Weight Self-Stigma Questionnaire Research Articles

The role of weight stigma and food literacy in eating behaviour

Abstract Background Overweight/obesity is associated with negative health outcomes that may be caused by experience and internalization of weight stigma. Weight stigma seems to diminish weight control efforts and may be associated with unhealthy eating behaviours. Moreover, lack is known about the protective factors against stigmatization. We aimed to assess the role of weight stigma and food literacy in eating behaviour in people with overweight and obesity controlling for sociodemographic and clinical variables. Methods A total of 189 participants with overweight/obesity (52.9% female; mean age 48.8±14.5 years; body-mass index (BMI) 32.6±6.5 kg/m2; waist-to-height ratio (WHtR) 0.6±0.1) completed the Experienced Weight Stigma Questionnaire and the Weight Self-Stigma Questionnaire. To examine eating behaviours including cognitive restraint, uncontrolled eating, and emotional eating we used the Three Factor Eating Questionnaire. Multiple linear regression analyses were performed. Results Higher WHtR and BMI were associated with emotional eating and uncontrolled eating. Experienced weight stigma was associated with emotional eating but was no longer significant when self-stigmatization was added to the regression model. Self-stigmatization was associated with emotional eating and uncontrolled eating. This association attenuated when food literacy was added to the final models. Low food literacy was significantly associated with emotional and uncontrolled eating. No role of weight-related measures, stigma or food literacy in the cognitive restrain was found. The explained variance in the final regression models for emotional eating and uncontrolled eating was 41%, and 32.7%, respectively. Conclusions Emotional eating and uncontrolled eating may represent crucial components to address in health and weight management. Nutrition literacy may have a positive effect on diminishing associations between weight stigma and unhealthy eating patterns. [Funding: VEGA: 1/0748/22]. Key messages • Eating disorder symptoms and their association with obesity should be considered when designing public health interventions. • Interventions targeting weight stigmatization and food literacy may mitigate the negative impact of weight stigma on eating behaviours.

Associations between weight self-stigma and healthy diet and physical activity among adults with type 2 diabetes:Cross-sectional results from the second Diabetes MILES - Australia (MILES-2) study.

To examine associations between weight self-stigma and healthy diet or physical activity, and potential moderating effects of self-esteem, diabetes self-efficacy, and diabetes social support, among adults with type 2 diabetes. Diabetes MILES-2 data were used, an Australian cross-sectional online survey. Participants with type 2 diabetes who considered themselves overweight, and reported concern about weight management (N = 726; 48% insulin-treated), completed the Weight Self-Stigma Questionnaire (WSSQ; total score and subscales: self-devaluation, fear of enacted stigma), measures of diabetes self-care (diet, exercise), and hypothesised psychosocial moderators (self-esteem, diabetes self-efficacy, and diabetes social support). Adjusted linear regression tested associations and interaction effects, separately by insulin treatment status. Greater weight self-stigma (WSSQ total) was associated with less optimal dietary self-care (both groups: β = -0.3), and with a lower level of exercise (non-insulin only: β = -0.2; all p < 0.001). All hypothesised moderators were negatively associated with weight self-stigma (range r = -0.2 to r = -0.5). Positive associations were identified between the hypothesised moderators and self-care behaviours (strongest between diet and diabetes self-efficacy, r = > 0.5). No significant interaction effects were observed. This study provides novel evidence of negative associations between weight self-stigma and self-care behaviours among adults with type 2 diabetes. Weight self-stigma is a demonstrated barrier to self-care behaviours in type 2 diabetes cohorts. Acknowledgement and strategies to address weight self-stigma are needed in clinical care and health programmes.

