Weight Bias Internalization Research Articles

Effects of weight stigma on BMI and inflammatory markers among people living with obesity

ObjectiveWeight stigma (WS) and prejudice are one of the most prevalent ways of discrimination among adults, comparable with rates of racial discrimination. Exposure to WS among patients with obesity (PWO) may make the adoption of healthy dietary patterns and regular physical activity even more challenging and, therefore, the achievement of weight loss. Additionally, WS could also induce physiological responses such as increased levels of inflammatory markers, due to stress exposure. MethodSubjects attending two obesity clinics were evaluated at baseline and after a minimum follow-up of six months. The weight Bias Internalization Scale (WBIS) and the Stigmatizing Situations Inventory (SSI) were administered to evaluate WS. Also, anthropometric and inflammatory markers, including cortisol, ferritin and C-reactive protein (CRP), were recorded at baseline. Results79 PWO (87.3%♀, 45.5 ± 1.3 years, 35.9 ± 6.3 kg/m2) were included. At baseline, 72.2% started liraglutide as anti-obesity drug. Baseline body mass index (BMI) correlated positively with both WBIS (r = 0.23; p = 0.03) and SSI (r = 0.25; p = 0.02) scores. Mean percentual weight loss after a mean follow-up of six months was -7.28%. However, there was a negative, but not statistically significant, correlation between weight loss and both WBIS (r=-0.14; p = 0.2) and SSI (r=-0.19; p = 0.08). Regarding inflammatory markers, plasma cortisol levels at baseline correlated positively with WBIS (p = 0.005) and SSI (p = 0.02). CRP at baseline also presented a positive correlation with SSI (p = 0.03). No significant correlations were found for stigma tests and ferritin levels. DiscussionAs weight increases among PWO, so does stigma. Despite we did not find a significant negative association between the presence of WS and weight loss outcomes, there was an increase in inflammatory markers among PWO who experienced higher levels of WS.

Understanding the Intersectional Relationship of Pain Stigma, Weight Bias Internalization, and Clinical Indicators in a Rural Population with Back Pain: A Survey-Based Study

Stigma is understood to be intersectional, meaning multiple characteristics can be stigmatizing, and they may be both overlapping and coconstitutive. Chronic pain and overweight are common complaints in the spinal surgery clinic. Since being overweight may relate to back pain in a complex fashion, we sought to understand if there is a moderating effect between weight bias and pain stigma. This study involves a survey-based, quantitative, cross-sectional, observational design using previously validated measures and demographic and clinical information. There were 192 participants. Statistical calculations were done with statistical package for the social sciences. Pain stigma was not significantly correlated with BMI (body mass index), and weight bias was not significantly correlated with back pain. There was a strong positive correlation between weight bias and pain stigma. There was a strong positive correlation between weight bias and BMI when pain stigma was also high. Given the relationship between weight stigma and pain, the intersection of weight and pain stigma is important because it indicates the vulnerability of patients with higher BMI to other forms of stigma, such as stigma for their pain complaints. Clinicians should be mindful of expressing pain stigma more significantly amongst patients with higher BMI.

Weight bias internalization among adolescents in Spain: psychological correlates across gender diversity and weight status

Weight bias internalization refers to the negative weight-related attributions applied to oneself, but it does not just occur in the highest weight statuses, but rather exists across the entire weight spectrum. There is a negative impact associated to increase psychological problems in adults, however, it has been less studied among the adolescent Spanish population. In this study, we assess the relationship between the internalization of weight bias, social attitudes towards appearance, body appreciation and self-esteem, and potential differences regarding gender and weight status. A community sample of 1258 Spanish adolescents between 12 and 18 years old (46.3% male gender; Mage = 15.58; SD = 1.59; 49.5% female gender; Mage = 15.59; SD = 1.67; and 4.1% non-binary gender; Mage = 14.86; SD = 2.86) participated in the study. The Modified Weight Bias Internalization Scale (WBIS-M), the Rosenberg Self-Esteem Scale (RSES), and the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ-4) were used. ANOVA’s test and bivariate correlations were performed. The results suggest that females (t = -.55; p ≤ .001) and non-binary adolescents (t = .64; p ≤ .01) have higher levels of WBI-M compared to males. Regarding weight status, the group with obesity (t = 1.39; p ≤ .001) and the group with overweight (t = -.81; p ≤ .001) have higher levels of WBI-M compared to the normal weight group. Significant correlations between WBI-M and the assessed psychological variables were found in the total sample, and across all-gender and weight categories, except for the underweight group. These results are a first approximation to the internalization of weight bias in a Spanish adolescent sample and highlight the need to introduce this concept in prevention and psychological interventions in school context.

