Dataset Information

Weight bias internalization in a commercial weight management sample: prevalence and correlates.

ABSTRACT:

Objective

Weight bias internalization (WBI) is associated with poor weight-related health. The purpose of this study was to identify the prevalence and correlates of WBI in a large sample of adults in a commercial weight management programme.

Methods

WW (the new Weight Watchers) members participated in an online survey. Participants (N = 18,769) completed the 10-item Weight Bias Internalization Scale - Modified (WBIS-M) and the Weight Self-Stigma Questionnaire (WSSQ). Participants reported details about weight-stigmatizing experiences, including the onset, frequency and distress, and interpersonal sources of weight stigma. Participants self-reported their demographics, weight history, and height and weight (to compute body mass index [BMI]).

Results

Weight bias internalization was relatively high compared with the general population (mean WBIS-M score = 4.3 ± 1.4; mean WSSQ total score = 35.2 ± 9.7). WBI was higher among participants who were female, younger and had higher BMIs (p < 0.001) and lower among those who were Black and were widowed or had a romantic partner (p < 0.001). Onset of weight stigma in childhood and young adulthood, and recent distress due to weight stigma, predicted higher WBI. Extended family and school sources of weight stigma had weaker associations with WBI than did other interpersonal sources.

Conclusions

Weight bias was internalized by a significant proportion of adults enrolled in a commercial weight management programme. A phenotype of WBI includes demographic characteristics and the timing and sources of weight stigma.

SUBMITTER: Pearl RL

PROVIDER: S-EPMC6700514 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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Publications

Weight bias internalization in a commercial weight management sample: prevalence and correlates.

Pearl R L RL Himmelstein M S MS Puhl R M RM Wadden T A TA Wojtanowski A C AC Foster G D GD

Obesity science & practice 20190711 4

<h4>Objective</h4>Weight bias internalization (WBI) is associated with poor weight-related health. The purpose of this study was to identify the prevalence and correlates of WBI in a large sample of adults in a commercial weight management programme.<h4>Methods</h4>WW (the new Weight Watchers) members participated in an online survey. Participants (<i>N</i> = 18,769) completed the 10-item Weight Bias Internalization Scale - Modified (WBIS-M) and the Weight Self-Stigma Questionnaire (WSSQ). Parti ...[more]

PMID: 31452919

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Project description:Weight stigma typically focuses on suggestions that people with overweight and obesity are incompetent and immoral. Integrating so far unconnected lines of research, the current research presents two studies that examine the motivational relevance of these aspects of weight stigma. Specifically, we tested the proposition that people with overweight and obesity respond differently to the public viewing them as incompetent compared to immoral, as these aspects of weight stigma differ in reparability. We expect that threats to competence are more acceptable and thus related to a constructive response that is more effective in losing weight in the long-run. By contrast, we propose that threats to morality elicit an acute urge to defend one's moral image, thereby prompting responses that are more visible to the social environment, but potentially less effective for losing weight. Study 1 experimentally compared exposure to weight stigma focused on morality vs. weight stigma focused on competence in a sample of adults with overweight and obesity (N = 122; M BMI = 31.89, SD BMI = 4.39). We found that when exposed to weight stigma focused on morality, people with overweight and obesity respond by defending their moral social-image but that this is less effective for encouraging weight loss, while exposure to weight stigma focused on competence led to an increased likelihood of engagement in weight loss behaviors. Complementing and extending the findings, Study 2 (N = 348, M BMI = 26.78, SD BMI = 6.78) tested the notion that internalized weight bias predominantly revolves around moral concerns, and thus will lead to less self-determined behavioral regulation. We found strong support for the moral core of weight bias internalization. In line with our predictions, greater weight bias internalization was associated less self-determined and more other-determined regulation of dieting and exercising. This suggests that weight bias internalization operates as a facilitator of maladaptive behavioral regulation following weight stigma, contributing to lower psychological functioning and well-being of people with overweight and obesity. The current research presents novel findings about the underlying mechanisms of weight stigma and weight bias internalization and identifies strategies to avoid maladaptive and facilitate adaptive health behaviors.

Project description:BackgroundInternalized weight stigma has gained growing interest due to its association with multiple health impairments in individuals with obesity. Especially high internalized weight stigma is reported by individuals undergoing bariatric surgery. For assessing this concept, two different self-report questionnaires are available, but have never been compared: the Weight Self-Stigma Questionnaire (WSSQ) and the Weight Bias Internalization Scale (WBIS). The purpose of the present study was to provide and to compare reliability, convergent validity with and predictive values for psychosocial health outcomes for the WSSQ and WBIS.MethodsThe WSSQ and the WBIS were used to assess internalized weight stigma in N = 78 prebariatric surgery patients. Further, body mass index (BMI) was assessed and body image, quality of life, self-esteem, depression, and anxiety were measured by well-established self-report questionnaires. Reliability, correlation, and regression analyses were conducted.ResultsInternal consistency of the WSSQ was acceptable, while good internal consistency was found for the WBIS. Both measures were significantly correlated with each other and body image. While only the WSSQ was correlated with overweight preoccupation, only the WBIS was correlated with appearance evaluation. Both measures were not associated with BMI. However, correlation coefficients did not differ between the WSSQ and the WBIS for all associations with validity measures. Further, both measures significantly predicted quality of life, self-esteem, depression, and anxiety, while the WBIS explained significantly more variance than the WSSQ total score for self-esteem.ConclusionsFindings indicate the WSSQ and the WBIS to be reliable and valid assessments of internalized weight stigma in prebariatric surgery patients, although the WBIS showed marginally more favorable results than the WSSQ. For both measures, longitudinal studies on stability and predictive validity are warranted, for example, for weight-related and psychosocial outcomes.

Dataset Information

Weight bias internalization in a commercial weight management sample: prevalence and correlates.

Objective

Methods

Results

Conclusions

Publications

Weight bias internalization in a commercial weight management sample: prevalence and correlates.

Similar Datasets

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