The Perceived Weight Stigma Scale and Weight Self-Stigma Questionnaire: Rasch analysis, confirmatory factor analysis, and network analysis among Chinese adolescents

ObjectivesThe objectives of the present study were to (i) re-evaluate and expand the psychometric properties of two weight stigma instruments—the Perceived Weight Stigma Scale (PWSS) and the Weight Self-Stigma Questionnaire (WSSQ) among a large sample of adolescents using advanced psychometric methods and (ii) examine how the different types of weight stigma (i.e., PWSS and WSSQ) are associated with psychological distress. Study designCross-sectional study. MethodsIn September 2023, a cross-sectional survey utilising convenience sampling was used to recruit 9995 adolescents (mean age = 16.36 years [standard deviation = 0.78]; 57.8% males). They completed the PWSS, WSSQ, and a measure on psychological distress. The data were analysed using Rasch analysis, confirmatory factor analysis (CFA), structural equation modelling (SEM), and network analysis. ResultsThe CFA and Rasch model results showed acceptable psychometric properties regarding factor structure, factor loading, difficulty, and infit and outfit mean squares (except Items 4 and 7 of the PWSS). There was no substantial differential item functioning for any tested items across the sex and weight categories. The CFA and SEM results showed promising validity indices with significant associations between both weight stigma scales and psychological distress (i.e., depression, anxiety, and stress). Network analysis showed inter-variable connectivity between nodes PWSS3 (“People act as if they are afraid of you”) and WSSQF7 (“I feel insecure about others’ opinions of me”). ConclusionsBoth weight stigma scales had acceptable psychometric properties and were significantly associated with psychological distress, although each assessed different types of weight stigma. This suggests that researchers and clinicians can use these scales to reliably and validly assess weight stigmas among adolescents.

Longitudinal associations of internalized weight stigma with physical activity and weight loss.

Cross-sectional research has demonstrated that internalized weight stigma (IWS) is associated with less engagement in weight management behaviors, including physical activity. However, limited research has explored longitudinal relationships among IWS, physical activity, and weight loss. This study examined longitudinal associations of changes in IWS, physical activity, and weight and tested whether physical activity mediated the relationship between IWS and weight change. Individuals with obesity and high IWS (N=105) participated in a 72-week behavioral weight loss intervention, with or without a weight stigma intervention. Measures of IWS (Weight Self-Stigma Questionnaire), physical activity (accelerometry and self-report), and weight were collected at baseline and weeks 20, 46 and 72. Correlations examined relationships among changes in variables from baseline to all timepoints, controlling for treatment condition. Mediation, controlling for treatment condition, tested whether IWS reductions during the first 20weeks predicted greater weight loss at weeks 46 and 72 via increased physical activity between weeks 20 and 46 or 72. Decreases in IWS at week 20 were associated with greater week-20 weight loss (r=0.265, p=0.012). Physical activity was not a significant mediator, but greater reductions in IWS at week 20 predicted greater week-46 weight loss with or without controlling for physical activity (WSSQ: b=0.30, confidence interval: 0.12, 0.54). Significant associations were not found at week 72. Initial reductions in IWS were associated with greater week-46 weight loss. Further research should investigate whether reducing IWS early in obesity treatment enhances long-term outcomes. ClinicalTrials.gov (NCT03704064).

The Effects of Sociodemographic Factors and BMI on Weight Stigma Among Adults With Obesity in Madinah Region, Saudi Arabia: A Cross-Sectional Analytical Study.