Relation between weight stigma and emotional eating: an approach from structural equation modeling

Introduction: dietary intake has been shown to be one of the main factors influencing weight gain, and weight stigma contributes to increased emotional eating. However, the factors that mediate this relationship have been less studied. Objective: the aim of this study was to identify the relationship between weight stigma and emotional eating, and whether this relationship is mediated by internalizing weight bias and psychological distress. Methods: a non-probabilistic sample of 332 people from the general population (192 women and 140 men) answered self-report psychological instruments and provided anthropometric measurements. Results: through structural equation analysis (SEM), direct relationships were identified, among which the relationship between weight stigma and emotional eating stands out (β = 0.422, p < 0.001), in addition to the indirect relationship between these variables mediated by internalized weight bias and psychological distress (βindirect = 0.016, p = < 0.05). The model had good indicators of goodness of fit and explained 85 % of the variance. Conclusion: the results show the importance of including psychological and behavioral variables in the treatment of emotional eating in people with overweight and obesity, as well as addressing these issues from public policies to reduce the associated stigma that still prevails in society.

Predictors of support for anti-weight discrimination policies among Canadian adults.

Weight discrimination of individuals with overweight or obesity is associated with adverse mental and physical health. Weight discrimination is prevalent in many sectors such as within workplaces, where individuals with overweight and obesity are denied the same opportunities as individuals with lower weight status, regardless of performance or experience. The purpose of this study was to understand the Canadian public's support or opposition of anti-weight discrimination policies and predictors of support. It was hypothesized that Canadians will show support of anti-weight discrimination policies to some extent. A secondary analysis was conducted on a previous cross-sectional sample of Canadian adults (N = 923, 50.76% women, 74.4% White) who responded to an online survey assessing weight bias and support of twelve anti-weight discrimination policies related to societal policies (e.g., implementing laws preventing weight discrimination) and employment-related policies (e.g., making it illegal to not hire someone due to their weight). Participants completed the Causes of Obesity Questionnaire (COB), the Anti-Fat Attitudes Questionnaire (AFA) and the Modified Weight Bias Internalization Scale (WBIS-M). Multiple logistic regressions were used to determine predictors of policy support. Support for policies ranged from 31.3% to 76.9%, with employment anti-discrimination policies obtaining greater support than societal policies. Identifying as White and a woman, being over the age of 45 and having a higher BMI were associated with an increased likelihood of supporting anti-weight discrimination policies. There were no differences between the level of support associated with attributing obesity to behavioral or non-behavioral causes. Explicit weight bias was associated with a reduced likelihood of supporting 8/12 policies. Weight Bias Internalization was associated with an increased likelihood of supporting all societal policies but none of the employment policies. Support for anti-weight discrimination policies exists among Canadian adults, and explicit weight bias is associated with a lower likelihood of supporting these policies. These results highlight the need for education on the prevalence and perils of weight discrimination which may urge policy makers to consider weight bias as a form of discrimination that must be addressed. More research on potential implementation of anti-weight discrimination policies in Canada is warranted.

