Greater History of Weight-related Stigmatizing Experience is Associated with Greater Weight Loss in Obesity Treatment (original) (raw)
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Weight stigma as a psychosocial contributor to obesity
American Psychologist
Weight stigma is a key aspect of the lived experience of individuals with obesity, and adversely affects health. This article provides an overview of recent evidence examining links between experiences of weight stigma and weight-related behaviors and health (e.g., maladaptive eating, physical activity, stress, obesity, weight loss), including health consequences for individuals with heightened vulnerability to weight stigma (e.g., youth and people seeking bariatric surgery) and implications for clinicians working with individuals who have obesity. This literature points to weight stigma as a psychosocial contributor to obesogenic behaviors, yet the role of weight stigma in weight loss among treatment-seeking individuals has received little attention. Research priorities are identified, including the need for future studies to (a) determine the potentially predictive value of specific characteristics of weight-stigmatizing experiences for weight loss (such as the time period, interpersonal sources, and coping responses for stigma experiences), (b) identify mechanisms through which weight stigma may undermine or facilitate weight-related treatment outcomes, and (c) test strategies that can be implemented in weight management programs to reduce the negative impact of weight stigma on health behaviors. Broadly, more attention should be directed to weight stigma in the obesity field as a relevant psychosocial factor in obesity-focused prevention and treatment. Public Significance Statement This article reviews evidence of the ways in which weight stigma may contribute to obesity in youth and adults, such as maladaptive eating behaviors, stress, and weight gain. Additionally, it highlights the importance of addressing weight stigma in clinical practice, through education and efforts to promote a supportive culture of patient care for individuals who are vulnerable to weight stigma.
Confronting and Coping with Weight Stigma: An Investigation of Overweight and Obese Adults*
Obesity, 2006
Objective: This study examined experiences of weight stigmatization, sources of stigma, coping strategies, psychological functioning, and eating behaviors in a sample of 2671 overweight and obese adults. Research Methods and Procedures: The total sample was partitioned into two subsamples for investigation. Sample I was comprised of 2449 adult women, and Sample II was a matched sample of adult men and women (N ϭ 222) that was disaggregated to investigate gender differences. Both samples completed an online battery of self-report questionnaires measuring frequency of weight stigmatization and coping responses to deal with bias, the most common sources of the bias, symptoms of depression, self-esteem, attitudes about weight and obesity, and binge eating behaviors. Results: Experiences of weight stigmatization, in many forms and across multiple occasions, was common in both samples. A variety of coping strategies were used in response. More frequent exposure to stigma was related to more attempts to cope and higher BMI. Physicians and family members were the most frequent sources of weight bias reported. No gender differences were observed in types or frequency of stigmatization. Frequency of stigmatization was not related to current psychological functioning, although coping responses were associated with emotional well-being. Discussion: These findings raise questions about the relationship between stigma and psychological functioning and have important implications for obesity treatment and stigma reduction intervention efforts, both of which are discussed.
The Role of Stigma in Weight Loss Maintenance Among U.S. Adults
Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 2017
Challenges of maintaining long-term weight loss are well-established and present significant obstacles in obesity prevention and treatment. A neglected but potentially important barrier to weight-loss maintenance is weight stigmatization. We examined the role of weight stigma-experienced and internalized-as a contributor to weight-loss maintenance and weight regain in adults. A diverse, national sample of 2702 American adults completed an online battery of questionnaires assessing demographics, weight-loss history, subjective weight category, experienced and internalized weight stigma, weight-monitoring behaviors, physical activity, perceived stress, and physical health. Analyses focused exclusively on participants who indicated that their body weight a year ago was at least 10% less than their highest weight ever (excluding pregnancy), the weight loss was intentional, and that attempts to lose or maintain weight occurred during the past year (n = 549). Participants were further cla...
The Negative and Bidirectional Effects of Weight Stigma on Health
Oxford Handbooks Online, 2017
This chapter introduces a model describing the mechanisms by which weight stigma can lead to poorer health outcomes among people who are or who perceive themselves to be overweight. It is proposed that enacted weight stigma (discrimination) directly impairs the health of heavier weight individuals by changing the social and material aspects of their lives in ways that are detrimental to health. It is also proposed that perceived weight stigma can lead to social identity threat, which in turn can indirectly impair health by increasing stress and negative emotions, physiological reactivity, calorie intake, and stigma-avoidance behaviors. Finally, it is proposed that weight stigma is bidirectional, in that experiencing weight stigma leads to weight gain or inhibits weight loss through increased eating and other biobehavioral mechanisms, which in turn lead to further stigmatization. Implications for health and recommendations for future research are discussed.