Introduction Weight stigma (WS), characterized by discrimination and stereotyping based on a person's weight, remains understudied in Saudi Arabia despite the country's high obesity rates. Particularly, limited research has been conducted on WS in Madinah. Understanding the factors contributing to WS in this region is crucial for developing targeted interventions to effectively address it. Hence, this study aimed to explore the effects of sociodemographic characteristics and body mass index (BMI) on WS among adults with obesity in Madinah. Methods Individuals with obesity who were seeking care at primary healthcare centers were included in this study. This research was an analytical cross-sectional study; Madinah City was divided into four areas. One primary health center from each area was randomly selected. Subsequently, a consecutive sampling technique was used to collect questionnaires from participants during the period of December 2023 to March 2024. The participants completed a self-administered electronic questionnaire, which included the Arabic-translated and validated version of the Weight Self-Stigma Questionnaire (WSSQ). Data analysis included descriptive, simple logistic regressionand multiple logistic regression with forward stepwise analysis. Results A total of 383 participants completed the questionnaire, of which 225 (58.7%) were men and 158 (41.3%) were women. The analysis showed that individuals without a family history of obesity experienced higher WS levels than those with a family history [adjusted odds ratio (AOR) = 1.853, 95% confidence interval (CI): 1.010-2.844]. Moreover, individuals with obesity demonstrated the lowest WS levels than those without obesity (AOR = 0.027, 95% CI: 0.009-0.08). These findings provide insights into the association among sociodemographic factors, BMI, and WS in adults with obesity residing in Madinah, Saudi Arabia. Conclusion This study provides evidence that WS is a complex issue that is not solely determined by an individual's obesity status; rather, it is influenced by a lack of family history of obesity, which establishes the impact of social factors on WS. Therefore, comprehending the role of family dynamics and societal norms in shaping an individual's weight status is crucial in managing WS.

Weight Stigma Perceived Body Shape and Psychological Distress in University Students with Different Weight Groups

Aim of the Study: This study sought to investigate the relationships among weight stigma, perceived body shape, and psychological distress in university students in different weight groups. It was hypothesized that there is likely to be a relationship between weight stigma, perceived body shape, and psychological distress. Perceived body shape and weight stigma are likely to positively predict psychological distress. Methodology: This research adopted a cross-sectional research methodology. The sample included n=289 participants (n=128 male and n=161 female students) from two government universities in Pakistan. The consent form, demographic information sheet, Weight Self Stigma Questionnaire (WSSQ) (Wong et al., 2018), Body Shape Questionnaire (BSQ) (Cooper et al., 2006), and Kessler Psychological Distress Scale (K10) (Kessler, 2002) were used to collect information. Findings: The research findings demonstrate that weight stigma and perceived body shape are positively correlated with psychological distress in university students in different weight groups. There was a mean difference in weight stigma, perceived body shape, and psychological distress among university students of varying weight groups. Perceived body shape is a perfect mediator between weight stigma and psychological distress. There was no gender difference in weight stigma, perceived body shape, or psychological distress. Conclusion: The findings significantly impact the development of awareness campaigns that teach obese students healthy coping mechanisms and self-esteem-enhancing techniques. These campaigns additionally promote the sense of pride that overweight people experience using social support-based programs.

Using inquiry based stress reduction to address self-stigma in severe spectrum obesity in general practice.

Obesity is a driver of multimorbidity. Knowledge regarding individual and population based solutions is evolving in primary care. Stigma/self-stigma are important in developing clinical solutions. Inquiry based stress reduction (IBSR) is emerging as a solution for self-stigma in a range of conditions. This study explores IBSR (also known as The Work of Byron Katie) in obesity self-stigma in the GP setting, with severe obesity, utilising a multidisciplinary approach. Is it feasible/acceptable to utilise Inquiry Based Stress Reduction in the GP setting for obesity? Mixed-method pilot study including a convenience sample of people with severe spectrum obesity from a three-doctor general practice, including use of IBSR provided in both group, partner and individual settings, predominantly online, utilising certified and accredited IBSR facilitators, a clinical psychologist, and participating GPs. Outcomes include pre- and post-intervention surveys (Becks Depression Scale, HRQoL, Weight Bias Internalisation Scale, Weight Self-stigma Questionnaire) and qualitative data from participants. Of 22 initially invited to participate, 14 commenced and 10 completed the intervention. Mean BMI was 42.8, mean age 49 years, female:male = 7:3. Many believed obesity was their own fault, related very difficult interactions with healthcare professionals, and valued opportunity to engage with the intervention. While participants had alarming levels of comorbidity, they were far more concerned regarding stigma and self-stigma. Results and experience in practice indicate this approach is feasible and acceptable. Results are valuable in planning a larger study in multiple practices.