A study of the relationship between self-perception and internalized weight bias in healthy young adults

A study of the relationship between self-perception and internalized weight bias in healthy young adults

Validation of Eating Screen in Hindi: A Step Forward to Combat an Under-researched Menace of Eating Disorders in India

Abstract Background: A culturally appropriate tool to screen and diagnose eating disorders (EDs) is lacking in India. Aim: This study aims to translate, adapt, and validate ED Diagnostic Scale (EDDS) in Hindi. Methodology: Hindi translation of EDDS was done by three psychiatrists, two of whom were familiar with Western culture, their mother tongue being Hindi. The bilingual panel of experts, including three surgeons, one Professor in the English language, and one person with severe obesity (International English Language Testing System score Band 8.5) resolved translation inconsistencies. Back translation to the English language was done by an independent translator. Pretesting/focused-group discussion/cognitive interviewing was done in persons with severe obesity (n = 55). Hindi-version so-developed was administered to students (n = 120) after a week. Test–retest reliability was assessed. The original EDDS, Modified Weight Bias Internalization Scale (WBIS-M), and Fat Phobia Scale-Short Form (FPS-SF) were applied to 175 participants (students [n = 120], patients [n = 55]). The psychometric properties of Hindi-EDDS were investigated. Results: The mean age of students and patients was 18.60 and 43.38 years, respectively. Students and patients’ mean body mass index was 21.77 and 43.21 kg/m2, respectively. Kaiser–Meyer–Olkin and Bartlett’s Test of Sphericity for sample adequacy were 0.859 and χ2 = 3155.775; P = 0.000, respectively. The Spearman–Brown coefficient for Hindi-EDDS was 0.755 and 0.707, respectively. Internal consistency (Cronbach’s alpha and Kuder–Richardson - 20) was α = 0.898. Cross-language concordance had a significant intra-class correlation coefficient (0.725–1.000). WBIS-M and FPS-SF showed a significant correlation with various items of Hindi-EDDS. Conclusion: The Hindi EDDS is a culturally sensitive tool with acceptable psychometric properties.

Refining the conceptualization and assessment of internalized weight stigma: A mixed methods approach

Internalized weight stigma has gained increasing attention in empirical studies, though questions remain about the adequacy of existing measures. The current study utilized a mixed methods approach, including a novel semi-structured interview, to revisit the conceptualization of internalized weight stigma and explore in more depth the stereotypes and impacts of weight reported by individuals with high scores on the widely-used Weight Bias Internalization Scale. All participants were interviewed as part of the screening procedures for two clinical trials (Study 1 n = 84, mean age=47.8 years, 83.3% women, 67.9% Black, mean BMI=39.2 kg/m2; Study 2 n = 129, mean age=50.0 years, 88.4% women, 65.1% white, mean BMI=37.8 kg/m2). The most common weight stereotypes identified were being lazy, lacking willpower or self-control, and having poor eating habits. Up to 66% of participants reported that they did not endorse negative weight stereotypes or apply them to themselves. The most highly identified impacts of weight were on self-image (>70%) and emotions (68–83%), followed by social (37–62%) and health concerns (20–25%). Approximately 60% of participants indicated that weight affected their self-directed thoughts and feelings “very much” to “extremely.” Findings have implications for understanding and assessing internalized weight stigma in research and in clinical settings where interventions are needed.

The role of weight stigma in weight regain in bariatric surgery.

Obesity is highly stigmatized, and individuals who undergo bariatric surgery are subject not only to weight stigma, but also to stigma related to the procedure itself. Patients lost to follow-up after surgery make estimating the amount of regain occurring after surgery difficult, and often patients fail to follow up due the shame of weight regain. Patients report difficulty following the diet necessary to maintain weight loss. Additionally, when they seek support after surgery, they often encounter stigmatizing messaging related to weight. Weight bias internalization, weight stigma, and stigma about having the surgery all contribute to feelings of social isolation, disordered eating, and reduced motivation to engage in physical activity. In this chapter, we present evidence for the impact of stigma on bariatric surgery outcomes and discuss the behavioral, physiological, and emotional processes that contribute to weight regain.

