Abstract
Research has shown a negative relationship between weight bias internalization (WBI) and general measures of health-related quality of life (QOL), such as the Short Form–36. Less is known about the impact of WBI on weight-specific domains of QOL. This study examined the relationship between WBI and weight-related QOL, as measured by the Impact of Weight on Quality of Life (IWQOL-Lite) scale. Participants were 178 adults with obesity [71.3% black, 87.6% female, mean body mass index (BMI) = 40.9 ± 5.9 kg/m2] enrolled in a weight loss trial testing the effects of lorcaserin on weight loss maintenance. At baseline, participants completed the Weight Bias Internalization Scale (WBIS), the IWQOL-Lite and the Patient Health Questionnaire (PHQ-9, to assess symptoms of depression). Total scores for the IWQOL-Lite and its five subscales (Physical Function, Self-Esteem, Sexual Life, Public Distress and Work) were calculated. Linear regression analyses showed that WBIS scores were associated with the IWQOL-Lite total score and all subscales above and beyond the effects of demographic variables, BMI, and depressive symptoms (beta values = -0.18 to -0.70, p values < 0.019). The relationship between WBIS and the IWQOL-Lite scales did not differ by gender or race. WBI was associated with mental and physical aspects of weight-related QOL in a predominantly black and female treatment-seeking sample of patients with obesity. Prioritizing the development of interventions to reduce WBI may be important for improving weight-related QOL.
Highlights
Health care professionals, employers, co-workers, parents, passing strangers, and even young children have been found to hold negative attitudes towards persons with overweight and obesity, describing them, for example, as lazy, worthless, awkward, ugly, and lacking in self-esteem (Puhl and Brownell, 2001)
The results of this study showed that, in treatment-seeking patients with obesity, those who reported higher levels of weight bias internalization (WBI) reported lower overall weight-related quality of life (QOL)
The present findings are consistent with prior reports of an association between WBI and lower general QOL, as measured by the global mental and physical health-related QOL scores of the SF-36 (Latner et al, 2013, 2014; Pearl et al, 2014), as well as a report of negative associations between Weight Bias Internalization Scale (WBIS) scores and the IWQOL-Lite Total and Self-Esteem subscale scores (Hübner et al, 2016)
Summary
Employers, co-workers, parents, passing strangers, and even young children have been found to hold negative attitudes towards persons with overweight and obesity, describing them, for example, as lazy, worthless, awkward, ugly, and lacking in self-esteem (Puhl and Brownell, 2001). Prior research has suggested that individuals with WBI report reduced quality of life (QOL) in both their physical function and mental health, as assessed by general measures such as the Medical Outcome Survey, Short-Form-36 (SF-36) (Latner et al, 2014; Pearl et al, 2014). Prior work has shown a relationship between WBI and negative general mental health outcomes (Latner et al, 2013, 2014; Pearl et al, 2014; Hübner et al, 2016), but the relationship between WBI and negative physical health outcomes is less established (Pearl and Puhl, 2018)
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