The Relationship between Social Support and Self -esteem with the Mediating role of Stigmatization among Obese Individuals

This study Aims to explore the Relationship between social support, self-esteem, and stigmatization within the context of obesity among Pakistani individuals, particularly adolescents. study aims to unravel the intriguing relationship between social support and self-esteem amidst the presence of obesity-related stigma. Employing a cross-sectional design, the study gathered data from a diverse sample of 202 adults residing in both urban and rural areas of Gujranwala. To measure the targeted variables, the researchers employed the esteemed Rosenberg Self-Esteem Scale, the Multidimensional Scale of Perceived Social Support, and the Weight Self-Stigma Questionnaire. The study's findings are nothing short of remarkable and shed light on previously unexplored dimensions. Surprisingly, a negative correlation emerged between self-esteem and social support, challenging long-held assumptions, and prompting a fresh perspective on these intricate dynamics. Additionally, weight stigma was found to act as a potent mediator between social support and self-esteem, revealing a crucial link in this complex chain. The study's findings are nothing short of remarkable and shed light on previously unexplored dimensions. Surprisingly, a negative correlation emerged between self-esteem and social support, challenging long-held assumptions, and prompting a fresh perspective on these intricate dynamics. Additionally, weight stigma was found to act as a potent mediator between social support and self-esteem, revealing a crucial link in this complex chain., These compelling findings underscore the pivotal role of combating weight stigma in interventions aimed at bolstering self-esteem and social support among the obese population. The implications of this research extend to the realms of clinical and social psychology, emphasizing the urgent need for targeted strategies to alleviate the adverse impacts of stigma within obese communities. This groundbreaking study illuminates the path forward, offering a wealth of knowledge to researchers, clinicians, and policymakers alike. It beckons us to embark on a transformative journey towards creating a society that nurtures self-esteem, fosters social support, and dismantles the shackles of weight stigma in the pursuit of holistic well-being among individuals grappling with obesity.

Relationship Between Depression, Anxiety, Stress, and Weight Self-Stigma Among Youths in Saudi Arabia: A Nationwide Study.

Background and objectives Many research studies show that self-stigma related to weight can exacerbate mental health issues. There is also evidence suggesting that depression, anxiety, and stress could be predictors of weight stigma. However, these connections have not been thoroughly investigated among young people in Saudi Arabia, where there is a high prevalence of obesity. This study aimed to explore the relationships between depression, anxiety, stress, and weight self-stigma in Saudi Arabian adolescents and young adults. Materials and methods This cross-sectional study was conducted between January and March 2022 and utilized online surveys, including the Weight Self-Stigma Questionnaire (WSSQ) and Depression, Anxiety, and Stress Scale 21 (DASS-21). We conducted descriptive analysis, independent samples t-tests, analysis of variance (ANOVA), and linear regression for the statistical analysis using SPSS version 25 (IBM Corp., Armonk, NY). Results A total of 1624 participants were enrolled in this survey. Most participants (889, 54.7%) were females. The mean age was 20.73 years (SD: 2.63). Males were more likely to report self-stigma compared to females (p = 0.018). Weight self-stigma demonstrated significant positive associations with body mass index (BMI) (p= 0.0001) and depression, anxiety, and stress (p = 0.0001) scores. Further analysis revealed weight self-stigma was positively correlated with psychological distress levels in the study population (p = 0.0001). The results demonstrated a statistically significant difference between different regions of Saudi Arabia with weight self-stigma being more prevalent in the Al-Baha region and least prevalent in the Al-Madinah region. Conclusions The results of this study indicate robust positive correlations between weight self-stigma scores and depression, anxiety, and stress scale scores among adolescents and young adults in Saudi Arabia.Further epidemiological and clinical studies on the national level are warranted.