Academic Achievement, School Absence and Self-Concept in Czech Prepubescent Children with Overweight and Obesity

Problem. The paper offers findings about selected educational aspects of children’s academic performance, examined here in terms of sociodemographic variables, BMI percentile values, cognitive test scores, weight bias internalization scale and self­ ­concept scale with an aim to detect whether and to what extent these factors contribute to children’s school results. Methods. 557 fifth graders were administered Vana’s Intelligence Test, the Piers‑Harris 2 self­‑concept questionnaire and other tools. Children’s educational aspects were assessed in terms of school Absence, Grade Point Average, and Czech and Mathematics grades, with data obtained from their most recent report cards under the Informed consent of their legal representatives and in compliance with ethical standards. Results. Prepubescent children from stronger socio­‑economic backgrounds suffer from overweight/obesity less often and perform slightly better at school. The present results suggest a link between weight bias internalization and overweight/obesity, and a somewhat weaker link between self­‑concept and overweight/obesity in the non­‑clinical population of prepubescent children. In these relationships of overweight/obese children, as in the cases of alarmingly high school absence, gender is an important variable. Multinomial logistic regression modelling the relationship between Czech and Mathematics grades and selected factors discovered that chances for a worse grade were significantly reduced by the results of Vana’s Intelligence Test in both the subjects, while the Self‑concept total score proved to be an insignificant factor. Conversely, pupils’ Czech grades were negatively influenced by increased BMI (quartile), higher Absence rate, male Gender, Presence of only one parent in the family and WBI, while in Mathematics, in addition to the above­ ­discussed, significant regressors only included Absence and Presence of only one parent. Discussions. The results of the Self‑concept total score, the level of which is generally lower in girls than in boys in the population of Czech prepubescent children, agree with other authors’ experience. The connection between the male sex and poorer performance in Czech can be partly explained by the fact that the development of speech, reading, writing and grammar is generally less complicated for school­‑age girls than boys. We can ask why a higher BMI quartile increases the chances of a worse grade only in the case of Czech language? So far, we can only speculate about the causes. In our opinion, it is possible that the impact of parents’ education on the performance of children of this age is more pronounced in the Czech language (compared to Mathematics). The other possibility of the impact of the BMI quartile on the Czech grade is the significant predominance of boys in the o/o group. On the other hand, it should be noted that this argument would not explain the o/o children’s poorer Grade Point Average score. However, we believe that the above reasons answer partially this question. Conclusion. The vulnerability of o/o girls is pronounced in some domains of Selfconcept and Weight bias internalization, while in boys it is reflected in the more frequent occurrence of high levels of Absenteeism, with the precise causes of this being still subject to speculation. In this regard, workers in the cooperating professions should pay continuous attention to strengthening the desirable aspects of education and healthy lifestyle among vulnerable groups of children. Educational aspects of overweight/obese children should therefore continue to receive increased attention.

Prevalence and Correlates of Weight Stigma among Postpartum Women in China.

Weight stigma is linked to a variety of psychological and health problems. In the postpartum period, women may be more likely to experience weight-based discrimination because of their changing social roles, weight, and the new functions their bodies fulfill. However, few studies have explored the issue of postpartum women's weight stigma. Thus, to investigate the prevalence and correlates of weight stigma for postpartum women in China, we conducted a cross-sectional study of 507 postpartum women. Results showed that almost one quarter (21.1%) of postpartum women claimed to have experienced perceived weight stigma (PWS). Two thirds (66.1%) scored at the mean and 14.8% at the highest levels of weight bias internalization (WBI). During the postnatal period, the conditions of those most likely to report experiences of weight-based discrimination included low income [b = -0.203, p = 0.004], occupation as a worker [b = 0.921, p = 0.017] or farmer [b = 0.826, p = 0.033], stress [b = 0.044, p = 0.035], depression [b = 0.057, p = 0.021], and higher WBIS [b = 0.018, p = 0.002]. In addition, postpartum women who lived alone [b = 7.511, p = 0.048], were overweight or obese [b = 5.443, p = 0.000], and had higher PWS [b = 0.897, p = 0.004] and anxiety symptoms [b = 0.219, p = 0.011] had higher levels of internalized weight stigma. Findings from this study provide a foundation to better understand characteristics of postpartum women in China who are at risk for weight stigma.

