Abstract
BackgroundWeight bias is widespread and has numerous harmful consequences. The internalization of weight bias has been associated with significant psychological impairment. Other forms of discrimination, such as racial and anti-gay bias, have been shown to be associated with physical health impairment. However, research has not yet examined whether internalized weight bias is associated with physical as well as psychological impairment in health-related quality of life.MethodsParticipants included 120 treatment-seeking overweight and obese adults (mean body mass index = 35.09; mean age = 48.31; 68% female; 59% mixed or Asian ethnicity). Participants were administered measures of internalized weight bias and physical and mental health-related quality of life, and they were assessed for the presence of chronic medical conditions, use of prescription and non-prescription medications, and current exercise.ResultsInternalized weight bias was significantly correlated with health impairment in both physical (r = −.25) and mental (r = −.48) domains. In multivariate analyses controlling for body mass index, age, and other physical health indicators, internalized weight bias significantly and independently predicted impairment in both physical (β = −.31) and mental (β = −.47) health.ConclusionsInternalized weight bias was associated with greater impairment in both the physical and mental domains of health-related quality of life. Internalized weight bias also contributed significantly to the variance in physical and mental health impairment over and above the contributions of BMI, age, and medical comorbidity. Consistent with the association between prejudice and physical health in other minority groups, these findings suggest a link between the effects of internalized weight-based discrimination and physical health. Research is needed on strategies to prevent weight bias and its internalization on both a societal and individual level.
Highlights
Weight bias is widespread and has numerous harmful consequences
Increased body weight is associated with impairments in health-related quality of life (HRQoL) [1]
Findings from population studies in different countries such as the U.S [2,3], Sweden [4], Germany [5], and Taiwan [6] suggest that higher body mass index (BMI; kg/m2) is correlated with greater physical impairment in HRQoL
Summary
Weight bias is widespread and has numerous harmful consequences. The internalization of weight bias has been associated with significant psychological impairment. Research has not yet examined whether internalized weight bias is associated with physical as well as psychological impairment in health-related quality of life. Increased body weight is associated with impairments in health-related quality of life (HRQoL) [1]. Overweight and obese individuals are far more likely to experience discrimination than their non-overweight peers [8]. This discrimination occurs in a range of settings, including medical, educational, and interpersonal contexts, and it is associated with a range of adverse personal, social, and economic outcomes [9,10]. In clinical and non-clinical obese samples, higher levels of IWB have been found to be associated with greater body dissatisfaction, more severe eating disturbances, higher levels of general psychological distress, and lower self-esteem [11,12,13,14]
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