Differential item functioning for the Tendency of Avoiding Physical Activity and Sport Scale across two subculture samples: Taiwanese and mainland Chinese university students

AimsThe aims of the study were to examine the differential item functioning (DIF) of the Tendency of Avoiding Physical Activity and Sport Scale (TAPAS) among three subgroups (gender, weight status, and region) and to test the construct and concurrent validities of the scale. MethodsUsing an online survey, university students (608 Taiwanese and 2319 mainland Chinese) completed the TAPAS. Rasch analysis examined if all the 10 TAPAS items fitted the same construct and displayed no substantial DIF across three subgroups: gender (male vs. female), weight status (overweight vs. non-overweight), and region (Taiwan vs. China). Concurrent validity was examined using the scores on the Weight Self-Stigma Questionnaire (WSSQ) and Weight Bias Internalization Scale (WBIS). ResultsAll TAPAS items, except for Item 10 (“Prefer to participate in physical activity in a more private setting”), fitted the same construct. None of the TAPAS items displayed DIF in any of the subgroups except for Item 10 across participants from Taiwan and China (DIF contrast = −1.41). ConclusionThe TAPAS can appropriately assess the tendency to avoid physical activity and sport among both Taiwanese and mainland Chinese university students. However, Item 10 may need to be further examined.

The Tendency to Avoid Physical Activity and Sport Scale (TAPAS): Rasch analysis with differential item functioning testing among a Chinese sample

BackgroundThe benefits of physical activity are well-known to prevent multiple long-term health conditions. Physical appearance and weight-related stigma may influence individuals’ decision to engage in physical activity and sport. Therefore, the present study examined the psychometric properties of a newly developed instrument, the Tendency to Avoid Physical Activity and Sport Scale (TAPAS), using modern test theory.MethodsA total of 2319 university students were recruited from mainland China and they completed the TAPAS. Rasch analysis was used to examine the TAPAS’ rating scaling functioning, test unidimensionality, item hierarchy, ceiling and floor effects, and differential item functioning (DIF). Moreover, the concurrent validity of the TAPAS was examined using the Weight Self-Stigma Questionnaire (WSSQ), Weight Bias Internalization Scale (WBIS), and body mass index (BMI).ResultsUnidimensionality was confirmed except for one item. Items corresponding to attitude toward physical activity were more easily adopted compared to items corresponding to actual behavioral aspects. No ceiling and floor effects were found. No DIF existed in the TAPAS items. The TAPAS was strongly correlated with both the WSSQ and WBIS, but not BMI.ConclusionThe study showed that overall, the TAPAS has robust psychometric properties. However, future research needs to address the misfit item and explore the feasibility of applying the TAPAS to other populations including wider ethnic groups, age ranges, and life stages.

Weight stigma is associated with body mass index among college students in Taiwan: the mediated role of internalized weight stigma

BackgroundWeight stigma is an issue often studied in Western countries; however, such information is scarce in Asian studies.MethodsThis study aimed to examine the role of internalized weight stigma as a mediator in the relationship between perceived weight stigma and changes in body mass index (BMI). The data were collected through a longitudinal online survey with two phases (n = 974; Phase 1: August and September 2021; Phase 2: November and December 2021). The Perceived Weight Stigma Scale (PWSS), Weight Self-Stigma Questionnaire (WSSQ), and Depression, Anxiety, Stress Scale − 21 (DASS-21) were administered to assess perceived weight stigma, internalized weight stigma, and psychological distress. Hierarchical regressions were used to examine the proposed model, and Hayes’ Process Macro was used to test a mediation model.ResultsThe changes in perceived weight stigma and internalized weight stigma were significantly and positively associated with changes in BMI. There were significant and positive associations between perceived weight stigma, internalized weight stigma and psychological distress over time. Change in internalized weight stigma was found to be a significant mediator in the association of change in perceived weight stigma with change in BMI for the entire sample (unstandardized coefficient = 0.04; 95% CI = 0.02, 0.06), female subgroup (unstandardized coefficient = 0.05; 95% CI = 0.02, 0.08), and male subgroup (unstandardized coefficient = 0.03; 95% CI = 0.01, 0.06). Change in perceived weight stigma also had significant effects on change in BMI for the entire sample and the female subgroup, but not for the male subgroup.ConclusionBecause perceived weight stigma may significantly impact changes in BMI through internalized weight stigma, treatment strategies to ameliorate self-stigma may enhance the results of weight-reduction programs. Such treatment strategies should be considered for inclusion in weight-loss interventions.

