July 20, 2019
2 min read

Sex, early weight-related stigma influence internalized weight bias

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Among adults with obesity, those who report experiencing weight-related stigma from others early in life had higher levels of internalized weight bias, according to survey findings published in Obesity Science and Practice.

Rebecca Pearl

“We don’t yet know why some people who struggle with their weight internalize society’s stigma and others do not,” Rebecca Pearl, PhD, an assistant professor of psychology in psychiatry in the Perelman School of Medicine at the University of Pennsylvania, said in a press release. “These findings represent a first step toward helping us identify, among people trying to manage their weight, who may be most likely to self-stigmatize. People who are trying to lose weight may be among the most vulnerable to weight self-stigma, but this issue is rarely discussed in treatment settings.”

Pearl and colleagues analyzed data from 18,769 adults enrolled in the commercial weight management program WW International (formerly Weight Watchers Inc.) for at least 3 months, recruited between February and August 2018. Participants completed an online survey that included the 10-item Weight Bias Internalization Scale-Modified (WBIS-M) and the Weight Self-Stigma Questionnaire (WSSQ). Participants also responded to three yes/no questions used in prior research, asking if participants had ever been teased, treated unfairly or discriminated against because of weight. Participants self-reported demographics, weight history, and height and weight.

Within the cohort, mean scores for the WBIS-M and WSSQ were 4.3 and 35.2, respectively. Most participants (63.5%) reported having had an experience of weight stigma; 46.3% reported that they first experienced weight stigma during childhood or adolescence.

Among adults with obesity, those who report experiencing weight-related stigma from others early in life had higher levels of internalized weight bias.
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Researchers found that weight bias internalization was higher among women, younger participants and those with a higher BMI (P < .001 for all), whereas weight bias internalization was lower among black participants, those who were widowed or had a romantic partner (P < .001 for all). Additionally, the onset of weight stigma in childhood and young adulthood, and recent distress due to weight stigma predicted higher weight bias internalization, according to the researchers. Interpersonal sources of weight bias were most strongly associated with weight bias internalization when compared with extended family and school sources, according to researchers.

In the release, the researchers noted that participants recalled when in their life they experienced weight stigma from other people, how frequent and how upsetting the experiences were, and who it was that called them names, rejected them or denied them an opportunity simply because of their weight.

“Our findings can inform ways to support people who are experiencing or internalizing weight stigma, including opportunities to address weight stigma as part of weight management and healthy lifestyle programs,” Rebecca Puhl, PhD, a professor of human development and family sciences at the University of Connecticut, said in the release. – by Regina Schaffer

Disclosures: Weight Watchers funded this study. Pearl reports she has served as consultant for Novo Nordisk and WW International and receives grant support from WW International. Please see the study for all other authors’ relevant financial disclosures.