Newspaper media framing of obesity during pregnancy in the UK: A review and framework synthesis.

Two thirds of women report experiencing weight stigma during pregnancy. Newspaper media is powerful in framing health issues. This review synthesized UK newspapermedia portrayal of maternal obesity. NexisUni was searched to identify newspaper articles, published January 2010 to May 2021, reporting content on obesity during pregnancy. Framework synthesis integrated quantitative and qualitative analysis of the content of articles. There were 442 articles included (59% tabloids and 41% broadsheets). Three overarching themes with interacting sub-themes were as follows: (1) Women were blamed for their weight, risks, and NHS impact. (2) Women were solely responsible for solving obesity, gendered from school age. (3) Women with obesity were a burden on individuals (e.g., themselves, their children, and health professionals), to society, and the NHS. Catastrophizing language framed the "problem," "scale," and "public health concern" of maternal obesity, emphasizing risk, and danger and was alarmist, aggressive, and violent as to elicit fear or devalue women. Articles platformed 'expert' voices rather than women's lived experiences. This review identified that UK newspaper media negatively frames and oversimplifies the topic of maternal obesity. Exposure to blaming and alarmist messaging could increase women's guilt, stigma, and internalized weight bias. The newspaper media should be harnessed to de-stigmatize maternal obesity and promote maternal well-being.

Experienced weight stigma, internalized weight bias, and maladaptive eating patterns amongheterosexual and sexual minorityindividuals.

The current study examined experienced weight stigma (EWS), internalized weight bias (IWB), and maladaptive eating patterns (ME) among sexual minority (SM) and heterosexual individuals. The sample consisted of cisgenderheterosexual and SM men and women. Participants were drawn from introductory psychology classes and a variety of supplemental recruitment methods (Facebook, Instagram, MTURK, etc.). SM individuals reported higher levels of EWS, IWB, and maladaptive eating patterns than heterosexual individuals.Heterosexual men reported the lowest levels of EWS, IWB, and ME compared to all other groups. Additionally,therewas a significant association between greater EWS and IWB and greater ME. Gender identityandsexual orientationimpacted the strength of the relationship between IWB and ME and, to a lesser extent, EWS and ME. This investigationcontributes toknowledgeoftheimpact ofgender identityandsexual orientationonEWS and IWB, and demonstrates that IWB and EWS are significant concerns for the SM community, especially in relation to ME. Level IV, cross-sectional study.

From Weight Bias Internalization to Health-Related Quality of Life: Self-esteem and Psychopathology in Pre-bariatric Surgery Patients

IntroductionIt has been reported that people seeking bariatric surgery have poor health-related quality of life (HRQoL). Weight bias internalization (WBI) is prevalent in this population and strongly associated with psychopathology and health status. However, the psychological mechanisms underlying the relationship between WBI and the physical and mental dimensions of HRQoL remain to be clarified.MethodsA preoperative sample of patients with obesity (N = 246; women = 75.2%; Mage = 32.07) completed validated measures as part of a routine preoperative psychological assessment to assess their WBI, self-esteem, anxiety symptoms, depressive symptoms, and HRQoL.ResultsAfter controlling for the effects of gender, age, and BMI, WBI was linked to poorer physical and mental HRQoL through low self-esteem and increased psychological distress, including anxiety and depressive symptoms.ConclusionIn pre-bariatric surgery patients with obesity, high WBI may predict impairments in mental and physical HRQoL by lowering self-esteem, and further increasing anxiety and depressive symptoms. Interventions targeting WBI may be an important aspect to consider in the clinical treatment of pre-bariatric surgery patients. Further longitudinal studies are warranted to determine causality.Graphical abstract