Examining the effect of weight self-stigma on attitudes toward sexuality during pregnancy using structural equation modeling.

Obesity can cause psychiatric, medical, sexuality and relationship problems. Thus, this study aimed to examine the effect of weight self-stigma on attitudes toward sexuality during pregnancy using structural equation modeling. This cross-sectional study and correlational design was conducted and included 328 pregnant women pre-pregnancy body mass index greater than 30 kg/m2. The data were collected using a socio-demographic information form, the Weight Self-Stigma Questionnaire, and the Attitude Scale toward Sexuality during Pregnancy. Data were analyzed using descriptive statistics, correlation analysis, mean comparison tests, and structural equation modeling. The correlation matrices of all weight self-stigma and attitudes toward sexuality scale scores showed a significant correlation (p<0.05). According to the path coefficient for the effect of weight self-stigma on sexual attitudes, as the pregnant women stigmatized themselves more, their attitudes toward sexuality during pregnancy changed negatively (β<0). Weight self-stigma leads to negative attitudes toward sexuality during pregnancy in pregnant women.

Effect of Weight Self-Stigma on Quality of Life and Dietary Habits among Adult Students in Riyadh, Saudi Arabia.

Weight self-stigma (WSS) is a personal experience of negative self-evaluations, perceived discrimination, and shame about body weight. Studies suggested that WSS could negatively affect quality of life, eating behavior, and psychological outcomes. WSS has been linked with a number of obesogenic health outcomes that complicate weight loss interventions. Thus, this study aimed to examine the effect of WSS on the quality of life and dietary habits among adult students. A sample of 385 students from Riyadh universities participated in this cross-sectional study and completed three online questionnaires: the WSS questionnaire, the WHO quality of life questionnaire, and a dietary habit questionnaire. The average age of participants was 24 ± 6.74, and the majority were female (78.4%). Results demonstrated a negative association between all QOL domains and WSS (p < 0.001). Moreover, higher BMI is associated with increased self-devaluation and fear of enacted stigma (p < 0.001). There was also a negative link between both quality and quantity of food with WSS (p < 0.01). No significant difference was seen in study outcomes concerning gender. The findings of this study suggest the importance of increasing awareness about the negative impact of WSS and developing social policies to prevent or decrease it. Additionally, multidisciplinary teams, especially dietitians, should be more aware of WSS when dealing with overweight and obese individuals.

Validity and Reliability of the Korean Version of the Weight Self-Stigma Questionnaire (WSSQ-K).

Weight self-stigma refers to negative self-prejudice due to the internalization of negative social messages about one's weight. People with high self-stigma may have low self-esteem and decreased social activity. Weight-related self-stigma can create diet-related disorders since it is highly related to the recognition of body types. However, there are no tools available to measure the weight-related stigma of the general public in Korea. This study evaluated the validity and reliability of the Korean version of the Weight Self-Stigma Questionnaire (WSSQ-K). A methodological study was conducted with 150 Korean university students. Construct validity was evaluated using exploratory factor analysis. The WSSQ-K was correlated with body mass index and measures of self-esteem and weight concern to evaluate concurrent validity. Internal consistency reliability was evaluated with Cronbach's alpha. In the exploratory factor analysis, two factors were proposed: "self-devaluation" (Cronbach's α = 79) and "fear of enacted stigma" (Cronbach's α = 82). Factor loadings for the 12 items on two factors ranged from 0.539 to 0.811, which explained 53.3% of the total variance. The WSSQ-K correlated with body mass index, self-esteem, and weight concern. The findings showed that the WSSQ-K was a reliable and valid measure that could be used for evaluating weight self-stigma in normal-weight adults in Korea.