Obesity Stigma: Important Considerations for Public Health
American Journal of Public Health, 2010
Stigma and discrimination toward obese persons are pervasive and pose numerous consequences for their psychological and physical health. Despite decades of science documenting weight stigma, its public health implications are widely ignored. Instead, obese persons are blamed for their weight, with common perceptions that weight stigmatization is justifiable and may motivate individuals to adopt healthier behaviors. We examine evidence to address these assumptions and discuss their public health implications. On the basis of current findings, we propose that weight stigma is not a beneficial public health tool for reducing obesity. Rather, stigmatization of obese individuals threatens health, generates health disparities, and interferes with effective obesity intervention efforts. These findings highlight weight stigma as both a social justice issue and a priority for public health.
International Journal of Obesity
To systematically review studies that have assessed the mediating role of internalised weight stigma on the relationship between experienced/perceived weight stigma and any biopsychosocial outcomes. METHODS: PsycINFO, PsycExtra, Web of Science, CINAHL, Medline and Embase were systematically searched. Identified studies were double screened (HB and XPG). RESULTS: Seventeen studies (across 16 articles) met our inclusion criteria (N = 21,172), and almost all studies measured only psychological outcomes (n = 15). Eight studies found consistent evidence for internalised weight stigma as a mediator of the relationship between experienced/perceived weight stigma and disordered eating outcomes. Preliminary evidence was found for the mediating role of internalised weight stigma on the relationship between experienced/perceived weight stigma and body shame, body dissatisfaction, exercise behaviour, healthcare experiences and behaviours, bodily pain and parental weight talk. However, the findings were inconsistent for depression and anxiety, although only two studies reported these. CONCLUSION: This review provides preliminary evidence for internalised weight stigma as an intervening variable in the relationship between experienced/perceived weight stigma and adverse health outcomes. Results suggest that there are potential benefits of interventions addressing internalised weight stigma to improve health outcomes. However, these findings must be considered in the context of the psychometric limitations of the Weight Bias Internalisation Scale, which was used in all but one study.
Obesity Surgery
Purpose Research suggests that internalised weight stigma may explain the relationship between perceived weight stigma and adverse psychological correlates (e.g. depression, disordered eating, body image disturbances). However, few studies have assessed this mechanism in individuals seeking bariatric surgery, even though depression and disordered eating are more common in this group than the general population. Materials and Methods We used data from a cross-sectional study with individuals seeking bariatric surgery (n = 217; 73.6% female) from Melbourne, Australia. Participants (Mage = 44.1 years, SD = 11.9; MBMI = 43.1, SD = 7.9) completed a battery of self-report measures on weight stigma and biopsychosocial variables, prior to their procedures. Bias-corrected bootstrapped mediations were used to test the mediating role of internalised weight stigma. Significance thresholds were statistically corrected to reduce the risk of Type I error due to the large number of mediation tests ...
Journal of Health Psychology, 2011
Health-related quality of life (HRQL) has been shown to deteriorate as body mass index (BMI) increases. Recent research suggests weight stigma and experiential avoidance may partially account for the relationship between BMI and HRQL. Eighty-seven adults recruited from a weight-loss clinic completed an intake assessment, which consisted of physical measurement taking and completion of self-report measures. Experiential avoidance and weight self-stigma were significant predictors of HRQL and mediated the relationship between BMI and HRQL. Results provide preliminary support for targeting weight stigma and experiential avoidance in order to produce changes in HRQL with or without concurrent weight loss.
Revue Européenne de Psychologie Appliquée, 2017
Objective The aim of this study is to examine whether self-esteem and fear of negative appearance evaluation are significant mediators in the association between weight-related self-devaluation and disordered eating. Method A sample of obese Canadian women (N = 111, M age = 40.9, SD = 10.2) completed the Weight Self-Stigma Questionnaire (WSSQ), the Rosenberg Self-Esteem Scale (RSES), the Fear of Negative Appearance Evaluation Scale (FNAES), and the Eating Disorder Examination Questionnaire (EDE-Q). Results Self-esteem mediated the relationship between weight-related self-devaluation and restraint and weight concerns, whereas fear of negative appearance evaluation mediated the relationship with weight, shape and eating concerns. Conclusion Since, for obese women, self-esteem and fear of negative appearance evaluation are likely to maintain disordered eating, they should be more frequently taken into consideration by researchers, health professionals and public policy stakeholders.