Examining weight bias before and/or after bariatric surgery: A systematic review

Research examining weight bias in the bariatric population, who may be at greater risk of weight stigma, is scarce. The present study aimed to systematically review the literature for quantitative evidence that explores the medical, psychosocial, and behavioral sequelae associated with experienced, internalized, and/or externalized weight bias in patients seeking or who have undergone bariatric surgery. Five databases were systematically searched for English peer-reviewed quantitative studies, which examined weight bias in a sample of individuals seeking or who had undergone bariatric surgery. Risk of bias was assessed. Twenty-nine studies were included, of which 13 examined internalized weight bias, 12 examined experienced weight bias, 4 examined both, and 0 examined externalized weight bias. Most studies were cross-sectional, and the results showed high risk of bias. The results suggested that both experienced and internalized weight bias were associated with a host of negative psychosocial, behavioral, and medical sequelae. The findings of this review underscore the need for more rigorous research to better understand the relationship between weight bias and bariatric surgery, particularly longitudinally. Future patients may benefit from research developing interventions for reducing weight bias prior to and following bariatric surgery in order to reduce the associated negative correlates and improve outcomes.

Body Checking and Body Image Avoidance as Partial Mediators of the Relationship between Internalized Weight Bias and Body Dissatisfaction.

Internalized weight bias is associated with body image disturbances and the development of disordered eating. The association between weight bias internalization and body dissatisfaction has proven difficult to disrupt. In order to develop more effective interventions, we must identify the behavioral targets which account for this robust association. The present study sought to examine whether body checking and body image avoidance mediate the relationship between weight bias internalization and body dissatisfaction. In total, 279 female undergraduates (Mage = 20.13, SD = 4.10) were administered a battery of survey measures. Results demonstrated that body checking partially mediates the relationship between weight bias internalization and body dissatisfaction, Z = 7.42, p < 0.001. Body image avoidance was also found to partially mediate the relationship between weight bias internalization and body dissatisfaction, Z = 70.03, p < 0.001. These findings suggest that body checking and body image avoidance may both partially account for the association between weight bias internalization and body dissatisfaction. These findings extend the existing literature on weight bias internalization by highlighting two behavioral targets for prevention and intervention efforts. Understanding these relationships has important implications for both reducing weight bias internalization and improving body dissatisfaction.

Exploring weight bias internalization in pregnancy

BackgroundRecent research has shown that pregnant individuals experience weight stigma throughout gestation, including negative comments and judgement associated with gestational weight gain (GWG). Weight bias internalization (WBI) is often a result of exposure to weight stigma and is detrimental to biopsychological health outcomes. The purpose of this study was to explore WBI in pregnancy and compare scores based on maternal weight-related factors including pre-pregnancy body mass index (BMI), obesity diagnosis and excessive GWG.MethodsPregnant individuals in Canada and USA completed a modified version of the Adult Weight Bias Internalization Scale. Self-reported pre-pregnancy height and weight were collected to calculate and classify pre-pregnancy BMI. Current weight was also reported to calculate GWG, which was then classified as excessive or not based on Institute of Medicine (2009) guidelines. Participants indicated if they were diagnosed with obesity by a healthcare provider. Inferential analyses were performed comparing WBI scores according to pre-pregnancy BMI, excessive GWG, and obesity diagnosis. Significance was accepted as p < 0.05 and effect sizes accompanied all analyses.Result336 pregnant individuals completed the survey, with an average WBI score of 3.9 ± 1.2. WBI was higher among those who had a pre-pregnancy BMI of obese than normal weight (p = 0.04, η2 = 0.03), diagnosed with obesity than not diagnosed (p < 0.001, Cohen’s d = 1.3), and gained excessively versus not (p < 0.001, Cohen’s d = 1.2).ConclusionsPregnant individuals who have a higher BMI, obesity and gain excessively may experience WBI. Given that weight stigma frequently occurs in pregnancy, effective person-oriented strategies are needed to mitigate stigma and prevent and care for WBI.