Developing and validating a Japanese version of the Weight Self-Stigma Questionnaire

PurposeWeight bias internalization (WBI) is significantly associated with negative physiological and psychological consequences. Given its negative effects, appropriate measurement of WBI is required for weight management and mental and physical health in people with weight problems. One of the most reliable and frequently used questionnaires to assess WBI is the Weight Self-Stigma Questionnaire (WSSQ). However, a Japanese version of the WSSQ has not yet been developed. Thus, the current study aimed to develop a Japanese version of the WSSQ (WSSQ-J) and validate its psychometric properties in the Japanese context.MethodsA total of 1454 Japanese participants (age 34.44 ± 6.92; male = 498) with diverse weight statuses (Body mass index: 21.44 ± 3.52, 13.79–41.40 kg/m2) completed an online survey for the WSSQ-J. The internal consistency of the WSSQ-J was estimated by calculating Cronbach’s α. Confirmatory factor analysis (CFA) was then carried out to confirm that the factor structure of the WSSQ-J was the same as that of the subscales of the original WSSQ.ResultsThe WSSQ-J had a Cronbach’s α of 0.917, indicating good internal consistency. In CFA, the comparative fit index was 0.945, the root mean square error of approximation was 0.085, and the standardized root mean square residual was 0.040, indicating that the two-factor model showed satisfactory goodness-of-fit.ConclusionThis study replicated the original findings related to the WSSQ, showing that the WSSQ-J is a reliable WBI questionnaire consisting of two factors. Therefore, the WSSQ-J would be a reliable tool for assessing WBI among Japanese.Level of evidenceLevel V, descriptive cross-sectional study.

Weight Stigma among Young Adults in Thailand: Reliability, Validation, and Measurement Invariance of the Thai-Translated Weight Self Stigma Questionnaire and Perceived Weight Stigma Scale

The previous studies found that the Weight Self Stigma Questionnaire (WSSQ) and Perceived Weight Stigma Scale (PWSS) have shown well-established psychometric properties for measuring weight stigma with strong reliability and validity from different languages. However, there is a lack of an appropriate instrument in assessing weight stigma in Thai samples. This study aimed to examine the Thai WSSQ and PWSS among Thai university students. Both instruments were also assessed for their measurement invariance across gender and weight status subgroups. A cross-sectional study was conducted on 801 university students in Thailand between January 2022 and July 2022. All participants completed a demographic questionnaire and a Thai version of the WSSQ, PWSS, and Depression Anxiety Stress Scale-21 (DASS-21) via an online survey. Reliability, validity, measurement invariance, and correlational analyses were performed to investigate whether the Thai versions of the WSSQ and PWSS psychometric properties were acceptable. Both translated questionnaires demonstrated overall acceptable psychometric properties and revealed a two-dimensional structure for the WSSQ, and unidimensional structure for the PWSS. Measurement invariance was obtained across gender and weight status subgroups. Additionally, both translated WSSQ and PWSS were significantly correlated with DASS-21. The Thai-translated WSSQ and PWSS showed strong validity, reliability, and factorial invariance across different subgroups for measuring weight stigma among Thai university students.

The Yale Food Addiction Scale 2.0 and the modified Yale Food Addiction Scale 2.0 in Taiwan: Factor structure and concurrent validity.

The most widely used instruments to assess food addiction - the Yale Food Addiction Scale 2.0 (YFAS 2.0) and its modified version (mYFAS 2.0) - have not been validated in a Taiwanese population. The present study compared the psychometric properties between the Taiwan versions of YFAS 2.0 and mYFAS 2.0 among university students. An online survey comprising the YFAS 2.0, mYFAS 2.0, Weight Self-Stigma Questionnaire (WSSQ) and International Physical Activity Questionnaire-Short Form (IPAQ-SF) were used to assess food addiction, self-stigma, and physical activity. All participants (n = 687; mean age = 24.00 years [SD ± 4.48 years]; 407 females [59.2%]) completed the entire survey at baseline and then completed the YFAS 2.0 and mYFAS 2.0 again three months later. The results of confirmatory factor analysis (CFA) indicated that the YFAS 2.0 and mYFAS 2.0 both shared a similar single-factor solution. In addition, both the YFAS 2.0 and mYFAS 2.0 reported good internal consistency (Cronbach's α = 0.90 and 0.89), good test-retest reliability (ICC = 0.71 and 0.69), and good concurrent validity with the total scores being strongly associated with the WSSQ (r = 0.54 and 0.57; p < 0.01), and less strongly associated with BMI (r = 0.17 and 0.13; p < 0.01) and IPAQ-SF (r = 0.23 and 0.25; p < 0.01). Based on the findings, the Taiwan versions of the YFAS 2.0 and mYFAS 2.0 appear to be valid and reliable instruments assessing food addiction.

