Abstract

Background

Weight stigma impairs health. Few studies have disentangled the associations of experienced versus internalized stigma with weight-related outcomes.

Purpose

To examine weight and health variables associated with weight stigma experiences and internalization in the largest-to-date sample of adults in weight management.

Methods

WW (formerly Weight Watchers) members (N = 18,769, 94.6% female, 91.1% white) completed an online survey from 2017 to 2018. Participants reported whether they had experienced weight stigma and, if so, the onset, past-year frequency and distress, and interpersonal sources of stigma. Participants completed the Modified Weight Bias Internalization Scale (WBIS-M) and self-reported: past-year weight and lifetime weight cycles; current self-monitoring behaviors; eating self-efficacy; physical activity; perceived stress; eating to cope; body image; and mental and physical health-related quality-of-life (HRQOL). Participants reported their demographic characteristics, including height and weight to compute body mass index.

Results

In logistic and linear regression analyses (controlling for participant characteristics), WBIS-M scores were negatively associated with weight loss, self-monitoring, eating self-efficacy, body image, and mental HRQOL and positively associated with weight gain, weight cycling, perceived stress, and eating to cope (p < .001). Experiencing weight stigma was associated with greater weight loss and less weight gain, although associations with other variables had small effect sizes (absolute β values < 0.10). WBIS-M scores remained significantly associated with all variables when including stigma onset, frequency/distress, and sources.

Conclusions

Internalized, but not experienced, weight stigma was consistently associated with adverse weight and health factors. Developing and testing interventions targeting internalized stigma in the context of weight management should be a research priority.

中文翻译：

---

体重耻辱和体重相关的健康：成人体重管理中自我报告措施的关联。

摘要

背景

体重耻辱会损害健康。很少有研究将经历过的耻辱与内化的耻辱与体重相关结果的关联分开。

目的

在迄今为止最大的体重管理成人样本中，检查与体重耻辱经历和内化相关的体重和健康变量。

方法

WW（前身为 Weight Watchers）成员（N = 18,769，94.6% 女性，91.1% 白人）在 2017 年至 2018 年期间完成了一项在线调查。参与者报告了他们是否经历过体重耻辱，如果有的话，发病率、过去一年的频率和痛苦和污名化的人际关系来源。参与者完成了修正体重偏差内化量表 (WBIS-M) 并自我报告：过去一年的体重和一生的体重周期；当前的自我监控行为；饮食自我效能感；体力活动; 感知压力；吃以应付；身体形象; 以及与身心健康相关的生活质量 (HRQOL)。参与者报告了他们的人口统计特征，包括身高和体重以计算体重指数。

结果

在逻辑和线性回归分析（控制参与者特征）中，WBIS-M 分数与体重减轻、自我监测、饮食自我效能、身体形象和心理 HRQOL 呈负相关，与体重增加、体重循环、感知压力和饮食来应对 ( p < .001)。尽管与其他变量的关联具有较小的影响大小（绝对 β 值 < 0.10），但经历体重耻辱与更大的体重减轻和更少的体重增加相关。WBIS-M 分数与所有变量保持显着相关性，包括耻辱发生、频率/痛苦和来源。

结论

内化但没有经历过的体重耻辱始终与不利的体重和健康因素相关。在体重管理的背景下开发和测试针对内化污名的干预措施应该是研究的重点。