Spanish validation of the Modified Weight Bias Internalization Scale (WBIS-M) for adolescents

PurposeWeight Bias Internalization (WBI) is pervasive and potentially damaging for health. Little is known about WBI in youth. As negative effects of WBI have been observed when controlling for BMI, measures that allow WBI to be assessed across different weight categories are needed. The Modified Weight Bias Internalization Scale (WBIS-M) is one of the most frequently used scales in this field. Our purpose was to obtain a Spanish validated version of the WBIS-M for adolescents across different weight statuses.MethodsThe data were collected from 298 secondary students (mean age 14.31; 48.32% girls; 18.8% were overweight and 6.4% had obesity). Internal structure was examined by a cross-validation analysis, using both exploratory and confirmatory factor analyses in different subsamples.ResultsItem 1 showed a psychometric anomalous functioning and was deleted. The one-factor structure of the 10-item version was confirmed with adequate fit ([EFA (KMO = 0.915, χ2(55) = 1075.633, p < 0.0001)]; [CFA (χ2(35) = 200.515; GFI = 0.995; PGFI = 0.992; NFI = 0.991; SRMR = 0.060)]). Internal consistency was high (alpha =0.93;ω = 0.93). Significant correlations with the same set of external variables assessed in the original version (anti-fat bias, self-esteem, mood, body dissatisfaction, drive for thinness, binge eating), all of them correlates of WBI in adolescents, were found. Girls and participants with obesity obtained higher scores.ConclusionThe results provide support for the validity and reliability of our WBIS-M version for use with adolescents across weight categories in Spain.Level of evidenceLevel III, evidence obtained from well-designed cohort studies.

Associations of Use of Social Media and Psychopathology and Body Image in Pre- and Post-surgical Bariatric Samples: a Cross-sectional Analysis.

PurposeInterest has grown regarding the impact of social media platforms on mental health including body image and internalized weight bias (IWB) in those who have struggled with weight issues. However, few studies have addressed social media usage in bariatric patient samples. The objective of this study was to understand how the amount of time spent on social media could serve as a predictor for IWB in both pre- and post-operative bariatric patients.Materials and MethodsPre- and post-operative patients at one academic medical center completed self-report measures assessing patients’ IWB, depression, anxiety, body dissatisfaction, sociodemographic variables, and social media usage. Data were collected from March 2019 to April 2020. Statistical methods that included correlations, logistical regression models, and ANOVA analysis were used to determine the relationship between time spent on social media and other covariates.ResultsA total of 148 responses were collected from the pre-surgical population, with 81 responses from the post-surgical sample. At baseline, the majority of respondents used social media for approximately 1 h per day (n = 37; 27.82%). Time spent on social media was negatively associated with age (r = − 0.24 [− 0.40, − 0.08]), and positively associated with IWB (r = 0.20 [0.02, 0.36]) and anxiety (r = 0.21 [0.01, 0.39]). In the post-operative group, only the 6-month BMI (r = 0.29 [0.05, 0.49]) was positively associated with time spent on social media.ConclusionGiven this study’s findings, providers are encouraged to become aware of patients’ use of social media, and to understand the impact social media usage can have on the mental well-being of patients.Graphical abstract Supplementary InformationThe online version contains supplementary material available at 10.1007/s11695-022-06206-6.

Internalized Stigma as a Transdiagnostic Factor for Women with Eating Disorders

ABSTRACT This study aimed to examine how internalized weight bias (IWB), body surveillance, and body shame relate to eating pathology in women with diagnosed eating disorders (EDs) across the weight spectrum. Previous research has examined these variables in primarily non-clinical populations, binge eating disorder, and higher weight populations. In a sample of 98 women with diagnosed EDs, the association of IWB, body surveillance, and body shame on the severity of ED symptoms was examined with hierarchical multiple regression analyses. Results indicate that IWB, body surveillance, and body shame significantly predicted global eating pathology, F (4, 93) = 40.74, p < .001. IWB, body surveillance, and body shame related to global eating pathology, even after controlling for previous weight bias experiences. Analyses with specific symptom clusters found that only body surveillance predicted dietary restraint, only IWB and body shame predicted overvaluation of shape/weight, and only IWB predicted body dissatisfaction. The findings in this study provide initial support for internalized stigma variables (IWB, body surveillance, and body shame) related to ED pathology in a transdiagnostic clinical eating disorder sample across the weight spectrum. Results suggest that further examination of internalized stigma is needed within ED treatment.