Abstract
BackgroundInternalized weight stigma (IWS) is generally operationalized as self-devaluation due to weight in higher-weight individuals. The most commonly used measure of IWS, the Weight Bias Internalization Scale (WBIS), was developed from an original pool of 19 items. Item selection was guided by statistical techniques based upon an a priori hypothesized unidimensional factor structure. The resulting 11-item scale mostly assesses appearance-related attitudes, fear of stigma, affect, and desire for change, all of which may be a natural response to societal weight stigma, even in the absence of self-devaluation. Items pertaining to self-blame, stigma awareness, perceived legitimacy of weight stigma, and most items pertaining to self-worth, were excluded from the final scale. It is unclear whether an a priori assumption of multi-dimensionality would have produced different results.MethodsExploratory and confirmatory factor analysis of the original 19-item questionnaire was conducted in 931 higher-weight individuals.ResultsA 13-item two-factor structure was identified. Factor 1 comprised seven items that could be loosely conceived as weight-related distress. Factor 2 comprised six items, all of which pertained to weight-related self-worth. Tested individually, the six items making up the self-devaluation factor were an excellent fit for the data on all fit indices.ConclusionIWS is a multi-dimensional construct. The two-factor WBIS (WBIS-2F) provides options to explore the relationships between different aspects of IWS and upstream and downstream variables. The Self-Devaluation subscale is suitable for standalone use when weight-related self-devaluation per se is the construct of interest.
Highlights
Weight stigma can be broadly defined as exposure to negative attitudes, behaviors, or structural indignities that befall higher-weight individuals because of their weight or size
Internalized weight stigma (IWS) moderated the relationship between BMI and physical health-related quality of life in a sample of 81 higher-weight women recruited from weightrelated Internet sites, such that the negative association was observed only in those individuals with high levels of IWS (Latner et al, 2014)
Twenty-six participants (2.7%) had a BMI less than 25 kg/m2 based on self-reported height and weight and these participants were excluded from subsequent analyses
Summary
Weight stigma can be broadly defined as exposure to negative attitudes, behaviors, or structural indignities that befall higher-weight individuals because of their weight or size. Internalized weight stigma (IWS) has been linked with a wide range of negative health outcomes, including mood disorders, psychological distress, worse body image, lower self-esteem, poorer health-related quality of life, metabolic dysfunction, disordered eating, avoidance of exercise, and social isolation and experiential avoidance (for a review, see Pearl and Puhl, 2018). The resulting 11-item scale mostly assesses appearance-related attitudes, fear of stigma, affect, and desire for change, all of which may be a natural response to societal weight stigma, even in the absence of self-devaluation. Items pertaining to self-blame, stigma awareness, perceived legitimacy of weight stigma, and most items pertaining to selfworth, were excluded from the final scale. It is unclear whether an a priori assumption of multi-dimensionality would have produced different results
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