Weight Bias Internalization Scale: Psychometric Properties and Population Norms

Abstract

ObjectiveInternalizing the pervasive weight bias commonly directed towards individuals with overweight and obesity, co-occurs with increased psychopathology and impaired quality of life. This study sought to establish population norms and psychometric properties of the most widely used self-report questionnaire, the Weight Bias Internalization Scale (WBIS), in a representative community sample.Design and MethodsIn a survey of the German population, N = 1158 individuals with overweight and obesity were assessed with the WBIS and self-report measures for convergent validation.ResultsItem analysis revealed favorable item-total correlation of all but one WBIS item. With this item removed, item homogeneity and internal consistency were excellent. The one-factor structure of the WBIS was confirmed using confirmatory factor analysis. Convergent validity was shown through significant associations with measures of depressive and somatoform symptoms. The WBIS contributed to the explanation of variance in depressive and somatoform symptoms over and above body mass index. Higher WBIS scores were found in women than in men, in individuals with obesity than in individuals with overweight, and in those with lower education or income than those with higher education or income. Sex-specific norms were provided.ConclusionsThe results showed good psychometric properties of the WBIS after removal of one item. Future research is warranted on further indicators of reliability and validity, for example, retest reliability, sensitivity to change, and prognostic validity.

Public Support for Weight-Related Antidiscrimination Laws and Policies

“…Strengths comprise the random selection of a large representative German sample approximating national census demographics [36]. Further strengths include the response rate of 53.2% that is comparable to previous German surveys [31]. To ensure accurate international comparisons, previously tested items assessing support for diverse legislative measures from recent research were used [14].…”

“…If any of these items was rated 1, WBV was coded 1, and 0 if not (Cronbach α = 0.89). Finally, the Weight Bias Internalization Scale [30], a self-report questionnaire with established reliability and validity [31], was used for the assessment of weight-related self-stigma (e.g., ‘I hate myself for my weight,' 1 = strongly disagree to 7 = strongly agree, mean score). In this study, its 3-item short form was applied (WBIS-3; Kliem et al, unpublished manuscript; Cronbach α = 0.92) [31].…”

Impact of Weight-Related Discrimination, Body Dissatisfaction and Self-Stigma on the Desire to Weigh Less

“…The original WBIS scale includes 11 items on a 7-point rating-scale (1 = strongly disagree, 7 = strongly agree). A German translation of all items has been published showing good psychometric properties [38,39]; however, as suggested by the literature [38,39], one item was excluded from analysis due to its negative correlation. Higher scores represent more internalization of stigma.…”

Sex Differences in Obesity and Mental Health

“…From childhood through older adulthood, weight-based stigmatization is associated with negative emotional consequences, including low self-esteem, heightened anxiety and depression, suicidal ideation, poor body image, disordered eating pathology, and greater overall psychological distress [63][64][65]. Internalized weight stigma is similarly associated with a host of negative mental health outcomes, including depression, anxiety, disordered eating, and impaired mental health-related quality of life [64,[66][67][68][69][70].…”

“…Men rated individuals with obesity as less preferred partners than did women [79], highlighting the imbalance of interpersonal rejection by sex (although participant sexual orientation was not reported in the study). Along with greater vulnerability to interpersonal stigmatization, women with obesity are more likely than men to selfstigmatize due to weight [67,70,80]. The relationship between internalized weight bias and psychopathology (such as depression and disordered eating) may also be stronger among women than men [80].…”