Psychometric properties of the Spanish version of the Weight Self-Stigma Questionnaire (S-WSSQ) in a sample of participants with obesity seeking weight loss treatment

PurposeWeight self-stigma may be defined as a self-devaluation due to one’s identification with the group of people with obesity. The Weight Self-Stigma Questionnaire (WSSQ) is an instrument specifically designed to measure weight self-stigma in populations with overweight or obesity. The objective of this study was to adapt the WSSQ to the Spanish population (S-WSSQ) following the guidelines for cross-cultural adaptations.MethodsThe sample comprised 165 participants with obesity seeking weight loss treatment (65% women) at the “Hospital de Valme” (Seville, Spain). Scales to measure life satisfaction, self-esteem, positive and negative affect, and antifat attitudes were used to analyze the convergent and divergent validity of the S-WSSQ.ResultsA confirmatory factor analysis showed adequate values of the goodness of fit indexes of a two-factor model (χ2/df = 2.01 CFI = 0.92, IFI = 0.92, SRMR = 0.08, RMSEA = 0.078), replicating the structure found by the original authors. Cronbach’s alphas of the two factors were 0.76 (self-devaluation) and 0.77 (fear of enacted stigma). Composite Reliability values were 0.72 (self-devaluation) and 0.76 (fear of enacted stigma). Self-devaluation and fear of enacted stigma were negatively related to self-esteem, and positive affect, and positively related to negative affect and antifat attitudes. Finally, life satisfaction was negatively correlated to fear of enacted stigma.ConclusionsBased on these results, it is concluded that the S-WSSQ has good psychometric properties and might be used by the Spanish-speaking scientific community to measure weight self-stigma.Level of evidenceLevel V, descriptive study.

Sequentially mediated effects of weight-related self-stigma and psychological distress in the association between perceived weight stigma and food addiction among Taiwanese university students: A cross-sectional study

BackgroundWeight-related stigma has negative physiological and psychological impacts on individuals’ quality of life. Stigmatized individuals may experience higher psychological distress and therefore increase the potential risk to develop obesity and/or food addiction. The present study examined the associations and mediated effect between perceived weight stigma, weight-related self-stigma, and psychological distress in explaining food addiction among Taiwanese university students.MethodsAll participants (n = 968) completed an online survey which included the Perceived Weight Stigma Questionnaire, Weight Self-Stigma Questionnaire, Depression, Anxiety, Stress Scale-21, and Yale Food Addiction Scale Version 2.ResultsAfter controlling for demographic variables, significant associations were found in the paths from (1) perceived weight stigma to weight-related self-stigma (beta = 0.23), psychological distress (beta = 0.35), and food addiction (beta = 0.23); (2) weight-related self-stigma to psychological distress (beta = 0.52) and food addiction (beta = 0.59); and (3) psychological distress to food addiction (beta = 0.59) (all p-values < 0.001). The mediation model showed the sequential mediated effect of weight-related self-stigma and psychological distress in the association between perceived weight stigma and food addiction.ConclusionsThe results provide novel insights that weight-related self-stigma and psychological distress sequentially mediated the relationship between perceived weight stigma and food addiction among Taiwanese university students. The findings of the present study could be implemented into interventions that aim to reduce food addiction derived from weight-related stigma. Future studies should consider group analysis to consider confounding factors or other populations to provide more evidence regarding the mechanism of weight-related stigma.