Abstract
BackgroundThe purpose of this study was to examine the relationships among weight stigma, eating behaviors, and stress, as well as to analyze the effect of stress in mediating the association between weight stigma and eating behaviors.MethodsThe study involved 1818 adolescents between 14 to 19 years of age and was conducted in Wuhan, China in 2019. Weight stigma, eating behaviors (cognitive restraint, uncontrolled eating, and emotional eating), and stress were assessed by self-report questionnaires. Hierarchical linear regression analyses were used to examine the predictors of cognitive restraint, uncontrolled eating, and emotional eating; the serial mediation models analyses were conducted to analyze the effect of stress in mediating the association between weight stigma and eating behaviors for the whole non-overweight (normal and underweight) and overweight or obese participants, respectively.ResultsHierarchical linear regression analyses showed that experiences of weight stigma significantly predicted uncontrolled eating and emotional eating regardless of body mass index (BMI) (non-overweight adolescents: uncontrolled eating: β [SE] = 0.161 [0.017]; emotional eating: β [SE] = 0.199 [0.008], p < 0.05; overweight or obese adolescents: uncontrolled eating: β [SE] = 0.286 [0.030]; emotional eating: β [SE] = 0.267 [0.014], p < 0.05); experiences of weight stigma significantly predicted cognitive restraint among non-overweight adolescents (β [SE] = 0.204 [0.013], p < 0.05). Mediation analyses showed that stress mediated the associations between weight stigma and uncontrolled eating and emotional eating among non-overweight adolescents (uncontrolled eating: indirect effect coefficient = 0.0352, 95% CI = 0.0241, 0.0478; emotional eating: indirect effect coefficient = 0.0133, 95% CI = 0.0085, 0.0186).ConclusionsThese findings suggest that non-overweight individuals can still experience weight stigma and its associated negative consequences; the relationship between weight stigma and eating behaviors is modulated by weight status; stress mediated the associations between weight stigma and uncontrolled and emotional eating among non-overweight adolescents.
Highlights
The purpose of this study was to examine the relationships among weight stigma, eating behaviors, and stress, as well as to analyze the effect of stress in mediating the association between weight stigma and eating behaviors
For non-overweight participants, stigma was strongly correlated with sex, cognitive restraint, uncontrolled eating, emotional eating, and stress
The entry of stress in a final model accounted for an additional 2.8% of the variance. These findings suggest that, after controlling for a participant’s age and sex, among non-overweight adolescents, the experience of weight stigma and stress are associated with greater levels of uncontrolled eating and emotional eating, only weight stigma is associated with greater levels of cognitive restraint
Summary
The purpose of this study was to examine the relationships among weight stigma, eating behaviors, and stress, as well as to analyze the effect of stress in mediating the association between weight stigma and eating behaviors. Weight stigma refers to an identity threat in response to negative weight-related biases, stereotypes, and prejudices due to overweight or obesity; it can be subtly or openly manifested [1, 2]. It is widespread across the world [3] and occurs in different groups, regardless of age and body weight status [2, 4,5,6,7]. Studies have shown that weight stigma is more prevalent among overweight or obese individuals [8]. Negatives outcomes include depression [11], poor self-esteem [12], social isolation [13], unhealthy eating behaviors [14, 15], decreased physical activity [16], and increased weight gain [17]
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