meta-Analysis of Cross-Sectional and Prospective Associations

Emotion in Motion: Weight Bias Internalization, Exercise Avoidance, and Fitness-Related Self-Conscious Emotions

“…Weight bias internalization (WBI) refers to the process of being aware of the negative stereotypes and attitudes associated with being overweight, agreeing with these stereotypes, and applying them to oneself [4,5]. Weight bias internalization leads to a devaluation of self-worth and worse body image [6] and has been associated with worse physical, psychological, and behavioral health [7]. For example, greater weight bias internalization has been associated with a heightened cardiometabolic risk [8], an increase in weight cycling in women [9], higher levels of anxiety and depression, and reduced mental health-related quality of life [6].…”

“…For example, greater weight bias internalization has been associated with a heightened cardiometabolic risk [8], an increase in weight cycling in women [9], higher levels of anxiety and depression, and reduced mental health-related quality of life [6]. Additionally, increased weight bias internalization is associated with disordered eating, including disinhibited eating, compensatory behaviors, and dietary restraint [7].…”

Weight bias internalization is positively associated with insomnia symptom severity in young women with disordered eating

“…In a systematic review of 74 studies, WBI was associated with depression and anxiety across body sizes and above-and-beyond BMI (Pearl & Puhl, 2018) and, similarly, a meta-analysis found that higher WBI was associated with poorer mental health, with a larger effect size than enacted stigma and mental health (Emmer et al, 2020). A recent meta-analysis expanded the scope of assessment and found that greater WBI was linked to worse negative mental health (e.g., negative affectivity, depression, anxiety), worse positive mental health (e.g., positive affect, self-esteem), higher emotion dysregulation, and poorer social functioning (Romano et al, 2023).…”

“…This study examined links between WBI and insomnia in a sample of young women with disordered eating. Studying this population is warranted as higher WBI is associated with higher disordered eating (Romano et al, 2023) and insomnia and disordered eating are proposed to have a bidirectional relationship (Christensen & Short, 2021). It is possible that WBI may contribute to the sleep problems frequently reported among people with eating disorders (Kim et al, 2010).…”

Demographic predictors of internalized weight stigma in a diverse sample of U.S. adults.

“…A growing body of evidence suggests that IWS is determinantal to health (Pearl & Puhl, 2018; Romano et al, 2023; Zhu et al, 2022). For example, people with higher (vs. lower) levels of IWS are more likely to engage in disordered eating behaviors such as binge eating and have more difficulty with weight cycling and maintaining weight loss (Pearl & Puhl, 2018).…”